Effect of substitutive growth hormone therapy on myopia control among Chinese children

PURPOSE: To explore the correlation between recombinant human growth hormone (rhGH) therapy and myopia progression, and to optimize the myopia control strategies in myopic children undergoing rhGH therapy. METHODS: This retrospective study included 27 myopic children receiving rhGH therapy and 57 myopic children in the control group, all of whom underwent myopia interventions. Axial length (AL) and refraction were measured by IOLMaster and an autorefractor after cycloplegia. AL changes were compared between the rhGH and control groups, before and after rhGH therapy, and among different myopia control strategies. Univariate and multivariate regression models analyzed factors associated with axial elongation. RESULTS: The rhGH group exhibited greater median AL change than the control group (0.29 mm/year; interquartile range [IQR], 0.19-0.40; n = 27 vs. 0.18 mm/year; IQR, 0.12-0.27; n = 57; P < 0.001). Median axial elongation increased after rhGH treatment (0.22 mm/year; IQR, 0.12-0.34 vs. 0.32 mm/year; IQR, 0.26-0.40; n = 14; P = 0.026), while it decreased after cessation (0.39 mm/year; IQR, 0.16-0.56 vs. 0.04 mm/year; IQR, -0.03-0.15; n = 6; P = 0.031). After adjusting for confounders, axial elongation was faster in the rhGH group (β = 0.13, P < 0.001). Longer rhGH therapy duration and shorter myopia control duration were associated with accelerated axial elongation (β = 0.13, P = 0.027). Dual-therapy myopia control appeared to mitigate excessive axial elongation in rhGH-treated children more effectively than monotherapy (0.27 mm/year; IQR, 0.18-0.31; n = 20 vs. 0.40 mm/year; IQR, 0.32-0.70; n = 7; P = 0.026). CONCLUSIONS: Myopic children undergoing rhGH therapy would exhibit accelerated axial elongation despite myopia control. Close monitoring and dual-therapy myopia control strategies are recommended for these children.