C A S E R E P O R T Choroidal neovascularization in patient undergoing growth hormone treatment João R de Oliveira Dias1 Eduardo B Rodrigues2 Maurício Martinazzo2 Michel E Farah2 1Faculty of Medicine, University of Passo Fundo, Rio Grande do Sul, Brazil; 2Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil Correspondence: João R de Oliveira Dias Almirante Barroso 45 Jade 204 João Paulo, Florianópolis, SC, Brazil 88030-460 Tel +55 48 3222 3380 Fax +55 48 3222 3380 Email dias_ joaor@yahoo.com.br Abstract: The association between growth-hormone (GH) and neovascular retinopathies in nondiabetic patients has been reported in earlier series. We report occurrence of choroidal neovascularization (CNV) in a 15-year-old male patient undergoing long-term GH therapy. The CNV could be a consequence of the GH-intake in a susceptible myopic patient. Keywords: choroidal neovascularization, growth hormone, optical coherence tomography, retina, angiogenesis The role of growth hormone (GH) in human angiogenesis and retinal neovascularization has been demonstrated in recent years.1 The hormone is mitogenic for a variety of vas- cular cells and thereby may exert regulatory functions in controlling metabolism and differentiated endothelial cell expression.2, 3 Herein we report occurrence of choroidal neovascularization (CNV) in a young patient undergoing long-term GH therapy. Case report A 15-year-old male patient presented with acute central vision loss OD. The patient had been taking daily dose of subcutaneous human GH (EutropinTM 4 UI/day) for the last 31 months due to early puberty and presumed diagnose of nanism. He had been also receiving monthly intramuscular doses of leuprolide (3.75 mg) for 24 months. Past ocular history was positive for myopia and his past medical history was unremarkable. Family history was positive for nanism. His best-corrected visual acuity (BCVA) was 20/30 OS; his BCVA OD dropped from 20/30 to 20/100 with metamorphopsia. The spherical correction was −10.75 diopter (D) OD and −9.75 D OS. Fundoscopy revealed myopic conus, peripapillary areas of retinal pigmented epithelium (RPE)-atrophy, but no detectable breaks in Bruch’s membrane. Fluorescein angiography disclosed early hyperﬂuorescence with late leakage corresponding to CNV OD (Figure 1). Optical coherence tomography disclosed RPE and neurosensory retina elevation due to sub-RPE CNV. The CNV OD regressed after photodynamic therapy and vision improved to 20/30 without metamorphopsia. Comments Growth hormone intake is widely used in the treatment of disorders with GH deﬁciency such as nanism. We hypothesize that, in our patient, the CNV could be a consequence of the GH-intake in a susceptible myopic patient. High myopia can induce myopic degeneration as well as CNV, but usually in older patients mainly between 30 and 50 years of age. However, even if CNV induced by myopia is usually more seen in adults, it can also be found in teenagers.4 Clinical Ophthalmology 2009:3 89–90 © 2009 de Oliveira Dias et al, publisher and licensee Dove Medical Press Ltd.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. 89