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Assessment of retinal thickness as a marker of brain masculinization in children with congenital adrenal hyperplasia: a pilot study

  • Hasan Onal EMAIL logo , Esra Kutlu , Banu Aydın , Atilla Ersen , Neval Topal , Erdal Adal , Hatice Güneş , Hilal Doktur , Canan Tanıdır , Dilara Pirhan and Nihat Sayın
Published/Copyright: June 12, 2019

Abstract

Objective

To investigate the relationship between brain masculinization and retinal thickness in children with congenital adrenal hyperplasia (CAH).

Methods

Forty-five patients with CAH aged between 4 and 18 years and 30 age-matched healthy controls were included in this prospective study. Macular area was examined with optical coherence tomography (OCT); central subfield thickness (CST), cube volume (CV) and macular retinal thickness (MT) were measured in each subject. A gender identity questionnaire (GIQ) was used for the evaluation of gender happiness index.

Results

Girls with CAH had a higher CV (p = 0.002) and MT (p = 0.003) than healthy girls. No significant difference was found between boys with CAH and healthy boys regarding the retinal thickness measurements. Mean CST, CV and MT were significantly higher in boys than in girls in the control group (p = 0.013, p < 0.001, respectively), but there was no significant difference in those parameters between girls and boys with CAH. The gender happiness index was not different between healthy boys and boys with CAH, but was significantly lower in girls with CAH than healthy girls (p = 0.01).

Conclusions

As retina is part of the brain, our finding appears to be a morphological evidence of the excess androgen exposure on brain structures in girls with CAH. In addition, we suggest using retinal thickness measurements as a marker of prenatal excess androgen exposure in future studies.


Corresponding author: Hasan Onal, MD, Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Department of Pediatric Endocrinology and Metabolism, Kınalıtepe sok simitaş 7.blok no:61, Merter, Istanbul, Turkey, Phone: +90 532 509 29 88, Fax: +90 212 414 31 77

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-09-15
Accepted: 2019-04-01
Published Online: 2019-06-12
Published in Print: 2019-07-26

©2019 Walter de Gruyter GmbH, Berlin/Boston

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