Frontiers in Endocrinology (Dec 2016)

Choroidal thickness and retinal abnormalities by optical coherence tomography in endogenous Cushing’s syndrome

  • Maria Fernanda Abalem,
  • Maria Fernanda Abalem,
  • Marcio Carlos Machado,
  • Helen Nazareth Veloso dos Santos,
  • Rafael Garcia,
  • Pedro Carlos Carricondo,
  • John Helal Jr,
  • Sergio Luis Gianotti Pimentel,
  • Mario Luiz Ribeiro Monteiro,
  • Cynthia X Qian,
  • Cynthia X Qian,
  • Marcello D Bronstein,
  • Maria Candida Barisson Villares Fragoso

DOI
https://doi.org/10.3389/fendo.2016.00154
Journal volume & issue
Vol. 7

Abstract

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Context: Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes. Objective: To compare choroidal thickness measurements using optical coherence tomography (OCT) in patients with endogenous active Cushing’s syndrome and to evaluate the occurrence of retinal abnormalities in the same group of patients. Design: Cross-sectional study.Setting: Outpatient clinic.Patients: Eleven female patients with Cushing’s syndrome in hypercortisolism state as determined by the presence of at least two abnormal measurements from urinary cortisol 24h, no suppression of cortisol with low dose dexamethasone suppression test and nocturnal salivary cortisol levels and 12 healthy controls.Methods: Choroidal and retinal morphology was assessed using OCT. Main outcome measures: Choroidal thickness measurements and the presence of retinal changes. Results: The mean subfoveal choroidal thickness was 372.96 ± 73.14 μm in the patients with Cushing’s syndrome and 255.63 ± 50.70 μm in the control group, (p<0.001). One patient (9.09%) presented with central serous chorioretinopathy and one patient (9.09%) with pachychoroid pigment epitheliopathy. Conclusions: Choroidal thickness is increased in the eyes of patients with active Cushing’s syndrome compared to healthy and matched control. Also, 18.18% of patients presented with macular changes, possibly secondary to choroidal thickening. While further studies are necessary to confirm our findings excess corticosteroid levels seems to have a significant effect on the choroid and might be associated with secondary retinal diseases.

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