Choroidal imaging in patients with Cushing syndrome

Area of Science:

• Ophthalmology
• Endocrinology
• Medical Imaging

Background:

• Glucocorticoid excess, as seen in Cushing syndrome, is linked to central serous chorioretinopathy, a condition within the pachychoroid spectrum disease (PSD) group.
• Cushing syndrome involves prolonged exposure to high cortisol levels, impacting various bodily systems, including ocular health.

Purpose of the Study:

• To determine the prevalence of PSD in patients with Cushing syndrome.
• To analyze the choroidal phenotype in individuals diagnosed with Cushing syndrome.

Main Methods:

• A cross-sectional study involving 28 Cushing syndrome patients and 28 matched healthy controls.
• Ophthalmic examinations included Enhanced-Depth Imaging Optical Coherence Tomography (EDI-OCT) to assess choroidal thickness and pachyvessels.
• Hormonal tests were conducted to evaluate the corticotropic axis.

Main Results:

• Pachychoroid spectrum disease (PSD) was significantly more prevalent in Cushing syndrome patients (21.4%) compared to controls (3.6%).
• Pachyvessels were observed more frequently in Cushing syndrome patients (71.4%) than in healthy subjects (42.9%).
• No significant difference in mean subfoveal choroidal thickness was found between the groups, nor a correlation with cortisol levels.

Conclusions:

• Cushing syndrome is associated with an increased prevalence of pachychoroid spectrum disease (PSD).
• Ophthalmologic screening using EDI-OCT is recommended for Cushing syndrome patients to identify chorioretinal abnormalities.
• Specialized follow-up and surveillance strategies can be adapted based on detected ocular findings.