CHOROIDAL AND RETINAL ABNORMALITIES IN CUSHING SYNDROME: Correlation with the Cortisol Level

Area of Science:

• Ophthalmology
• Endocrinology
• Medical Imaging

Background:

• Cushing syndrome is characterized by prolonged exposure to high cortisol levels.
• Ocular structures like the retina and choroid may be affected by hormonal imbalances.
• Understanding these effects is crucial for managing Cushing syndrome complications.

Purpose of the Study:

• To investigate retinal and choroidal structure and blood flow in Cushing syndrome.
• To determine the relationship between cortisol levels and ocular changes.
• To assess the impact of adrenalectomy on these parameters.

Main Methods:

• A series of patients with Cushing syndrome and adrenocortical carcinoma were studied.
• Optical coherence tomography and angiography were used for retinal and choroidal assessment.
• Correlation analysis was performed between cortisol levels and fundus changes before and after surgery.

Main Results:

• Increased cortisol levels correlated with reduced central macular thickness (P = 0.019).
• Increased cortisol levels were associated with increased central choroidal thickness (P < 0.001).
• Higher cortisol levels correlated with increased choriocapillaris flow area (P = 0.02), linked to emotional distress and 24-hour urine-free cortisol.

Conclusions:

• Elevated cortisol in Cushing syndrome is associated with thinner macula and thicker choroid.
• Decreased choriocapillaris flow area correlates with 24-hour urine-free cortisol.
• These findings highlight cortisol's impact on choroidal vasculature.