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Topical corticosteroid therapy and pituitary-adrenal function

T Krupin, A I Mandell, S M Podos

    Archives of Ophthalmology (Chicago, Ill. : 1960)
    |June 1, 1976
    PubMed
    Summary
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    Corticosteroid eye drops can cause partial adrenal suppression, indicated by lower cortisol levels. However, the hypothalamic-pituitary-adrenal axis remains functional in patients using these drops.

    Area of Science:

    • Ophthalmology
    • Endocrinology
    • Pharmacology

    Background:

    • Systemic absorption of corticosteroid eye drops is a known concern.
    • Prolonged use may lead to adrenocortical insufficiency and adrenal crisis during stress.

    Purpose of the Study:

    • To investigate the impact of corticosteroid eye drops on the hypothalamic-pituitary-adrenal axis.
    • To assess adrenal function in patients using dexamethasone sodium phosphate eye drops.

    Main Methods:

    • Fifteen patients received 0.1% dexamethasone sodium phosphate eye drops (one drop/eye, 4x/day) for six weeks.
    • Plasma cortisol levels were measured.
    • The hypothalamic-pituitary-adrenal axis was evaluated using the oral metyrapone tartrate test.

    Main Results:

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    • Dexamethasone eye drops led to partial adrenal suppression.
    • Reduced plasma cortisol levels were observed in patients.
    • The hypothalamic-pituitary-adrenal axis was found to be intact in all patients.

    Conclusions:

    • While corticosteroid eye drops can cause partial adrenal suppression, the overall hypothalamic-pituitary-adrenal axis function remains intact.
    • Monitoring cortisol levels is important for patients on prolonged corticosteroid eye drop therapy.