Plasma cortisol suppression test used to predict the development of primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Endocrinology
• Glaucoma Research

Background:

• High responders to dexamethasone testing (GG) have elevated intraocular pressure (IOP).
• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Predictive markers for POAG development are crucial for early intervention.

Purpose of the Study:

• To evaluate the predictive value of plasma cortisol suppression testing in high responders to dexamethasone.
• To determine if cortisol suppression patterns correlate with the development of glaucomatous visual field loss.

Main Methods:

• Forty high-responder (GG) patients underwent plasma cortisol suppression testing.
• Follow-up data over five years were analyzed for 35 patients.
• Cortisol suppression patterns were compared between patients who developed visual field loss and those who did not.

Main Results:

• Eight of 35 patients developed glaucomatous visual field loss over five years.
• No significant difference in plasma cortisol suppression sensitivity was found between patients with and without visual field loss.
• Dexamethasone-diphenylhydantoin suppression testing showed varied responses, similar to POAG and control groups.

Conclusions:

• Plasma cortisol suppression testing is not a reliable predictor for the development of POAG in high-responder individuals.
• Current suppression testing methods do not identify patients at high risk for POAG progression within this cohort.