AUTHOR=Abalem Maria Fernanda , Machado Marcio Carlos , Santos Helen Nazareth Veloso Dos , Garcia Rafael , Helal John , Carricondo Pedro Carlos , Pimentel Sérgio Luis Gianotti , Monteiro Mario Luiz Ribeiro , Qian Cynthia X. , Bronstein Marcello Delano , Fragoso Maria Cândida Villares Barisson 

TITLE=Choroidal and Retinal Abnormalities by Optical Coherence Tomography in Endogenous Cushing’s Syndrome

JOURNAL=Frontiers in Endocrinology

VOLUME=7

YEAR=2016

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2016.00154

DOI=10.3389/fendo.2016.00154

ISSN=1664-2392

ABSTRACT=<sec id="ST1"><title>Context</title><p>Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes.</p></sec><sec id="ST2"><title>Objective</title><p>To compare choroidal thickness measurements using optical coherence tomography (OCT) in patients with endogenous active Cushing’s syndrome (CS) and to evaluate the occurrence of retinal abnormalities in the same group of patients.</p></sec><sec id="ST3"><title>Design</title><p>Cross-sectional study.</p></sec><sec id="ST4"><title>Setting</title><p>Outpatient clinic.</p></sec><sec id="ST5"><title>Patients</title><p>Eleven female patients with CS in hypercortisolism state as determined by the presence of at least two abnormal measurements from urinary cortisol 24 h, no suppression of cortisol with low dose dexamethasone suppression test, and nocturnal salivary cortisol levels and 12 healthy controls.</p></sec><sec id="ST6"><title>Methods</title><p>Choroidal and retinal morphology was assessed using OCT.</p></sec><sec id="ST7"><title>Main outcome measures</title><p>Choroidal thickness measurements and the presence of retinal changes.</p></sec><sec id="ST8"><title>Results</title><p>The mean subfoveal choroidal thickness was 372.96 ± 73.14 µm in the patients with CS and 255.63 ± 50.70 µm in the control group (<italic>p</italic> &lt; 0.001). One patient (9.09%) presented with central serous chorioretinopathy and one patient (9.09%) with pachychoroid pigment epitheliopathy.</p></sec><sec id="ST9"><title>Conclusion</title><p>Choroidal thickness is increased in the eyes of patients with active CS 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 seem to have a significant effect on the choroid and might be associated with secondary retinal diseases.</p></sec>