IS THERE A ROLE OF ACTH IN INCREASED CHOROIDAL THICKNESS IN CUSHING SYNDROME?

Retina. 2017 Mar;37(3):536-543. doi: 10.1097/IAE.0000000000001198.

Abstract

Purpose: To evaluate choroidal thickness (CT) in patients with Cushing syndrome (CS) with enhanced depth imaging optical coherence tomography.

Methods: Twenty-eight patients with CS and 38 healthy volunteers were enrolled in this observational cross-sectional study. Patients with newly diagnosed CS who have been admitted to Erciyes University Department of Endocrinology in 3 years time interval were compared with age- and sex-matched healthy volunteers. Choroidal thickness was measured at the fovea and 2 points nasal and 2 points temporal to the fovea with 500-μm intervals each.

Results: Choroidal thickness measurements were higher in patients with CS than in the control group at all examination points; however, the difference was found to be significant at the center of the fovea (367.8 ± 94.4 μm vs. 329 ± 90.5 μm) and 1,000 μm temporal to the fovea. Choroidal thickness measurements were significantly higher in adrenocorticotrophic hormone (ACTH)-dependent CS group than in the control group at all measurement points (CT at fovea 388.2 ± 92.4 μm vs. 329.1 ± 90.5 μm). All CT measurements were found to be correlated with ACTH levels.

Conclusion: Cushing syndrome is associated with increased CT. The ACTH-dependent CS may increase CT more than ACTH-independent CS. This effect may be directly related to ACTH itself or increased plasma cortisol levels or both.

MeSH terms

  • Adrenocorticotropic Hormone / blood*
  • Adult
  • Choroid / diagnostic imaging
  • Choroid / pathology*
  • Choroid Diseases / diagnostic imaging
  • Choroid Diseases / etiology*
  • Cross-Sectional Studies
  • Cushing Syndrome / blood
  • Cushing Syndrome / complications*
  • Dehydroepiandrosterone Sulfate / blood
  • Female
  • Healthy Volunteers
  • Humans
  • Hydrocortisone / blood
  • Immunoradiometric Assay
  • Male
  • Organ Size
  • Radioimmunoassay
  • Tomography, Optical Coherence / methods

Substances

  • Dehydroepiandrosterone Sulfate
  • Adrenocorticotropic Hormone
  • Hydrocortisone