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CHOROIDAL THICKENING AND PACHYCHOROID IN CUSHING SYNDROME: Correlation With Endogenous Cortisol Level

Wang, Erqian, MD*; Chen, Shi, MD; Yang, Hongbo, MD; Yang, Jingyuan, MD*; Li, Yanlong, MD; Chen, Youxin, MD, PhD*

doi: 10.1097/IAE.0000000000001956
Original Study: PDF Only

Purpose: To investigate subfoveal choroidal thickness and pachychoroid and their correlation with hormone level in patients with endogenous Cushing syndrome (CS).

Methods: We enrolled a consecutive series of patients with CS and healthy controls. All participants had swept-source optical coherence tomography. All patients with CS had hormone test including morning plasma-free cortisol, 24-hour urine-free cortisol (24UFC), and plasma adrenocorticotropic hormone. We compared subfoveal choroidal thickness and pachychoroid changes between two groups. We performed univariate and multivariate analysis to study correlation between hormone level and choroid thickness as well as pachychoroid in patients with CS.

Results: Compared with control group, Cushing group had significantly greater subfoveal choroidal thickness (371.6 ± 114.9 and 320.0 ± 74.0, P = 0.002) and higher proportion of eyes with pachychoroid (53.1 and 14.3%, P < 0.001). Subfoveal choroidal thickness was significantly correlated with 24UFC (P = 0.007) but not with plasma-free cortisol (P = 0.48) or adrenocorticotropic hormone (P = 0.56). Pachychoroid was significantly correlated with 24UFC (P = 0.03) but not with plasma-free cortisol (P = 0.24) or adrenocorticotropic hormone (P = 0.32).

Conclusion: There was a positive correlation between elevated 24UFC and choroid thickening as well as pachychoroid, indicating the importance of normal endogenous cortisol level in maintaining the human choroid vasculature.

Patients with endogenous Cushing syndrome tended to have increased subfoveal choroidal thickness and pachychoroid, which were significantly correlated with elevated 24-hour urine cortisol.

Departments of *Ophthalmology, and

Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; and

Department of Epidemiology and Statistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China.

Reprint requests: Youxin Chen, MD, PhD, Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dongcheng District, Beijing 100730, China; e-mail: chenyouxinpumch@hotmail.com

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.