title: Intraocular pressure in patients with Cushing's disease.
abstract: Externally applied corticosteroids increase the intraocular pressure in one-third of the general population. We evaluated the intraocular pressure in 62 patients with endogenously elevated serum cortisol levels due to hypothalamic pituitary-dependent Cushing's disease. All patients underwent transphenoidal microsurgical sella exploration within 4 years after the onset of subjective symptoms. The intraocular pressure (preoperative mean, 14.9 +/- 3.5 mm Hg) exceeded 21 mm Hg in four eyes before surgery and in one eye after surgery (postoperative mean, 14.3 +/- 2.8 mm Hg). In patients attaining postoperative remission and whose pressure readings were taken at least 3 months after surgery, the postoperative intraocular pressure was significantly (P = 0.04) lower than that measured preoperatively (14.2 +/- 2.7 vs 13.0 +/- 2.0 mm Hg). Biomorphometry of the optic disc topography and the retinal nerve-fiber layer in 19 patients revealed no glaucomatous changes. In contrast to topically applied corticosteroids, endogenously elevated serum cortisol levels in patients with hypothalamic pituitary-dependent Cushing's disease increased intraocular pressure only slightly, with no great risk of glaucomatous optic nerve damage.
authors.affiliation: Universitäts-Augenklinik, Universität Erlangen-Nürnberg, Federal Republic of Germany.
authors.forename: J B
authors.initials: JB
authors.lastname: Jonas
authors.forename: O
authors.initials: O
authors.lastname: Huschle
authors.forename: G
authors.initials: G
authors.lastname: Koniszewski
authors.forename: M
authors.initials: M
authors.lastname: Buchfelder
authors.forename: R
authors.initials: R
authors.lastname: Fahlbusch
mesh_terms: D000293:Adolescent; D000328:Adult; D003480:Cushing Syndrome / Q000097:blood / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012658:Sella Turcica / Q000601:surgery; D014785:Vision, Ocular
chemical_list: D006854:Hydrocortisone