Intraocular pressure in patients with Cushing's disease.
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.
Jonas
J B
JB
Universitäts-Augenklinik, Universität Erlangen-Nürnberg, Federal Republic of Germany.
Huschle
O
O
Koniszewski
G
G
Buchfelder
M
M
Fahlbusch
R
R
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
D006854:Hydrocortisone