The pituitary-adrenal axis in idiopathic retinal vasculitis.
OBJECTIVE
To determine whether patients with idiopathic retinal vasculitis have altered production of cortisol and dehydroepiandrosterone sulphate (DHEA-S), and whether differences in these variables occur between those who are sensitive (SS) and resistant (SR) to steroids.


METHODS
20 patients with retinal vasculitis (off treatment) and 10 control subjects were prospectively recruited. Morning cortisol and DHEA-S levels were measured, and cortisol secretion rates and short synacthen tests (SST) carried out in patients before treatment, when on prednisolone 20 mg/day, and in controls.


RESULTS
There were no differences in any variables between patients and controls. For retinal vasculitis patients pretreatment, the SST was lower in SR patients (p=0.02). More of the SR patients had ischaemic retinal vasculitis ( p<0.001).


CONCLUSIONS
Cortisol and DHEA-S are not involved in the pathogenesis of retinal vasculitis. SR in retinal vasculitis may be associated with a defective hypothalamic-pituitary-adrenal axis.
Palmer
H E
HE
Medical Eye Unit, St Thomas's Hospital, London.
Stanford
M R
MR
Lowy
C
C
Wheeler
M J
MJ
Wallace
G R
GR
Graham
E M
EM
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D010913:Pituitary-Adrenal System / Q000502:physiology*; D011239:Prednisolone / Q000627:therapeutic use; D011446:Prospective Studies; D012164:Retinal Diseases / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D012171:Retinal Vessels; D014657:Vasculitis / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*
D000893:Anti-Inflammatory Agents; D019314:Dehydroepiandrosterone Sulfate; D011239:Prednisolone; D006854:Hydrocortisone