title: Choroidal and Retinal Abnormalities by Optical Coherence Tomography in Endogenous Cushing's Syndrome.
abstract: BACKGROUND
  Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes.
  
  
  OBJECTIVE
  To compare choroidal thickness measurements using optical coherence tomography (OCT) in patients with endogenous active Cushing's syndrome (CS) and to evaluate the occurrence of retinal abnormalities in the same group of patients.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Outpatient clinic.
  
  
  METHODS
  Eleven female patients with CS in hypercortisolism state as determined by the presence of at least two abnormal measurements from urinary cortisol 24 h, no suppression of cortisol with low dose dexamethasone suppression test, and nocturnal salivary cortisol levels and 12 healthy controls.
  
  
  METHODS
  Choroidal and retinal morphology was assessed using OCT.
  
  
  METHODS
  Choroidal thickness measurements and the presence of retinal changes.
  
  
  RESULTS
  The mean subfoveal choroidal thickness was 372.96 ± 73.14 µm in the patients with CS and 255.63 ± 50.70 µm in the control group (p< 0.001). One patient (9.09%) presented with central serous chorioretinopathy and one patient (9.09%) with pachychoroid pigment epitheliopathy.
  
  
  CONCLUSIONS
  Choroidal thickness is increased in the eyes of patients with active CS compared to healthy and matched control. Also, 18.18% of patients presented with macular changes, possibly secondary to choroidal thickening. While further studies are necessary to confirm our findings, excess corticosteroid levels seem to have a significant effect on the choroid and might be associated with secondary retinal diseases.
authors.affiliation: Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil; Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Abalem
authors.affiliation: Department of Endocrinology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil; Endocrinology Service, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil.
authors.forename: Marcio Carlos
authors.initials: MC
authors.lastname: Machado
authors.affiliation: Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: Helen Nazareth Veloso Dos
authors.initials: HN
authors.lastname: Santos
authors.affiliation: Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Garcia
authors.affiliation: Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: John
authors.initials: J
authors.lastname: Helal
authors.affiliation: Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: Pedro Carlos
authors.initials: PC
authors.lastname: Carricondo
authors.affiliation: Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: Sérgio Luis Gianotti
authors.initials: SL
authors.lastname: Pimentel
authors.affiliation: Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: Mario Luiz Ribeiro
authors.initials: ML
authors.lastname: Monteiro
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA; Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Montreal, QC, Canada.
authors.forename: Cynthia X
authors.initials: CX
authors.lastname: Qian
authors.affiliation: Department of Endocrinology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: Marcello Delano
authors.initials: MD
authors.lastname: Bronstein
authors.affiliation: Department of Endocrinology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
authors.forename: Maria Cândida Villares Barisson
authors.initials: MC
authors.lastname: Fragoso
keywords: Cushing syndrome; choroid; eye; hypercortisolism; optical coherence tomography