Central Serous Chorioretinopathy as a Presenting Symptom of Endogenous Cushing Syndrome: A Case Report

Iannetti, Ludovico; Spinucci, Giovanni; Pesci, Francesca Romana; Vicinanza, Roberto; Stigliano, Antonio; Pivetti-Pezzi, Paola

doi:10.5301/ejo.2011.6449

Cited by 13 publications

(8 citation statements)

References 7 publications

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“…Several previous reports have documented visual loss in endogenous CS resulting from central serous chorioretinopathy (CSC), a disease that impairs central vision and is characterized by serous retinal detachment, retinal pigment epithelium (RPE) changes, and choroidal vascular hyperpermeability (2–4). While the pathogenesis of CSC is still poorly understood, several risk factors seem to be involved such as younger age, male gender, type-A behavioral pattern, history of organ transplant, pregnancy, systemic blood hypertension, use of exogenous corticosteroids, and endogenous hypercortisolism (5–7).…”

Section: Introductionmentioning

confidence: 99%

Choroidal and Retinal Abnormalities by Optical Coherence Tomography in Endogenous Cushing’s Syndrome

et al. 2016

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ContextCortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes.ObjectiveTo 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.DesignCross-sectional study.SettingOutpatient clinic.PatientsEleven 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.MethodsChoroidal and retinal morphology was assessed using OCT.Main outcome measuresChoroidal thickness measurements and the presence of retinal changes.ResultsThe 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.ConclusionChoroidal 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.

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Section: Introductionmentioning

confidence: 99%

Choroidal and Retinal Abnormalities by Optical Coherence Tomography in Endogenous Cushing’s Syndrome

et al. 2016

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“…However, 2 new cases of CSCR have been reported as a result of hypercortisolism due to an adrenocortical adenoma [8]. Because both CSCR and adrenocortical adenomas are not very common diseases, a coincidental association is highly improbable.…”

Section: Discussionmentioning

confidence: 99%

Adrenocortical Adenoma and Central Serous Chorioretinopathy: A Rare Association?

Pastor‐Idoate

Pena

Herreras

2011

Case Rep Ophthalmol

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A 28-year-old man with bilateral central serous chorioretinopathy (CSCR) and body weight gain was diagnosed with Cushing’s syndrome secondary to an adrenocortical adenoma. The patient had high levels of free cortisol and the tumor was confirmed by histopathology. After surgery, cortisol levels decreased and the CSCR spontaneously resolved. This case highlights the role of cortisol in the pathogenesis of CSCR. A diagnosis of endogenous Cushing’s syndrome should be considered in patients with CSCR as an initial symptom.

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“…In the previous reports regarding CSR in patients with ACTH-independent Cushing syndrome secondary to adrenocortical adenoma, the findings were typically bilateral multifocal posterior pigment epitheliopathy, a form of chronic CSR. The disease showed remarkable response following surgical management of the adenoma 1 2. Increased fragility of choriocapillaris together with local ischaemia due to the reduction in fibrinolysis as a response to free plasma glucocorticoids may be the aetiology of CSR 2 3.…”

Section: Descriptionmentioning

confidence: 99%

“…The role of ACTH in causing increased choroidal thickness has been studied recently in patients of endogenous Cushing syndrome 1 2. Cushing syndrome due to adrenal adenoma or benign adrenal hyperplasia, however, is independent of ACTH.…”

Section: Descriptionmentioning

confidence: 99%

Central serous retinopathy as presentation of an adrenal adenoma

et al. 2018

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Central Serous Chorioretinopathy as a Presenting Symptom of Endogenous Cushing Syndrome: A Case Report

Abstract: Central serous chorioretinopathy may be the presenting symptom of Cushing syndrome in a patient with adrenocortical adenoma.

Cited by 13 publications

References 7 publications

Choroidal and Retinal Abnormalities by Optical Coherence Tomography in Endogenous Cushing’s Syndrome

Choroidal and Retinal Abnormalities by Optical Coherence Tomography in Endogenous Cushing’s Syndrome

Adrenocortical Adenoma and Central Serous Chorioretinopathy: A Rare Association?

Central serous retinopathy as presentation of an adrenal adenoma

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