Differences of Adrenal Stress Control Mechanisms in Subjects With Glaucoma and Normal Subjects

Decreased Plasma Cortisol in Response to Intramuscular ACTH in Ocular Hypertensives and Primary Open-angle Glaucomas

“…8 Increased levels of plasma ACTH are produced with vasopressin stimulation. 22 Suppression of the response of the hypothalamicpituitary unit to vasopressin is known to occur with excess plasma corticosteroids.…”

“…However, with the pyrogen test, which is known to be a stronger stimulus than vasopressin to the hypothalamic-pituitary unit causing the liberation of larger amounts of ACTH, 22 the response of plasma cortisol in glaucomas was greater compared with normals. 8 This present study was done on subjects hospitalized in a Clinical Study Unit. This was in contrast to our previous studies on plasma cortisol levels, which were done on outpatients with a much larger sample size.…”

“…For the 24 OH and POAG subjects, 9 were on epinephrine-type drops, 11 were on systemic carbonic The systemic diagnoses (number of patients) for the normals were diabetes mellitus (2), vascular hypertension (8), epilepsy (1), coronary artery disease (2), psoriasis (1), hypothyroidism (1), and osteoarthritis (1). The systemic medications taken by the normals (number of patients) were tolbutamide (2), reserpine (2), chlorothiazide (4), methyldopa (1), phenytoin (1), pentaerythritol tetranitrate (1), levothyroxine (1), and methalazone (1).…”

“…8 Thirty-three of these subjects (20 normals and 13 OH plus POAG) in this study were previously studied for their response of plasma cortisol levels to intravenous metyrapone. 9 For all subjects, single optic disc photographs were obtained with the Zeiss telecentric fundus camera (Zeiss-Dublin, CA).…”

Decreased Plasma Cortisol in Response to Intramuscular ACTH in Ocular Hypertensives and Primary Open-angle Glaucomas

“…8 Increased levels of plasma ACTH are produced with vasopressin stimulation. 22 Suppression of the response of the hypothalamicpituitary unit to vasopressin is known to occur with excess plasma corticosteroids.…”

“…However, with the pyrogen test, which is known to be a stronger stimulus than vasopressin to the hypothalamic-pituitary unit causing the liberation of larger amounts of ACTH, 22 the response of plasma cortisol in glaucomas was greater compared with normals. 8 This present study was done on subjects hospitalized in a Clinical Study Unit. This was in contrast to our previous studies on plasma cortisol levels, which were done on outpatients with a much larger sample size.…”

“…For the 24 OH and POAG subjects, 9 were on epinephrine-type drops, 11 were on systemic carbonic The systemic diagnoses (number of patients) for the normals were diabetes mellitus (2), vascular hypertension (8), epilepsy (1), coronary artery disease (2), psoriasis (1), hypothyroidism (1), and osteoarthritis (1). The systemic medications taken by the normals (number of patients) were tolbutamide (2), reserpine (2), chlorothiazide (4), methyldopa (1), phenytoin (1), pentaerythritol tetranitrate (1), levothyroxine (1), and methalazone (1).…”

“…8 Thirty-three of these subjects (20 normals and 13 OH plus POAG) in this study were previously studied for their response of plasma cortisol levels to intravenous metyrapone. 9 For all subjects, single optic disc photographs were obtained with the Zeiss telecentric fundus camera (Zeiss-Dublin, CA).…”

Decrease of Ocular Pressure With Oral Metyrapone

“…47 Although metyrapone has been used in long-term management of Cushing's syndrome, we do not advo¬ cate its use in the treatment of abnor¬ mal IOP. This could imply that IOP in responders is more sensitive than IOP in nonre¬ sponders to a given change in cortisol levels.…”

Decreased Plasma Cortisol in Response to Intramuscular ACTH in Ocular Hypertensives and Primary Open-angle Glaucomas

“…8 Increased levels of plasma ACTH are produced with vasopressin stimulation. 22 Suppression of the response of the hypothalamicpituitary unit to vasopressin is known to occur with excess plasma corticosteroids.…”

“…However, with the pyrogen test, which is known to be a stronger stimulus than vasopressin to the hypothalamic-pituitary unit causing the liberation of larger amounts of ACTH, 22 the response of plasma cortisol in glaucomas was greater compared with normals. 8 This present study was done on subjects hospitalized in a Clinical Study Unit. This was in contrast to our previous studies on plasma cortisol levels, which were done on outpatients with a much larger sample size.…”

“…For the 24 OH and POAG subjects, 9 were on epinephrine-type drops, 11 were on systemic carbonic The systemic diagnoses (number of patients) for the normals were diabetes mellitus (2), vascular hypertension (8), epilepsy (1), coronary artery disease (2), psoriasis (1), hypothyroidism (1), and osteoarthritis (1). The systemic medications taken by the normals (number of patients) were tolbutamide (2), reserpine (2), chlorothiazide (4), methyldopa (1), phenytoin (1), pentaerythritol tetranitrate (1), levothyroxine (1), and methalazone (1).…”

“…8 Thirty-three of these subjects (20 normals and 13 OH plus POAG) in this study were previously studied for their response of plasma cortisol levels to intravenous metyrapone. 9 For all subjects, single optic disc photographs were obtained with the Zeiss telecentric fundus camera (Zeiss-Dublin, CA).…”

Decrease of Ocular Pressure With Oral Metyrapone

“…47 Although metyrapone has been used in long-term management of Cushing's syndrome, we do not advo¬ cate its use in the treatment of abnor¬ mal IOP. This could imply that IOP in responders is more sensitive than IOP in nonre¬ sponders to a given change in cortisol levels.…”

Decreased Plasma Cortisol in Response to Intramuscular ACTH in Ocular Hypertensives and Primary Open-angle Glaucomas

“…8 Increased levels of plasma ACTH are produced with vasopressin stimulation. 22 Suppression of the response of the hypothalamicpituitary unit to vasopressin is known to occur with excess plasma corticosteroids.…”

“…However, with the pyrogen test, which is known to be a stronger stimulus than vasopressin to the hypothalamic-pituitary unit causing the liberation of larger amounts of ACTH, 22 the response of plasma cortisol in glaucomas was greater compared with normals. 8 This present study was done on subjects hospitalized in a Clinical Study Unit. This was in contrast to our previous studies on plasma cortisol levels, which were done on outpatients with a much larger sample size.…”

“…For the 24 OH and POAG subjects, 9 were on epinephrine-type drops, 11 were on systemic carbonic The systemic diagnoses (number of patients) for the normals were diabetes mellitus (2), vascular hypertension (8), epilepsy (1), coronary artery disease (2), psoriasis (1), hypothyroidism (1), and osteoarthritis (1). The systemic medications taken by the normals (number of patients) were tolbutamide (2), reserpine (2), chlorothiazide (4), methyldopa (1), phenytoin (1), pentaerythritol tetranitrate (1), levothyroxine (1), and methalazone (1).…”

“…8 Thirty-three of these subjects (20 normals and 13 OH plus POAG) in this study were previously studied for their response of plasma cortisol levels to intravenous metyrapone. 9 For all subjects, single optic disc photographs were obtained with the Zeiss telecentric fundus camera (Zeiss-Dublin, CA).…”

Decrease of Ocular Pressure With Oral Metyrapone

“…47 Although metyrapone has been used in long-term management of Cushing's syndrome, we do not advo¬ cate its use in the treatment of abnor¬ mal IOP. This could imply that IOP in responders is more sensitive than IOP in nonre¬ sponders to a given change in cortisol levels.…”