Eye Diseases Disproportionately Common in Cushing’s, Study Finds
Researchers see cases of pachychoroid spectrum diseases in Cushing's syndrome
Rates of eye-related disorders called pachychoroid spectrum diseases are higher among people with Cushing’s syndrome than in the general population, a recent study reported.
“We find that patients with Cushing’s syndrome have a high prevalence of any pachychoroid spectrum disease. Thus, in patients with Cushing’s syndrome there should be generally low threshold to recommend or to refer to an ophthalmic examination,” the researchers wrote.
The study, “Pachychoroid Spectrum Diseases in Patients with Cushing’s Syndrome: A Systematic Review with Meta-Analyses,” was published in the Journal of Clinical Medicine.
Cushing’s syndrome is caused by excess levels of the hormone cortisol. In Cushing’s disease, the most common form of the syndrome, cortisol overproduction is driven by a tumor in the brain’s pituitary gland.
High cortisol levels have been linked to an increased risk of central serous chorioretinopathy (CSC), a disorder where fluid builds under the light-sensing portion of the eye, which can obscure vision.
CSC is a form of pachychoroid spectrum disease, a group of conditions characterized by abnormal thickness of the choroid — the middle part of the eye, sitting between the white outer layer called sclera and the inner retina, which houses light-sensitive cells.
A team led by scientists in Denmark conducted a review of the scientific literature to assess the prevalence of CSC and other pachychoroid spectrum diseases in people with Cushing’s syndrome.
They identified six studies covering 159 people with Cushing’s, as well as 159 people without the disorder, all of whom had undergone eye examinations. Studies were conducted in Brazil, China, France, Italy, the Netherlands, and Turkey. Among the people included, most were female, though there was a wide range of ages and disease durations.
Scientists then conducted meta-analyses, where they pooled available data from all studies and analyzed it together.
Results showed that choroid thickness was significantly higher in people with Cushing’s, by nearly 50 micrometers on average.
The prevalence of CSC among Cushing’s patients was estimated at 7.7%. Other forms of pachychoroid spectrum disease, specifically pachychoroid pigment epitheliopathy (PPE) and polypoidal choroidal vasculopathy (PCV), were present in 20.8% and 2.8% of Cushing’s patients, respectively.
Researchers noted that these rates are markedly higher than would be expected in the general population, where rates of CSC and PCV are usually lower than 1%.
“These findings of our review strongly suggest that pachychoroid spectrum diseases are significantly more common in patients with Cushing’s syndrome,” the team wrote.
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