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Intraocular pressure in patients with Cushing's disease

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Abstract

Externally applied corticosteroids increase the intraocular pressure in one-third of the general population. We evaluated the intraocular pressure in 62 patients with endogenously elevated serum cortisol levels due to hypothalamic pituitary-dependent Cushing's disease. All patients underwent transphenoidal microsurgical sella exploration within 4 years after the onset of subjective symptoms. The intraocular pressure (preoperative mean, 14.9 ± 3.5 mm Hg) exceeded 21 mm Hg in four eyes before surgery and in one eye after surgery (postoperative mean, 14.3 ± 2.8 mm Hg). In patients attaining postoperative remission and whose pressure readings were taken at least 3 months after surgery, the postoperative intraocular pressure was significantly (P=0.04) lower than that measured preoperatively (14.2±2.7 vs 13.0 ±2.0 mm Hg). Biomorphometry of the optic disc topography and the retinal nerve-fiber layer in 19 patients revealed no glaucomatous changes. In contrast to topically applied corticosteroids, endogenously elevated serum cortisol levels in patients with hypothalamic pituitary-dependent Cushing's disease increased intraocular pressure only slightly, with no great risk of glaucomatous optic nerve damage.

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Authors and Affiliations

  1. Universitäts-Augenklinik, Germany

    Jost B. Jonas, Oliver Huschle & Gerhard Koniszewski

  2. Neurochirurgische Universitätsklinik, Universität Erlangen-Nürnberg, Schwabachanlage 6, D-8520, Erlangen, Germany

    Michael Buchfelder & Rudolf Fahlbusch

Authors
  1. Jost B. Jonas
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  2. Oliver Huschle
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  3. Gerhard Koniszewski
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  4. Michael Buchfelder
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  5. Rudolf Fahlbusch
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Jonas, J.B., Huschle, O., Koniszewski, G. et al. Intraocular pressure in patients with Cushing's disease. Graefe's Arch Clin Exp Ophthalmol 228, 407–409 (1990). https://doi.org/10.1007/BF00927251

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  • DOI: https://doi.org/10.1007/BF00927251

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