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Increased serum cortisol is associated with alterations in cross-sectional and topographic OCT parameters in diabetic retinopathy: a preliminary study

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Abstract

Purpose

Cortisol, a steroid hormone, plays an essential role in metabolic processes of diabetes mellitus. This study for the first time evaluated the association of serum cortisol with spectral domain optical coherence tomography (SD-OCT)-based cross-sectional and topographic parameters with severity of diabetic retinopathy (DR).

Methods

A tertiary care center-based preliminary study was undertaken. Fourteen consecutive cases of DR and fifteen healthy controls were included. Cases were graded according to ETDRS classification: non-proliferative DR (NPDR, n = 8) and proliferative DR (PDR, n = 6). All study subjects underwent complete ophthalmological evaluation. Serum cortisol was analyzed using chemiluminescence microparticle assay method. Central subfield thickness (CST), cube average thickness (CAT), cube volume (CV), retinal nerve fiber layer (RNFL) thickness, disorganization of inner retinal layers (DRIL), grade of retinal photoreceptor ellipsoid zone (EZ) disruption and grade of retinal pigment epithelium (RPE) alterations were evaluated using SD-OCT. Statistical analysis was done using ANOVA and Pearson’s correlation analysis.

Results

Mean serum cortisol levels (µg/dL) were NPDR = 11.59 ± 0.42, PDR = 14.50 ± 0.26 and controls = 8.22 ± 0.77. With increasing severity of DR, mean CST, CAT, CV showed positive correlation, whereas mean RNFL thickness showed negative correlation with serum cortisol levels (p < 0.01). DRIL, EZ disruption and RPE alterations showed positive correlation with serum cortisol levels (p < 0.001).

Conclusion

Serum cortisol levels are significantly associated with severity of DR and correlate positively with CST, CAT, CV, DRIL, EZ disruption and RPE alterations and negatively with RNFL thickness.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

No financial support was received for this submission.

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Authors and Affiliations

  1. Department of Ophthalmology, King George’s Medical University, Lucknow, India

    Akshay Mohan, Sandeep Saxena, Somnath De & Apjit Kaur

  2. Department of Pathology, King George’s Medical University, Lucknow, India

    Wahid Ali

  3. South Australian Institute of Ophthalmology, Royal Adelaide, Adelaide, Australia

    Jagjit S. Gilhotra

  4. Augenklinik, Davos, Switzerland

    Carsten H. Meyer

Authors
  1. Akshay Mohan
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  2. Sandeep Saxena
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  3. Somnath De
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  4. Apjit Kaur
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  5. Wahid Ali
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  6. Jagjit S. Gilhotra
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  7. Carsten H. Meyer
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Correspondence to Sandeep Saxena.

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This original study was conducted after approval of institutional ethical committee.

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A written informed consent was taken from all study subjects. Study was conducted under tenets of Helsinki declaration.

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Mohan, A., Saxena, S., De, S. et al. Increased serum cortisol is associated with alterations in cross-sectional and topographic OCT parameters in diabetic retinopathy: a preliminary study. Int Ophthalmol 41, 3623–3630 (2021). https://doi.org/10.1007/s10792-021-01941-8

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  • DOI: https://doi.org/10.1007/s10792-021-01941-8

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