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September 1993

Central Serous Chorioretinopathy in Endogenous Hypercortisolism

Author Affiliations

From the Ophthalmic Genetics and Clinical Services Branch, National Eye Institute (Drs Bouzas, Scott, and Kaiser-Kupfer), and the Developmental Endocrinology Branch, National Institute of Child Health and Human Development (Drs Mastorakos and Chrousos), National Institutes of Health, Bethesda, Md.

Arch Ophthalmol. 1993;111(9):1229-1233. doi:10.1001/archopht.1993.01090090081024

Objective:  To examine the potential association of central serous chorioretinopathy with endogenous hypercortisolism (Cushing's syndrome).

Design:  Ophthalmologic survey of consecutively admitted patients with endogenous Cushing's syndrome.

Setting:  An eye clinic of a research center (National Eye Institute, Bethesda, Md).

Patients:  Sixty consecutive patients with confirmed endogenous Cushing's syndrome.

Main Outcome Measures:  Findings from complete ophthalmologic evaluation.

Results:  Three (5%) of 60 patients had one or more episodes of appropriately documented central serous chorioretinopathy. In all cases, the episodes occurred during the period of hypercortisolism.

Conclusions:  Central serous chorioretinopathy is an uncommon manifestation of endogenous Cushing's syndrome. Since central serous chorioretinopathy has been associated with other hypercortisolemic states, we suggest that glucocorticoids may play a role in the development of this disease.

Gass JDM.  Idiopathic central serous chorioretinopathy . In: Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment . 3rd ed. St Louis, Mo: CV Mosby Co; 1987:46-59.
Spitznas M.  Central serous retinopathy . In: Ryan SJ, Schachat AP, Murphy RP, Patz A, eds. Retina . St Louis, Mo: CV Mosby Co; 1989;2:217-227.
Orth DN, Kovacs WJ, DeBold CR.  The adrenal cortex . In: Wilson JD, Foster DW, eds. Williams Textbook of Endocrinology . 8th ed. Philadelphia, Pa: WB Saunders Co; 1992:489-619.
Jain IS, Singh K.  Maculopathy a corticosteroid side-effect . J All India Ophthalmol Soc . 1966;14:250-252.
Williamson J, Nuki G.  Macular lesions during systemic therapy with depot tetracosactrin . Br J Ophthalmol . 1970;54:405-409.Article
Wakakura M, Ishikawa S.  Central serous chorioretinopathy complicating systemic corticosteroid treatment . Br J Ophthalmol . 1984;68:329-331.Article
Wakakura M, Ishikawa S.  An evaluation of corticosteroid treatment for central serous retinopathy . Rinsho Ganka . 1980;34:123-129.
Chumbley LC, Frank RN.  Central serous retinopathy and pregnancy . Am J Ophthalmol . 1974;77:158-160.
Bedrossian RH.  Central serous retinopathy and pregnancy . Am J Ophthalmol . 1974;78:152.
Cruysberg JRM, Deutman AF.  Visual disturbances during pregnancy caused by central serous choroidopathy . Br J Ophthalmol . 1982;66:240-241.Article
Fastenberg DM, Ober RR.  Central serous choroidopathy in pregnancy . Arch Ophthalmol . 1983;101:1055-1058.Article
Gass JDM.  Central serous chorioretinopathy and white subretinal exudation during pregnancy . Arch Ophthalmol . 1991;109:677-681.Article
Nolten WE, Rueckert PA.  Elevated free cortisol index in pregnancy: possible regulatory mechanisms . Am J Obstet Gynecol . 1981;139:492-498.
Cousins L, Rigg L, Hollingsworth D, et al.  Qualitative and quantitative assessment of the circadian rhythm of cortisol in pregnancy . Am J Obstet Gynecol . 1983;145:411-416.
Horniker E.  Su di unaforma di retinite centrale di origine vasoneurotica . Ann Ottalmol . 1927;55:578-600.
Gelber GS, Schatz H.  Loss of vision due to central serous chorioretinopathy following psychological stress . Am J Psychiatry . 1987;144:46-50.
Yannuzzi LA.  Type-A behavior and central serous chorioretinopathy . Retina . 1987;7:111-130.Article
Yoshioka H, Katsume Y, Akune H.  Experimental central serous chorioretinopathy in monkey eyes: fluorescein angiographic findings . Ophthalmologica . 1982;185:168-178.Article
Bird AC.  Pathogenesis of serous detachment of retina and pigment epithelium . In: Ryan SJ, Schachat AP, Murphy RP, Patz A, eds. Retina . St Louis, Mo: CV Mosby Co; 1989;2:99-105.
Chrousos GP, Gold PW.  The concepts of stress and stress system disorders: overview of physical and behavioral homeostasis . JAMA . 1992;267:1244-1252.Article
Williams RB.  Physiological mechanisms underlying disease . In: Gentry WD, Williams RB Jr, eds. Physiological Aspects of Myocardial Infarction and Coronary Care . St Louis, Mo: CV Mosby Co; 1975:131-146.
Williams RB, Lane JD, Kuhn CM, Melosh W, White AD, Schanberg SM.  Type A behavior and elevated physiological and neuroendocrine responses to cognitive tasks . Science . 1982;218:483-485.Article
Harrison TS, Chawla RC, Wojtalik RS.  Steroid influences on catecholamines . N Engl J Med . 1968;279:136-143.Article
Natrajan PG, McGarrigle HHG, Lawrence DM, Lachelin GCL.  Plasma noradrenaline and adrenaline levels in normal pregnancy and in pregnancyinduced hypertension . Br J Obstet Gynecol . 1982;89:1041-1045.Article
Barron WM, Mujais SK, Zinaman M, Bravo EL, Lindheimer MD.  Plasma catacholamine responses to physiologic stimuli in normal human pregnancy . Am J Obstet Gynecol . 1986;154:80-84.Article
Gass JDM.  Pathogenesis of disciform detachment of the neuroepithelium, II: idiopathic central serous choroidopathy . Am J Ophthalmol . 1967;63:587-615.
Leuenberger A, Gasche A.  Lichtkoagulation der retinopathia serosa centralis . Ophthalmologica . 1972;165:366-372.Article
Peyman GA, Bok D.  Peroxidase diffusion in the normal and laser-coagulated primate retina . Invest Ophthalmol . 1972;11:35-45.
Spitznas M.  Pathogenesis of central serous retinopathy: a new working hypothesis . Graefes Arch Clin Exp Ophthalmol . 1986;224:321-324.Article
Piccolino FC.  Central serous chorioretinopathy: some considerations on the pathogenesis . Ophthalmologica . 1981;182:204-210.Article
Marmor MF.  New hypotheses on the pathogenesis and treatment of serous retinal detachment . Graefes Arch Clin Exp Ophthalmol . 1988;226:548-552.Article
Oikarinen Al, Uitto J, Oikarinen J.  Glucocorticoid action on connective tissue: from molecular mechanisms to clinical practice . Med Biol . 1986;64:221-230.
Smith PR, Benos DJ.  Epithelial Na+ channels . Annu Rev Physiol . 1991;53:509-530.Article