Endogenous cortisol profile in patients with central serous chorioretinopathy (CSC)

Endogenous cortisol profile in patients with central serous chorioretinopathy (CSC) is controversial. Hence this control study was conducted to evaluate endogenous cortisol levels in CSC patients.

To evaluate endogenous cortisol levels in patients with CSC and to correlate it in different stages of the disease.

Prospective, interventional case control study.

40 cases of CSC were included in the study and 30 cases with acute, unilateral, sudden, painless loss of vision of recent onset were taken as controls. Serum cortisol estimation was done between 8am to 9am by chemiluminiscence method. Resolution of CSC was assessed based on clinical findings, Fundus fluorescence angiography (FFA), indocyanine green angiography (ICG) and optical coherence tomography (OCT).

‘Z’ test was used to test the significance of the means of serum cortisol level between the control group and the CSC group on the first visit and Paired ‘t’ test was used to test the significance for the difference of means of serum cortisol level on the 1st, 2nd and 3rd visits of the CSC group only. Regression analysis was done to test the population correlation coefficient of cortisol in the CSC group.

Mean age of the cases was 35.9 + 3.77 years and all were male. Mean 8 am serum cortisol level was 12.33 + 3.87 μg/dl in cases during the first visit and 13.33 + 4.28 μg/dl in the control group. It was within normal biological range in both the groups. Difference between mean serum cortisol in each group was statistically insignificant (P = 0.83). Difference of mean of serum cortisol levels estimated during 3rd and 6th months’ follow-up in cases was also not statistically significant. But population correlation coefficient detected a strong positive correlation (+0.655) between serum cortisol levels and CSC cases at each examination visits during the 3rd and 6th months’ follow-up. Healing of CSC was independent of cortisol levels.

CSC was found to be associated with normal endogenous cortisol level. Serum Cortisol level at 8am was within the normal limit, both in the test and control groups. But a strong positive (+0.655) correlation between serum cortisol levels and CSC at each follow-up visits during the time the disease was active indicates the relationship between serum cortisol and CSC aetiopathogenesis at the biological level.