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

• Published in: International ophthalmology Vol. 41; no. 11; pp. 3623 - 3630
• Main Authors: Mohan, Akshay, Saxena, Sandeep, De, Somnath, Kaur, Apjit, Ali, Wahid, Gilhotra, Jagjit S., Meyer, Carsten H.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.11.2021; Springer Nature B.V
• Subjects: Chemiluminescence; Correlation analysis; Cortisol; Diabetes; Diabetes mellitus; Diabetic retinopathy; Disruption; Epithelium; Evaluation; Hormones; Mean; Medicine; Medicine & Public Health; Microparticles; Ophthalmology; Optical Coherence Tomography; Original Paper; Parameters; Retina; Retinal pigment epithelium; Retinopathy; Statistical analysis; Thickness; Topography; Variance analysis; Spectral domain optical coherence tomography; Diabetic retinopathy; Cortisol; Ellipsoid zone; Diabetes mellitus; Disorganization of inner retinal layers
• ISSN: 0165-5701; 1573-2630; 1573-2630
• DOI: 10.1007/s10792-021-01941-8

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.