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Abstract

ENDOGENOUS CORTISOL AND TESTOSTERONE LEVEL IN CENTRAL SEROUS CHORIORETINOPATHY: A CASE CONTROL STUDY

Himanshu Devender Kumar, Ashuma Sachdeva*, Manisha Nada, Sumit Sachdeva, Sumeet Khanduja, Richa Goel and Veena Singh Ghalaut

ABSTRACT

Central serous chorioretinopathy (CSCR) is characterized by an exudative neurosensory layer detachment of retina. Male gender, type- A personality, emotional stress, pregnancy, infections, hormonal regulatory factors and several immunological reactions have all been implicated in causing CSCR. Although several hypotheses have tried to establish a link between endocrinal abnormalities and CSCR, still none is able to explain the true etiopathogenesis of CSCR. This study was designed to estimate serum cortisol and testosterone levels in patients of CSCR and study their potential role in etiopathogenesis of the disease. In this study, 25 patients of CSCR satisfying the inclusion and exclusion criteria were enrolled as cases and 25 age and sex matched patients with an acute unilateral rhegmatogenous retinal detachment (RD) were enrolled as controls. Levels of serum cortisol and testosterone were estimated in both groups. Serum cortisol measurement was done twice, due to diurnal variation in its levels. Data analysis was done by Pearson’s correlation analysis and independent student t-test. The 8:00 AM mean serum cortisol value in the cases (20.21 ± 4.86 μg/dl) was significantly (p = 0.046) higher than controls (17.74 ± 3.53 μg/dl). Although the 11:00 PM mean serum cortisol value of cases (8.13 ± 3.52 μg/dl) was more than controls (6.97 ± 2.50 μg/dl) but difference was not statistically significant (p = 0.187). No statistically significant difference (p > 0.05) was observed while comparing the mean level of testosterone in both groups. Elevated cortisol level in CSCR patients strengthens the belief of its potential role in pathogenesis of disease. Also, regular posterior chamber examination can reduce the ocular morbidity in patients with exo- or endogenous hypercortisolism. It is suggested that monitoring of cortisol levels could be beneficial in deciding the outcome of CSCR.

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