Holtz Jeppe K, Larsson Janni M E, Hansen Michael S, van Dijk Elon H C, Subhi Yousif
Department of Ophthalmology, Odense University Hospital, DK-5000 Odense, Denmark.
Department of Otolaryngology, Odense University Hospital, DK-5000 Odense, Denmark.
J Clin Med. 2022 Jul 29;11(15):4437. doi: 10.3390/jcm11154437.
Cushing's syndrome is a rare disease with an endogenous cause of excess cortisol secretion. More evidence substantially links cortisol levels to the pachychoroid spectrum diseases. In this systematic review and meta-analysis, we summarize available evidence on pachychoroid spectrum diseases in patients with Cushing's syndrome. We performed a systematic literature search in 11 databases on 21 May 2022. Studies were considered eligible if they performed retinal examination of a consecutive group of patients with Cushing's syndrome using optical coherence tomography (OCT) scans. We extracted data on subfoveal choroidal thickness in patients with Cushing's syndrome compared to matched controls. We also extracted data on the prevalence of pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), and polypoidal choroidal vasculopathy (PCV). We identified six eligible studies with a total of 159 patients with Cushing's syndrome. On average, patients with Cushing's syndrome have 49.5 µm thicker subfoveal choroidal thickness compared to matched healthy individuals. Pachychoroid spectrum diseases were relatively common in these patients: PPE in 20.8%, CSC in 7.7%, and PCV in 2.8%. We conclude that there should be low threshold to recommend ophthalmic examination to patients with Cushing's syndrome, and that a macular OCT is recommended during this examination.
库欣综合征是一种由内源性皮质醇分泌过多引起的罕见疾病。越来越多的证据充分表明皮质醇水平与厚脉络膜谱系疾病有关。在这项系统评价和荟萃分析中，我们总结了库欣综合征患者厚脉络膜谱系疾病的现有证据。我们于2022年5月21日在11个数据库中进行了系统的文献检索。如果研究使用光学相干断层扫描（OCT）对一组连续的库欣综合征患者进行视网膜检查，则被认为符合条件。我们提取了库欣综合征患者与匹配对照组相比的黄斑下脉络膜厚度数据。我们还提取了厚脉络膜色素上皮病变（PPE）、中心性浆液性脉络膜视网膜病变（CSC）和息肉样脉络膜血管病变（PCV）的患病率数据。我们确定了六项符合条件的研究，共有159例库欣综合征患者。平均而言，与匹配的健康个体相比，库欣综合征患者的黄斑下脉络膜厚度厚49.5μm。厚脉络膜谱系疾病在这些患者中相对常见：PPE为20.8%，CSC为7.7%，PCV为2.8%。我们得出结论，对于库欣综合征患者，应降低推荐眼科检查的阈值，并且在此检查期间建议进行黄斑OCT检查。
