A recent study highlighted a significant association between endogenous Cushing’s syndrome and an increased risk of glaucoma.
The researchers conducted a nationwide retrospective matched-cohort study analyzing 609 patients diagnosed with Cushing’s syndrome (CS) between 2000 and 2023. These individuals were matched with 3,018 controls based on age, sex, socioeconomic status, and body mass index. The study tracked glaucoma diagnoses, timing of disease onset, and related risk factors. Ultimately, the study found CS-affected patients developed glaucoma at a younger age compared to the general population.
Specifically, CS patients were diagnosed with glaucoma approximately four years earlier than controls, with a mean onset age of 62 years compared to 66 years. Patients with CS were also five times more likely to develop glaucoma before the age of 40 compared to controls (1.5% vs. 0.3%), and patients with unresolved hypercortisolism were diagnosed with glaucoma six months earlier on average than those in remission (82.1 vs. 88.6 months post-CS diagnosis).
“We have shown for the first time,” they wrote in their Acta Ophthalmologica article, “that endogenous CS, whether caused by a pituitary or adrenal adenoma, is associated with an increased risk for glaucoma and a clinical manifestation at an earlier age versus general population, regardless of remission status or degree of urinary free cortisol elevation.”
CS patients exhibited a 74% higher overall risk for glaucoma compared to matched controls. When the study ended, 12.8% of CS patients had developed glaucoma, compared to 8.3% of controls. In addition to glaucoma, diabetes mellitus, and stroke were observed more frequently among CS patients.
Even after achieving biochemical remission, the researchers suggested that patients with endogenous CS should be monitored proactively for glaucoma, and ophthalmologic screening should be included as part of the routine management of CS to mitigate the risk of vision loss. “A delay in diagnosing both CS and glaucoma can result in significant ocular and systemic morbidities,” they concluded.
A full list of author disclosures can be found in the published research.
