1Wiechens B., 2Kovács N., 3Mönig H.

1Dept. of Ophthalmology, Klinikum Hannover, Haltenhoffstr. 41, D-30167 Hannover, 2Dept. of Ophthalmology, Christian-Albrechts-University Kiel, Hegewischstr. 2, D-24105 Kiel, 3Dept. of General Internal Medicine, Christian-Albrechts-University Kiel, Schittenhelmstr. 12, D-24105 Kiel

Objective: Central serous retinopathy (CSR) is a self limiting disease with accumulation of transparent fluid beneath the neurosensory retina of the posterior pole. The pathogenesis is still unknown. Recently, a disaese with a similar clinical appearance as a complication after steroid therapy has been reported. The study was performed to investigate the role of endogenous cortisol in the pathogenesis of CSR.
Patients and methods: 16 patients (3 female and 13 male) with acute CSR were recruted for this study. The mean age at diagnosis was 43.0 years (range: 32-56 years). Duration of symptoms was 4 days prior to diagnosis (range: 2-7 days). There were no underlying general diseases in any of the patients. Because intravenous levels of corticoids show great diurnal fluctuations free cortisol was measured in the urine by ELISA as well as creatinin. In every patient two measurements on two successive days were performed.
Results: In 13 of the patients cortisol levels were between 25.3 und 105.0 µ/24 h (normal range: 20.0-120.0 µg/24 h). In the remaining 3 patients (male) free cortisol in the urine was elevated to 138.0, 158.4 and 161.7 µg/24 h, respectively. Control studies at the next day, however, were within normal limits of 86.4, 84.7 and 75.3 µg/24 h, respectively.
Conclusion: Endogenous levels of cortisol in the urine are elevated in a few cases of acute CSR only. According to the results of this study a pathogenetic role of cortisol in the etiology of CSR seems to be unlikely.

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