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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Retinal Microvascular and Peripapillary Profiles in Mild Autonomous Cortisol Secretion Versus Nonfunctioning Adrenal Adenomas

  • Selin Şimşek Alkan1
  • Aslı Vural2
  • Vildan Gürses Beşli2
  • Sibel Zırtıloğlu3
  • Seda Karslı4
  • Seda Turgut4
  • Didem Acarer Bugün4
  • Naim Pamuk4
  • Hamide Pişkinpaşa4
  • Sema Çiftçi4
4 affiliations
  1. 1Department of Ophthalmology, Faculty of Medicine, Biruni University, 34010 Istanbul, Türkiye
  2. 2Department of Ophthalmology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences Türkiye, 34147 Istanbul, Türkiye
  3. 3Department of Ophthalmology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences Türkiye, 34303 Istanbul, Türkiye
  4. 4Department of Endocrinology and Metabolism, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences Türkiye, 34147 Istanbul, Türkiye
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Abstract

Background/Objectives: Mild autonomous cortisol secretion (MACS) is associated with increased cardiometabolic morbidity, but its relationship with the retinal microcirculation is unknown. We compared retinal and peripapillary microvascular parameters between MACS and nonfunctioning adrenal adenoma (NFA) and, secondarily, examined their associations with continuously modeled post-dexamethasone cortisol. Methods: In this single-center, retrospective, cross-sectional study, 98 patients (45 NFA, 53 MACS) were included, and optical coherence tomography angiography (OCTA) and structural OCT data from one eye per patient were analyzed. The primary outcome was whole-image deep capillary plexus (DCP) vessel density. Multivariable models were adjusted for age, sex, body mass index, and cardiometabolic comorbidities; secondary analyses were corrected using the Benjamini–Hochberg false discovery rate (q values). Results: OCTA was evaluable in 89 patients. The primary outcome did not differ significantly between groups in the main analysis (NFA vs. MACS, 48.64 ± 5.71% vs. 47.31 ± 5.77%; adjusted difference −1.29 percentage points, 95% CI −3.97 to 1.38; p = 0.339) or in any sensitivity analysis. In secondary analyses, superior retinal nerve fiber layer (RNFL) thickness was greater in MACS (β = 17.38 µm; q < 0.001) and increased with ln(post-dexamethasone cortisol) (β = 13.74 µm; q = 0.010). Higher ln(post-dexamethasone cortisol) was also associated with lower parafoveal DCP (β = −2.72 percentage points; p = 0.013) and inside-disc radial peripapillary capillary vessel density (β = −3.13 percentage points; p = 0.026), which did not survive multiplicity correction; no superficial capillary plexus sector was associated with either exposure (all p ≥ 0.37). Conclusions: MACS was not significantly associated with whole-image DCP vessel density. The secondary associations with continuous cortisol are cross-sectional and hypothesis-generating and require prospective confirmation.

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Cite

BibTeXRIS
BibTeX
@article{alkan2026retinal,
  title = {{Retinal Microvascular and Peripapillary Profiles in Mild Autonomous Cortisol Secretion Versus Nonfunctioning Adrenal Adenomas}},
  author = {Selin Şimşek Alkan and Aslı Vural and Vildan Gürses Beşli and Sibel Zırtıloğlu and Seda Karslı and Seda Turgut and Didem Acarer Bugün and Naim Pamuk and Hamide Pişkinpaşa and Sema Çiftçi},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15207850},
  url = {https://www.mdpi.com/2077-0383/15/20/7850},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Retinal Microvascular and Peripapillary Profiles in Mild Autonomous Cortisol Secretion Versus Nonfunctioning Adrenal Adenomas
AU  - Selin Şimşek Alkan
AU  - Aslı Vural
AU  - Vildan Gürses Beşli
AU  - Sibel Zırtıloğlu
AU  - Seda Karslı
AU  - Seda Turgut
AU  - Didem Acarer Bugün
AU  - Naim Pamuk
AU  - Hamide Pişkinpaşa
AU  - Sema Çiftçi
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15207850
UR  - https://www.mdpi.com/2077-0383/15/20/7850
AB  - Background/Objectives: Mild autonomous cortisol secretion (MACS) is associated with increased cardiometabolic morbidity, but its relationship with the retinal microcirculation is unknown. We compared retinal and peripapillary microvascular parameters between MACS and nonfunctioning adrenal adenoma (NFA) and, secondarily, examined their associations with continuously modeled post-dexamethasone cortisol. Methods: In this single-center, retrospective, cross-sectional study, 98 patients (45 NFA, 53 MACS) were included, and optical coherence tomography angiography (OCTA) and structural OCT data from one eye per patient were analyzed. The primary outcome was whole-image deep capillary plexus (DCP) vessel density. Multivariable models were adjusted for age, sex, body mass index, and cardiometabolic comorbidities; secondary analyses were corrected using the Benjamini–Hochberg false discovery rate (q values). Results: OCTA was evaluable in 89 patients. The primary outcome did not differ significantly between groups in the main analysis (NFA vs. MACS, 48.64 ± 5.71% vs. 47.31 ± 5.77%; adjusted difference −1.29 percentage points, 95% CI −3.97 to 1.38; p = 0.339) or in any sensitivity analysis. In secondary analyses, superior retinal nerve fiber layer (RNFL) thickness was greater in MACS (β = 17.38 µm; q < 0.001) and increased with ln(post-dexamethasone cortisol) (β = 13.74 µm; q = 0.010). Higher ln(post-dexamethasone cortisol) was also associated with lower parafoveal DCP (β = −2.72 percentage points; p = 0.013) and inside-disc radial peripapillary capillary vessel density (β = −3.13 percentage points; p = 0.026), which did not survive multiplicity correction; no superficial capillary plexus sector was associated with either exposure (all p ≥ 0.37). Conclusions: MACS was not significantly associated with whole-image DCP vessel density. The secondary associations with continuous cortisol are cross-sectional and hypothesis-generating and require prospective confirmation.
SN  - 2077-0383
ER  -