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Decreased plasma cortisol in response to intramuscular ACTH in ocular hypertensives and primary open-angle glaucomas.

Schwartz B, Rabin PA, Wysocki A, Martin J

Glaucoma Research, Inc and Tufts University School of Medicine, Boston, MA, USA. glaucomares@mva.net

PURPOSE: To determine if there is a difference in response of the adrenal gland to intramuscular adrenocorticotropic hormone (ACTH) between normals and ocular hypertensives (OHs) plus primary open-angle glaucomas (POAGs) without pigmented angles. METHODS: Intramuscular ACTH was given to 29 normals and 24 OH plus POAG hospitalized in a Clinical Study Unit. Blood samples were obtained at baseline (0 hours) before administration of intramuscular ACTH and 4, 8, and 24 hours after administration of intramuscular ACTH for analysis of plasma cortisol/body mass index (BMI). RESULTS: The OH plus POAG group showed lower cortisol/BMI values compared with the normal group at 4, 8, and 24 hours with a significantly lower peak/BMI value (P=0.030). Multivariate analyses with the peak plasma cortisol/BMI level as the dependent variable showed that a lower peak plasma/BMI was associated with the OH plus POAG group. Also, a lower peak plasma cortisol/BMI level was associated with a lower 0-hour cortisol/BMI (Log). CONCLUSIONS: Compared with normals, the OH plus POAG subjects showed lower plasma cortisol levels in response to intramuscular ACTH. This observation suggests adrenal suppression in the OH plus OAG group.

Published 17 April 2007 in J Glaucoma, 16(3): 282-6.
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