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

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).