Doctors and researchers are taking chronic stress’s toll on the body more seriously than ever and research across disciplines is showing that. They’re finding that systems as diverse as neurobiology, sexual functioning and inflammation can all be impacted by mental or emotional stress.1-3 In eye care, stress can raise intraocular pressure (IOP), but researchers say they’ve only found weak associations between endogenous stress marker concentrations and retinal nerve fiber layer (RNFL) thickness in young adult subjects.4

The investigators looked at 863 subjects who underwent a Trier Social Stress Test. Endogenous plasma adrenocorticotropic hormone (ACTH) and cortisol were measured for those who provided biological samples, and adrenal sensitivity was calculated.4 On the basis of cortisol levels before and after the stress test, participants were categorized into one of three stress response types: anticipatory-responders, reactive-responders and nonresponders.4 They also evaluated their peripapillary RNFL thickness using spectral-domain OCT.4

They were able to show higher levels of ACTH in subjects with thinner RNFL globally, and at the inferotemporal, superotemporal and temporal sectors.4 They also noted lower adrenal sensitivity in those patients inferotemporally and temporally.4 However, these effect sizes were small, and ACTH levels were associated with only a 3µm thinner RNFL.4 RNFL thickness was not associated with plasma cortisol levels, nor was it significantly different between groups of acute stress response patterns.4

1. McEwen B. Neurobiological and systemic effects of chronic stress. Chronic Stress (Thousand Oaks). 2017 Jan-Dec;1

2. Hamilton L, Meston C. Chronic stress and sexual function in women. J Sex Med. 2013;10(10):2443-54.

3. Liu Y, Wand Y, Jiang C. Inflammation: the common pathway of stress-related diseases. Front Hum Neurosci. 2017;11:316.

4. Lee S, Sanfilippo P, Yazar S, et al. Do levels of stress markers influence the retinal nerve fiber layer thickness in young adults? J Glaucoma. April 13, 2020. [Epub ahead of print].