Retinal vein occlusion as the presenting feature of Cushing's syndrome.
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Authors
Ayuk, John
Buch, Harit
Chopra, Roopa
Kalaria, Tejas
Issue Date
2021-01-25
Journal
Type
Article
Peer-Reviewed Publication
Peer-Reviewed Publication
Keywords
ACTH-secreting pituitary adenoma
Adenoma
Case report
Cushing's syndrome
Delayed diagnosis
Endocrinology
Hospital admission
Hypokalaemia
Hypothyroidism
Hypophysectomy
Local neoplasm recurrence
Magnetic resonance imaging
Male
Middle aged
Neoplasms
Peer-reviewed article
Pituitary disorders
Radiotherapy
Reccurrence
Reoperation
Restinal vein occlusion
Retina
Adenoma
Case report
Cushing's syndrome
Delayed diagnosis
Endocrinology
Hospital admission
Hypokalaemia
Hypothyroidism
Hypophysectomy
Local neoplasm recurrence
Magnetic resonance imaging
Male
Middle aged
Neoplasms
Peer-reviewed article
Pituitary disorders
Radiotherapy
Reccurrence
Reoperation
Restinal vein occlusion
Retina
Journal Title
BMJ Case Reports
Volume
14
Issue
1
Begin page
e238204
End page
Abstract
A 53-year-old man presented to his optician with blurring of vision in the right eye and was diagnosed to have branch retinal vein occlusion. Over the following 3 months, he had further progressive visual impairment due to right central retinal vein occlusion (CRVO) and then left CRVO. Soon thereafter, during a hospital admission for infected submandibular gland, he was noted to have secondary hypothyroidism and persistent hypokalaemia which led to the diagnosis of Cushing's syndrome. This case was unusual as the patient did not manifest any classical features of Cushing's syndrome at the time of presentation with bilateral CRVO, and only 3 months later had dramatic weight loss, muscle weakness and acute psychosis. He received intravenous etomidate and underwent emergency transsphenoidal hypophysectomy with dramatic clinical and biochemical improvement and complete visual recovery in the left eye but unfortunately vision in the right eye remained limited to hand movements.
Citation
Kalaria TR, Chopra R, Ayuk J, Buch H. Retinal vein occlusion as the presenting feature of Cushing's syndrome. BMJ Case Rep. 2021 Jan 25;14(1):e238204. doi: 10.1136/bcr-2020-238204. PMID: 33495181.