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Endogenous steroid glaucoma secondary to Cushing syndrome

Poster Details

First Author: H.Yung HONG KONG

Co Author(s):    K. Wan                    

Abstract Details

Purpose:

Steroid induced glaucoma is usually attributed to exogenous steroid and is rarely endogenous. We report a rare case of endogenous Cushing syndrome secondary to benign adrenocortical adenoma presenting as refractory ocular hypertension and exophthalmos

Setting:

Department of Ophthalmology, Tuen Mun Hospital, Hong Kong

Methods:

A 49 years old lady presented with features of Grave's Ophthalmopathy and raised intraocular pressure to the 30s. Despite topical and oral anti-glaucoma medication her intraocular pressure raised to the 40s. Bilateral orbital fat decompression was performed but the intraocular pressure remained elevated. Subsequently bilateral deep sclerectomy was done and her intraocular pressure return to normal without medication.

Results:

Her intraocular pressure was normal months after surgery. subsequent investigation show she have ACTH-independent Cushing syndrome due to an adenoma of her right adrenal gland. The tumour was later removed.

Conclusions:

Ocular manifestations in Cushing syndrome may include ocular hypertension and exophthalmos, which was present in up to one-third of the patients in Harvey Cushing�â�€�™s original case series. This case highlights the importance of a careful systemic review in diagnosing her endogenous Cushing syndrome. Endogenous Cushing syndrome should be suspected in those with OHT refractory to medical treatment and with systemic features of endocrine disturbances

Financial Disclosure:

NONE

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