Departamento de Oftalmología, Hospital Puerta de Hierro Majadahonda, Madrid, España; Centro Internacional de Oftalmología Avanzada, Madrid, España.
Departamento de Oftalmología, Hospital Puerta de Hierro Majadahonda, Madrid, España.
Arch Soc Esp Oftalmol (Engl Ed). 2020 Jul;95(7):353-356. doi: 10.1016/j.oftal.2020.03.008. Epub 2020 May 15.
A 31-year-old male was referred for evaluation after being diagnosed with Cushing syndrome secondary to a pituitary microadenoma. He presented with a reduced visual acuity and high intraocular pressure (IOP) of 48mmHg in both eyes. The examination with biomicroscopy showed normal anterior segment, increased cup to disc ratio, and open angle. There was a moderate-advanced involvement in the visual field. The patient was diagnosed with glaucoma secondary to endogenous corticosteroids, and medical treatment was initiated pending the removal of the adenoma. The IOP did not return to normal after the incomplete removal of the adenoma, so a trabeculectomy was performed to control the IOP. As conclusions: In the case of an ocular hypertension with pituitary tumour, secondary glaucoma to endogenous cortisone should be suspected. Early treatment of the tumour is necessary to bring the cortisone and IOP levels back to normal. Late diagnosis or incomplete treatment of these tumours may lead to not obtaining adequate IOP control.
一位 31 岁男性因垂体微腺瘤继发库欣综合征而就诊。他表现为双眼视力下降和高眼压（IOP），分别为 48mmHg。眼前节检查正常，杯盘比增加，房角开放。视野中度晚期受累。该患者被诊断为内源性皮质类固醇引起的青光眼，在腺瘤切除之前开始进行药物治疗。在不完全切除腺瘤后，IOP 未恢复正常，因此进行小梁切除术以控制 IOP。结论：对于伴有垂体肿瘤的眼压升高，应怀疑为内源性皮质激素继发青光眼。早期治疗肿瘤对于使皮质激素和 IOP 水平恢复正常非常必要。这些肿瘤的诊断延迟或治疗不完全可能导致不能获得充分的 IOP 控制。
