Endogenous Steroid Induced Glaucoma due to Cushing Syndrome
DOI:
https://doi.org/10.12974/2309-6136.2014.02.02.1Keywords:
Steroid induced glaucoma, endogenous, adrenal hyperplasia, Cushing’s syndrome.Abstract
Exogenous steroid usage is a documented cause of increase in intraocular pressure in susceptible individuals; with systemic use having a lower propensity than topical. Endogenous hypercortisolism is an uncommon cause of steroid induced glaucoma with few reported cases due to adrenal adenoma, ectopic ACTH production in para-neoplastic syndromes, and pituitary adenomas. We report a case of steroid induced glaucoma occurring due to adrenal hyperplasia with confounding feminizing features which caused a diagnostic dilemma.
References
Bernstein HN, Schwartz B. Effects of long term systemic steroids on ocular pressure and tonographic values. Arch Ophthal. 1962; 68: 742-53. http://dx.doi.org/10.1001/archopht.1962.00960030746009
Hill SR, Holley HL, Ullao A, Starnes WR, Hibbitt LL, McNeil JH. Studies on adrenal cortical activity in patients with rheumatoid arthritis: The diurnal patterns and 24-hour levels of urinary total 17-Hydroxy-corticosteroids and 17- Ketosteroids. Arthritis Rheum. 1959; 2(2): 114-26. http://dx.doi.org/10.1002/1529-0131(195904)2:2<114::AIDART1780020204> 3.0.CO;2-V
Bernstein HN, Mills DW, Becker B. Steroid induced elevation of intraocular pressure. Arch Ophthal. 1963; 70: 15-18. http://dx.doi.org/10.1001/archopht.1963.00960050017005
Neuner HP, Dardenne U. Ocular changes in Cushing Syndrome. Klin Monbl Augenheilkd. 1968; 152(4): 570–574.
Haas JS, Nootens RH. Glaucoma secondary to benign adrenal adenoma. Am J Ophthalmol. 1974; 78(3): 497–500. http://dx.doi.org/10.1016/0002-9394(74)90238-4
Robbin DS, Haas JS. A 16-year follow-up in a corticosteroidsensitive patient with glaucoma secondary to a benign adrenal adenoma. Am J Ophthalmol. 1989; 107: 293–295. http://dx.doi.org/10.1016/0002-9394(89)90316-4
Blumenthal EZ, Muszkat M, Pe'er J, Ticho U. Corticosteroid induced glaucoma attributable to an adrenocorticotropinsecreting malignant carcinoid tumor of the thymus. Am J Ophthalmol. 1999; 128(1): 100-101. http://dx.doi.org/10.1016/S0002-9394(99)00052-5
Virevialle C, Brasnu E, Fior R, Baudouin C. Open-angle glaucoma secondary to Cushing syndrome related to an adrenal adenoma: Case report. J Fr Ophthalmol. 2014; Sep 25. [Epub ahead of print].
