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Retinal vein occlusion as the presenting feature of Cushing’s syndrome
  1. Tejas R Kalaria1,
  2. Roopa Chopra2,
  3. John Ayuk3 and
  4. Harit Buch4
  1. 1Blood Sciences, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  2. 2Endocrinology and Diabetes, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  3. 3Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  4. 4Endocrinology and Diabetes, New Cross Hospital, Wolverhampton, UK
  1. Correspondence to Dr John Ayuk; John.Ayuk{at}


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.

  • endocrinology
  • pituitary disorders
  • retina

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  • Contributors HB, JA, TRK and RC were involved in the care of the patient and conception of the manuscript. TRK did a literature search and wrote the first draft of the manuscript. HB, JA and RC critically reviewed and edited the manuscript. All the authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.