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Open angle glaucoma secondary to endogenous cortisone due to pituitary microadenoma in a young patient, a case report
Glaucoma de ángulo abierto secundario a cortisona endógena por microadenoma hipofisario en un paciente joven, a propósito de un caso
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Lackluster cornea. Central corneal ulcer with infiltrate throughout the corneal thickness and hyphema.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Díaz Barrón, L. Sanz Gallen, J.M. Hervás Hernandis, E. Tarragó Simón, A.M. Duch-Samper" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Díaz Barrón" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Sanz Gallen" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Hervás Hernandis" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Tarragó Simón" ] 4 => array:2 [ "nombre" => "A.M." 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Where are we and where are we going?" 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Perucho-González, J. García-Feijoó" "autores" => array:2 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Perucho-González" ] 1 => array:2 [ "nombre" => "J." 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Kudsieh, E. Casado López De la Franca, M.A. Díez Gómez, J.M. Ruiz Moreno" "autores" => array:4 [ 0 => array:4 [ "nombre" => "B." "apellidos" => "Kudsieh" "email" => array:1 [ 0 => "bacharkudsieh@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "E. Casado" "apellidos" => "López De la Franca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M.A." "apellidos" => "Díez Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "J.M." "apellidos" => "Ruiz Moreno" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Puerta de Hierro Majadahonda, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro Internacional de Oftalmología Avanzada, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Oftalmología, Universidad de Castilla La Mancha, Albacete, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Glaucoma de ángulo abierto secundario a cortisona endógena por microadenoma hipofisario en un paciente joven, a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1013 "Ancho" => 1800 "Tamanyo" => 363875 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">optical coherence tomography of peripapillary neuroretinal fiber layer (RNFL), showing advanced loss of RNFL more in the right eye than in the left one.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Corticosteroids are anti-inflammatory agents widely used for treating various systemic and ocular disorders. Exposure to corticosteroids could give rise to important ocular side effects, including the formation of cataracts and glaucoma. Corticosteroid-induced glaucoma is one of the most frequent secondary open angle glaucomas, with development risk factors including open angle primary glaucoma, pigments dispersion syndrome, high myopia, young age, diabetes mellitus and connective tissue diseases<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Corticosteroids that produce glaucoma are frequently exogenous, with ocular administration being the most frequent pathway either through the topical, periocular or intraocular pathway. It could also arise due to oral or intravenous systemic corticosteroid administration, dermatological preparations or through the inhalation pathway<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Less frequently, said glaucoma-producing corticosteroids could be endogenous. In these cases, tumors that alter the metabolism of blood cortisol and increase their production should be at the top of the differential diagnostic list, together with hypophysis tumors, adrenal gland tumors, ectopic adrenocorticotropic hormone (ACTH) syndrome or thymus gland tumors<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a>. In these cases, early diagnostic is very important to prevent the development of glaucoma. Surgical treatment of these tumors is associated to intraocular pressure (IOP) normalization after surgery<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>. In refractory cases, treatment of glaucoma is similar to that of glaucoma secondary to exogenous corticosteroids<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> including medical treatment with drugs, laser trabeculoplasty, filtrating surgery and minimally invasive glaucoma surgery.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The case is presented of a male, 31 years of age, with bilateral open angle glaucoma secondary to endogenous corticosteroids due to Cushing syndrome caused by hypophysis microadenoma that required surgical treatment for controlling IOP.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Clinic case report</span><p id="par0025" class="elsevierStylePara elsevierViewall">Male, 31, diagnosed with Cushing syndrome secondary to hypophysis microadenoma with 8 mm maximum diameter with 9 months evolution. The analytic and endocrinology study reported compatibility with ACTH secreting tumor, exhibiting ACTH levels of 100 pg/ml (normality level: 9-55) and cortisol in blood of 32.40 μg/dl (normality level: 4.3-22.4). While awaiting surgery, the patient was treated with ketokonazole 400 mg per day, which was discontinued due to alteration of liver transaminases.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The patient was referred to the Ophthalmology Dept. for assessment. Antecedents included right non-artheritic ischemic optic neuropathy secondary to resolved arterial hypertension, ocular hypertension with nonspecific campimetric defect 6 months earlier and familial history of mother with primary open angle glaucoma. Examination produced best corrected visual acuity in the right eye of 0.1 and 0.4 in the left eye (both in the decimal scale), IOP measured with Goldmann applanation tonometer of 48 mmHg in both eyes, normal anterior segment biomicroscopy and gonioscopy of the open angle showing slight trabecular mesh pigmentation without other angle or iridian anomalies. Slight paleness and increased optic nerve cup to disc ratio was observed in funduscopy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Automated campimetry (Humphrey) showed in the right eye a nearly complete visual field defect, while the left eye showed an island of central vision (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Neuroretinal fiber layer study with optical coherence tomography showed a severe diffuse defect in both eyes (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The diagnostic of open angle glaucoma secondary to endogenous corticosteroids was considered, initiating maximum medical treatment with oral acetazolamide 250 mg, eyedrops with a fixed combination of brimonidin and timolol (2 mg/ml and 5 mg/ml), and 0.3% bimatoprost eyedrops, observing a small IOP reduction down to 40 mmHg in the right eye and 38 mmHg in the left eye, awaiting surgical removal of the microadenoma.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">After incomplete surgical resection of the hypophysis microadenoma through the transsphenoidal route, ophthalmological checkup showed that IOP did not return to normal levels with maximum medical treatment. Accordingly it was decided to conduct filtrating glaucoma surgery with trabeculectomy and mitomycin C in both eyes. Six months after trabeculectomy, IOP remains at 16 mmHg without medical treatment in both eyes and stable visual acuity and visual field.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">Glaucoma secondary to exogenous corticosteroids is an entity that has been analyzed and studied in great depth<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,7</span></a>. However, very few cases can be found in the literature on secondary glaucoma induced by endogenous corticosteroids. Said cases are mainly secondary to tumors that alter the blood levels of ACTH and cortisone. The majority of these tumors reside in the hypophysis or adrenal gland and can be benign or malign<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–6,8</span></a>.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The present case was caused by a benign hypophysis ACTH-secreting microadenoma. In a series comprising 50 cases of glaucoma and hypophysis tumors, Kobayashi et al. found that the Rathke pouch cyst was present in 76% of cases, only 10% of which were adenomas<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>. In these cases, glaucoma diagnostic is usually late and complex because the visual field and the optic papilla exhibits changes secondary to glaucoma and to the compression of the optic pathway in macroadenomas. These cases should be suspected in patients with systemic hormonal imbalance characteristics, in conditions in which IOP cannot be controlled despite maximum medical treatment<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>.</p><p id="par0050" class="elsevierStylePara elsevierViewall">For the above type of cases, treatment is similar to that of other corticosteroid-induced glaucomas<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,7</span></a>; initially, the source of cortisone must be eliminated and subsequently, if IOP does not recover normal levels, the choice can be made for medical treatment, laser and surgery. Haas and Nootens, and Virevialle et al.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> described that the extirpation of the corticoid-secreting adrenal tumor was enough to normalize IOP values. Gupta et al<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>. Referred that incomplete resection of the tumor could produce recurrence of ocular hypertension after the initial success in controlling IOP. In the present case, incomplete extirpation of the hypophysis tumor did not suffice to control blood levels of corticosteroids and normalize IOP values.</p><p id="par0055" class="elsevierStylePara elsevierViewall">In these cases, surgical options include minimally invasive glaucoma surgery, implanting drainage devices and glaucoma filtrating surgery such as trabeculectomy<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,10</span></a>. In the present case, as the campimetric defense was advanced and IOP was 38-40 mmHg in both eyes despite maximum medical treatment, it was decided to conduct trabeculectomy with mitomycin C in both eyes, which was an efficient measure to maintain IOP under control 6 months after surgery.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Open angle glaucoma secondary to endogenous corticosteroids is an infrequent entity. Diagnosis must be suspected in young patients with hormone alterations with hypophysis and adrenal gland tumors as the most frequent causes. Therapeutic options include in the first place early treatment of these tumors, while in refractory cases the approach is similar to that of glaucoma induced by exogenous corticosteroids.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conflict of interests</span><p id="par0065" class="elsevierStylePara elsevierViewall">None of the authors of this paper have any conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1359781" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Case Report" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1250369" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1359780" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Caso Clínico" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1250370" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinic case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-01-19" "fechaAceptado" => "2020-03-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1250369" "palabras" => array:4 [ 0 => "Intraocular pressure" 1 => "Micropulse trans scleral laser" 2 => "Glaucoma surgery" 3 => "Blindness" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1250370" "palabras" => array:4 [ 0 => "Presión intraocular" 1 => "Láser transescleral de micropulso" 2 => "Cirugía de glaucoma" 3 => "Ceguera" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case Report</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">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 48 mmhg 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.</p></span>" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Case Report" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Caso Clínico</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Varón de 31 años que fue derivado para valoración tras ser diagnosticado de síndrome de Cushing secundario a un microadenoma hipofisario. En la exploración se observó reducción de la agudeza visual (AV) y presión intraocular (PIO) de 48 mmHg en ambos ojos. El segmento anterior fue normal, la papila excavada y el ángulo abierto explorado mediante gonioscopia. Se realizó también campimetría que reveló una afectación avanzada. Se diagnosticó de glaucoma secundario a corticosteroides endógenos y se inició tratamiento médico a la espera de la extirpación del adenoma. La PIO no se normalizó tras la extirpación incompleta del adenoma, por lo que se optó por realizar trabeculectomía para controlarla. Como conclusiones: ante de una hipertensión ocular con tumor hipofisario se debe sospechar glaucoma secundario a cortisona endógena; el tratamiento precoz del tumor es necesario para normalizar los niveles de la cortisona y controlar la PIO, el diagnóstico tardío o el tratamiento incompleto de estos tumores puede llevar a no obtener un control adecuado de la PIO.</p></span>" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Caso Clínico" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Kudsieh B, Casado López De la Franca E, Díez Gómez MA, Ruiz Moreno JM. Glaucoma de ángulo abierto secundario a cortisona endógena por microadenoma hipofisario en un paciente joven, a propósito de un caso. Arch Soc Esp Oftalmol. 2020;95:353–356.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 844 "Ancho" => 1500 "Tamanyo" => 105245 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">color retinography of both optic papilla, showing increased optic papilla cup and paleness of the neuroretinal ring that remains more in the right eye than in the left one.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1941 "Ancho" => 3459 "Tamanyo" => 628854 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Humphrey-type automatic visual campimetry of both eyes, with almost complete scotoma of the right eye and central vision island remaining in the left eye.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1013 "Ancho" => 1800 "Tamanyo" => 363875 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">optical coherence tomography of peripapillary neuroretinal fiber layer (RNFL), showing advanced loss of RNFL more in the right eye than in the left one.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "[1]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corticosteroid-induced ocular hypertension and glaucoma: a brief review and update of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R Jones 3rd" 1 => "D.J. Rhee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.icu.0000193079.55240.18" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Ophthalmol." "fecha" => "2006" "volumen" => "17" "paginaInicial" => "163" "paginaFinal" => "167" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16552251" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "[2]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Steroide-induced Glaucoma: AnAvoidable Irreversible Blindness" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Phulke" 1 => "S. Kaushik" 2 => "S. Kaur" 3 => "SS Pandav" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5005/jp-journals-l0028-1226" "Revista" => array:6 [ "tituloSerie" => "J Curr Glaucoma Pract" "fecha" => "2017" "volumen" => "11" "paginaInicial" => "67" "paginaFinal" => "72" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28924342" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "[3]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Glaucoma secondary to benign adrenal adenoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "JS Haas" 1 => "RH Nootens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0002-9394(74)90238-4" "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol." "fecha" => "1974" "volumen" => "78" "paginaInicial" => "497" "paginaFinal" => "500" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4413577" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "[4]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Open-angle glaucoma secondary to Cushing syndrome related to an adrenal adenoma: case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Virevialle" 1 => "E. Brasnu" 2 => "R. Fior" 3 => "C Baudouin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Fr Ophtalmol." "fecha" => "2014" "volumen" => "37" "paginaInicial" => "e169" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "[5]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corticosteroid-induced glaucoma attributable to an adrenocorticotropin-secreting malignant carcinoid tumor of the thymus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.Z. Blumenthal" 1 => "M. Muszkat" 2 => "J. Peier" 3 => "U Ticho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0002-9394(99)00052-5" "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol." "fecha" => "1999" "volumen" => "128" "paginaInicial" => "100" "paginaFinal" => "101" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10482103" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "[6]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Functional pituitary tumors masquerading as primary glaucoma and effect of hypophysectomy on intraocular tension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Gupta" 1 => "R. Sihota" 2 => "V. Gupta" 3 => "T. Dada" 4 => "V. Gogia" 5 => "A. Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/IJG.0b013e31829521f2" "Revista" => array:6 [ "tituloSerie" => "J Glaucoma." "fecha" => "2015" "volumen" => "24" "paginaInicial" => "e7" "paginaFinal" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23970340" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "[7]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corticosteroid-induced glaucoma: a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "JP Kersey" 1 => "DC Broadway" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eye (Lond)." "fecha" => "2006" "volumen" => "20" "paginaInicial" => "407" "paginaFinal" => "416" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "[8]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ocular hypertension secondary to high endogenous steroid load in Cushing’s disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.N. Habib" 1 => "Z. Lin" 2 => "N. Puvanachandra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "BMJ Case Rep." "fecha" => "2019" "volumen" => "10" "paginaInicial" => "12" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "[9]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characteristics of Fifty Cases of Pituitary Tumors in Eyes Diagnosed with Glaucoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N. Kobayashi" 1 => "H. Ikeda" 2 => "K. Kobayashi" 3 => "T. Onoda" 4 => "E. Adachi-Usami" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nippon Ganka Gakkai Zasshi." "fecha" => "2016" "volumen" => "120" "paginaInicial" => "101" "paginaFinal" => "109" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26987208" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "[10]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term outcomes of repeat vs initial trabeculectomy in open-angle glaucoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.K. Law" 1 => "K. Shih" 2 => "D.H. Tran" 3 => "A.L. Coleman" 4 => "J. Caprioli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Ophthalmol." "fecha" => "2009" "volumen" => "148" "paginaInicial" => "685" "paginaFinal" => "695" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009500000007/v1_202007090642/S217357942030089X/v1_202007090642/en/main.assets" "Apartado" => array:4 [ "identificador" => "5812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009500000007/v1_202007090642/S217357942030089X/v1_202007090642/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357942030089X?idApp=UINPBA00004N" ]
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