Self assessment questions
| Answers on p 736. |
Visual disturbances and weight gain
S Sharmaa, R Granota, N Thomasa, G A Wilcsekb, C Whitea, R Fitzsimonsb, J Tidmarshc, B E Tuchaa Prince of Wales
Hospital, Randwick, Sydney, Australia: Department of Endocrinology, b Department of Ophthalmology, c Department of Endocrinology, Bankstown Hospital,
Bankstown, Sydney, Australia
Correspondence to: Professor B Tuch, Pancreas Transplant Unit, Department of Endocrinology, Diabetes and Metabolism, Prince of Wales Hospital, Corner Avoca and High Streets, Randwick, NSW 2031, Australia b.tuch@unsw.edu.au
Submitted 22 June
2000;
Accepted 19 July 2000
| The first 100% of the full text of this article appears below. |
A 51 year old man presented with a two year history of gradually deteriorating vision in his left eye, accompanied by 34 kg weight gain, easy bruising, and hypertension which was relatively resistant to conventional treatment. The patient denied any history of headaches. On examination, his general appearance was as shown (fig 1). On ocular examination his visual acuity was 6/6 in the right and 6/12 in the left eye. A left relative afferent pupillary defect was present and fundoscopically there was left optic nerve atrophy. Numerous investigations were performed, including Humphrey's field analysis (fig 2), and a cerebral magnetic resonance imaging (MRI) scan (fig 3). Eye positions on left lateral gaze were as shown (fig 4).
| Figure Removed (Available Only in the Full Text) |
| Figure Removed (Available Only in the Full Text) |
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Questions
| (1) | Explain the ocular findings, and give the differential diagnosis. |
| (2) | What further investigations would you perform? |
| (3) | What does his MRI reveal? |
| (4) | Outline initial management, and, should this fail, what alternative treatment options exist? |
© 2001 by The Fellowship of Postgraduate Medicine
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