Correspondence
A rare association: Cushing disease and central serous chorioretinopathy
Central serous chorioretinopathy (CSCR) consists of subretinal accumulation of serous fluid leading to a circumscribed detachment of the neural retina.1,2 The fluid accumulates in the macular region, resulting in decreased visual acuity, blurry vision, color desaturation, metamorphopsia, and impaired dark adaptation.1 Although the pathogenesis of CSCR remains unknown and most cases are idiopathic, excess corticosteroid levels have been reported in association with CSCR.3 This is rare in the setting of Cushing disease.Perioperative nonarteritic anterior ischemic optic neuropathy in Jehovah’s Witnesses
A 62-year-old, female, African American, Jehovah’s Witness experienced bilateral and simultaneous vision loss 2 days after hip arthroplasty. Her 5-hour supine hip replacement surgery resulted in 1 L of blood loss; given her religious status, she refused replacement blood products. Her hemoglobin was 6.3 g/dL preoperatively and 4.7 g/dL postoperatively. The etiology of her preoperative anemia was not known. Her lowest postsurgical blood pressure was 75/45 mm Hg. Her hypotensive medications were discontinued, she was kept in Trendelenburg position, and was treated with intravenous (IV) iron and darbepoetin alfa.
