SHM Converge Scientific Abstract ePoster Gallery-Prolactin, More Than Breastfeeding: A Case of Low Prolactin Causing Retinal Detachment

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Northwell Health describes itself as New York State’s largest health care provider and private employer, focused on clinical care, education, biomedical research, health promotion, and community service regardless of ability to pay. The document then presents a case report titled “Got Prolactin? A Case of Low Prolactin Causing Retinal Detachment.”<br /><br />The case involves a 65-year-old man with a history of bilateral retinal detachment, coronary artery disease, type 2 diabetes, hypothyroidism, and hypertension who presented with left eye pain, bitemporal headache, decreased vision, and a third nerve palsy. Labs showed leukocytosis and very low prolactin. MRI revealed a pituitary macroadenoma measuring about 2.0 x 1.0 cm abutting the optic chiasm. He underwent transsphenoidal resection and was treated with steroids and testosterone replacement.<br /><br />The report explains that pituitary apoplexy or tumor expansion can cause visual symptoms through compression of the optic chiasm or invasion of the cavernous sinus, which likely accounted for the patient’s oculomotor palsy. However, this did not explain his bilateral retinal detachments. The authors propose that hypoprolactinemia may have contributed, since prolactin has neuroprotective and pro-angiogenic effects in the retina. Loss of prolactin may lead to retinal cell apoptosis and structural disruption, increasing risk for detachment.<br /><br />A brief literature review found only a few similar reports linking pituitary tumors, abnormal prolactin levels, and retinal pathology. The authors conclude that in patients with bilateral retinal detachments, clinicians should consider brain imaging and prolactin testing, and that prolactin replacement may potentially help protect the retina in cases of prolactin deficiency.

Asset Subtitle

Melissa Neumann

Meta Tag

Author List Eileen Kim, Leigha Carryl, Melissa Neumann

Category Clinical Vignettes

Concept Pituitary Apoplexy

Concept Pituitary Macroadenoma

Concept Bitemporal Hemianopsia

Concept Retinal Detachment

Concept Optic Chiasm

Distinguished Non-Finalist

Presenter Organization Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset NY, USA

Presenting Author Melissa Neumann

Track Adult

Keywords

Northwell Health

pituitary macroadenoma

low prolactin

retinal detachment

third nerve palsy

optic chiasm compression

pituitary apoplexy

hypoprolactinemia

transsphenoidal resection

prolactin replacement

Pituitary Apoplexy

Pituitary Macroadenoma

Bitemporal Hemianopsia

Retinal Detachment

Optic Chiasm