Bilateral Ischemic Retinopathy and Optic Neuropathy as an Isolated Ophthalmic Clinical Entity in Altitude Sickness – a Case Report

Česká verzia

Authors: N. Jirásková ¹; E. Rencová ¹; O. Renc ²; P. Rozsíval ¹
Authors place of work: LF UK a FN Hradec Králové Oční klinika ¹; LF UK a FN Hradec Králové Radiologická klinika ²
Published in the journal: Cesk Slov Neurol N 2011; 74/107(5): 575-578
Category: Case Report

Summary

The authors relate a case of bilateral ischemic damage to the choroid, retina and optic nerve in a patient with sudden painless damage to vision that she suffered at the end of a month in Nepal which involved short trips to altitudes of around 5000 m. At initial ophthalmic examination she presented with asymmetrical oedema of the optic nerve discs, more pronounced in the left eye, with reduced visual acuity and lower altitudinal visual field defect. The results of tests and examinations were negative for infectious, auto-immune and demyelinating aetiology of the fundus. Treatment with corticosteroids and aceazolamid produced good results – resolution of ischemic and inflammatory changes in the fundus. In this case, a permanent deterioration of visual function in the left eye corresponding to subatrophy of the optic nerve head was observed, according to the literature a rare condition.

Key words:
altitude sickness – ischemic optic neuropathy – high-altitude retinopathy

Zdroje

1. Wiedman M, Tabin GC; High-altitude retinopathy and altitude illness. Ophthalmology 1999; 106(10): 1924–1927.

2. Morris DS, Sommer J, Donald MJ, Mc Cormick IJ, Bourne RR, Huang SS et al. The eye altitude. Adv Exp Med Biol 2006; 588: 249–270.

3. Clarke C. Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia. Postgrad Med J 2006; 82(973): 748–752.

4. Bosch MM, Merz TM, Barthelmes D, Petrig BL, Truffer F, Bloch KE et al. New insights into ocular blood flow at very high altitudes. J Appl Physiol 2009; 106(2): 454–460.

5. Müllner-Eidenböck A, Rainer G, Strenn K, Zidek T. Hihg-altitude retinopathy and retinal vascular dysregulation. Eye 2000; 14(5): 724–729.

6. Rennie D, Morrisey J. Retinal changes in Himalayan climbers. Arch Ophthalmol 1975; 93(6): 395–400.

7. Bosch MM, Barthelmes D, Merz TM, Bloch KE, Turk AJ, Hefti U et al. High incidence of optic disc swelling at very high altitudes. Arch Ophthalmol 2008; 126(5): 644–650.