High altitude retinopathy: Difference between revisions
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==Background== | ==Background== | ||
*[[Retinal hemorrhage]]s are common at sleeping altitudes >16,000ft | *[[Retinal hemorrhage]]s are common at sleeping altitudes > 5000m (16,000ft) | ||
*Incidence increases with higher altitude<ref>Wiedman M, Tabin GC. High-altitude retinopathy and altitude illness. Ophthalmology. 1999;106(10):1924-1926; discussion 1927.</ref> | |||
==Clinical Features== | ==Clinical Features== | ||
[[File:Roth spots.png|thumb|Roth spots due to retinal vein occlusion]] | [[File:Roth spots.png|thumb|Roth spots due to retinal vein occlusion]] | ||
*'''Roth Spots''': retinal hemorrhages with white center, seen on [[fundoscopy]] | *'''Roth Spots''': retinal hemorrhages with white center, seen on [[fundoscopy]] | ||
*Cotton wool spots on [[fundoscopy]] | |||
*May be asymptomatic, or cause [[vision loss|visual loss]] | *May be asymptomatic, or cause [[vision loss|visual loss]] | ||
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==Disposition== | ==Disposition== | ||
*Generally improves with descent. If persistent visual loss, referral to ophthalmology | |||
==See Also== | ==See Also== | ||
Latest revision as of 00:39, 23 May 2021
Background
- Retinal hemorrhages are common at sleeping altitudes > 5000m (16,000ft)
- Incidence increases with higher altitude[1]
Clinical Features
- Roth Spots: retinal hemorrhages with white center, seen on fundoscopy
- Cotton wool spots on fundoscopy
- May be asymptomatic, or cause visual loss
Differential Diagnosis
Acute Vision Loss (Noninflamed)
- Painful
- Arteritic anterior ischemic optic neuropathy
- Optic neuritis
- Temporal arteritis†
- Painless
- Amaurosis fugax
- Central retinal artery occlusion (CRAO)†
- Central retinal vein occlusion (CRVO)†
- High altitude retinopathy
- Open-angle glaucoma
- Posterior reversible encephalopathy syndrome (PRES)
- Retinal detachment†
- Stroke†
- Vitreous hemorrhage
- Traumatic optic neuropathy (although may have pain from the trauma)
†Emergent Diagnosis
High Altitude Illnesses
- Acute mountain sickness
- Chronic mountain sickness
- High altitude cerebral edema
- High altitude pulmonary edema
- High altitude peripheral edema
- High altitude retinopathy
- High altitude pharyngitis and bronchitis
- Ultraviolet keratitis
Evaluation
- Clinical diagnosis
Management
- Not considered an indication for descent unless vision changes are present
Disposition
- Generally improves with descent. If persistent visual loss, referral to ophthalmology
See Also
References
- ↑ Wiedman M, Tabin GC. High-altitude retinopathy and altitude illness. Ophthalmology. 1999;106(10):1924-1926; discussion 1927.