Acute Serous Retinal Detachment in Idiopathic Pulmonary Arterial Hypertension

Martiano, David; Chevreaud, Olivier; Lam, Delphine; Cohen, Salomon Y.; Souied, Eric H.

doi:10.1097/icb.0000000000000336

Cited by 13 publications

(11 citation statements)

References 13 publications

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“…Uveal effusion, choroidal detachment, exudative retinal detachment and retinal vein occlusion has been described. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 Furthermore, hypoxia induces vascular endothelial growth factor in ischemic tissues including the retina. 4 A multi-disciplinary approach is necessary to achieve cardiopulmonary hemodynamic balance.…”

Section: Discussionmentioning

confidence: 99%

“…Ocular complications are uncommon but may include secondary glaucoma, retinal vascular occlusion, choroidal effusion, and serous retinal detachment. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 We describe herein a patient with severe pulmonary hypertension who developed secondary open-angle glaucoma and serous macular detachments resembling central serous retinopathy associated with choroidal engorgement documented with enhanced depth optical coherence topography (ED-OCT).…”

Section: Introductionmentioning

confidence: 99%

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Secondary open-angle glaucoma and serous macular detachment associated with pulmonary hypertension

Gupta

Haddock

Greenfield

2020

American Journal of Ophthalmology Case Reports

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Purpose We describe a patient with secondary open-angle glaucoma and serous macular detachment associated with pulmonary hypertension. Observations A 59 year-old male with pulmonary hypertension presented with vision loss and was noted to have bilateral engorged epibulbar vessels, blood in Schlemm's canal, elevated intraocular pressure, retinal venous tortuosity and serous retinal detachments. Enhanced depth optical coherence tomography (ED-OCT) showed bilateral serous macular detachments with marked choroidal thickening. Fluorescein angiography and indocyanine green angiography revealed choroidal vascular congestion and engorgement. Improvement of subretinal fluid was achieved with systemic control of his venous hypertension, and the intraocular pressure responded to medical anti-glaucoma therapy. Conclusions Pulmonary hypertension may be associated with secondary open-angle glaucoma, choroidal engorgement and serous macular detachment, and should be considered in the differential diagnosis of elevated episcleral venous pressure. Management of ocular complications is challenging and requires a multi-disciplinary approach.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Secondary open-angle glaucoma and serous macular detachment associated with pulmonary hypertension

Gupta

Haddock

Greenfield

2020

American Journal of Ophthalmology Case Reports

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“…7 Aside from CRVO, other associated ocular findings that have been hypothesized to be due to vascular congestion include uveal effusion syndrome, serous retinal and macular detachment, choroidopathy, retinal pigment epithelial tear, branch retinal vein occlusion, and angle-closure glaucoma. [8][9][10][11][12][13] It is essential to keep in mind that CRVO is a multifactorial disease. In addition to vascular congestion, the elevated IOP in both eyes may have predisposed our patient to the development of CRVO.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Central Retinal Vein Occlusion in Idiopathic Pulmonary Arterial Hypertension

Pham

Akduman

Kavali

2018

Journal of VitreoRetinal Diseases

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To report a case of bilateral central retinal vein occlusion in a young female patient with idiopathic pulmonary arterial hypertension. Methods: Case report and literature review. Patient: A 33-year-old female with a history of idiopathic pulmonary hypertension initially presented with progressive vision loss in the right eye and subsequently presented with vision loss in the left eye 2 weeks later. Results: Clinical examination revealed central retinal vein occlusion (CRVO) in the right eye followed by CRVO in the left eye within 2 weeks as confirmed by clinical examination, fundus photography, spectral domain optical coherence tomography, and fundus fluorescein angiography. Conclusion: Central retinal vein occlusion is an ocular finding associated with pulmonary arterial hypertension and can be bilateral.

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“…Based on available evidence, the ocular manifestations of PAH including, uveal effusion syndrome, exudative retinal detachment, venous stasis retinopathy, central retinal vein occlusion, choroidal detachment, delayed choroidal perfusion on ﬂuorescein angiography, are thought to be related to the venous hypertension, causing circulatory disorders and thrombotic events, primarily in choriocapillaries 6–14 . In a recent study, Nickel and colleagues reported that PAH may be associated with an increase in retinal microvascular tortuosity 15 .…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Based on available evidence, the ocular manifestations of PAH including, uveal effusion syndrome, exudative retinal detachment, venous stasis retinopathy, central retinal vein occlusion, choroidal detachment, delayed choroidal perfusion on fluorescein angiography, are thought to be related to the venous hypertension, causing circulatory disorders and thrombotic events, primarily in choriocapillaries. [6][7][8][9][10][11][12][13][14] In a recent study, Nickel and colleagues reported that PAH may be associated with an increase in retinal microvascular tortuosity. 15 Although this recent evidence has shown that the vasculature of the retina and pulmonary circulation share some common characteristics, to our knowledge, no study has investigated the possible relationship and interaction between retinal microcirculation and hemodynamic measurements of pulmonary circulation in patients with PAH.…”

mentioning

confidence: 99%

The relationship between retinal microcirculation and right heart catheterization and echocardiography findings in patients with idiopathic pulmonary arterial hypertension

Hekimsoy

Şekeroğlu

et al. 2021

Microcirculation

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Objective To determine the possible alterations of retinal microcirculation associated with right‐sided intracardiac pressures in patients with IPAH. Methods Twenty patients with IPAH and 20 age‐ and sex‐matched healthy controls were included in the study. Hemodynamic data were obtained from the most recent right heart catheterization. Echocardiographic examination was performed within 24 h of ophthalmological examination. For the right eyes of all participants, high‐resolution scans of chorioretinal microvascular networks at different depths of the retina were captured via OCT angiography. Results The perfusion of the superﬁcial and deep capillary plexus (SCP and DCP), and choriocapillaris (CCP) flow area were significantly lower than those in healthy control subjects (p < .05 for all). In IPAH group, PVR and mPAP were correlated significantly with the perfusion measurements at SCP and DCP (r = .461, r = .626 and r = .625, r =0.730, respectively, p < .05). sPAP and TRV were positively correlated with the perfusion measurements at SCP and DCP (r = .600, r = .662 and r = .670, r = .655 p < .05). Conclusions The positive correlation of retinal perfusion at SCP and DCP with right‐sided echocardiographic and hemodynamic measurements unveiled that retinal microcirculation is affected by the pressure alterations in the pulmonary circulation of IPAH patients.

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Acute Serous Retinal Detachment in Idiopathic Pulmonary Arterial Hypertension

Cited by 13 publications

References 13 publications

Secondary open-angle glaucoma and serous macular detachment associated with pulmonary hypertension

Secondary open-angle glaucoma and serous macular detachment associated with pulmonary hypertension

Bilateral Central Retinal Vein Occlusion in Idiopathic Pulmonary Arterial Hypertension

The relationship between retinal microcirculation and right heart catheterization and echocardiography findings in patients with idiopathic pulmonary arterial hypertension

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