High Altitude as a Risk Factor for the Development of Nonarteritic Anterior Ischemic Optic Neuropathy

Liu, Yin A.; Mesentier-Louro, Louise A.; Shariati, Mohammad Ali; Moss, Heather E.; Beres, Shannon; Liao, Yaping Joyce

doi:10.1097/wno.0000000000001629

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…The emergence of NAION in response to hypobaric hypoxia can be attributed to failure of retinal circulatory autoregulation in the face of decreased SaO 2 and perfusion pressure, with the concomitant increase in venous pressure. Hypoxia-induced oxidative stress, glial cell dysfunction, and up-regulation of inflammatory pathways [ 148 , 149 ] have also been suggested to play a role.…”

Section: Discussionmentioning

confidence: 99%

Impact of flight and equivalent short-term high-altitude exposure on ocular structures and function

Totou,

Karmiris,

Kanakis

et al. 2023

Med Hypothesis Discov Innov Ophthalmol

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Background: Exposure to high-altitude conditions during flight or similar activities affects many aspects of visual function, which is critical not only for flight safety but for any altitude-related activity. We aimed to summarize the available literature pertaining to ocular changes during flight or equivalent short-term high-altitude exposure (e.g., hypobaric chamber, effortless ascent lasting less than or equal to 24 h) and to highlight future research priorities. Methods: Using the PubMed/MEDLINE and Web of Science/ISI Web of Knowledge databases with structured search syntax, we conducted a systematic review of the literature spanning a 40-year period (January 1, 1983, to October 10, 2023). Articles pertaining to ocular changes during flight or flight-equivalent exposure to altitude were retrieved. The reference lists of retrieved studies were also searched, and citations of these references were included in the results. Results: Of 875 relevant PubMed and ISI publications, 122 qualified for inclusion and 20 more were retrieved from the reference lists of initially selected records, for a total of 142 articles. Reported anterior segment changes included deterioration in tear film stability and increased dry eye incidence, increased corneal thickness, discomfort and bubble formation in contact lens users, refraction changes in individuals with prior refractive surgery, decreased intraocular pressure, and alterations in pupillary reaction, contrast sensitivity, and visual fields. Photoreceptor–visual pathway changes included alterations in both photoreceptors and neuro-transduction, as evidenced in dark adaptation, macular recovery time, reduction in visual field sensitivity, and optic neuritis (likely an element of decompression sickness). Retinochoroidal changes included increases in retinal vessel caliber, retinal blood flow, and choroidal thickness; central serous chorioretinopathy; and retinal vascular events (non-arteritic ischemic optic neuropathy, high-altitude retinopathy, and retinal vein occlusion). Conclusions: The effect of short-term high-altitude exposure on the eye is, in itself, a difficult area to study. Although serious impairment of visual acuity appears to be rare, ocular changes, including tear film stability, contact lens wear, central corneal thickness, intraocular pressure, contrast sensitivity, stability of refractive surgeries, retinal vessels, visual fields, and macula recovery time, should be considered in civilian aviators. Our report provides guidance to climbers and lowlanders traveling to altitude if they have pre-existing ocular conditions or if they experience visual symptoms while at altitude. However, key outcomes have been contradictory and comprehensive studies are scarce, especially those pertaining to the choroid and retina. Such studies could not only deepen our understanding of high-altitude ocular pathophysiology, but could also offer valuable information and treatment possibilities for a constellation of other vision-threatening diseases.

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Section: Discussionmentioning

confidence: 99%

Impact of flight and equivalent short-term high-altitude exposure on ocular structures and function

Totou,

Karmiris,

Kanakis

et al. 2023

Med Hypothesis Discov Innov Ophthalmol

View full text Add to dashboard Cite

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Eye disease and international travel: a critical literature review and practical recommendations

Lee

Forristal

Harney

et al. 2023

Journal of Travel Medicine

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Rationale for review: Eye diseases pose a significant public health and economic burden, particularly for travellers exposed to ocular hazards who may lack access to specialist eye care. This article offers an evidence-based review for travel-health practitioners, with a particular emphasis on ocular infections and trauma that are more prevalent among travellers. Providing an overview of these issues will allow travel health practitioners to comprehensively address ophthalmic considerations of travel. Methods: A systematic literature search was conducted on PubMed and Embase electronic databases, using keywords related to travel medicine and ophthalmology. Inclusion was based on the relevant contribution to epidemiology, aetiology, diagnostics, management, and long-term consequences of travel-related eye conditions. The data were analysed using narrative synthesis. Key findings: This literature review highlighted that various travel-related eye conditions may occur. Travellers should be aware of the risk of travel-related ocular complications, which can arise from ocular infections, high-risk activities, high altitude and space travel. The economic and logistical challenges associated with medical tourism for ophthalmic procedures are discussed. For travellers with pre-existing eye conditions or visual impairment, careful planning may be needed to promote eye health and ensure safety of travel. Conclusions: Travel medicine practitioners should have a comprehensive understanding of the major ocular risks associated with overseas travel, including eye infections, eye injuries and solar eye damage. Further research in this area can enhance overall wellness and alleviate the burden of ocular diseases on travellers. Evidence-based guidelines based on research can also improve the quality of care and prevent long-term vision problems.

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Bilateral anterior ischemic optic neuropathy after acute high-altitude exposure

Yao,

Xue,

Yang

2024

QJM: An International Journal of Medicine

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High Altitude as a Risk Factor for the Development of Nonarteritic Anterior Ischemic Optic Neuropathy

Cited by 4 publications

References 18 publications

Impact of flight and equivalent short-term high-altitude exposure on ocular structures and function

Impact of flight and equivalent short-term high-altitude exposure on ocular structures and function

Eye disease and international travel: a critical literature review and practical recommendations

Bilateral anterior ischemic optic neuropathy after acute high-altitude exposure

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