High‐altitude retinopathy

Abstract

Purpose To report the clinical characteristics of 3 cases of high altitude retinopathy (HAR) and a review of the literature. Methods We report 3 cases of patients consulting for HAR after high trekking above 7000m. Results Patient 1 was a 27 years‐old man, high level sportsman, coming back from a GASNERBRUM expedition (7600m) and complaining of right eye central scotoma. Fundus examination revealed 2 haemorrhages : one next the fovea and one on the temporal arcade vessel. Patient 2 was a 52 years‐old man, high mountain guide, coming back from EVERSEST ascent (8000m) and complaining of left eye central scotoma and visual acuity deficit. Fundus examination found one parafoveal haemorrhage in the left eye and paramacular haemorrhages in the right eye. Patient 3 was a young 25 years‐old military doctor coming back from a high altitude expedition (7000m), he was complaining of right eye central scotoma during the descent and headache. Fundus examination found three macular haemorrhages and one on the inferior temporal arcade vessel. Only one of the three patients presented other symptomes of high altitude illness. All of us presented a positive outcome with complete functional and anatomical resolution of HAR, less than 2 month, without sequela. Conclusion The real incidence and physiopathology of HAR are not very well known. Retinal haemorrhages after a high trekking are an early manifestation of HAR and more generally high altitude illness. It usually occurs at altitudes above 4000m. While macular involvement or retinal vein occlusion may result in permanent visual acuity deficit, these haemorrhages are generally asymptomatic and spontaneous regressive.