Ocular manifestations of pulmonary hypertension

Lewczuk, Natalia; Zdebik, Alexander; Bogusławska, Joanna; Turno-Kręcicka, Anna; Misiuk-Hojło, Marta

doi:10.1016/j.survophthal.2019.02.009

Cited by 21 publications

(25 citation statements)

References 27 publications

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“…Mechanisms include secondary open-angle glaucoma associated with elevated EVP, neovascular glaucoma, or angle-closure glaucoma. 4 , 5 , 7 , 8 , 9 As demonstrated in our patient, glaucoma due to elevated EVP may present with asymmetric damage. Medical therapy consists of topical and oral IOP-lowering therapy and simultaneous treatment of any associated underlying systemic condition.…”

Section: Discussionsupporting

confidence: 69%

“…PAH is defined as a mean pulmonary arterial pressure of 25 mm Hg or greater at rest. 4 , 10 Chronically elevated right ventricular systolic pressure leads to right sided ventricular hypertrophy (RVH) in order to maintain cardiac output. Sequela of maladaptive RVH include distension of the internal jugular vein, cavernous sinus and superior and inferior ophthalmic veins.…”

Section: Discussionmentioning

confidence: 99%

“… 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. Our patient achieved improvement in subretinal fluid exudation and choroidal congestion with enhanced systemic vasodilatory therapy.…”

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: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…Der Patient wurde bei Arterienastverschluss zwar stationär aufgenommen, anschließend abernichts zurAbklärung (arteriitisch/nichtarteriitisch, Nachweis einer Emboliequelle) oder weiteren Therapie dieses Verschlusses (Fibrinolyse, isovolämische Hämodilution, Antikoagulation, Bulbusmassage) berichtet [5]. Dies ist umso bedenklicher, da jede getroffene Maßnahme gewürdigt werden sollte, bevor Rückschlüsse auf mögliche Arzneimittelinteraktionen von Leuprorelin gezogen werden.…”

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Leuprorelin ist unschuldig

Häger¹

2020

Ophthalmologe

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Retinal vessel changes in pulmonary arterial hypertension

et al. 2022

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Pulmonary arterial hypertension (PAH) is classically considered an isolated small vessel vasculopathy of the lungs with peripheral pulmonary vascular obliteration. Systemic manifestations of PAH are increasingly acknowledged, but data remain limited. We hypothesized that retinal vascular changes occur in PAH. PAH subjects underwent retinal fluorescein angiography (FA) and routine disease severity measures were collected from the medical record. FA studies were analyzed using VESsel GENerational Analysis (VESGEN), a noninvasive, user‐interactive computer software that assigns branching generation to large and small vessels. FAs from controls (n = 8) and PAH subjects (n = 9) were compared. The tortuosity of retinal arteries was higher in PAH subjects compared to unmatched controls (1.17, 95% confidence interval: [1.14, 1.20] in PAH vs. 1.13, 95% CI: [1.12, 1.14] in controls, p = 0.01). Venous tortuosity was higher and more variable in PAH (1.17, 95% CI: [1.14, 1.20]) compared to controls (1.13, 95% CI: [1.12, 1.15]), p = 0.02. PAH subjects without connective tissue disease had the highest degree of retinal tortuosity relative to controls (arterial, p = 0.01; venous, p = 0.03). Younger PAH subjects had greater retinal arterial tortuosity, which attenuated with age and was not observed in controls. Retinal vascular parameters correlated with some clinical measures of disease in PAH subjects. In conclusion, PAH subjects exhibit higher retinal vascular tortuosity. Retinal vascular changes may track with pulmonary vascular disease progression. Use of FA and VESGEN may facilitate early, noninvasive detection of PAH.

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Ocular manifestations of pulmonary hypertension

Cited by 21 publications

References 27 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

Leuprorelin ist unschuldig

Retinal vessel changes in pulmonary arterial hypertension

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