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February 13, 1981

High-Altitude Retinopathy

Author Affiliations

From the Arctic Institute of North America, Calgary; the Department of Ophthalmology, the University of British Columbia, Vancouver (Dr McFadden); Department of Medicine, the University of Vermont, Burlington (Dr Houston); McMaster University, Hamilton, Ontario (Drs Sutton and Powles and Mr Roberts); Defense and Civil Institute of Environmental Medicine, Toronto (Dr Gray).

JAMA. 1981;245(6):581-586. doi:10.1001/jama.1981.03310310023016

Thirty-nine healthy subjects were examined before and after a stay at 5,360 m by ophthalmoscopy and by retinal photography. Twenty of them were also tested for visual acuity, scotomata, and capillary leakage. Vascular engorgement and tortuosity and disc hyperemia were seen in all subjects at altitude and are a "normal" response to hypoxia. Twenty-two (56%) of the subjects had retinal hemorrhages and one showed "cotton-wool spots." These changes are abnormal reactions and are considered high-altitude retinopathy. After maximal exertion on a cycle ergometer, fresh hemorrhages were observed in seven of 34 subjects. The incidence of hemorrhage associated with exercise was significantly greater than predicted. Fluorescein leakage was noted after exercise in eight of 20 persons tested and was associated with exercise-induced hemorrhages. Two persons developed premacular hemorrhages.

(JAMA 1981;245:581-586)