Fundus Changes at High Altitude Pulmonary Oedema

Shrivavstava S. K.; Gokhale S. K.; Karpe R. R.

Volume : VI, Issue : III, March - 2016

Fundus Changes at High Altitude Pulmonary Oedema

Shrivavstava S. K. , Gokhale S. K. , Karpe R. R.

Abstract :

Background: The prospective study was done to study the fundus changes in 253 consecutive admissions of high altitude pulmonary oedema (HAPE), at a tertiary care service hospital located at 11,000 ft. Methods: All were males and majority were serving soldiers with age group ranging from 12 to 45 yrs. All were acclimatised before being inducted to various HA posts. The soldiers were diagnosed with HAPE and were evacuated from various posts to this service hospital. Their complete ocular examination was done and fundus was examined with direct ophthalmoscope. The fundus photographs were taken with a Nikon NFC 50 camera. None of these cases had an history of Diabetes Mellitus or Hypertension. Results: Incidence of abnormal fundi in HAPE cases were found to be 67% and these changes included venous engorgement with tortuocity, disc hyperaemia, papilloedema, retinal haemorrhages and neovascularisation. The incidence of retinal haemorrhages in HAPE was found to be 10.3%. Conclusion: Apart from incidence of fundus changes in HAPE, an attempt was made to correlate the findings with various factors. It was found that fundus changes as a whole and Retinal haemorrhage (RH) in particular showed a direct correlation with altitude and with clinical severity of the illness. Fresh inductees to HA were as prone to develop these changes as the reinductees. The fundus changes were usually transient and reverted back to normal prior to discharge from hospital.