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Acute mountain sickness and retinal evaluation by optical coherence tomography.
Francisco J Ascaso1, María A Nerín, Laura Villén
1Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain. jascaso@gmail.com
European Journal of Ophthalmology
|December 6, 2011
Summary
Acute mountain sickness (AMS) can cause subtle changes in the optic nerve head, detectable by optical coherence tomography (OCT). These OCT findings may indicate physiological acclimatization to high altitude.
Area of Science:
- Ophthalmology
- Altitude Medicine
- Physiology
Background:
- Acute mountain sickness (AMS) is a common altitude illness, potentially an early sign of high altitude cerebral edema (HACE).
- Assessing optic nerve head (ONH) changes is crucial for understanding altitude-related physiological responses.
Purpose of the Study:
- To investigate optic nerve head (ONH) and retinal nerve fiber layer (RNFL) changes in climbers experiencing AMS using optical coherence tomography (OCT).
- To evaluate if OCT can detect subclinical ONH alterations associated with acute mountain sickness.
Main Methods:
- Prospective study involving 12 healthy male climbers on 4 Himalayan expeditions.
- Ophthalmic evaluations including OCT were performed pre- and post-expedition to measure RNFL thickness and ONH parameters.
- Acute mountain sickness (AMS) severity was assessed using the Lake Louise Scoring (LLS) questionnaire.
Main Results:
- All climbers reported AMS symptoms (LLS: 5.1±1.1).
- A significant increase in average peripapillary RNFL thickness (p=0.034) and specific ONH parameters (VIRA: p=0.002, Horizontal integrated rim width: p=0.004) was observed post-expedition.
- No correlation was found between AMS severity (LLS) and OCT measurements.
Conclusions:
- Optical coherence tomography (OCT) detected subtle increases in peripapillary RNFL thickness and ONH measurements in climbers with AMS.
- These OCT findings may serve as sensitive indicators of physiological acclimatization and the pathogenesis of AMS, even without overt HACE or papilledema.
