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The eye in CHD
Subha Nasir-Ahmad1, Rachael Cordina2, Gerald Liew3
11Heart Research Institute,Newtown,NSW,Australia.
Insights
Adults with congenital heart disease (CHD) often experience ocular abnormalities due to their condition or medications. Regular eye screenings are crucial for early detection and management of these vision risks.
Area of Science:
- Cardiology
- Ophthalmology
- Pharmacology
Background:
- Increasing survival rates for congenital heart disease (CHD) lead to a growing adult population with complex medical needs.
- Adults with CHD face various non-cardiac complications, including significant ocular abnormalities, stemming from their underlying condition or treatments.
Purpose of the Study:
- To review and highlight the spectrum of ocular abnormalities in adults with CHD.
- To examine the relationship between specific CHD conditions (cyanosis, coarctation of the aorta, endocarditis) and visual impairment.
- To discuss the ocular side effects of commonly prescribed medications like Sildenafil and Amiodarone in this patient group.
Main Methods:
- Systematic review of literature focusing on ocular manifestations in adult CHD.
- Analysis of reported ocular changes associated with cyanosis, coarctation of the aorta, and endocarditis.
- Evaluation of documented ocular side effects of Sildenafil and Amiodarone in the context of CHD management.
Main Results:
- Changes in retinal vasculature are common in cyanotic patients and those with coarctation of the aorta.
- Retinal vessel occlusion can occur in cyanotic CHD and infectious endocarditis.
- Established ocular risks of Sildenafil (for pulmonary hypertension) and Amiodarone are summarized.
Conclusions:
- Adults with CHD exhibit a high prevalence of ocular complications.
- Awareness of these risks and appropriate, frequent ophthalmological screening are essential for managing visual health in adult CHD patients.
Abstract:
In recent years, there has been a rise in the number patients with CHD surviving into adulthood. Many have complications related to their CHD or its treatments, outside the heart, including ocular abnormalities. The objective of this review is to highlight the ocular abnormalities that occur in adults with CHD, either from their condition or related to the common drugs prescribed to manage it. In particular, we reviewed the effects of cyanosis, coarctation of the aorta, endocarditis, and the side effects of Sildenafil and Amiodarone. A change in the retinal vasculature is a common observation with cyanosis or coarctation of the aorta. Occlusion of the retinal vessels may also be observed in cyanotic patients, as well as those with infectious endocarditis. Sildenafil has established ocular side effects; here they are explored in the context of therapy for pulmonary hypertension. Similarly, Amiodarone has established ocular risks, which are summarised. The high prevalence of ocular consequences in adult CHD patients reinforces the need for knowledge of the risks involved and for frequent ophthalmological screening where appropriate.
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