High-altitude retinopathy

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Abstract
Thirty-nine healthy subjects were examined before and after a stay at 5360 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 7 of 34 subjects. The incidence of hemorrhage associated with exercise was significantly greater than predicted. Fluorescein leakage was noted after exercise in 8 of 20 persons tested and was associated with exercise-induced hemorrhages. Two persons developed premacular hemorrhages.