Unbound MEDLINE

High incidence of optic disc swelling at very high altitudes. Archives of ophthalmology [Arch Ophthalmol] Journal article

 
TitleHigh incidence of optic disc swelling at very high altitudes.
Author(s)Bosch MM, Barthelmes D, Merz TM, Bloch KE, Turk AJ, Hefti U, Sutter FK, Maggiorini M, Wirth MG, Schoch OD, Landau K 
InstitutionDepartment of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland. martina.boesch@bluewin.ch
SourceArch Ophthalmol 2008 May; 126(5):644-50.
MeSHAdult
Altitude Sickness
Brain Edema
Female
Humans
Incidence
Male
Middle Aged
Mountaineering
Optic Disk
Oxygen Consumption
Papilledema
Prospective Studies
AbstractOBJECTIVES: To determine the incidence of optic disc swelling as a possible indicator of cerebral edema in a large group of healthy mountaineers exposed to very high altitudes and to correlate these findings with various clinical and environmental factors and occurrence of acute mountain sickness and high-altitude cerebral edema.
METHODS: This multidisciplinary, prospective, observational cohort study was performed in 2005 within the scope of a medical research expedition to Muztagh Ata (7546 m [24,751 ft]) in Western Xinjiang Province, China. Twenty-seven healthy mountaineers aged 26 to 62 years participated. Medical examinations were performed in Switzerland 1 month before and 4 1/2 months after the expedition. Ophthalmologic examinations were performed at 4 high camps (maximum elevation, 6865 m [22,517 ft]). Optic disc status was documented using digital photography. Further assessments included arterial oxygen saturation and cerebral acute mountain sickness scores.
RESULTS: Sixteen of 27 study subjects (59%) exhibited optic disc swelling during their stay at high altitudes, with complete regression on return to lowlands. Significant correlation was noted between optic disc swelling and lower arterial oxygen saturation (odds ratio, 0.86 per percentage of arterial oxygen saturation; 95% confidence interval, 0.81-0.92; P < .001), younger age (odds ratio, 0.95 per year; 95% confidence interval, 0.90-0.99; P = .03), and higher cerebral acute mountain sickness scores (odds ratio, 2.32 per 0.1 point; 95% confidence interval, 1.48-3.63; P < .001).
CONCLUSION: Optic disc swelling occurs frequently in high-altitude climbers and is correlated with peripheral oxygen saturation and symptoms of acute mountain sickness. It is most likely the result of hypoxia-induced brain volume increase.
Languageeng
Pub Type(s)Journal Article
Research Support, Non-U.S. Gov't
PubMed ID18474774
  
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