|Year : 2018 | Volume
| Issue : 2 | Page : 136-137
Macular hemorrhage in high altitudes traveler
Amit Mohan1, Navjot Kaur2
1 Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh; Department of Community Ophthalmology, Global Hospital Institute of Ophthalmology, Talehati, Rajasthan, India
2 Department of Community Ophthalmology, Global Hospital Institute of Ophthalmology, Talehati, Rajasthan, India
|Date of Web Publication||28-Aug-2018|
Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mohan A, Kaur N. Macular hemorrhage in high altitudes traveler. Kerala J Ophthalmol 2018;30:136-7
A 29-year-old male presented with sudden painless diminution of vision for 4 days in the left eye. Vision was 6/6 in the right eye and 6/36 in the left eye. The anterior segment was within normal limits. Posterior segment biomicroscopy with 90D revealed premacular hemorrhage in the left eye confirmed on fundus photography [Figure 1]. Optical coherence tomography showed a highly reflective, sharply demarcated, and dome-shaped hemorrhage in the superficial retinal layer [Figure 2]. There was no history of trauma, heavy exertion, and valsalva maneuvering. Complete hemogram, coagulation profile, and peripheral blood smear are within normal limits. On inquiring about any visit to hill station, the patient gave the positive history of travel to Leh 10 days back by air leading to rapid ascent. At 6-week follow-up, there was complete resolution of premacular hemorrhage with the attainment of 6/6 vision.
|Figure 2: Optical coherence tomography showing a highly reflective, sharply demarcated, and dome-shaped hemorrhage in the superficial retinal layer at the macula|
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High-altitude illness is a rare cause of premacular hemorrhage. It occurs due to rapid ascent to high altitude >2500 m. Leh is at an altitude of 3524 m. It may be associated with retinal vascular dilatation, superficial hemorrhages, papilledema, vitreous hemorrhage, exudates, neovascularization, glial bands, and retinal detachment. High-altitude retinopathy was graded by Weidman according to number and area of distribution of retinal hemorrhage. He has only premacular hemorrhage with no other findings. There are several other causes of premacular hemorrhages which include proliferative diabetic retinopathy, anemic retinopathy, blunt trauma, retinal vein occlusion, Valsalva retinopathy, retinal macroaneurysm rupture, Terson syndrome, Shaken baby syndrome, and age-related macular degeneration.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]