May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Optic Disc Swelling at High Altitudes Varies With Age
Author Affiliations & Notes
  • M. M. Bosch
    University Hospital Zurich, Zurich, Switzerland
    Ophthalmology,
  • D. Barthelmes
    Ophthalmology,
    University Hospital Bern, Bern, Switzerland
  • T. M. Merz
    Intensive Care Unit,
    University Hospital Bern, Bern, Switzerland
  • F. K. P. Sutter
    University Hospital Zurich, Zurich, Switzerland
    Ophthalmology,
  • K. E. Bloch
    University Hospital Zurich, Zurich, Switzerland
    Pneumology,
  • A. J. Turk
    University Hospital Zurich, Zurich, Switzerland
    Pneumology,
  • U. Hefti
    Surgery, Cantonal Hospital Aarau, Aarau, Switzerland
  • M. G. Wirth
    University Hospital Zurich, Zurich, Switzerland
    Ophthalmology,
  • M. Maggiorini
    University Hospital Zurich, Zurich, Switzerland
    Intensive Care Unit,
  • K. Landau
    University Hospital Zurich, Zurich, Switzerland
    Ophthalmology,
  • Footnotes
    Commercial Relationships M.M. Bosch, None; D. Barthelmes, None; T.M. Merz, None; F.K.P. Sutter, None; K.E. Bloch, None; A.J. Turk, None; U. Hefti, None; M.G. Wirth, None; M. Maggiorini, None; K. Landau, None.
  • Footnotes
    Support Swiss National Science Foundation
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 2473. doi:
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    • Get Citation

      M. M. Bosch, D. Barthelmes, T. M. Merz, F. K. P. Sutter, K. E. Bloch, A. J. Turk, U. Hefti, M. G. Wirth, M. Maggiorini, K. Landau; Optic Disc Swelling at High Altitudes Varies With Age. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2473.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To determine and analyze the incidence of optic disc swelling in healthy mountaineers of various ages at different altitudes during an expedition to very high altitudes.

Methods:: Thirty-two mountaineers took part in a medical research expedition to Muztagh Ata (7546m/24,757ft), Western China. Fundus photographs were taken one month prior to the expedition at 400m (1,300ft), 4497m (14,754ft), 5533m (18,153ft), 6265m (20,554ft), 6865m (22,523ft) and 4 months thereafter at 400m. The optic discs were graded by three masked ophthalmologists in three groups (0= no swelling, 1= possible swelling, 2= swollen disc). Acute mountain sickness-cerebral (AMS-c) scores of the environmental symptoms questionnaire and oxygen saturation were assessed on every expedition day. Statistical significance was defined as p < 0.05.

Results:: Complete data records of 27 participants (54 eyes) were analyzed. 16 of 27 mountaineers (60%) were observed to have bilateral swollen discs (8 climbers) or a unilateral swollen disc and possible swelling of the contralateral disc (n=8). Logistic regression revealed significant positive correlation of optic disc swelling with AMS-c score (r=0.229, p=0.033) and negative correlation with age (r=-0.232, p=0.003) and oxygen saturation (r=-0.27, p=0.012).

Conclusions:: Optic disc swelling has a high incidence in mountaineers climbing to high altitudes. Positive correlations with AMS score and low oxygen saturation suggest optic nerve swelling as a marker of subclinical high altitude cerebral edema.The observed protective effect of age on optic disc swelling may be explained by the increasing ratio of cranial cerebrospinal fluid to brain volume.

Keywords: optic disc • hypoxia • aging 
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