Branch retinal artery occlusion secondary to high-altitude exposure and diabetic retinopathy: a case report

Xue, Feng; Wang, Luping; Wang, Haiwei; Qi, Hong; Zhang, Jianqiang; Wang, Yanling

doi:10.1186/s12886-020-01563-1

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Current reports showed that an extremely high Hct level may be associated with RAO [ 12 , 13 , 30 , 31 , 32 , 33 , 34 ]. Feng et al, has reported a case of BRAO in a high-altitude male climber with a Hct level of 52.4%; in addition, the man also had DM, which might be a predisposing factor for RAO [ 30 ]. Polycythemia vera, a hyperviscosity disease reflected in increased Hct, have been reported to cause RAO [ 12 , 13 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

The Association between Elevated Hematocrit and Retinal Artery Occlusion in Adult Patients

Lai

Lin

Yin

et al. 2022

JCM

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Retinal artery occlusion (RAO) is most commonly caused by embolism. Evidence showed that hematocrit (Hct) levels are often associated with embolic events. In this study, we aim to investigate the relationship between Hct levels and RAO. This retrospective study enrolled RAO patients between January 2011 and March 2020, who were 1:4 matched by age, gender, index date, and relevant comorbidities with the non-RAO group. Patient characteristics and laboratory data were collected. Univariate conditional logistic regression was applied by estimating crude matched odds ratios to determine the relevant factors for the occurrence of RAO. Furthermore, a narrative review of the relevant study was conducted to explore the association between Hct levels and embolism. Between January 2011 to March 2020, 82 RAO patients and 328 non-RAO patients matched with age, gender, index date, comorbidities of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, stroke, and atrial fibrillation were enrolled after excluding ineligible individuals. Conditional logistic regression analysis showed that Hct level ≥40% was associated with developing RAO. A forest plot showed a trend of a non-linear dose-response association between Hct levels and ischemic vascular events in male patients. Hct levels ≥40% in patients older than 65 years with at least six comorbidities could be associated with RAO. We suggest that older patients who have multiple comorbidities, combined with elevated Hct levels, should be informed of the possible occurrence of RAO.

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Section: Discussionmentioning

confidence: 99%

The Association between Elevated Hematocrit and Retinal Artery Occlusion in Adult Patients

Lai

Lin

Yin

et al. 2022

JCM

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“…Although some studies have suggested the beneficial effects of living at HA on glucose homeostasis, the relationship between HA and DR remains unclear owing to multiple factors and potential confounders, such as varying altitudes of the investigated population, duration of exposure to HA, genetic backgrounds, living conditions, dietary habits, and physiological adaptation. Table 1 summarizes the main findings of previous studies [9][10][11][12][13][14][15] that explored the impact of HA on DR. This review aimed to comprehensively explore the impact of HA exposure on DR, encompassing genetic adaptations, changes in glucose homeostasis, and related factors.…”

Section: Introductionmentioning

confidence: 99%

High-Altitude Exposure and Diabetic Retinopathy: Unveiling the Impact and Mechanisms of Alleviation

Gong,

Zhou,

Gama

et al. 2023

Ophthalmic Res

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High altitude (HA) is an extremely challenging environment for millions of people who either travel to HA regions or inhabit there permanently. Significant progress has been made over the past decades in the understanding of physiological adaptations in HA conditions, and recently, more studies regarding its influence on metabolic disease have been published. However, the effect of HA on diabetic retinopathy (DR), the leading cause of blindness, remains unclear. The present article provides an overview of the changes in the principal physiology and clinical characteristics related to DR after HA exposure. Despite conflicting evidence, this review synthesizes the available studies and explores the potential mechanisms, such as genetic adaptations, glucose homeostasis, and related physiological changes, by which long-term exposure to HA may alleviate the progression of DR. By shedding light on this complex relationship, it also provides insights into the interplay between HA and DR, offering valuable implications for clinical practice and further research.

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Branch and Central Retina Artery Occlusion and its treatment according to OCT-A Findings

Parfitt,

Quiroz-Reyes

2023

Optical Coherence Tomography Angiography for Choroidal and Vitreoretinal Disorders – Part 2

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The retina requires a large blood supply to cope with the metabolic demands of the tissue, so it is vulnerable to hypoxia when the arterial blood flow is obstructed. Retinal artery occlusions are not common, but they can cause severe vision loss and may be indicative of cardiovascular disorders, such as cerebral stroke and ischemic heart disease. The central retinal artery arises from the ophthalmic artery and its branches supply blood to the inner retina via the superficial capillary plexus. Central retinal artery occlusion (CRAO) is characterized by an obstruction to the central retinal artery that often presents with severe vision loss and a poor prognosis. Branch retinal artery occlusion (BRAO) is defined by a blockage of a branch of the central retinal artery, which typically has a good prognosis if visual acuity is 20/40 or better on presentation. Optical coherence tomography-angiography (OCT-A) is a rapid, highresolution imaging technique that can visualize the microvasculature of the retinal layers, including the superficial and deep capillary plexuses. Therefore, it is possible to determine the microvascular changes that occur following retinal artery occlusions, and before and after potential therapies that are being actively researched. Therapies under investigation for the treatment of CRAO and BRAO include hyperbaric oxygen, fibrinolysis, and embolysis with laser therapy. In this chapter, the capabilities of OCT-A imaging to visualize and quantify retinal microvascular changes following CRAO and BRAO are assessed. Moreover, the use of OCT-A to understand the benefit of potential therapies is reviewed.

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Branch retinal artery occlusion secondary to high-altitude exposure and diabetic retinopathy: a case report

Cited by 3 publications

References 20 publications

The Association between Elevated Hematocrit and Retinal Artery Occlusion in Adult Patients

The Association between Elevated Hematocrit and Retinal Artery Occlusion in Adult Patients

High-Altitude Exposure and Diabetic Retinopathy: Unveiling the Impact and Mechanisms of Alleviation

Branch and Central Retina Artery Occlusion and its treatment according to OCT-A Findings

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