title: High altitude and retinal detachment.
abstract: We describe the case of a 38-year-old man who presented with bilateral retinal detachments following a trek in Tibet during which time he took acetazolamide for prophylaxis of acute mountain sickness (AMS). This is the first time that retinal detachment has been described following a sojourn to high altitude. Acetazolamide has not been previously associated with retinal detachment when used for prophylaxis of AMS or indeed during its many ophthalmic applications. The patient made a good recovery following surgery, and we speculate that, although this could be coincidental and the patient did have risk factors for retinal detachment, the possibility of a causal link to high altitude should at least be entertained. We hypothesize that vitreous dehydration may have caused vitreoretinal traction and that hypobaric hypoxia may have changed the dynamic relationship between vitreous, retina, retinal pigment epithelium (RPE) and choroid, causing preexisting retinal holes to open, allowing subretinal fluid to accumulate and detach the retina.
authors: Department of Ophthalmology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK. danielsmorris@hotmail.com
authors: Daniel S
authors: DS
authors: Morris
authors: Philip S
authors: PS
authors: Severn
authors: Jonathan
authors: J
authors: Smith
authors: John E A
authors: JE
authors: Somner
authors: Kevin P
authors: KP
authors: Stannard
authors: David G
authors: DG
authors: Cottrell
mesh_terms: D000086:Acetazolamide / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000150:complications* / Q000188:drug therapy; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009051:Mountaineering; D012163:Retinal Detachment / Q000139:chemically induced / Q000209:etiology* / Q000601:surgery; D018609:Tibet; D016896:Treatment Outcome
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide