title: Vitreo-retinal disorders at high altitude in Nepal.
abstract: BACKGROUND
  Nepal has many mountains including the highest one in the world. People living in high altitude are often involved in climbing mountains.
  
  
  OBJECTIVE
  To explore the pattern of vitreo-retinal disorders at high altitude in Nepal.
  
  
  METHODS
  Consecutive patients aged 40 years and older who presented at the micro-surgical eye camp at Lukla of Solukhumbu district (2,860 metres) were included. Detailed ocular and systemic histories and ocular examination including dilated fundus evaluation were done.
  
  
  RESULTS
  There were a total 81 patients with the mean age of 56.7 years (S.D 11.15). Females (51.9 %) outnumbered males. Sherpa comprised of 76.5 % followed by Rai (9.8 %). The main occupation was agriculture (51.9 %) followed by mountain trekking (28.4 %). Smokers comprised of 13.5 %. Hypertension was the predominant systemic problem (28 %). The best corrected visual acuity of 6/18 and better was found in 86.4 % of cases and less than 3/ 60 in 3.6 % of cases. Age-related macular degeneration (AMD) was found in 19.6 % of cases with a predominant mild AMD (16 %), hypertensive retinopathy in 12.2 %, with grade I hypertensive change in 8.6 %, retinal vein occlusion (RVO) in 7.1 % of cases and with a branch RVO in 4.9 %. Dilated and tortuous retinal vessels were present in 25.9 % of cases; out of this, 9.8 % of the cases had concurrent AMD and/or hypertensive retinopathy. Other retinal problems were macular hole (2.46 %), solar retinopathy (2.46 %) and choroidal tear (1.2 %).
  
  
  CONCLUSIONS
  AMD, hypertensive retinopathy, and RVO are the main vitreo-retinal disorders besides the dilated and tortuous retinal vessels in people living at high altitude in Nepal.
authors.affiliation: Vitreo-retinal Unit, Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
authors.forename: R
authors.initials: R
authors.lastname: Thapa
authors.forename: G
authors.initials: G
authors.lastname: Poudyal
authors.forename: A S
authors.initials: AS
authors.lastname: Crandall
authors.forename: G
authors.initials: G
authors.lastname: Tabin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000531:Altitude; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008269:Macular Edema / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D012170:Retinal Vein Occlusion / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity; D018630:Vitreoretinopathy, Proliferative / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology