An unusual case of high altitude-like retinopathy caused by anemia and thrombocytopenia at recreational altitude.
OBJECTIVE
To report an unusual presentation of high altitude-like retinopathy at recreational altitude after chemotherapy-induced anemia and thrombocytopenia.


METHODS
Case report.


RESULTS
A 43-year-old man undergoing chemotherapy for testicular cancer traveled to an altitude of 2,930 m and subsequently developed significant visual deficit in his right eye and was later diagnosed with bilateral severe high altitude-like retinopathy pathology with associated retinal hemorrhages.


CONCLUSIONS
Altitude-related illnesses like high-altitude retinopathy result from rapid physiologic adaptation to altitude-induced hypoxia. These illnesses are typically experienced at altitudes above 3,000 m, with high-altitude retinal hemorrhages observed above 4,270 m. The patient participated in no strenuous physical activity but had severe enough retinal hypoxia from chemotherapy-induced anemia and thrombocytopenia that he experienced visually significant retinal hemorrhages. The occurrence of high-altitude retinopathy in such patients could portend the development of high-altitude cerebral edema at lower altitudes than traditionally reported and without exposure to known risk factors. Therefore, funduscopic examination should be performed on patients with anemia and thrombocytopenia who are complaining of decreased vision after traveling at high altitude.
*University of Alabama at Birmingham, Birmingham, Alabama †Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama ‡Baton Rouge, Louisiana.
Jason P
JP
Skelley
Mark L
ML
Hill
Sara M
SM
Mullins
Sean C
SC
Allison