Abstract：
Background Advanced diagnostics are not easily accessible in austere topographical locations. We documented retinal changes in patients with acute mountain sickness (AMS+) and compared these with asymptomatic individuals (AMS-) with recent induction into high altitude using direct ophthalmoscopy as a screening tool. Methods We evaluated 97 individuals (43 AMS- and 54 AMS+) who were inducted to an altitude 3800 m above sea level by direct ophthalmoscopy after pupillary dilatation, on day 2 of arrival. Results Retinal vein dilatation was seen in 36 (66.7%) AMS+ v. 14 (32.6%) AMS- (p<0.01), hyperaemia of the optic disc in 30 (55.6%) AMS+ v. 14 (32.6%) AMS- (p<0.05), hyperaemia of the optic disc along with retinal vein dilatation in 27 (50%) AMS+ v. 9 (20.9%) AMS- (p<0.01), retinal vein tortuosity in 12 (22.2%) AMS+ v. 3 (7%) AMS- (p<0.02). In AMS+ with retinal vein dilatation 17 (50%) had SpO2 >91% and 19 (79.2%) had SpO2 <91% (p<0.01). An AMS score of >5 was recorded in 25 (69.4%; p<0.001) with venular dilatation and in 19 (52.8%; p<0.001) who were AMS+ with an induction number ≥3 had retinal dilatation. Conclusion Acute hypobaric hypoxia causes retinal venous dilatation, tortuosity and hyperaemia of the optic disc in those with AMS and correlates directly with SpO2 levels. The incidence of retinal vein dilatation increases with frequent re-entry into high altitude and more severe symptoms of AMS. Hence, all those being inducted to high altitude should be screened for retinal vascular changes.
摘要：
背景技术高级诊断在严峻的地形位置不容易获得。我们记录了急性高山病（AMS）患者的视网膜变化，并将其与最近使用直接检眼镜作为筛查工具诱导进入高海拔的无症状个体（AMS-）进行了比较。方法我们评估了97个人（43AMS-和54AMS），他们在瞳孔扩张后通过直接检眼镜引导到海拔3800m，到达的第二天。结果36例(66.7%)AMS+v.14例(32.6%)AMS-可见视网膜静脉扩张(p<0.01),在30（55.6％）AMSv.14（32.6％）AMS-（p<0.05）中，视盘充血视盘充血伴随视网膜静脉扩张在27（50％）AMS+v.9（20.9％）AMS-（p<0.01），12(22.2%)AMS+v.3(7%)AMS-(p<0.02)中的视网膜静脉弯曲。在带视网膜静脉扩张的AMS+中,17(50%)的SpO2>91%,19(79.2%)的SpO2<91%(p<0.01)。在25例（69.4％；p<0.001）的静脉扩张中记录到AMS评分>5，在19例（52.8％；p<0.001）中，诱导数≥3的AMS中有视网膜扩张。结论急性低压低氧引起视网膜静脉扩张,AMS患者的视盘弯曲和充血，并与SpO2水平直接相关。视网膜静脉扩张的发生率随着频繁再次进入高海拔和AMS的更严重症状而增加。因此，所有被引导到高海拔地区的人都应该进行视网膜血管变化的筛查。
