Ocular manifestations of pulmonary hypertension

Abstract

Pulmonary hypertension, if left untreated, may result in increasing cardiac back pressures and lead to right heart failure and death. An increase in venous pressure in cases of pulmonary hypertension influences other organs. Ocular complications occur as a result of elevated venous pressure in the superior vena cava and in the ophthalmic veins, which cause dilation of the ocular veins, resulting in congestion of the choroid and leading to complications such as ciliary detachment, central retinal vein occlusion, acute serous retinal detachment, macular edema, retinal neovascularization, choroidal effusions, chemosis, angle-closure glaucoma, transient myopia, and proptosis. Other ophthalmic disorders are the results of side effects of treatment. Patients may present primarily to an ophthalmologist, who may diagnose these diseases. Patients with pulmonary hypertension should be taught careful self-observation of visual function, and if it deteriorates, they should immediately report this to an ophthalmologist. Before initiation of any target-oriented therapy, the patient must be informed about possible sight-threatening complications. We review ophthalmological disorders that may develop in the course of pulmonary hypertension and emphasize multidisciplinary cooperation.

Keywords: CRVO; choroidal detachment; choroidal effusions; dilatation of ocular veins; elevated venous systemic pressure; pulmonary hypertension.