1 Department of Emergency Medicine, Denver Health Medical Center , Denver, Colorado.
High Alt Med Biol. 2013 Dec;14(4):342-5. doi: 10.1089/ham.2013.1024.
Acute mountain sickness (AMS) is common at high altitude and may lead to high altitude cerebral edema (HACE) if not properly recognized. Previous studies have suggested that AMS is associated with increases in intracranial pressure (ICP). Increased ICP has been associated with increased intra-ocular pressure (IOP). This study was designed to determine the association between IOP and AMS.
Subjects were recruited from a convenience sample of travelers in the Khumbu region of Nepal, elevation 14,410 ft (4392 m). Study participation involved completion of a questionnaire to assess for AMS by the Lake Louise Score (LLS), followed by three IOP measurements in each eye. Investigators were blinded to the LLS. Subjects with a history of ocular surgery were excluded. Three IOP measurements per eye were made using an applanation tonometer (Tono-Pen XL(®), Reichart Technologies) and averaged across both eyes. Multivariable logistic regression analysis was used to estimate the association between IOP and AMS while adjusting for age, ascent or descent, and use of acetazolamide. IOP and blood O2 saturation were compared using a Spearman correlation coefficient.
161 subjects were enrolled with a median age of 36 (IQR: 29-45) years; 60% were male, 75% were ascending, and 64% were taking acetazolamide; additionally, 38%, (95% CI: 31%-47%) were diagnosed with AMS (LLS ≥3). The median IOP was 21 (IQR 18-24) mmHg. The logistic regression model demonstrated no association between IOP and AMS as measured by LLS (odds ratio [OR] 1.0, 95% CI: 0.9-1.1),age (OR 1.0, 95% CI: 0.9-1.0) or with use of acetazolamide (OR 1.4, 95% CI: 0.6-2.6). Ascent (OR 0.4, 95% CI: 0.2-0.9) was negatively associated with IOP but not significantly so. IOP and O2 saturation were not correlated (p=0.93).
IOP measured at high altitude is not associated with the diagnosis of AMS. Other approaches to diagnose AMS easily and accurately are needed.
急性高原病（AMS）在高海拔地区很常见，如果不能及时识别，可能导致高原脑水肿（HACE）。先前的研究表明，AMS 与颅内压（ICP）升高有关。ICP 升高与眼内压（IOP）升高有关。本研究旨在确定 IOP 与 AMS 之间的关系。
从尼泊尔昆布地区的旅行者中选择了方便的样本进行研究，海拔 14410 英尺（4392 米）。研究参与包括完成一份评估 AMS 的洛矶山评分（LLS）问卷，然后对每只眼睛进行三次 IOP 测量。研究人员对 LLS 结果不知情。排除有眼部手术史的患者。使用眼压计（Tono-Pen XL®，Reichart Technologies）对每只眼睛进行三次 IOP 测量，并对双眼进行平均。使用多变量逻辑回归分析来估计 IOP 与 AMS 之间的关系，同时调整年龄、上升或下降以及乙酰唑胺的使用。使用 Spearman 相关系数比较 IOP 和血液 O2 饱和度。
共纳入 161 名受试者，中位年龄为 36（IQR：29-45）岁；60%为男性，75%为上升，64%服用乙酰唑胺；此外，38%（95%CI：31%-47%）被诊断为 AMS（LLS≥3）。中位 IOP 为 21（IQR 18-24）mmHg。逻辑回归模型显示，洛矶山评分（LLS）测量的 IOP 与 AMS 之间无关联（优势比[OR]1.0，95%CI：0.9-1.1），年龄（OR 1.0，95%CI：0.9-1.0）或乙酰唑胺的使用（OR 1.4，95%CI：0.6-2.6）也无关联。上升（OR 0.4，95%CI：0.2-0.9）与 IOP 呈负相关，但无统计学意义。IOP 和 O2 饱和度之间没有相关性（p=0.93）。
高海拔地区测量的 IOP 与 AMS 诊断无关。需要其他方法来轻松、准确地诊断 AMS。
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