Sudden Vision Loss in a Young Patient with Pulmonary Hypertension, A Rare and Unusual Finding

Abstract

Loss of vision associated with pulmonary hypertension in the pediatric age group has been rarely reported in the literature and often goes unnoticed for a long period. Pulmonary hypertension may manifest as shortness of breath limiting the activity of the individual, palpitation, headaches, easy fatiguability, dizziness been the most common symptoms encountered. However, primary pulmonary hypertension would not present itself instead secondary to other diseases like congenital heart disease, lung disease, connective tissue disorders or genetic diseases. Our case demonstrated a 17-year old individual with a primary complaint of progressive loss of vision in the left eye leading to complete vision loss. The patient experienced dyspnea two years back which exacerbated affecting his normal routine activity. His Echocardiography revealed severe pulmonary hypertension and was started on appropriate medications. His vision worsened and slit-lamp examination revealed multiple hemorrhages. Further investigations with FFA and OCT revealed significant hypoperfusion and significant elevation of the retina of the left eye. Anti-VEGF injections were given in an attempt to restore vision, but it resulted in no further improvement. Our case emphasizes the importance of prompt ophthalmologic examination in Pulmonary Hypertension.