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The eye in CHD

Published online by Cambridge University Press:  25 July 2018

Subha Nasir-Ahmad ,
Rachael Cordina ,
Gerald Liew ,
Peter McCluskey  and
David Celermajer
Subha Nasir-Ahmad
Affiliation:
Heart Research Institute, Newtown, NSW, Australia
Rachael Cordina
Affiliation:
Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
Gerald Liew
Affiliation:
The Westmead Institute, Westmead, NSW, Australia
Peter McCluskey
Affiliation:
Save Sight Institute, Sydney, NSW, Australia
David Celermajer*
Affiliation:
Heart Research Institute, Newtown, NSW, Australia Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
*
Author for correspondence: Professor David Celermajer, Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW 2050, Australia. Tel: +612 9515 7110; Fax: +612 9550 6262; E-mail: [email protected]
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Abstract

In recent years, there has been a rise in the number patients with CHD surviving into adulthood. Many have complications related to their CHD or its treatments, outside the heart, including ocular abnormalities. The objective of this review is to highlight the ocular abnormalities that occur in adults with CHD, either from their condition or related to the common drugs prescribed to manage it. In particular, we reviewed the effects of cyanosis, coarctation of the aorta, endocarditis, and the side effects of Sildenafil and Amiodarone. A change in the retinal vasculature is a common observation with cyanosis or coarctation of the aorta. Occlusion of the retinal vessels may also be observed in cyanotic patients, as well as those with infectious endocarditis. Sildenafil has established ocular side effects; here they are explored in the context of therapy for pulmonary hypertension. Similarly, Amiodarone has established ocular risks, which are summarised. The high prevalence of ocular consequences in adult CHD patients reinforces the need for knowledge of the risks involved and for frequent ophthalmological screening where appropriate.

Keywords

Adult CHDocular pathologycyanosisendocarditiscoarctation
Type
Review Article
Information
Cardiology in the Young , Volume 28 , Issue 8 , August 2018 , pp. 981 - 985
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Nasir-Ahmad S, Cordina R, Liew G, McCluskey P, Celermajer D. (2018) The eye in CHD. Cardiology in the Young28: 981–985. doi: 10.1017/S1047951118000859

References

1. van Konings, EE, Slager, MA, Witsenburg, M, et al. Birth prevalence of congenital heart disease worldwide. J Am Coll Cardiol 2011; 58: 2241–2247.Google Scholar
2. Vilela, MA, Sbruzzi, G, Pellanda, LC. Prevalence of ophthalmological abnormalities in children and adolescents with CHD: systematic review and meta-analysis of observational studies. Cardiol Young 2016; 26: 477–484.Google Scholar
3. Petersen, RA, Rosenthal, A. Retinopathy and papilledema in cyanotic congenital heart disease. Pediatrics 1972; 49: 243–249.Google Scholar
4. Mansour, AM, Bitar, FF, Traboulsi, EI, et al. Ocular pathology in congenital heart disease. Eye 2005; 19: 29–34.Google Scholar
5. Rodriguez, N, Eliott, D. Bilateral central retinal vein occlusion in Eisenmenger syndrome. Am J Ophthalmol 2001; 132: 268–269.CrossRefGoogle ScholarPubMed
6. Zhao, L, Wang, J, Liu, YF, Qian, J. Central retinal artery occlusion in eisenmenger syndrome. Exp Ophthalmol 2012; 3: 241.Google Scholar
7. Cordina, R, Leaney, J, Golzan, M, Grieve, S, Celermajer, DS, Graham, SL. Ophthalmological consequences of cyanotic congenital heart disease: vascular parameters and nerve fibre layer. Clin Exp Ophthalmol 2015; 43: 115–123.CrossRefGoogle ScholarPubMed
8. Tsui, I, Shamsa, K, Perloff, JK, Lee, E, Wirthlin, RS, Schwartz, SD. Retinal vascular patterns in adults with cyanotic congenital heart disease. Semin Ophthalmol 2009; 24: 262–265.Google Scholar
9. Hartnett, ME, Martiniuk, D, Byfield, G, Geisen, P, Zeng, G, Bautch, VL. Neutralizing VEGF decreases tortuosity and alters endothelial cell division orientation in arterioles and veins in a rat model of ROP: relevance to plus disease. Invest Ophthalmol Vis Sci 2008; 49: 3107–3114.Google Scholar
10. Cheng, C, van Haperen, R, de Waard, M, et al. Shear stress affects the intracellular distribution of eNOS: direct demonstration by a novel in vivo technique. Blood 2005; 106: 3691–3698.CrossRefGoogle ScholarPubMed
11. Li, H, Wallerath, T, Forstermann, U., Li, H, Wallerath, T, Forstermann, U. Physiological mechanisms regulating the expression of endothelial-type NO synthase. Nitric Oxide 2002; 7: 132–147.Google Scholar
12. Kushner, BJ, Essner, D, Cohen, IJ, Flynn, JT. Retrolental fibroplasia. II. Pathologic correlation. Arch Ophthalmol 1977; 95: 29–38.Google Scholar
13. Caprara, C, Grimm, C. From oxygen to erythropoietin: relevance of hypoxia for retinal development, health and disease. Prog Retin Eye Res 2012; 31: 89–119.Google Scholar
14. Penn, JS, Madan, A, Caldwell, RB, Bartoli, M, Caldwell, RW, Hartnett, ME. Vascular endothelial growth factor in eye disease. Prog Retin Eye Res 2008; 27: 331–371.Google Scholar
15. Krarup, JC. Atypical rubeosis iridis in congenital cyanotic heart disease. Report of a case with microhaemangiomas at the pupillary margin causing spontaneous hyphaemas. Acta Ophthalmol (Copenh) 1977; 55: 581–585.CrossRefGoogle ScholarPubMed
16. Cordina, RL, Nakhla, S, O’Meagher, S, Leaney, J, Graham, S, Celermajer, DS. Widespread endotheliopathy in adults with cyanotic congenital heart disease. Cardiol Young 2015; 25: 511–519.CrossRefGoogle ScholarPubMed
17. de Aguiar Remigio, MC, Brandt, CT, Santos, CC, Arantes, TE, de Aguiar, MI. Macular and peripapillary retinal nerve fibre layer thickness in patients with cyanotic congenital heart disease. Eye (Lond) 2015; 29: 465–468.Google Scholar
18. Celermajer, DS, Greaves, K. Survivors of coarctation repair: fixed but not cured. Heart 2002; 88: 113–114.Google Scholar
19. Granstrom, KO. Retinal changes in coarctation of the aorta. Br J Ophthalmol 1951; 35: 143–148.Google Scholar
20. Gloan, L, Chakor, H, Mercier, LA, et al. Le Aortic coarctation and the retinal microvasculature. Int J Cardiol 2014; 174: 25–30.Google Scholar
21. Shamsa, K, Perloff, JK, Lee, E, Wirthlin, RS, Tsui, I, Schwartz, SD. Retinal vascular patterns after operative repair of aortic isthmic coarctation. Am J Cardiol 2010; 105: 408–410.Google Scholar
22. Walker, GL, Stanfield, TF. Retinal changes associated with coarctation of the aorta. Trans Am Ophthalmol Soc 1952; 50: 407–414.Google Scholar
23. Potaz, P, Aleszewicz-Baranowska, J, Raczyńska, K. Epidemiology of hypertensive retinopathy in young patients after coarctation of the aorta repair. Klin Oczna 2004; 106: 456–459.Google Scholar
24. Wathek, C, Rannen, R. Ocular manifestations of endocarditis. In Firstenberg MS (ed). Contemporary Challenges in Endocarditis. InTech, London, 2016: 95–101.CrossRefGoogle Scholar
25. Seles, S, Lang, GE. Okuläre Manifestation einer infektiösen Endokarditis. Klin Monatsbl Augenheilkd 2007; 224: 606–608.CrossRefGoogle Scholar
26. Loughrey, PB, Armstrong, D, Lockhart, CJ. Classical eye signs in bacterial endocarditis. QJM 2015; 108: 909–910.CrossRefGoogle ScholarPubMed
27. Khawly, JA, Pollock, SC. Litten’s sign (Roth’s spots) in bacterial endocarditis. Arch Ophthalmol 1994; 112: 683–684.Google Scholar
28. Schmidt, D, Zehender, M. Retinal arterial occlusion in infectious endocarditis. Der Ophthalmologe 1999; 96: 264–266.Google Scholar
29. Barisani-Asenbauer, T, Maca, SM, Mejdoubi, L, Emminger, W, Machold, K, Auer, H. Uveitis - a rare disease often associated with systemic diseases and infections-a systematic review of 2619 patients. Orphanet J Rare Dis 2012; 7: 57–63.Google Scholar
30. Sahin, O. Ocular complications of endocarditis. In Breijo-Márquez FR (ed). Endocarditis. InTech, London, 2012: 125–146.Google Scholar
31. Vobig, MV, Klotz, TJ, Staak, M, Bartz-Schmidt, KU, Englemann, U, Walter, P. Retinal side-effects of sildenafil. Lancet 1999; 353: 375.Google Scholar
32. Yu, A, Rilk, A, Sadowski, B, et al. Visual short-term effects of Viagra: double-blind study in healthy young subjects. Am J Ophthalmol 2004; 137: 842–849.Google Scholar
33. Fraunfelder, FW. Visual side effects associated with erectile dysfunction agents. Am J Ophthalmol 2005; 140: 723–724.Google Scholar
34. Pomeranz, HD. The relationship between phosphodiesterase-5 inhibitors and nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol 2016; 36: 193–196.Google Scholar
35. Michelakis, E, Tymchak, W, Lien, D, Webster, L, Hashimoto, K, Archer, S. Oral sildenafil is an effective and specific pulmonary vasodilator in patients with pulmonary arterial hypertension. Circulation 2002; 105: 2398–2403.Google Scholar
36. Barnett, CF, Machado, RF. Sildenafil in the treatment of pulmonary hypertension. Vasc Health Risk Manag 2006; 2: 411.Google Scholar
37. Wirostko, BM, Tressler, C, Hwang, LJ, Burgess, G, Laties, AM. Ocular safety of sildenafil citrate when administered chronically for pulmonary arterial hypertension: results from phase III, randomised, double masked, placebo controlled trial and open label extension. BMJ, 2012; 344: e554.Google Scholar
38. Kumari, R, Kumar, N, Hazra, S, Paul, UK, Bandyopadhyay, A. Ocular side effects of sildenafil: study. Int J Sci Study 2016; 4: 75–78.Google Scholar
39. Khan, MH. Oral class III antiarrhythmics: what is new? Curr Opin Cardiol 2004; 19: 47–51.Google Scholar
40. Santaella, RM, Fraunfelder, FW. Ocular adverse effects associated with systemic medications. Drugs 2007; 67: 75–93.Google Scholar
41. Tuppurainen, K., Mäntyjärvi, M, Ikäheimo, K. Ocular side effects of amiodarone. Surv Ophthalmol, 1998; 42: 360-366.Google Scholar
42. Falke, K, Büttner, A, Schittkowski, M, et al. The microstructure of cornea verticillata in Fabry disease and amiodarone-induced keratopathy: a confocal laser-scanning microscopy study. Graefes Arch Clin Exp Ophthalmol 2009; 247: 523–534.Google Scholar
43. Wasielica-Poslednik, J, Pfeiffer, N, Reinke, J, Pitz, S. Confocal laser-scanning microscopy allows differentiation between Fabry disease and amiodarone-induced keratopathy. Graefes Arch Clin Exp Ophthalmol 2011; 249: 1689–1696.Google Scholar
44. Hollander, DA, Aldave, AJ. Drug-induced corneal complications. Curr Opin Ophthalmol 2004; 15: 541–548.Google Scholar
45. Passman, RS, Bennett, CL, Purpura, JM, et al. Amiodarone-associated optic neuropathy: a critical review. Am J Med 2012; 125: 447–453.Google Scholar
46. Hayreh, SS. Amiodarone, erectile dysfunction drugs, and non-arteritic ischemic optic neuropathy. J Neuroophthalmol 2006; 26: 154–155.Google Scholar