[Pathologic fundus changes in advanced liver cirrhosis. Reduction of symptoms after portosystemic shunt]. / Pathologische Fundusveränderungen bei fortgeschrittener Leberzirrhose. Reduzierung des Befundes nach Anlage eines portosystemischen Shunts.

BACKGROUND: In patients with advanced cirrhosis and portal hypertension a portosystemic shunting procedure is often necessary. This induces haemodynamic changes in the systemic circulation. The aim of this study was to find out whether there were changes in the retinal perfusion as well. METHODS AND PATIENTS: 17 patients with mainly ethyl-toxic cirrhosis (13 male, 4 female; mean age 54 years, range 34-72 years) underwent ophthalmologic examination before and 3 months after TIPS (transjugular intrahepatic portosystemic stent shunt). RESULTS: Before TIPS there were pathological findings in 11 patients: In five cases cotton-wool spots, in three cases discrete vessel abnormalities, in two cases small intraretinal haemorrhages and in one case papilloedema. In all cases these pathological findings were similar in both eyes. Three months after TIPS all these changes had completely disappeared or were at least considerably declining. CONCLUSIONS: The pathological findings in patients with advanced cirrhosis were interpreted as signs of reduced retinal perfusion. After a portosystemic shunting procedure signs of recovery were seen.