Furthermore, numerous authors have described venous stasis retinopathy, bilateral choroidal detachments, intraretinal hemorrhages, vessel tortuosity, microaneurysms, capillary leakage, central retinal vein occlusion, open angle glaucoma, choroidal effusion, etc. in patients with pulmonary arterial hypertension. Elevated venous pressure found in pulmonary arterial hypertension is responsible for the delayed choroidal perfusion and the reduced venous blood outflow. This explains the clinical findings of venous stasis retinopathy, choroidal detachments, etc. which are related to elevated episcleral, retinal and choroidal venous pressure secondary to elevated systemic venous pressure (increased pulmonary vascular resistance in patients with pulmonary arterial hypertension leads to right heart failure and subsequent elevation in systemic venous pressure).