Preretinal hemorrhage preventing subretinal involvement in multilayer macular hemorrhages: coincidence or plausible relationship?

Nascimento, Priscila Alves; Carbajo, Cristina Nery; Mendonça, Luísa S.M.; Okimoto, Juliana Taemy; Barros, Bogdan C. M.; Abucham-Neto, Júlio Zaki

doi:10.1186/s40942-021-00291-y

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…The data also shows that retinal hemorrhages that are “dense, extensive, covering a large surface area, and/or extending to the ora serrata.” are common and occur relatively commonly in non-AHT. This supports a growing body of research [ [28] , [29] , [30] , [31] , [32] , [33] , [34] ] that has shown that severe retinal hemorrhages in infants can have a range of causes. The known relation between severity of intracranial pathological conditions and rates of severe retinal hemorrhages is also found in the pediBIRN data and seems to be a very robust relation.…”

Section: Discussionsupporting

confidence: 75%

Evidence for significant misdiagnosis of abusive head trauma in pediBIRN data

Brook

2023

Forensic Science International: Synergy

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Section: Discussionsupporting

confidence: 75%

Evidence for significant misdiagnosis of abusive head trauma in pediBIRN data

Brook

2023

Forensic Science International: Synergy

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“…It is thought that blood delimited by the sub-ILM space creates a tension greater than the vitreous pressure upon the adjoining neuro-sensory retina. [ 30 ]…”

Section: Mechanism Of Damagementioning

confidence: 99%

Characterization of retinal hemorrhages delimited by the internal limiting membrane

Brar,

Ramachandran,

Takkar

et al. 2023

Indian Journal of Ophthalmology

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Clinically, hemorrhages at the vitreoretinal interface have been termed as ‘pre-retinal’ in location. However, there is a careful distinction to be made between sub-hyaloid and sub-internal limiting membrane (ILM) planes of blood collection. In the past half-century, a body of literature has accrued on sub-internal limiting membrane hemorrhage. We characterize the etiopathological, clinical, anatomical, and imaging characteristics of this entity (often misconstrued as sub-hyaloid hemorrhage). Management decisions are briefly described, and a unifying term of sub-internal limiting membrane macular hemorrhage is proposed to aid in further research.

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“…As the name suggests, the condition appears after the Valsalva maneuver has been performed in some capacity during day-to-day activities. The most common activities include weight-lifting, vomiting, coughing, sneezing, aerobic exercises, straining with defecation, blowing musical instruments, strenuous physical activities, sexual intercourse, pregnancy, and after general anesthesia [2,[5][6][7][8][9]. Valsalva retinopathy has also been reported after cardiopulmonary resuscitation [10] and compression injuries [11].…”

Section: Etiology and General Pathologymentioning

confidence: 99%

A brief review of Valsalva retinopathy

Asteris¹,

Kalogeropoulos²,

Moussa³

et al. 2022

Med Hypothesis Discov Innov Optom

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Background: Valsalva retinopathy is a specific type of retinopathy that appears following an acute rise in intrathoracic or intra-abdominal pressure. This review focuses on current literature and future directions for the diagnosis and management of Valsalva retinopathy. Methods: In this brief review, the literature was searched to provide an extensive general and updated description of Valsalva retinopathy, focusing on its management and prognosis. Selected articles are summarized to present the etiology, general pathology, pathophysiology, symptoms, signs, diagnosis, differential diagnosis, treatment, and prognosis of Valsalva retinopathy. Results: The main symptom of Valsalva retinopathy is loss of visual acuity following exertion. This is caused by the rupture of small superficial vessels in the macula and perimacular areas, leading to extravasation of blood. No link between age, sex, or race has been found, although fundus vessel abnormalities pose some predisposition to the disease. During fundoscopy, Valsalva retinopathy appears most frequently as well-defined preretinal hemorrhages confined to the sub-internal limiting membrane (ILM) or subhyaloid space. If ILM rupture occurs, hyaloid hemorrhage can appear. Diagnosis is based on the patient’s medical history and a standard examination. Usually, only observation of the patient is required, with the hemorrhage resolving within weeks to months. In cases of large premacular hemorrhage or large sub-ILM/subhyaloid hemorrhage, vitrectomy or Nd:YAG krypton laser membranotomy can be performed. Conclusions: Of all the aspects of Valsalva retinopathy that might trouble the physician, the most challenging features are differential diagnosis and the choice of optimal treatment. Therapeutic strategies for Valsalva retinopathy can be either conservative or based on Nd:YAG laser membranotomy and/or vitrectomy. All methods seem to have good outcomes. However, physicians should not be afraid of advancing beyond conservative therapy, especially in the event of persistent premacular hemorrhage, which could lead to permanent retinal damage if valuable time is lost, even after vitrectomy.

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Preretinal hemorrhage preventing subretinal involvement in multilayer macular hemorrhages: coincidence or plausible relationship?

Cited by 3 publications

References 10 publications

Evidence for significant misdiagnosis of abusive head trauma in pediBIRN data

Evidence for significant misdiagnosis of abusive head trauma in pediBIRN data

Characterization of retinal hemorrhages delimited by the internal limiting membrane

A brief review of Valsalva retinopathy

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