Nd:YAG laser hyaloidotomy for valsalva pre-macular haemorrhage

Kirwan, R.P.; Cahill, Mark

doi:10.1007/s11845-009-0355-z

Cited by 12 publications

(8 citation statements)

References 11 publications

(12 reference statements)

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“…Neodymium-doped yttrium aluminum garnet laser membranotomy with drainage into the vitreous cavity or vitrectomy with membrane peeling can remove the preretinal hemorrhage [14,[24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

Patane¹,

Krummenacher

Rao

2015

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 99%

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

Patane¹,

Krummenacher

Rao

2015

Journal of Clinical Anesthesia

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“…By contrast, the spontaneous resolution of large and dense haemorrhages, as we presented in five cases of this study, is very unlikely. Several types of treatment are available, such as drainage of the haemorrhage into the vitreous cavity with Nd-YAG laser hyaloidotomy [7,8,10], gas injection [11] with or without recombinant tissue plasminogen activator [9], classical pars plana vitrectomy [6] and non-vitrectomising vitreous surgery as reported by Wu et al . [12].…”

Section: Discussionmentioning

confidence: 99%

“…Different techniques have been used to treat premacular haemorrhage. These include puncturing the posterior hyaloid face with a neodymium-doped yttrium aluminium garnet (Nd-YAG) [7,8] or green argon laser, pneumatic displacement of the haemorrhage by an intravitreal injection of gas [9] with or without recombinant tissue plasminogen activator [10] and pars plana vitrectomy [6]. …”

Section: Introductionmentioning

confidence: 99%

Long-term evolution of Valsalva retinopathy: a case series

2012

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IntroductionValsalva retinopathy may occur as a sudden, dramatic loss of central vision due to the premacular location of the haemorrhage. It has been described in different clinical settings, and there are several options for its treatment.Case presentationsWe present the cases of six patients with sudden visual acuity loss caused by Valsalva retinopathy, treated in our hospital in the last ten years. Case 1 involves a 32-year-old Caucasian man with a unilateral premacular haemorrhage after vomiting. A neodymium-doped yttrium aluminium garnet laser was used due to sufficient depth of the haemorrhage pocket, but it was unsuccessful. Instead, 20G pars plana vitrectomy was performed with excellent visual recuperation (visual acuity:1.0). Case 2 was of a 36-year-old Caucasian woman with Valsalva retinopathy after vomiting during pregnancy. A neodymium-doped yttrium aluminium garnet laser was also insufficient due to the coagulated blood. After labour, 23G pars plana vitrectomy was performed, and her final visual acuity was 1.0. Case 3 involved a 52-year-old Caucasian man with premacular bleeding due to vomiting after general anaesthesia. The haemorrhage did not resolve spontaneously, so 23G pars plana vitrectomy was performed, with excellent visual outcomes (visual acuity:1.0). Case 4 was a 24-year-old Caucasian man with a macular haemorrhage after thoracic trauma. He was observed over four weeks, after which we performed 23G pars plana vitrectomy, with complete visual restoration (visual acuity:1.0). Case 5 involved a 28-year-old man who developed a premacular bleed after vigorous dancing. After a period of observation, 23G pars plana vitrectomy was performed. A retinal break with a small haemorrhage around the break occurred, related to the peribulbar anaesthesia manoeuvers, but was resolved successfully. His final visual acuity was 1.0. Case 6 was a 22-year-old Caucasian woman who developed a premacular haemorrhage after weightlifting. Conservative management was performed due to the small size of her haemorrhage. It resolved spontaneously within one month, and her final visual acuity was 1.0.ConclusionValsalva retinopathy is a rare condition that causes a sudden loss of visual acuity. In patients with too dense haemorrhage, the best option could be the vitrectomy, with excellent visual outcomes, although surgery is not free of risks.

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“…Nd:YAG laser posterior hyaloidotomy has been indicated for subhyaloid hemorrhages16 and premacular vitreous floaters 17. Likewise, Nd:YAG laser anterior hyaloidotomy has been indicated for malignant glaucoma following cataract surgery 18.…”

Section: Discussionmentioning

confidence: 99%

Neodymium: Yttrium-aluminum-garnet laser anterior hyaloidotomy to treat trapped triamcinolone acetonide behind the crystalline lens after intravitreal injection

Fj¹,

2012

Middle East Afr J Ophthalmol

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A 65-year-old male underwent intravitreal triamcinolone acetonide (IVTA) injection for treating a clinically significant macular edema (CSME) due to background diabetic retinopathy in his left eye. On the first postoperative day, visual acuity dropped from 20/80 to hand movements. Slit-lamp examination showed the drug between the posterior capsule of the lens and the anterior hyaloid face. Two weeks later, visual acuity and the milky fluid seemed unchanged. Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser anterior hyaloidotomy was performed. One week later, slit-lamp examination of the retrolental space revealed the complete disappearance of triamcinolone and intraocular pressure remained stable. After a follow-up period of 2 months, visual acuity increased to 20/50 with the lens remaining clear. Nd:YAG laser anterior hyaloidotomy is an effective, simple, useful and minimally invasive outpatient procedure in patients with persistent entrapment of triamcinolone behind the crystalline lens, allowing the drug to clear without trauma to the lens.

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Nd:YAG laser hyaloidotomy for valsalva pre-macular haemorrhage

Abstract: Nd:YAG laser posterior hyaloidotomy is a useful outpatient procedure for successful clearance of large pre-macular haemorrhages that offers patients rapid recovery of visual acuity and the avoidance of more invasive intraocular surgery.

Cited by 12 publications

References 11 publications

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

Long-term evolution of Valsalva retinopathy: a case series

Neodymium: Yttrium-aluminum-garnet laser anterior hyaloidotomy to treat trapped triamcinolone acetonide behind the crystalline lens after intravitreal injection

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