Spontaneous Macular Hole Closure after Valsalva Retinopathy and Nd:YAG Laser Treatment

Süren, Elçin; Akıdan, Melih; Erol, Muhammet Kazım; Toslak, Devrim

doi:10.1155/2018/1782847

Cited by 7 publications

(9 citation statements)

References 22 publications

(22 reference statements)

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“…10 While most authors prefer to manage PMH ≤3DD size conservatively, some prefer to treat even the smaller hemorrhages. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Nd:YAG laser membranotomy is the simplest, quickest, most inexpensive, office-based procedure with a high success rate for the treatment of PMH. However, the technique has a few drawbacks.…”

Section: Discussionmentioning

confidence: 99%

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Inverse drainage Nd:YAG membranotomy for pre-macular hemorrhage

Babu

Kohli

Rajan

et al. 2022

European Journal of Ophthalmology

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Aim To report the outcomes of the “inverse drainage Nd:YAG laser membranotomy” technique for the management of pre-macular hemorrhage (PMH), which has its inferior margin near the fovea. Methods This retrospective study included eyes with PMH, with its inferior margin located within 0.5 disc-diameter (DD) of the fovea. Laser membranotomy was performed near the superior margin of PMH followed by intravitreal injection of 0.3 mL undiluted sulphur hexafluoride (SF6) gas. The patients were advised to maintain a prone position for three days. Results Twenty patients (20 eyes) with a mean age of 46.1 ± 18.6 years were included in the study. The mean duration of symptoms was 6.9 ± 7.0 days. The mean size of PMH was 4.1 ± 1.2DD. The causes of PMH were Valsalva retinopathy (n = 11) and retinal artery macroaneurysm (RAM, n = 9). The mean maximum height of the blood collection, measured by optical coherence tomography (OCT), within 1 disc-diameter from the inferior and superior borders of the PMH was 738.9 ± 232.9μm and 1240.6 ± 338.1μm respectively ( p = 0.001). The mean best-corrected visual acuity (BCVA) improved from logMAR 1.32 ± 0.44 (Snellen equivalent, 20/418) to logMAR 0.11 ± 0.20 (Snellen equivalent, 20/26) ( p = 0.001). Vitrectomy was not required in any case. Persistent pre-macular cavity, macular hole, epiretinal membrane (ERM), intra-ocular pressure spike, or rhegmatogenous retinal detachment (RRD) was not noted in any patient. Conclusion This technique can be safely used to treat eyes with PMH having its inferior margin near the fovea.

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Section: Discussionmentioning

confidence: 99%

“…Firstly, it cannot be used in cases where the inferior margin of the blood collection lies near the fovea as the use of high energy close to the fovea can lead to macular hole, burn, and/ or scarring. [12][13][14][15][16] The only treatment option available for such patients is vitrectomy. However, surgery has its own risk of complications.…”

Section: Discussionmentioning

confidence: 99%

Inverse drainage Nd:YAG membranotomy for pre-macular hemorrhage

Babu

Kohli

Rajan

et al. 2022

European Journal of Ophthalmology

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“…A macular hole associated with Valsalva retinopathy has been reported infrequently, to our knowledge. Elcin et al reported a spontaneously closed macular hole that developed after an uneventful Nd:YAG laser treatment in Valsalva retinopathy–induced premacular hemorrhage. The formation of macular hole in this case might be the result of the posterior vitreous detachment caused by a Valsalva maneuver and the associated traction at the vitreofoveal interface.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Closure of a Macular Hole After Nd:YAG Laser Treatment for Valsalva Retinopathy in Pregnancy

Tian¹,

Zhu³

et al. 2021

JAMA Ophthalmol

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“…But in our patient, the location of ILM defect observed in the fundus after 7 weeks after the membranotomy was far from the inferior border of the initial sub-ILM hemorrhage, which may indicate that the laser performed at an inappropriate location. The explanation for the location of ILM defect far from the inferior border was due to the tangential traction of the ILM [25].…”

Section: Discussionmentioning

confidence: 99%

Bilateral and multiple sub-internal limiting membrane hemorrhages in a familial retinal arteriolar tortuosity patient by Valsalva-like mechanism: an observational case report

Chen¹,

Zheng²,

Wang³

et al. 2020

BMC Ophthalmol

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Background: Bilateral and multiple Valsalva-related sub-internal limiting membrane (ILM) hemorrhages in a familial retinal arteriolar tortuosity (FRAT) patient is rare, and we treated this patient by both observation and Neodymium yttrium aluminum garnet (Nd: YAG) laser membranotomy methods. Case presentation: A 13-year-old female student presented with sudden visual loss and central scotoma in both eyes after running 800 m at the school gym. The examination revealed six sub-ILM hemorrhages with the biggest hemorrhage measuring approximately 1.5-disc diameters (DD) in the right eye and two sub-ILM hemorrhages with the biggest one measuring 5.5 DD in the left eye. The patient was diagnosed as having Valsalva retinopathy associated with FRAT. Nd: YAG laser membranotomy was performed at the biggest hemorrhages and the rest hemorrhages were treated with observation in both eyes. The visual acuity recovered to 20/16 in the right eye and 20/20 in the left eye. Epiretinal membrane (ERM) formation was observed in the left eye. Conclusions: Nd: YAG laser could be considered for treating premacular hemorrhage in FRAT patient especially when a quick vision recovery was needed. This is the first reported case of a FRAT patient suffering from bilateral and multiple Valsalva-related sub-ILM hemorrhages which were treated by both observation and Nd: YAG laser treatment.

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Spontaneous Macular Hole Closure after Valsalva Retinopathy and Nd:YAG Laser Treatment

Cited by 7 publications

References 22 publications

Inverse drainage Nd:YAG membranotomy for pre-macular hemorrhage

Inverse drainage Nd:YAG membranotomy for pre-macular hemorrhage

Spontaneous Closure of a Macular Hole After Nd:YAG Laser Treatment for Valsalva Retinopathy in Pregnancy

Bilateral and multiple sub-internal limiting membrane hemorrhages in a familial retinal arteriolar tortuosity patient by Valsalva-like mechanism: an observational case report

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