Valsalva retinopathy with double ring sign: Laser membranotomy for twin bleeds

Mathew, David J.; Sarma, Saurabh Kumar

doi:10.1016/j.sjopt.2015.10.003

Cited by 13 publications

(23 citation statements)

References 11 publications

(13 reference statements)

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“…VR occurs as a result of a Valsalva maneuver [ 5 , 6 ], which consists in a forcible expiration against a closed glottis that produces a sudden rise in venous blood pressure due to the rise in intrathoracic or intra-abdominal pressure. Incompetent valves in the venous system of the head and neck allow transmission of thoracic and abdominal pressure into the eye [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Nd:YAG membranotomy for sub-inner limiting membrane hemorrhage: a case report

Larrea¹,

Javier²,

Rivera-Valdivia³

et al. 2021

rjo

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Case Description: A 16-year-old male patient presented with a 12-days sudden painless loss of vision in his left eye after diving in a lake. Best corrected visual acuity (BCVA) in the left eye was counting fingers. Anterior segment was unremarkable. Fundoscopy in the left eye revealed a pre-retinal hemorrhage in the macular region and swept-source ocular coherence tomography (SS-OCT) confirmed the location in the sub-inner limiting membrane (ILM) space. An Neodymium:YAG (Nd:YAG) laser membranotomy was performed the next day in order to drain the hemorrhage into the vitreous cavity. A couple of days after, the BCVA in the left eye improved to 20/ 25, at fundoscopy the blood being almost reabsorbed and the SS-OCT showing a resolution of the sub-ILM hemorrhage. Discussion: Due to Valsalva retinopathy, sub-ILM hemorrhage may lead to a sudden painless vision loss. Spontaneous resolution of the hemorrhage is possible but absorption may take a long time. During this period, intraretinal tissue migration and proliferation may lead to permanent structural damage. Posterior vitrectomy is a treatment option but the fact that it is an invasive procedure fuels the search for less invasive treatment methods and Nd:YAG laser membranotomy fits this place. Conclusion: Given the excellent results and low complication rates, Nd:YAG laser membranotomy is highly recommended to treat this condition as it offers a simple, relatively safe and a non-invasive treatment option for drainage of sub-ILM hemorrhages.

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Section: Discussionmentioning

confidence: 99%

Nd:YAG membranotomy for sub-inner limiting membrane hemorrhage: a case report

Larrea¹,

Javier²,

Rivera-Valdivia³

et al. 2021

rjo

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“…Nd: YAG laser membranotomy is a widely used noninvasive method that usually improves vision acuity rapidly especially in cases of haemorrhage above 3 DD [ 8 ]. As regards complications, there is a small risk of epiretinal membrane, premacular cavity formation, and ILM thickening [ 9 ]. Another treatment options is vitrectomy whereas it is usually recommended for cases with dense haemorrhage and insufficient reabsorption that do not respond to the other treatments due to its potential complications and costs [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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

Süren

Akıdan²,

Erol

et al. 2018

Case Reports in Ophthalmological Medicine

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Purpose The purpose of this report is to present a case who had spontaneous macular hole closure after Nd:YAG laser membranotomy applied to premacular haemorrhage associated with Valsalva retinopathy. Methods Case report. Results A 19-year-old young male patient presented to our clinic with sudden vision loss in his right eye, which had occurred 2 weeks before, following push-up and sit-up exercise. The patient was found to have premacular haemorrhage associated with Valsalva retinopathy. Nd:YAG laser membranotomy was performed. During his follow-up at week 1, full-thickness MH was observed and he was put under observation. At month 6, his vision acuity improved, laser coagulation sites in the fundus disappeared, and macular hole closed spontaneously. Conclusion Macular hole that develops after Nd:YAG laser treatment of Valsalva retinopathy may spontaneously be closed like in our case. However, there is a need for further research to understand the mechanism of closure.

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“…Valsalva retinopathy occurs in young healthy adults following a valsalva maneuver. 2 , 3 , 4 , 5 During a valsalva maneuver, a rapid increase in thoracic venous pressure occurs, which can lead to rupture of the superficial retinal capillaries, leading to hemorrhagic detachments of the internal limiting membrane. The blood is usually localized to the sub-internal limiting membrane (ILM) space and/or the subhyaloid space.…”

Section: Discussionmentioning

confidence: 99%

“…If blood is trapped in both spaces, it presents a “double-ring sign.” The outer and inner rings represent subhyaloid and sub-ILM bleed, respectively. 2 …”

Section: Discussionmentioning

confidence: 99%

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A unique case of valsalva retinopathy in a conch blower

Gurung

2017

American Journal of Ophthalmology Case Reports

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PurposeValsalva hemorrhagic retinopathy is a form of preretinal hemorrhage that develops after a valsalva maneuver, leading to rupture of the superficial retinal capillaries. Here, we report a case of valsalva retinopathy secondary to blowing a conch, the first case report of its kind. The patient blew conch, which was part of his daily ritual to pray to God as he was a Hindu priest.ObservationsA 58-year-man developed an acute decrease in vision to 5/60 in his right eye after blowing the conch while performing “Puja,” which is the act of praying to God in Hindu culture. Ophthalmoscopy showed a fresh preretinal hemorrhage over the macula in his right eye. YAG laser membranotomy was performed, and his vision returned to 6/6.Conclusions and importanceConch “Shankha” is a religious instrument used routinely in Hindu culture. Its mechanism is very much similar to that of a wind instrument. This is the first case report of valsalva retinopathy caused by conch blowing.

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Valsalva retinopathy with double ring sign: Laser membranotomy for twin bleeds

Cited by 13 publications

References 11 publications

Nd:YAG membranotomy for sub-inner limiting membrane hemorrhage: a case report

Nd:YAG membranotomy for sub-inner limiting membrane hemorrhage: a case report

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

A unique case of valsalva retinopathy in a conch blower

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