Valsalva Retinopathy

Abstract

Purpose: To report the clinical presentation and outcomes in patients with Valsalva retinopathy. Methods: This was a retrospective case series of patients diagnosed with Valsalva retinopathy between June 1, 2010, and May 31, 2020. Clinical notes, operative reports, fundus photography, and optical coherence tomography images were reviewed. Results: This study comprised 58 eyes of 58 patients. The most common causes were lifting (34.4%), vomiting (20.6%), straining (20.6%), and coughing (17.2%). Mean best-corrected visual acuity at diagnosis was 20/163. The most frequently involved vitreoretinal compartment was the subhyaloid space (42.3%) followed by the intraretinal (32.7%), intravitreal (23.1%), and subretinal (13.4%) spaces. Mean best-corrected visual acuity of all patients was 20/59 at 3 months, 20/48 at 6 months, and 20/22 at 1 year. Mean time to clearance of hemorrhage on clinical examination was 99.0 ± 18.7 days in patients who underwent observation and 4.5 ± 3.5 days after surgery in patients who received pars plana vitrectomy. Conclusion: Valsalva retinopathy is generally associated with a favorable visual prognosis. Most eyes perform well with observation although pars plana vitrectomy may be indicated in patients requiring rapid resolution of hemorrhage.

Valsalva retinopathy in a child on non-invasive ventilation: exploring the possible mechanisms

“…It can also be induced intraoperatively by anaesthetists for certain applications, like confirmation of venous haemostasis during head and neck surgeries, assessing the integrity of the autonomic nervous system, pain management, etc 3. VR as a side effect of mechanical ventilation or during general anaesthesia has been reported and probably occurs due to one of the above mechanisms 2 4 5. The possible mechanism of VR in our patient can be NIV-associated ventilation along with respiratory asynchrony caused by coughing.…”

“…Valsalva manoeuvres typically cause sub-ILM bleeding with a greater propensity to involve the macula. Rarely, subretinal and vitreous haemorrhages may be seen 2…”

Preretinal Hemorrhage Caused by Valsalva Retinopathy and Terson Syndrome

“…Величина геморрагий может быть различна, от незначительных до больших, достигающих нескольких диаметров диска зрительного нерва (ДЗН) [1]. Чаще всего в офтальмологической практике преретинальные геморрагии встречаются при ретинопатии Вальсальвы [2], синдроме Терсона [3], гематологических нарушениях [4], макроаневризмах сетчатки [5] или травмах [6].…”

“…Авторы исследований отмечают, что при форсированном выдохе при закрытой голосовой щели происходит внезапное повышение венозного кровяного давления вследствие повышения внутригрудного или внутрибрюшного давления. Вены головы и шеи не имеют клапанной системы, и поэтому повышенное внутригрудное или внутрибрюшное давление передается напрямую к сосудистой системе головы и шеи, что приводит к резкому повышению внутриглазного венозного давления и разрыву поверхностных капилляров сетчатки [2].…”

Manejo cirúrgico da retinopatia de valsalva

“…Apesar do bom prognóstico visual nesta patologia, o sangramento cursa com baixa visual severa por acometer, na maioria dos casos, a região da fóvea, estando indicada intervenção nos casos em que a recuperação precoce seja desejada. 1 O tratamento pode ser feito através da membranotomia com Nd Yag laser ou com a cirurgia de vitrectomia via pars plana (VVPP) e peeling com remoção do sangue sub MLI.…”