Impact of Valsalva manuever on choroidal vascularity index, central choroid and central macula

Abstract

BackgroundEvaluation of the effects of the Valsalva maneuver on choroidal vascularity index, central choroid and the central macula. MethodsEighty-four eyes of 42 healthy volunteers were evaluated in this prospective study. The central macular layer was assesed using the retinal map mode of the spectral domain OCT (Optovue RTVue XR, Optovue Inc., Fremont, CA), OCT images taken in the Enhanced Deep Imaging mode were transferred to the Image J program and the choroidal vascularity index and subfoveal choroidal thickness measurements were calculated. ResultsThe mean age of volunteers was 35.4±7.2 years. Choroidal vascularity index, subfoveal choroidal thickness, central macular thickness and intraocular pressure measurements in the resting position were 67.99±2.1%, 337.73±12.8 µm, 232.04± 8.4 µm, 14.04±2.5 mmHg respectively, during Valsalva maneuver were 69.44±2.1%, 351.15±12.2 µm, 238.84±8.1 µm, 19.4±5.4 mmHg respectively. There was a statistically significant increase during Valsalva maneuver. ConclusionThe Valsalva maneuver may cause temporary changes in choroidal vascularity index, subfoveal choroidal thickness, central macular thickness and intraocular pressure. These measurements may be misinterpreted in situations where patients breath-hold inadvertantly causing the Valsalva maneuver.