Abstract
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.
Highlights
Valsalva retinopathy may occur as a sudden, dramatic loss of central vision due to the premacular location of the haemorrhage
Valsalva retinopathy is a rare condition that causes a sudden loss of visual acuity
Valsalva retinopathy is an uncommon disease which presents itself with sudden visual loss due to a premacular haemorrhage, caused by a rapid increase in intraocular venous pressure
Summary
Valsalva retinopathy is an uncommon disease which presents itself with sudden visual loss due to a premacular haemorrhage, caused by a rapid increase in intraocular venous pressure. Case 2 A 36-year-old Caucasian woman presented with unilateral sudden visual loss after vomiting during the eighth month of her pregnancy. Her VA at first examination was 0.1. Case 3 A 52-year-old Caucasian man complained of a decrease in vision after strong vomiting associated with general anaesthesia for cervical lipoma surgery He had developed a unilateral premacular haemorrhage. Our patient was observed for four weeks, after which we decided to perform 23G three-port pars plana vitrectomy with the same technique described previously. Case 6 A 22-year-old Caucasian woman came to our emergency room with a complaint of blurred vision in her right eye three hours after participating in weightlifting She presented with a small haemorrhage in the macula, so we decided on conservative management. The haemorrhage resolved itself spontaneously and her VA recovered to 10 out of 10
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
