Abstract
Purpose: To determine the outcomes of double frequency Nd:YAG laser membranotomy for premacular hemorrhage secondary to Valsalva retinopathy. Methods: Retrospective case series of 24 consecutive patients with premacular hemorrhage of duration less than two months between Jan 2008 and Dec 2012 were included. Patients with any other vascular diseases such as diabetic retinopathy were excluded. The main outcome measure was the best-corrected visual acuity (BCVA) at final follow up. Results: Among 24 patients, majority 16 (67%) were men and all had unilateral Valsalva retinopathy. All patients underwent laser membranotomy using the double frequency Nd:YAG laser on the same day of presentation. The mean age of subjects was 44.03 ± 17.33 years (14-78 years) and the mean duration of symptoms was 10.29 ± 11.7days. The mean follow-up duration was 4.72 ± 2.54 months. All patients presented with blindness or severe vision loss with a mean baseline visual acuity of 1.72 ± 0.58 logMAR (Snellen’s equivalent 20/1050; range 0.17-2.3). Significant improvement of visual recovery was noted in 91.66% of patients at 1 month (mean final BCVA 0.20 ± 0.56 logMAR (Snellen’s equivalent 20/30; range 0-2.3 logMAR). Twenty-two (91.66%) patients were successfully treated with laser alone. No complications were noted. Two patients underwent vitrectomy and achieved 20/20 visual acuity. Conclusion: Prompt treatment using the frequency doubled Nd YAG laser appears to be safe and effective in achieving significant visual recovery in patients with premacular hemorrhage due to Valsalva retinopathy.
Highlights
Valsalva retinopathy is caused by valsalva maneuver, which produces a sudden increase in the venous blood pressure, secondary to a rise in intra-thoracic or intra-abdominal pressure
We evaluated the outcomes of frequency doubled Nd:YAG membranotomy in 24 consecutive patients of premacular hemorrhage secondary to Valsalva maneuver
A total of 24 eyes of 24 patients with premacular hemorrhage were included in the study
Summary
Valsalva retinopathy is caused by valsalva maneuver, which produces a sudden increase in the venous blood pressure, secondary to a rise in intra-thoracic or intra-abdominal pressure. More often than not, self-limited, it can take a considerable amount of time to clear and may be visually disabling to the patient. It is generally unilateral, but can occur bilaterally [2,3]. The condition has been stated to resolve on its own in certain cases over a period of several months, but may require treatment [1]. In cases of small premacular haemorrhage, spontaneous resolution has been reported within a month [5]. In large non-resolving premacular haemorrhage surgery remains the only option
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