Abstract
BackgroundTo report a long-term complication of unsealed and un-reattached internal limiting membrane in Valsalva retinopathy after neodymium-doped yttrium–aluminium–garnet (Nd:YAG) laser membranotomy.Case presentationA 41-year-old man presenting with a massive premacular hemorrhage due to Valsalva retinopathy underwent Nd:YAG laser membranotomy. During follow-up, best-corrected visual acuity, retinal alteration and optical coherence tomography (OCT) outcomes were documented. One month after membranotomy, his visual acuity improved to 20/20 and the hemorrhage resolved completely. At an 8-month follow-up visit, the fundus showed progressive wrinkling of the internal limiting membrane with the laser perforation located in the center. OCT showed a persistent unsealed and un-reattached internal limiting membrane.ConclusionsNot all patients with Valslava retinopathy with premacular hemorrhage are appropriate candidates for laser membranotomy, especially patients with sub- internal limiting membrane hemorrhage. The key point for observation is the interface between internal limiting membrane and retinal surface. The long-term consequences of unsealed internal limiting membrane after Nd:YAG laser membranotomy require further understanding.
Highlights
To report a long-term complication of unsealed and un-reattached internal limiting membrane in Valsalva retinopathy after neodymium-doped yttrium–aluminium–garnet (Nd:YAG) laser membranotomy.Case presentation: A 41-year-old man presenting with a massive premacular hemorrhage due to Valsalva retinopathy underwent Nd:YAG laser membranotomy
Valsalva retinopathy can present as a sudden, dramatic loss of central vision due to premacular hemorrhage [1]
While there is no widely accepted treatment modality other than observation, since the 1980s neodymium-doped yttrium– aluminium–garnet (Nd:YAG) laser membranotomy has been pushed to the forefront for the treatment of large macular hemorrhages in Valsalva retinopathy [2]
Summary
Nd:YAG lasers have been used for disruption of the posterior hyaloid or the ILM in the treatment of Valsalva retinopathy. The long-term complications of Nd:YAG laser membranotomy include macular hole [5], retinal detachment [5], epiretinal membrane formation [6] and a persistent premacular cavity [7]. Kwok and colleagues (2003), reported a case with ERM secondary to Nd:YAG treatment, and there was a similar retinal outcome with our patient [6]. A persistent unsealed and unreattached ILM membrane may drive ERM formation. To avoid this complication, the timing of the Nd:YAG laser procedure and the size of laser opening are important issues. During the follow-up after Nd:YAG laser membranotomy, assessing ILM alterations at the macular region is rather important and the long-term consequences of an unsealed ILM require further consideration.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
