Valsalva retinopathy and branch retinal artery occlusion after cardiopulmonary cerebral resuscitation

Abstract

We report a 53-year-old woman who had acute visual loss 10 days after cardiopulmonary cerebral resuscitation performance. Immediately after she had performed cardiopulmonary cerebral resuscitation, she developed floater symptoms in her left eye, which persisted for 2 hours, and she was diagnosed as having Valsalva retinopathy. Ten days later, she had an acute painless visual loss in the same eye (visual acuity 20/1000). On fundus examination, optic disk edema, peripapillary hemorrhage, and retinal artery occlusion were detected in the superior half of her left retina and she was diagnosed as having branch retinal artery occlusion. Four months later, her visual acuity had increased to 20/40; however, the inferior altitudinal visual field defect remained. To rule out cardiac associations of branch retinal artery occlusion, transesophageal echocardiography was performed and a patent foramen ovale on her atrial septum was detected. This case indicates a possible risk that emergency medical personnel could have medical problems while performing strenuous tasks to help other people.