Valsalva retinopathy

Last updated
Valsalva retinopathy
Specialty Ophthalmology, Optometry
Complications Vitreous hemorrhage
Causes Intrathoracic or intra-abdominal pressure, Valsalva manoeuvre [1]
Diagnostic method Ophthalmoscopy

Valsalva retinopathy is a form of retinopathy due to retinal bleeding secondary to rupture of retinal vessels caused by intrathoracic or intra-abdominal pressure due to physical activities.

Contents

Pathophysiology

Valsalva retinopathy is a form of sub-retinal, sub-hyaloid or sub-internal limiting membrane hemorrhage occur due to rupture of retinal vessels caused by a strenuous physical activity. [1] Physical exertion like weight lifting and aerobic exercise, coughing, sneezing, straining at stool, vomiting, sexual intercourse, pregnancy, [2] asthma, [3] blowing up balloons, blowing musical instruments, cardiopulmonary resuscitation or compression injuries may cause sudden increase in intrathoracic or intra-abdominal pressure may lead to rupture of superficial retinal blood vessels. [4] A sudden increase in venous pressure due to intrathoracic or intra-abdominal pressure cause the small perifoveal capillaries of retina to rupture, leading to premacular hemorrhage of varying intensity. [5]

Signs and symptoms

The main symptom of valsalva retinopathy is painless sudden loss of vision. [6] Sudden-onset floaters and central or paracentral visual field defects and nausea resulting from increased intraocular pressure are other symptoms. [1] [3] [7]

Diagnosis

Patients may have a history of sudden vision loss after a strenuous physical activity. Physical examination and eye examination is needed for diagnosis of valsalava retinopathy. OCT scanning can be used to identify the location of the bleeding. [4]

Complications

One of the main complications of valsalva retinopathy is vitreous hemorrhage. [5]

Epidemiology

As of 2022, there is currently no specific age, gender or racial preference noted for this retinopathy in the medical literature. [6]

Treatment

Depending on the location and extent of the bleeding, valsalva retinopathy usually resolves within weeks to months, without any complications. [4] Patients are instructed to avoid anticoagulant drugs and physical activities which cause increase in intrathoracic or intra-abdominal pressure. [4] For a speedy recovery, sometimes Nd:YAG laser or argon laser membranotomy may be advised. [8]

History

Valsalva retinopathy was first described in 1972 by American ophthalmologist Thomas D. Duane. [4]

References

  1. 1 2 3 Rajshri, Hirawat; Krishnappa, Nagesha C.; Sharma, Unnatti; Ganne, Pratyusha (1 March 2021). "Long-standing Valsalva retinopathy". BMJ Case Reports. 14 (3) e240812. doi:10.1136/bcr-2020-240812. ISSN   1757-790X. PMC   7938996 . PMID   33674301. S2CID   232129854.
  2. Al-Mujaini, Abdullah S.; Montana, Carolina C. (7 April 2008). "Valsalva retinopathy in pregnancy: a case report". Journal of Medical Case Reports. 2 (1): 101. doi: 10.1186/1752-1947-2-101 . ISSN   1752-1947. PMC   2311321 . PMID   18394189. S2CID   10134512.
  3. 1 2 "Valsalva Retinopathy: Vision loss after asthma attack".
  4. 1 2 3 4 5 "Valsalva Retinopathy - EyeWiki". eyewiki.aao.org. Retrieved 2022-04-24.
  5. 1 2 Salmon JF (13 December 2019). "Retinal vascular disease". Kanski's clinical ophthalmology: a systematic approach (9th ed.). Elsevier. p. 549. ISBN   978-0-7020-7711-1.
  6. 1 2 Simakurthy, Sriram; Tripathy, Koushik (2022-02-21). "Valsalva Retinopathy". StatPearls. PMID   31424803.
  7. "Ocular Manifestations Of Valsalva Maneuver". Clinical and Refractive Optometry.
  8. Ophthalmology (Fifth ed.). Edinburgh: Elsevier. 2019. p. 681. ISBN   978-0-323-52820-7.