Valsalva retinopathy

Last updated
Valsalva retinopathy
Specialty Ophthalmology, Optometry
Complications Vitreous hemorrhage
CausesIntrathoracic 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. It can occur in any person irrespective of age, gender, race or health status.[ excessive detail? ][ citation needed ]

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]

Related Research Articles

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Retinopathy is any damage to the retina of the eyes, which may cause vision impairment. Retinopathy often refers to retinal vascular disease, or damage to the retina caused by abnormal blood flow. Age-related macular degeneration is technically included under the umbrella term retinopathy but is often discussed as a separate entity. Retinopathy, or retinal vascular disease, can be broadly categorized into proliferative and non-proliferative types. Frequently, retinopathy is an ocular manifestation of systemic disease as seen in diabetes or hypertension. Diabetes is the most common cause of retinopathy in the U.S. as of 2008. Diabetic retinopathy is the leading cause of blindness in working-aged people. It accounts for about 5% of blindness worldwide and is designated a priority eye disease by the World Health Organization.

<span class="mw-page-title-main">Diabetic retinopathy</span> Medical condition

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<span class="mw-page-title-main">Hypertensive retinopathy</span> Medical condition

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<span class="mw-page-title-main">Valsalva maneuver</span> Technique for equalising pressure in the middle ears

The Valsalva maneuver is performed by a forceful attempt of exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut while expelling air out as if blowing up a balloon. Variations of the maneuver can be used either in medical examination as a test of cardiac function and autonomic nervous control of the heart, or to clear the ears and sinuses when ambient pressure changes, as in scuba diving, hyperbaric oxygen therapy, or air travel.

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<span class="mw-page-title-main">Uterine rupture</span> Medical condition

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Thomas David Duane was an American ophthalmologist better known for studies in the field of retina. He identified that the blackouts experienced by wartime pilots during acceleration is due to reduced blood supply to the retina. In 1972, he first described Valsalva retinopathy a form of retinopathy caused by a sudden increase in intrathoracic or intra-abdominal pressure.

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.