Valsalva Retinopathy

= Haemorrhagic retinal pathology secondary to sudden rise in intrathoracic pressure.

• Happens in normal eyes and resolves spontaneously.

• Haemorrhages at sub ILM layer (commonly) but can be subhyaloid or vitreous.

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Clinical presentation:

• Sudden painless loss of vision with history suggestive of Valsalva maneouver.

• Well-circumscribed red elevation (round or bi-lobed) at premacular region below ILM.

• Occasionally subhyaloid bleed or vitreous haemorrhage.

• Blood – bright red –> yellow (after days-to-weeks).

• Resolves sponatenously and vision recovers.

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Management:

• Diagnosis of exclusion

• Rule out DM, SCD, anaemia and other blood dyscrasia – perform FBC, glucose, sickle cell prep, APTT, PT, serum electrophoresis, antiphospholipid antibody and urinalysis.

• OCT / FFA

• Observe and propped up positioning.

• Nd:YAG in subhyaloid haemorrhage (< 3 weeks old and > 3 DD size)

• PPV – non-resolving VH.