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.
​
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.
​
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.