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.

 
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