Medicine:Valsalva retinopathy
| 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.
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 or argon laser membranotomy may be advised.[8]
History
Valsalva retinopathy was first described in 1972 by American ophthalmologist Thomas D. Duane.[4]
References
- ↑ 1.0 1.1 1.2 Rajshri, Hirawat; Krishnappa, Nagesha C.; Sharma, Unnatti; Ganne, Pratyusha (1 March 2021). "Long-standing Valsalva retinopathy" (in en). BMJ Case Reports 14 (3): e240812. doi:10.1136/bcr-2020-240812. ISSN 1757-790X. PMID 33674301. PMC 7938996. https://casereports.bmj.com/content/14/3/e240812.
- ↑ 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. PMID 18394189.
- ↑ 3.0 3.1 "Valsalva Retinopathy: Vision loss after asthma attack". https://webeye.ophth.uiowa.edu/eyeforum/cases/67-Valsalva-Retinopathy-Vision-Loss-Asthma.htm.
- ↑ 4.0 4.1 4.2 4.3 4.4 "Valsalva Retinopathy - EyeWiki" (in en). https://eyewiki.aao.org/Valsalva_Retinopathy#:~:text=Valsalva%20retinopathy%20is%20a%20preretinal,healthy%20eye%20and%20spontaneously%20resolves..
- ↑ 5.0 5.1 "Retinal vascular disease". Kanski's clinical ophthalmology : a systematic approach (9th ed.). Elsevier. 13 December 2019. p. 549. ISBN 978-0-7020-7711-1.
- ↑ 6.0 6.1 Simakurthy, Sriram; Tripathy, Koushik (2022-02-21). "Valsalva Retinopathy" (in en). StatPearls. PMID 31424803. https://www.statpearls.com/ArticleLibrary/viewarticle/28466.
- ↑ "Ocular Manifestations Of Valsalva Maneuver". Clinical and Refractive Optometry. http://digital.crojournal.com/articles/ocular-manifestations-of-valsalva-maneuver?article_id=3136352.
- ↑ Ophthalmology (Fifth ed.). Edinburgh: Elsevier. 2019. p. 681. ISBN 978-0-323-52820-7.
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