| Valsalva retinopathy | |
| Field: | Ophthalmology, Optometry |
| Complications: | Vitreous hemorrhage |
| Causes: | Intrathoracic or intra-abdominal pressure, Valsalva manoeuvre[1] |
| Diagnosis: | 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.
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, 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.[3] 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.[4]
The main symptom of valsalva retinopathy is painless sudden loss of vision. Sudden-onset floaters and central or paracentral visual field defects and nausea resulting from increased intraocular pressure are other symptoms.[1] [5] [6]
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.[3]
One of the main complications of valsalva retinopathy is vitreous hemorrhage.[4]
As of 2022, there is currently no specific age, gender or racial preference noted for this retinopathy in the medical literature.[7]
Depending on the location and extent of the bleeding, valsalva retinopathy usually resolves within weeks to months, without any complications.[3] Patients are instructed to avoid anticoagulant drugs and physical activities which cause increase in intrathoracic or intra-abdominal pressure.[3] For a speedy recovery, sometimes or argon laser membranotomy may be advised.[8]
Valsalva retinopathy was first described in 1972 by American ophthalmologist Thomas D. Duane.[3]