Valsalva retinopathy is a form of

retinopathy Retinopathy is any damage to the retina of the eyes, which may cause vision impairment. Retinopathy often refers to retinal vascular disease, or damage to the retina caused by abnormal blood flow. Age-related macular degeneration is technically inc ...

due to retinal bleeding secondary to rupture of retinal vessels caused by intrathoracic or intra-abdominal pressure due to physical activities. It can occur in any person irrespective of age, gender, race or health status.

Pathophysiology

Valsalva retinopathy is a form of sub-retinal, sub-hyaloid or sub-internal limiting membrane

hemorrhage Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagi ...

occur due to rupture of retinal vessels caused by a strenuous physical activity. Physical exertion like weight lifting and aerobic exercise, coughing, sneezing, straining at stool, vomiting, sexual intercourse, pregnancy, asthma, blowing up balloons, blowing musical instruments, cardiopulmonary resuscitation or compression injuries may cause sudden increase in

intrathoracic The thoracic cavity (or chest cavity) is the chamber of the body of vertebrates that is protected by the thoracic wall (rib cage and associated skin, muscle, and fascia). The central compartment of the thoracic cavity is the mediastinum. There ...

or intra-abdominal pressure may lead to rupture of superficial retinal blood vessels. 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.

Signs and symptoms

The main symptom of valsalva retinopathy is painless sudden loss of vision. Sudden-onset

floater Floaters or eye floaters are sometimes visible deposits (e.g., the shadows of tiny structures of protein or other cell debris projected onto the retina) within the eye's vitreous humour ("the vitreous"), which is normally transparent, or between ...

s and central or paracentral visual field defects and nausea resulting from increased

intraocular pressure Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. Most tonometers are calibrated t ...

are other symptoms.

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.

Complications

One of the main complications of valsalva retinopathy is

vitreous hemorrhage Vitreous hemorrhage is the extravasation, or leakage, of blood into the areas in and around the vitreous humor of the eye. The vitreous humor is the clear gel that fills the space between the lens and the retina of the eye. A variety of condition ...

Epidemiology

As of 2022, there is currently no specific age, gender or racial preference noted for this retinopathy in the medical literature.

Treatment

Depending on the location and extent of the bleeding, valsalva retinopathy usually resolves within weeks to months, without any complications. Patients are instructed to avoid anticoagulant drugs and physical activities which cause increase in intrathoracic or intra-abdominal pressure. For a speedy recovery, sometimes Nd:YAG laser or

argon laser An ion laser is a gas laser that uses an ionized gas as its lasing medium. Like other gas lasers, ion lasers feature a sealed cavity containing the laser medium and mirrors forming a Fabry–Pérot resonator. Unlike helium–neon lasers, the ...

membranotomy may be advised.

History

Valsalva retinopathy was first described in 1972 by American ophthalmologist Thomas D. Duane.

References

{{Eye pathology Disorders of choroid and retina Ophthalmology