become visually impaired after sneezing :VALSALVA RETINOPATHY

Author: Abdelhedi mariem (Tunisia)

Co-authors: Rekik Mona, Dorra Sallemi, Sammouda Takwa, Ben Amor Salwa, Trigui Amira

Purpose

to report a rare case of valsalva retinopathy after a simple effort of sneezing in a patient with no previous medical history

Setting/Venue

Department of Ophthalmology, Habib Bourguiba University Hospital, Faculty of Medicine, University of Sfax, Tunisia

Methods

case report

Results

A 54-year-old female patient presented with complains of rapidly progressive lower visual field amputation followed by persistent unilateral myodesopsia in the right eye. The anamnesis revealed the notion of a sneezing a few hours before the onset of symptoms. She was without personal previous medical history except a moderate myopia. Visual acuity was 10/10 in the right eye. The anterior segment was normal. The fundus examination showed pre-retinal hemorrhage in peri-papillary zone and in the posterior pole. Fluorescein angiography did not reveal any vascular abnormalities. The optical coherence tomography revealed no abnormal findings in the macular region of retina, a sub- internal limiting membrane hemorrhage was observed at the area of the bleeding site. Two months later, the pre-retinal hemorrhagere solved spontaneously and it progressed to vitreous hemorrhage which resolved in a month. Based on these findings and an in-depth review of systems, a diagnosis of Valsalva retinopathy was made, associated with patient's history.

Conlusions

Valsalva retinopathyis a specific form of retinopathy characterized by pre-retinal hemorrhages. The mechanism of a Valsalva maneuver is characterized by a sudden rise in intrathoracic or intraabdominal pressure against a closed glottis, which leads to a rapid rise of intravenous pressure within the eye, causing retinal capillaries to spontaneously rupture. It can occur in any person irrespective of health status. Patients present with sudden onset painless diminution of vision. It has to be kept in mind in young individuals presenting with sudden diminution of vision. A careful history is the key to the diagnosis. Prognosis is usually good with the spontaneous clearing of hemorrhage within weeks to months and vision returns to normal depending on the location of the bleed in the retina.

Financial Disclosure

No financial disclosure