Título

TOMOGRAPHIC CONFIRMATION OF DOUBLE RING SIGN IN VALSALVA RETINOPATHY

Objetivo

To present the tomographic confirmation of the double ring sign in a patient who presented valsalva retinopathy

Métodos

case report

Resultados

A 33-year-old female patient reported a sudden and painless unilateral low visual acuity on the left eye. Visual acuity equal to 20/20, with no findings on biomicroscopy, tonometry or funduscopy. In the left eye (LE) the best visual acuity was equal to finger count, biomicroscopy and tonometry without alterations, and funduscopic examination showed dense preretinal hemorrhage, with fluid level and double ring sign. There were no changes in the retinal vascular framework. Optical coherence tomography (OCT) showed the presence of hemorrhagic detachment of the internal limiting membrane and partial detachment of the posterior hyaloid, confirming the clinical finding known as the double ring sign

Discussão e Conclusões

The consequent increase in intrathoracic or intra-abdominal pressure may eventually result in the rupture of normal or abnormal superficial retinal capillaries, leading to hemorrhagic detachment of the internal limiting membrane and possible vitreous hemorrhages.
These types of hemorrhages occasionally have a double ring sign. In the present case, OCT was able to detect two types of hemorrhage (sub-limiting and sub-hyaloid).
The prognosis is generally favorable and the condition resolves spontaneously after a few weeks or months. Selected cases may benefit from treatments such as Yag Laser membranectomy, intravitreal gas injection, or vitrectomy. In the case presented, it was decided to wait for the spontaneous absorption of the hemorrhage

Palavras Chave

valsalva retinopathy; double ring sign in valsava retinopathy

Área

Clínica