Título / Title

SPONTANEOUS VALSALVA RETINOPATHY TREATED WITHND:YAG MEMBRANECTOMY

Introdução / Purpose

To report the follow-up of a case with premacular hemorrhage secondary to valsalva retinopathy which occurred spontaneously during sleep and treated with Nd:YAG membranectomy.

Material e Método / Methods

Case report.

Resultados / Results

A 39-years-old white woman, presents with the main complaint of severe and painless vision loss on the right eye (OD) noticed after waking up in the morning. She denied any remarkable medical history event. The best corrected visual acuity (BCVA) was hand movement on the OD and 20/20 on the left eye (OS). Anterior segment biomicroscopy of both eyes was unremarkable. The fundus examination revealed large pre retinal hemorrhage with macular involvement in the OD and no alterations in the OS. The patient was then diagnosed with Valsalva retinopathy and underwent hialoidotomy with Nd: YAG Laser. 3,6 mJ power shots were applied to the superior and inferior areas of the hemorragic internal limitating membrane (ILM) detachment which immediately started to drain out into the vitreous cavity. After 4 months of follow-up the BCVA of the OD was 20/20.

Discussão e Conclusões / Conclusion

Valsalva retinopathy is a rare disorder which occurs more often in healthy young adults, generally unilateral after coughing, vomiting, lifting, sexual activity or straining for a bowel movement. As risk factors which has been indicated in the literature the main are diabetes, arterial hypertension and blood dyscrasias. The main complaint is generally sudden and painless loss of vision. During the fundus examination sub-ILM hemorrhage with fixed borders is observed usually in front of the macula. After several weeks the spontaneous resolution commonly occurs and possibly causes complications such as epi-retinal membrane and macular tractional detachment. In cases with larger amounts of hemorrhage the laser membranectomy and the vitrectomy are management options. The Nd:YAG laser is a simple, effective and safe procedure which enables quick recovery of the visual acuity.

Palavras Chave

Retinal Hemorrhage; Laser Therapy; Retinal Diseases.