Valsalva retinopathy associated with overall favorable visual prognosis
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NEW YORK — Valsalva retinopathy usually has a favorable visual prognosis, according to a study. Most eyes perform well with observation, although a few may benefit from surgery.
Valsalva retinopathy is a form of retinopathy characterized by the formation of retinal hemorrhages secondary to raised intrathoracic pressure. It typically occurs after weightlifting, coughing, vomiting and compressive injuries. Patients present with painless sudden-onset vision loss, and the diagnosis is made by fundus photography and OCT.
In a poster at the American Society of Retina Specialists annual meeting, Veshesh Patel and co-authors presented the results of a retrospective chart review study conducted at the University of Miami Miller School of Medicine in patients with Valsalva retinopathy between 2010 and 2020.
Fifty-eight eyes of 58 patients with a mean age of 50 years were included. The mean visual acuity at presentation was 20/163, the mean vertical and horizontal hemorrhage diameters were 3.6 ± 3.4 mm and 4 ± 5.1 mm, respectively, and the mean two-dimensional hemorrhage area was 22.1 ± 57.8 mm2. Hemorrhages were seen in any layer of the vitreoretinal space.
Pars plana vitrectomy was performed in four patients (6.9%), while 54 patients (93.1%) underwent observation. Best corrected visual acuity gradually improved up to 20/22 at 1 year and was stable around 20/26 to 20/27 between 2 years and 5 years.
“As expected, the current study demonstrated an inverse relationship between hemorrhage size and visual acuity at diagnosis. However, there were no correlations between initial hemorrhage size and visual acuity at any time after diagnosis,” the authors wrote.
A less favorable visual outcome was found in older patients and in patients with vitreous hemorrhage.
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Patel V, et al. Valsalva retinopathy: Clinical features and treatment outcomes. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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