Exercise-induced Valsalva retinopathy: A case report and literature review

Introduction. Valsalva retinopathy is an uncommon disorder that usually presents with acute onset of unilateral, or less frequently, bilateral visual impairment varying from subtle scotoma to total vision loss. It occurs as a result of Valsalva’s maneuver. In the vast majority of cases, hemorrhage i...

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Main Authors: Kovačević Igor, Mirković Jelena, Šobot Vesna, Bila Mladen, Vasilijević Jelena
Format: Article
Language:English
Published: Serbian Medical Society 2022-01-01
Series:Srpski Arhiv za Celokupno Lekarstvo
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0370-8179/2022/0370-81792200064K.pdf
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author Kovačević Igor
Mirković Jelena
Šobot Vesna
Bila Mladen
Vasilijević Jelena
author_facet Kovačević Igor
Mirković Jelena
Šobot Vesna
Bila Mladen
Vasilijević Jelena
author_sort Kovačević Igor
collection DOAJ
description Introduction. Valsalva retinopathy is an uncommon disorder that usually presents with acute onset of unilateral, or less frequently, bilateral visual impairment varying from subtle scotoma to total vision loss. It occurs as a result of Valsalva’s maneuver. In the vast majority of cases, hemorrhage is preretinal although subretinal, intraretinal and vitreous hemorrhage can be found. Valsalva retinopathy often develops due to numerous triggering activities such as vomiting, coughing, heavy weight lifting, intense aerobic exercise, labor, and general anesthesia. Management options are either clinical observation or invasive techniques. We report a case of premacular hemorrhage due to Valsalva retinopathy induced by gym training. Case outline. A 34-year-old woman was referred to the Eye Clinic, University Clinical Center of Serbia, complaining of sudden and painless unilateral decrease in vision occurred during intense physical activity. Best corrected visual acuity was measured as counting fingers at five meters distance. Dilated fundoscopy demonstrated a large, well demarcated premacular subhyaloid hemorrhage with visible rupture of the retinal vein branch. The patient was treated conservatively. Three months after the onset of symptoms, hemorrhage absorbed and best corrected visual acuity was 20/20. Conclusion. Valsalva retinopathy, although a rare condition, should not be omitted as a differential diagnosis of retinal and vitreous hemorrhages. Standard, observational treatment is generally sufficient for complete vision recovery; however, literature suggests that an individualized approach to each patient is required.
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spelling doaj.art-ae2977d5a934405b9b2422066fdd69742022-12-22T04:30:52ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792406-08952022-01-011507-848048310.2298/SARH220407064K0370-81792200064KExercise-induced Valsalva retinopathy: A case report and literature reviewKovačević Igor0Mirković Jelena1Šobot Vesna2Bila Mladen3Vasilijević Jelena4https://orcid.org/0000-0002-4806-0497University Clinical Centre of Serbia, Eye Clinic, Belgrade, Serbia + University of Belgrade, Medical faculty, Belgrade, SerbiaUniversity Clinical Centre of Serbia, Eye Clinic, Belgrade, SerbiaUniversity Clinical Centre of Serbia, Eye Clinic, Belgrade, SerbiaUniversity Clinical Centre of Serbia, Eye Clinic, Belgrade, SerbiaUniversity Clinical Centre of Serbia, Eye Clinic, Belgrade, Serbia + University of Belgrade, Medical faculty, Belgrade, SerbiaIntroduction. Valsalva retinopathy is an uncommon disorder that usually presents with acute onset of unilateral, or less frequently, bilateral visual impairment varying from subtle scotoma to total vision loss. It occurs as a result of Valsalva’s maneuver. In the vast majority of cases, hemorrhage is preretinal although subretinal, intraretinal and vitreous hemorrhage can be found. Valsalva retinopathy often develops due to numerous triggering activities such as vomiting, coughing, heavy weight lifting, intense aerobic exercise, labor, and general anesthesia. Management options are either clinical observation or invasive techniques. We report a case of premacular hemorrhage due to Valsalva retinopathy induced by gym training. Case outline. A 34-year-old woman was referred to the Eye Clinic, University Clinical Center of Serbia, complaining of sudden and painless unilateral decrease in vision occurred during intense physical activity. Best corrected visual acuity was measured as counting fingers at five meters distance. Dilated fundoscopy demonstrated a large, well demarcated premacular subhyaloid hemorrhage with visible rupture of the retinal vein branch. The patient was treated conservatively. Three months after the onset of symptoms, hemorrhage absorbed and best corrected visual acuity was 20/20. Conclusion. Valsalva retinopathy, although a rare condition, should not be omitted as a differential diagnosis of retinal and vitreous hemorrhages. Standard, observational treatment is generally sufficient for complete vision recovery; however, literature suggests that an individualized approach to each patient is required.http://www.doiserbia.nb.rs/img/doi/0370-8179/2022/0370-81792200064K.pdfvalsalva retinopathyvalsalva’s maneuverpreretinal hemorrhagevitreous hemorrhage
spellingShingle Kovačević Igor
Mirković Jelena
Šobot Vesna
Bila Mladen
Vasilijević Jelena
Exercise-induced Valsalva retinopathy: A case report and literature review
Srpski Arhiv za Celokupno Lekarstvo
valsalva retinopathy
valsalva’s maneuver
preretinal hemorrhage
vitreous hemorrhage
title Exercise-induced Valsalva retinopathy: A case report and literature review
title_full Exercise-induced Valsalva retinopathy: A case report and literature review
title_fullStr Exercise-induced Valsalva retinopathy: A case report and literature review
title_full_unstemmed Exercise-induced Valsalva retinopathy: A case report and literature review
title_short Exercise-induced Valsalva retinopathy: A case report and literature review
title_sort exercise induced valsalva retinopathy a case report and literature review
topic valsalva retinopathy
valsalva’s maneuver
preretinal hemorrhage
vitreous hemorrhage
url http://www.doiserbia.nb.rs/img/doi/0370-8179/2022/0370-81792200064K.pdf
work_keys_str_mv AT kovacevicigor exerciseinducedvalsalvaretinopathyacasereportandliteraturereview
AT mirkovicjelena exerciseinducedvalsalvaretinopathyacasereportandliteraturereview
AT sobotvesna exerciseinducedvalsalvaretinopathyacasereportandliteraturereview
AT bilamladen exerciseinducedvalsalvaretinopathyacasereportandliteraturereview
AT vasilijevicjelena exerciseinducedvalsalvaretinopathyacasereportandliteraturereview