19.3

Valsalva Retinopathy

Introduction:

Valsalva retinopathy results from a sudden increase in intraocular venous pressure due to forced exhalation against a closed glottis. This leads to rupture of superficial capillaries in predisposed individuals.

Clinical Features:

Preretinal hemorrhage accumulates in the sub-internal limiting membrane space, typically overlying the macula (Fig. 19.3.1). With rest, the red blood cells layer such that there is a serous component superiorly.

Figure 19.3.1 Color photograph of valsalva retinopathy with a layered pre-macular hemorrhage. (Modified from Goldman, D.R. & Baumal, C.R. Natural history of valsalva retinopathy in an adolescent. Journal of Pediatric Ophthalmology and Strabismus, in press.)

OCT Features:

The superior serous component forms a hyporeflective cavity (Fig. 19.3.2), whereas the inferior hemorrhagic component forms a hyper-reflective cavity that blocks the underlying structures (Fig. 19.3.3

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