Miriam Garcia Fernandez_SCIENTIFIC POSTER 2015_4


To increase awareness of the possible complication of maculopathy occurring in individuals during the Valsalva manoeuvre, and the efficacy of the laser Nd:YAG laser treatment.


Two men, 26 and a 46 years old ,complained of sudden, painless loss of vision in their left eye. One of them became symptomatic after lifting a suitcase (Case 1), and the other one after vigorous dancing (Case 2). There was no history of trauma. Medical, ocular and familial history were unremarkable, except for systemic hypertension in Case 1. A complete ocular examination, including determination of Visual Acuity (VA), anterior and posterior biomicroscopy, and optical coherence tomography (OCT), were performed, at first and last examination. The systemic examination and all relevant blood tests were normal, and there was no other relevant social history.

Effectiveness / Safety:

At first visit, Best corrected visual acuity (BCVA) was 0.05 (decimal notation) in left eye (LE) and 1.0 in right eye (RE) in Case 1, and 0.2 in LE, and 1.0 in RE in Case 2. Anterior segment examination revealed no abnormalities in both cases. Fundoscopy revealed the presence of a submacular hemorrhage in their left eye. Funduscopy appearance of right eye was normal in both patients. The appearance of the left fundus, combined with an associated unequivocal history of physical exertion, was consistent with a diagnosis of Valsalva maculopathy. So, 24 hours after diagnosis, they underwent Nd:YAG laser treatment to drain the entrapped premacular blood into the vitreous. In Case 1, after photodisruption, vision in the affected eye improved rapidly due to exposure of the macula, with a final VA of 1.0. In Case 2, VA was 0.5 48 hours after treatment, 0.7 seven days after treatment, and 1.0 one month later. Their vision continues to remain normal to date.

In conclusion, Nd:YAG laser treatment may be a good alternative for recent preretinal hemorrhages. Clinical benefits include rapid visual rehabilitation and the avoidance of vitrectomy. The prognosis for Valsalva maculopathy is extremely favourable, and patients should be reassured accordingly.

Contact Details:

Email: migarci@hotmail.es
Cell Phone: +34629853800