Retinopatia de Vasalva

Resumo

Valsalva retinopathy is a rare, specific retinal disorder characterized by preretinal hemorrhage caused by raised intrathoracic or intraabdominal pressure. It was firstly described by Duane in 1972.1 Patients present with sudden visual impairment, usually occurring in otherwise healthy eyes. The condition is triggered by Valsalva maneuvers including weight lifting, vomiting, coughing, constipation, blowing musical instruments, strenuous physical activities, vigorous sexual intercourse and labor. The prognosis is usually good with progressive spontaneous resolution.

A 35-year-old healthy female presented with sudden onset of unilateral myodesopia referred to the right eye. Symptoms started 24 hours prior, following an intense CrossFit training session. She had no history of previous ophthalmologic disorders. Best-corrected visual acuity was 20/20 bilaterally. Anterior segment slit-lamp examination and intraocular pressure were unremarkable. Fundoscopy of the affected eye revealed a well-circumscribed, round and bright red, preretinal hemorrhage causing an elevated hemorrhagic posterior hyaloid detachment, nasal to the optic disc. The lesion had several disc areas of diameter and a horizontal, upper fluid level with gravitated blood corpuscles inferiorly. Additional small, preretinal and intraretinal hemorrhages were scattered through the macula and peripheral retina. Complete blood work, which included coagulation tests, was regular. A conservative approach was assumed. Three months later, visual acuity remained stable with complete resolution of retinal findings.