Valsalva retinopathy associated with the choking game.

A 41-year-old man with high myopia presented with a central scotoma in the left eye. Initial visual acuity in the left eye was count fingers. Color fundus photos, fluorescein/indocyanine green angiography, and optical coherence tomography of the macula were performed showing intraretinal and subretinal hemorrhage over the macula. The patient admitted to developing acute vision loss after holding his breath and blowing against a closed glottis to obtain a euphoric sensation. It is extremely important to recognize this possible cause of Valsalva retinopathy due to the potentially life-threatening outcome of this game.