Park Ju-Hong, Sagong Min, Chang Woohyok
Ju-Hong Park, Min Sagong, Woohyok Chang, Department of Ophthalmology, Yeungnam University College of Medicine, Daegu 705-717, South Korea.
World J Gastroenterol. 2014 Mar 21;20(11):3056-8. doi: 10.3748/wjg.v20.i11.3056.
We report a case of Valsalva retinopathy associated with esophagogastroduodenoscopy (EGD) under propofol sedation. A 43-year-old woman who had no previous history of systemic or ocular disease presented with a complaint of decreased vision in her left eye, which developed one day after EGD under propofol sedation. According to the referring physician, the patient had experienced multiple sustained Valsalva maneuvers during EGD. The fundus examination of the left eye showed a large preretinal hemorrhage surrounded by multiple small retinal hemorrhages in the posterior pole. One month later, fundus examination revealed a floating organized vitreous hemorrhage. The pars plana vitrectomy was performed to treat persistent vitreous hemorrhage. One month after vitrectomy, fundus examination showed normal retina and the patient's vision recovered to 20/20. Valsalva maneuver can occur during EGD under sedation, and Valsalva retinopathy should be considered as a possible cause. Valsalva retinopathy should be included in the differential diagnosis when a patient complains of blurred vision following EGD.
我们报告一例在丙泊酚镇静下进行食管胃十二指肠镜检查(EGD)相关的瓦尔萨尔瓦视网膜病变。一名43岁女性,既往无全身或眼部疾病史,在丙泊酚镇静下进行EGD检查一天后,出现左眼视力下降的主诉。据转诊医生称,患者在EGD检查期间经历了多次持续性瓦尔萨尔瓦动作。左眼眼底检查显示后极部有一个大的视网膜前出血,周围有多个小的视网膜出血。一个月后,眼底检查发现有漂浮的机化玻璃体出血。进行了玻璃体切割术以治疗持续性玻璃体出血。玻璃体切割术后一个月,眼底检查显示视网膜正常,患者视力恢复到20/20。在镇静下进行EGD检查时可能会发生瓦尔萨尔瓦动作,应考虑瓦尔萨尔瓦视网膜病变为可能的病因。当患者在EGD检查后出现视力模糊的主诉时,瓦尔萨尔瓦视网膜病变应列入鉴别诊断。