Department of Ophthalmology, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
BMC Ophthalmol. 2020 Oct 27;20(1):428. doi: 10.1186/s12886-020-01662-z.
Central retinal vein occlusion is a variable disease pattern. Preliminary stages of a complete occlusion of the central vein, wich are subsumed under the term venous stasis retinopathy, may occur as transient blurred vision and with subtle alterations of the fundus. Course and prognosis are benign, visual acuity usually recovers. By now, venous stasis retinopathy in children due to Valsalva maneuver has not been described in literature yet.
We present an impressive case of venous stasis retinopathy in a 10-year-old boy with ocular hypertension and megalocornea due to increased intraocular pressure provoked by Valsalva maneuver. Main symptom was transient blurred vision in the left eye. The intraocular pressure was 28 mmHg, fundus exam revealed tortuous veins and a flame shaped hemorrhage at 7 o'clock. Total recovery under topical antiglaucomatous therapy could be observed after 1 month.
Acute increase in intraocular pressure, provoked by Valsalva maneuver is a risk factor for venous stasis retinopathy. Further general and vascular risk factors should be ruled out by extensive examination. Children with ocular hypertension might be at higher risk for impending vein occlusion as shown in this case.
视网膜中央静脉阻塞是一种多变的疾病模式。完全阻塞中央静脉的初步阶段,即静脉淤血性视网膜病变,可能表现为短暂的视力模糊,并伴有细微的眼底改变。病程和预后均良好,视力通常可恢复。目前,文献中尚未描述儿童因瓦尔萨尔瓦动作引起的静脉淤血性视网膜病变。
我们报告了一例 10 岁男孩的静脉淤血性视网膜病变的典型病例,该男孩因眼压升高和大角膜导致眼内压升高,眼内压升高由瓦尔萨尔瓦动作引起。主要症状为左眼一过性视力模糊。眼压为 28mmHg,眼底检查显示 7 点钟处静脉扭曲和火焰状出血。经过 1 个月的局部降眼压治疗后,视力完全恢复。
瓦尔萨尔瓦动作引起的急性眼压升高是静脉淤血性视网膜病变的一个危险因素。应通过全面检查排除其他一般和血管危险因素。如本例所示,眼压升高的儿童可能面临更高的静脉阻塞风险。