Cyrino Francyne Veiga Reis, Marques Joao Pedro Guzzi, Jorge Rodrigo
Retina and Vitreous Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Ophtalmology Resident, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil; and.
Retin Cases Brief Rep. 2024 May 1;18(3):340-345. doi: 10.1097/ICB.0000000000001401. Epub 2023 Jan 13.
We report a patient with recurrent optic disc pit (ODP) maculopathy after Valsalva's maneuver and discuss its pathophysiology. We also hypothesize the role of Valsalva's maneuver in its genesis.
Case report of one patient, male, 12 years old.
Serous retinal detachment may occur in association with the ODP, a developmental anomaly of the optic nerve head. Histopathologically, it consists of a dysplastic retina herniation into a pocket extending posteriorly through a defect in the lamina cribrosa into the subarachnoid space. These three different compartments-intraocular space, optic nerve head, and subarachnoid space-and the dynamic interactions among them should be understood as the key factors for the occurrence of ODP-related serous retinal detachment.
Based on the possibility that serous retinal detachment secondary to the ODP could be related to the Valsalva's maneuver, we strongly recommend that patients with ODP be advised to avoid intense physical or work activities that may increase abdominal, thoracic, and cerebral pressure and to refrain from playing wind instruments to avoid pretreatment, per treatment, and post-treatment intercurrences.
我们报告一例在瓦尔萨尔瓦动作后出现复发性视盘小凹（ODP）黄斑病变的患者，并讨论其病理生理学。我们还推测瓦尔萨尔瓦动作在其发病机制中的作用。
一名12岁男性患者的病例报告。
浆液性视网膜脱离可能与视盘小凹（一种视神经乳头的发育异常）相关。组织病理学上，它由发育异常的视网膜疝入一个通过筛板缺损向后延伸至蛛网膜下腔的腔隙组成。这三个不同的腔隙——眼内空间、视神经乳头和蛛网膜下腔——以及它们之间的动态相互作用应被理解为ODP相关浆液性视网膜脱离发生的关键因素。
基于ODP继发的浆液性视网膜脱离可能与瓦尔萨尔瓦动作有关的可能性，我们强烈建议ODP患者避免可能增加腹压、胸压和脑压的剧烈体力或工作活动，并避免吹奏管乐器，以避免治疗前、治疗期间和治疗后的并发症。
