Rohowetz Landon J, Patel Veshesh, Sridhar Jayanth, Yannuzzi Nicolas A
Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida.
Retina. 2023 Aug 1;43(8):1317-1320. doi: 10.1097/IAE.0000000000003772.
To report the clinical presentation and outcomes in patients with Valsalva retinopathy.
This was a retrospective case series of patients diagnosed with Valsalva retinopathy between June 1, 2010, and May 31, 2020. Clinical notes, operative reports, fundus photography, and optical coherence tomography images were reviewed.
This study comprised 58 eyes of 58 patients. The most common causes were lifting (34.4%), vomiting (20.6%), straining (20.6%), and coughing (17.2%). Mean best-corrected visual acuity at diagnosis was 20/163. The most frequently involved vitreoretinal compartment was the subhyaloid space (42.3%) followed by the intraretinal (32.7%), intravitreal (23.1%), and subretinal (13.4%) spaces. Mean best-corrected visual acuity of all patients was 20/59 at 3 months, 20/48 at 6 months, and 20/22 at 1 year. Mean time to clearance of hemorrhage on clinical examination was 99.0 ± 18.7 days in patients who underwent observation and 4.5 ± 3.5 days after surgery in patients who received pars plana vitrectomy.
Valsalva retinopathy is generally associated with a favorable visual prognosis. Most eyes perform well with observation although pars plana vitrectomy may be indicated in patients requiring rapid resolution of hemorrhage.
报告瓦尔萨尔瓦视网膜病变患者的临床表现及预后。
这是一项回顾性病例系列研究，纳入了2010年6月1日至2020年5月31日期间诊断为瓦尔萨尔瓦视网膜病变的患者。回顾了临床记录、手术报告、眼底照片和光学相干断层扫描图像。
本研究包括58例患者的58只眼。最常见的病因是提举重物（34.4%）、呕吐（20.6%）、用力（20.6%）和咳嗽（17.2%）。诊断时平均最佳矫正视力为20/163。最常受累的玻璃体视网膜腔隙是玻璃膜下间隙（42.3%），其次是视网膜内间隙（32.7%）、玻璃体内间隙（23.1%）和视网膜下间隙（13.4%）。所有患者在3个月时平均最佳矫正视力为20/59，6个月时为20/48，1年时为20/22。临床检查中出血清除的平均时间，接受观察的患者为99.0±18.7天，接受玻璃体切割术的患者术后为4.5±3.5天。
瓦尔萨尔瓦视网膜病变通常预后良好。大多数眼睛观察即可，不过对于需要快速清除出血时，可能需要行玻璃体切割术。
