Título / Title

VALSALVA MACULOPATHY: A CASE REPORT

Introdução / Purpose

To report a case of Valsava Maculopathy in which the patient was benefited by expectant management.

Material e Método / Methods

Outpatient follow-up of a 55-year-old healthy patient presented with sudden and painless vision loss of his left eye, denies any other symptom and ophthalmologic antecedents. After physical examination and OCT it was possible to identify typical macular hemorrhage of Valsalva Maculopathy and then choose the appropriate treatment.

Resultados / Results

After discussing the treatment options, we opted for a non cirurgical conduct to observe if the bleeding would regress spontaneously. After three months of follow-up, there was an important improvement in symptoms and macular hemorrhage, demonstrating the benefit of expectant management without the need for invasive procedures.

Discussão e Conclusões / Conclusion

Valsalva maculopathy is caused by a sudden increase in intra-abdominal or intrathoracic pressure against the closed glottis (Valsalva maneuver), most often related to intense physical exercises, effort to evacuate, vomiting, coughing, chest pain, among others. As a result, it causes increased venous pressure and may lead to spontaneous ruptures of the retinal superficial capillaries. Common symptoms are sudden and painless decrease in visual acuity and appearance of scotomas at the center of vision, usually with young individuals and no previous history of ocular pathology. Treatment options include observation, laser, pneumatic displacement of intravitreal gas injection bleeding and vitrectomy. The decision to intervene or not depends on several factors, including bilaterality, extent of hemorrhage and surgical risks.

Palavras Chave

Valsalva maculopathy; intrathoracic pressure; sudden and painless vision loss; expectant management