Nd:YAG laser hyaloidotomy in a case of Valsalva retinopathy with premacular hemorrhage


  • Mete Guler
  • Ozlem Guler
  • Burak Bilgin




Intraretinal, preretinal, and vitreous hemorrhages in Valsalva retinopathy result from retinal capillary rupture following sudden increased retinal venous pressure from a rise in intrathoracic or intraabdominal pressure.  While preretinal hemorrhages may resolve on their own or may be treated with vitrectomy, we report a case of Valsalva retinopathy with a dense premacular hemorrhage which was successfully treated with Nd:YAG laser hyaloidotomy.  A healthy 27-years-old man presented with sudden painless visual loss after heavy cement bag lifting.  His visual acuity was count fingers in the affected eye.  A dilated fundus examination revealed a large dome shaped preretinal hemorrhage.  Nd:YAG laser hyaloidotomy was performed at the inferotemporal margin of the preretinal hemorrhage.  Within two weeks, the visual acuity improved to 20/20 and there was near complete resolution of the preretinal hemorrhage.  Non-visually-significant pigment epithelial injury was noted at the site of the laser application.  Nd:YAG laser hyaloidotomy may be a safe and effective therapeutic option in select patients with Valsalva retinopathy with preretinal hemorrhage.






Case Reports