Retrohyaloidal Macular Hemorrhage Following a Valsalva Manoeuvre: Case Report and Review of Literature
Published: 2020-01-18
Page: 25- 30
Issue: 2019 - Volume 2 [Issue 1]
M. Essakhi *
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
I. Er-rachik
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
I. Adnane
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
A. Mchachi
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
L. Benhmidoune
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
M. Chakib
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
R. Rachid
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
M. Elbelhadji
Department of Adult Ophthalmology, Faculty of Medicine and Pharmacy, Hassan II University – Casablanca, Hospital 20 August 1953, Ibn Rochd UHC, Morocco.
*Author to whom correspondence should be addressed.
Abstract
A pre-retinal haemorrhage can complicate several pathologies including Valsalva retinopathy. It can cause symptomatic visual disturbances that lead the patient to seek medical attention. We report the case of a 39-year-old patient, with no particular pathological history, who has a sudden drop in visual acuity in her right eye. This symptomatology appeared a few minutes after defecation following constipation. The ophthalmological examination found a corrected visual acuity in the right eye that was quantified by counting the fingers at close range. The fundus revealed a macular haemorrhage suspended in a pigeon's nest. The diagnosis of spontaneous right retrohyaloidal haemorrhage secondary to cephalic venous hyper pressure was retained. A Yag laser membranotomy was performed at a distance from the fovea. The evolution was favourable with an increase in visual acuity to 6/10. The main aetiology of retrohyaloidal haemorrhages is rarely venous cephalic hypertension. However, Valsalva's retinopathy should always be considered in case of effort with chest blockage in inspiration.
Keywords: Retro-hyaloidal haemorrhage, macula, valsalva retinopathy, membranotomy, Nd: YAG laser.