A Case of Atypical Valsalva Retinopathy after Strenuous Exercise

ABSTRACT

PURPOSE: To report a case of recurrent bilateral preretinal hemorrhages in a healthy male with no previous history of systemic or ocular diseases and to review the relevant literature. METHODS: History taking, measurement of visual acuity and intraocular pressure, slit-lamp examination, fundoscopy, and fluorescein angiography were performed in a 15-year-old male who had experienced a sudden decrease in visual acuity in both eyes after a couple of strenuous exercises in school. RESULTS: Best-corrected visual acuity (BCVA) was 0.9 in the right eye and 0.2 in the left, and bilateral premacular hemorrhages were observed. Most of the preretinal hemorrhages were completely resolved by the sixth week and visual acuity in the left eye improved to 0.6. Nine months after the initial event, preretinal hemorrhages recurred bilaterally, worse in the left eye, and BCVA decreased to 0.3 in the right eye and 0.02 in the left eye. We performed Nd YAG laser disruption of the internal limiting membrane in the left eye. Four weeks after the procedure, most of the preretinal hemorrhages were resolved and visual acuity in the left eye improved to 0.2. CONCLUSIONS: Clinical improvement was achieved after Nd YAG laser disruption of the internal limiting membrane in a case of recurrent bilateral preretinal hemorrhages.