A Case of Recurrent Valsalva Retinopathy Associated with Exercising a Barbell

ABSTRACT

PURPOSE: To report one case of recurrent Valsalva retinopathy presented as subretinal hemorrhage associated with exercising a barbell in a healthy man. METHODS: A 47-year-old healthy man visited our hospital complaining of a pericentral blind-spot in the right visual field. At first visit, visual acuity was 20/20 without correction. Anterior segment examination was unremarkable and dilated fundus examination revealed a subretinal hemorrhage in the inferior area of the macula. We followed up the visual acuity, anterior segment exam, fundus examination, and fluorescein angiography for several weeks. RESULTS: Three weeks after the first visit, the size of subretinal hemorrhage decreased, but recurrent subretinal hemorrhage presented after exercising a barbell at the existing hemorrhagic part and its inferior area. Six weeks after the recurrent hemorrhage, the hemorrhage was resolved completely and the pericentral blind-spot was recovered. CONCLUSIONS: Valsalva hemorrhagic retinopathy is characterised by retinal hemorrhage occurring in healthy individuals due to a rapid rise in intrathoracic or intra-abdominal pressure. In this case, there was recurrent subretinal hemorrhage after repeatedly exercising a barbell. So, it is very important to educate patients about the restriction of excessive Valsalva maneuver to prevent recurrent Valsalva retinopathy.