Valsalva Retinopathy: Clinical Features and Treatment Outcomes.

PURPOSE: To report the clinical presentation and outcomes in patients with Valsalva retinopathy.

METHODS: Retrospective case series of patients diagnosed with Valsalva retinopathy between June 1, 2010 and May 31, 2020. Clinical notes, operative reports, fundus photography, and optical coherence tomography images were reviewed.

RESULTS: The study comprised 58 eyes of 58 patients. The most common causes were lifting (34.4%), vomiting (20.6%), straining (20.6%), and coughing (17.2%). Mean best-corrected visual acuity (BCVA) at diagnosis was 20/163. The most frequently involved vitreoretinal compartment was the subhyaloid space (42.3%) followed by the intraretinal (32.7%), intravitreal (23.1%), and subretinal (13.4%) spaces. Mean BCVA of all patients was 20/59 at 3 months, 20/48 at 6 months, and 20/22 at 1 year. Mean time to clearance of hemorrhage on clinical exam was 99.0 ± 18.7 days in patients who underwent observation and 4.5 ± 3.5 days after surgery in patients who received pars plana vitrectomy.

CONCLUSION: Valsalva retinopathy is generally associated with a favorable visual prognosis. Most eyes perform well with observation although pars plana vitrectomy may be indicated in patients requiring rapid resolution of hemorrhage.