Nd:YAG Laser Treatment For Valsalva Premacular Hemorrhages: 6 Month Follow Up Alternative Management Options For Preretinal Premacular Hemorrhages In Valsalva Retinopathy

Muhammad Tariq Khan, Vitreoretinal Consultant

LRBT Hospital, Lahore Pakistan

The aim of this study was to determine visual outcomes, complications, and long-term effects of drainage of preretinal (premacular) hemorrhage into the vitreous with Neodymium (Nd)-YAG laser in patients due to Valsalva retinopathy. A total of 12 patients with preretinal and premacular hemorrhage presumably caused by Valsalva maneuver was studied. All patients denied any history of ocular disease prior to presentation. Conservative treatment with observation, Nd-YAG hyaloidotomy, and vitrectomy were offered to all patients. A total of 11 patients opted for laser treatment, and one opted for conservative treatment with observation after counseling and informed consent. Nd-YAG-laser hyaloidotomy was performed to drain the hemorrhage into the vitreous cavity. Visual acuity and was recorded prior to treatment and at 1- and 6-month intervals after treatment. Complete retinal examination was undertaken at each visit when possible. Visual acuity improved in 11 patients after the Nd-YAG hyaloidotomy. No postlaser complications were noted at 6 months follow-up. One patient declined treatment and was monitored. Drainage of premacular preretinal hemorrhage due to Valsalva retinopathy into the vitreous with a Nd-YAG laser is a treatment alternative with potential of quick visual rehabilitation. Long-term results are unknown; however, short-term (up to 6 months) follow-up showed good results.

Keywords: Valsalva - Retinopathy - Preretinal - Hemorrhage - Macula - Nd-YAG - Laser