A Case of Spontaneously Resolving Valsalva Retinopathy in a 29-Year-Old Patient

Valsalva retinopathy (VR) occurs when a sudden rise in pressure within the thoracic or abdominal cavity results in a pre-retinal hemorrhage. The elevated venous pressure leads to increased blood flow through the retinal vessels, causing the rupture of peripapillary capillaries. This rupture leads to unilateral or bilateral pre-retinal hemorrhage, with blood pooling beneath the inner limiting membrane (ILM). A 29-year-old patient presented to the Emergency Eye Care Unit of the Professor Kornel Gibiński University Hospital Center of the Silesian Medical University in Katowice due to deterioration of vision in the right eye over the past five days. On physical examination, the visual acuity (VA) in the right eye was 0.4, and the ocular pressure was 24 mmHg. In the left eye, the VA was 1.0, and the ocular pressure was 22 mmHg. A fundus examination showed a tear-shaped hemorrhage in the fovea. On admission, an optical coherence tomography (OCT) scan of the right eye was performed, confirming the presence of a hemorrhage under the ILM, measuring 524 μm × 246 μm. One month after the initial visit, the VA in the right eye improved to 1.0. The dimension of the hemorrhage, measured by OCT, had decreased to 153 μm × 62 μm. Effective management of VR includes close observation and the avoidance of strenuous physical activity, which gives the patient a chance to regain useful VA and avoid surgical treatment.