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Case Reports
. 2023 May 3;7(5):444-447.
doi: 10.1177/24741264231167698. eCollection 2023 Sep-Oct.

Valsalva Retinopathy Associated With COVID-19: Diagnosis and Surgical Management

Wesley Han  1 , Sean D Adrean  2
Affiliations
Case Reports

Valsalva Retinopathy Associated With COVID-19: Diagnosis and Surgical Management

Wesley Han et al. J Vitreoretin Dis. .

Abstract

Purpose: To report a case of severe Valsalva retinopathy secondary to intense coughing and vomiting as symptoms of COVID-19 and describe the presentation, diagnosis, and surgical management. Methods: The patient's subjective findings, examination, fundus photography, optical coherence tomography (OCT) examinations, and laboratory results were used to diagnose the patient. Results: Surgical management was required to remove a vitreous hemorrhage (VH) and a sub-internal limiting membrane (sub-ILM) hemorrhage. Another foveal hemorrhage was determined to be intraretinal with intraoperative OCT. The patient's visual acuity improved from hand motions to 20/20 OD at postoperative week 6. Conclusions: The related COVID-19 symptoms of severe coughing and vomiting led to the Valsalva retinopathy. The VH and sub-ILM hemorrhage were successfully removed surgically. On intraoperative OCT, a foveal hemorrhage was determined to be intraretinal; thus, the decision was made to monitor it and allow it to resolve over time.

Keywords: COVID-19; Valsalva retinopathy; intraoperative OCT; vitrectomy.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Color fundus photograph of the right eye shows a predominately subhyaloid hemorrhage in the posterior pole, with a mild vitreous hemorrhage. Multiple intraretinal and subhyaloid hemorrhages are present.
Figure 2.
Figure 2.
(A) Optical coherence tomography (OCT) at presentation shows a subhyaloid hemorrhage, leading to the diagnosis of a Valsalva retinopathy. (B) OCT 1 week after presentation shows that the hemorrhage had become smaller.
Figure 3.
Figure 3.
Color fundus photograph of the left eye shows no abnormalities.
Figure 4.
Figure 4.
(A) Optical coherence tomography 1 week after surgery shows an intraretinal clot. (B) OCT image from 6 weeks shows the clot had gradually decreased in size.
See this image and copyright information in PMC

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