{"id":17869,"date":"2024-06-07T07:12:13","date_gmt":"2024-06-07T05:12:13","guid":{"rendered":"https:\/\/albertobellone.it\/?p=17869"},"modified":"2024-06-07T07:12:13","modified_gmt":"2024-06-07T05:12:13","slug":"valsalva-retinopathy","status":"publish","type":"post","link":"https:\/\/albertobellone.it\/en\/valsalva-retinopathy\/","title":{"rendered":"Valsalva Retinopathy"},"content":{"rendered":"

Valsalva retinopathy, first described in 1972 by Thomas Duane, is a particular form of retinopathy characterized by pre-retinal hemorrhages caused by a sudden increase in intrathoracic pressure. This condition has been associated with situations such as weightlifting, coughing, straining during defecation, or vomiting. The term “Valsalva” derives from the name of the Italian anatomist Antonio Maria Valsalva, known for defining the Valsalva ligaments and the anatomy related to forced expiration against a closed glottis.<\/p>\n

Valsalva retinopathy classically manifests as pre-retinal hemorrhage secondary to the rupture of superficial retinal vessels caused by physical exertion. The mechanism of the Valsalva maneuver is characterized by a sudden increase in intrathoracic or intra-abdominal pressure against a closed glottis, leading to a rapid increase in intravenous pressure in the eye, causing spontaneous rupture of the retinal capillaries.<\/p>\n

Generally, the prognosis is good, with spontaneous resolution occurring within months of onset, depending on the location of the hemorrhage and the layer of the retina involved.<\/p>\n

From a pathophysiological perspective, the increase in intrathoracic pressure against a closed glottis reduces venous return to the heart, decreasing stroke volume and consequently increasing pressure in the venous system. The process occurs in four distinct phases: initially, the increase in intrathoracic pressure reduces venous return to the right side of the heart; subsequently, the decrease in cardiac filling lowers mean arterial pressure, slowing the pulse and inducing reflex tachycardia and peripheral vasoconstriction; the release of the strain causes an immediate reduction in intrathoracic pressure, further lowering blood pressure and simultaneously increasing cardiac pressure; finally, there is a sharp rise in blood pressure as venous blood returns to the heart, inducing reflex bradycardia.<\/p>\n

During a Valsalva maneuver, blood pressure in the peripheral parts of the body rapidly increases, causing spontaneous rupture of the retinal capillaries due to the sudden increase in intraocular venous pressure.<\/p>\n

The epidemiology of Valsalva retinopathy is difficult to determine due to the rarity of the condition. Symptoms include decreased vision in the affected eye or eyes, ranging from complaints of floaters to complete loss of central vision. Vision often improves over weeks or months, depending on the severity of retinal findings. There is no racial or gender predilection for this condition, and it can affect individuals of any age.<\/p>\n

The case observed by us involves a forty-year-old woman referred for an emergency ophthalmic evaluation due to a sudden reduction in visual acuity in the left eye after a CrossFit workout. During the evaluation, the patient reported no personal or family history of ophthalmic problems. No systemic medical history was reported.<\/p>\n

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Valsalva retinopathy, first described in 1972 by Thomas Duane, is a particular form of retinopathy characterized by pre-retinal hemorrhages caused by a sudden increase in intrathoracic pressure. This condition has been associated with situations such as weightlifting, coughing, straining during defecation, or vomiting. The term “Valsalva” derives from the name of the Italian anatomist Antonio […]<\/p>\n","protected":false},"author":2,"featured_media":16595,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[547],"tags":[],"class_list":["post-17869","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pathologies"],"_links":{"self":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/posts\/17869","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/comments?post=17869"}],"version-history":[{"count":0,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/posts\/17869\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/media\/16595"}],"wp:attachment":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/media?parent=17869"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/categories?post=17869"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/tags?post=17869"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}