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Retin Cases Brief Rep 2018 Oct 8. Epub 2018 Oct 8.

Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Purpose: To present an atypical case of syphilis that presented with findings concerning for endocarditis and valsalva retinopathy.

Methods: History and clinical examination of 42-year-old white man who presented to the emergency department with acute onset vision changes associated with gastrointestinal symptoms, otalgia, and constitutional symptoms.

Results: The review of this case highlights the atypical nature in which syphilis can present and can remain undiagnosed even in the face of extensive workups for other systemic conditions. Read More

Rev Fac Cien Med Univ Nac Cordoba 2018 06 29;75(2):111-118. Epub 2018 Jun 29.

HOSPITAL CORDOBA.

Background: Cardiovascular autonomic neuropathy (CAN) is a common complication of diabetes and is associated with cardiovascular morbidity and mortality. Despite its prevalence, it is usually underdiagnosed. Objective to assess frequency of CAN in type 2 diabetes, treated at the Diabetology Service at Cordoba Hospital, Argentina. Read More

Case Rep Ophthalmol Med 2018 23;2018:1782847. Epub 2018 Aug 23.

Antalya Education and Research Hospital, Ophthalmology Department, Antalya, Turkey.

Purpose: The purpose of this report is to present a case who had spontaneous macular hole closure after Nd:YAG laser membranotomy applied to premacular haemorrhage associated with Valsalva retinopathy.

Methods: Case report.

Results: A 19-year-old young male patient presented to our clinic with sudden vision loss in his right eye, which had occurred 2 weeks before, following push-up and sit-up exercise. Read More

Eur J Ophthalmol 2018 Sep 12:1120672118799627. Epub 2018 Sep 12.

4 Vitreoretinal & Uveitis Department, Ophthalmica Clinic, Thessaloniki, Greece.

Introduction: The purpose of this report is to describe a case of Valsalva retinopathy in an intranasal cocaine user.

Case Report: A 49-year-old male presented with a history of sudden loss of vision and inferior visual field defect in his left eye. Clinical evaluation of the affected eye showed best corrected visual acuity of 20/25 and fundus examination revealed a preretinal hemorrhage superior to the disk with multiple intraretinal hemorrhages in and around the posterior pole. Read More

Indian J Ophthalmol 2018 09;66(9):1321-1322

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Case Rep Ophthalmol Med 2018 3;2018:2874908. Epub 2018 Jun 3.

Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.

A 27-year-old male was presented with a sudden onset of visual loss in his right eye. A secondary care center referred the patient with fundus photographs which were screened 4 days before and after the Nd: YAG laser hyaloidotomy treatment. Snellen acuity was 10/10 in both eyes. Read More

Arch Soc Esp Oftalmol 2018 Dec 1;93(12):e92. Epub 2018 Jun 1.

Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España; Facultad de Medicina, Universidad de Valencia, Valencia, España.

Case Rep Ophthalmol Med 2018 8;2018:8950682. Epub 2018 May 8.

Vitreo-Retina Department, Biratnagar Eye Hospital, Biratnagar, Nepal.

Valsalva retinopathy is a common condition but retinal holes secondary to Valsalva retinopathy are rarely reported. The author believes this to be the first report to describe multiple retinal holes after hyaloidotomy for Valsalva retinopathy. Read More

BMJ Case Rep 2018 Apr 17;2018. Epub 2018 Apr 17.

Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

J Ophthalmic Vis Res 2018 Jan-Mar;13(1):83-84

Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

BMJ Case Rep 2018 Jan 26;2018. Epub 2018 Jan 26.

St Thomas Hospital, London, UK.

We present a case in which a large, bullous, predominantly inferior, serous retinal detachment developed acutely after the Valsalva manoeuvre (from a coughing fit) in an eye with morning glory disc anomaly. We postulate that a rapid alteration in intracranial pressure was transmitted through the cavitary disc defect. This allowed a sudden influx of cerebrospinal fluid and/or liquefied vitreous into the subretinal space. Read More

Am J Case Rep 2018 Jan 2;19:5-9. Epub 2018 Jan 2.

Eye Center, Zhongshan Hospital of Sun Yat-Sen University, Zhongshan, Guangdong, China (mainland).

BACKGROUND Valsalva retinopathy is a rare but sight-threatening condition with sudden visual loss. Twin-pregnancy is known as a confirmed risk factor for Valsalva retinopathy. CASE REPORT A 21-year-old twin-pregnant Chinese woman with 31 weeks of gestation complained of a sudden decrease of visual acuity in her right eye for five hours. Read More

Am J Ophthalmol Case Rep 2017 Sep 8;7:140-142. Epub 2017 Jul 8.

Biratnagar Eye Hospital, Mills Area, Biratnagar, Rani 17, Nepal.

Purpose: Valsalva hemorrhagic retinopathy is a form of preretinal hemorrhage that develops after a valsalva maneuver, leading to rupture of the superficial retinal capillaries. Here, we report a case of valsalva retinopathy secondary to blowing a conch, the first case report of its kind. The patient blew conch, which was part of his daily ritual to pray to God as he was a Hindu priest. Read More

Int J Ophthalmol 2017 18;10(11):1779-1782. Epub 2017 Nov 18.

Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.

Retina 2018 Jan;38(1):e1-e2

Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Retin Cases Brief Rep 2018 Fall;12 Suppl 1:S9-S11

Department of Ophthalmology, University of California, San Francisco, San Francisco, California.

Purpose: To report the intraoperative occurrence of acute intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy.

Method: A review of a surgical patient who developed acute intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy because of bucking under general anesthesia.

Results: A 32-year-old obese woman with proliferative diabetic retinopathy and traction retinal detachment in the left eye who developed intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy because of bucking under general anesthesia while doing endolaser under air infusion. Read More

Case Rep Ophthalmol Med 2017 12;2017:9650287. Epub 2017 Sep 12.

Clinical Eye Research Division, Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.

Purpose: To describe a case of Valsalva-related subretinal hemorrhage as a presenting symptom of polypoidal choroidal vasculopathy (PCV). The patient refrained from treatment against our best advice, and thus this is also a rare case of the natural course of an untreated PCV.

Methods: Case report. Read More

BMJ Case Rep 2017 Sep 25;2017. Epub 2017 Sep 25.

Smt Kanuri Santhamma Center for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India.

A 40-year-old man presented with a sudden onset of diminution of vision in his left eye for 2 days. Anterior segment of both eyes was within normal limits. Right eye retinal evaluation was normal. Read More

Front Physiol 2017 28;8:553. Epub 2017 Jul 28.

Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan UniversityShanghai, China.

The impairment of retinal vascular autoregulation can be an early manifestation of many systemic and ocular diseases. Therefore, quantifying retinal vascular autoregulation in a non-invasive manner is very important. This study evaluated the effects of a Valsalva maneuver (VM)-induced blood pressure increases on retinal vascular autoregulation. Read More

BMJ Case Rep 2017 Aug 11;2017. Epub 2017 Aug 11.

Department of Ophthalmology, Leicester Royal Infirmary, Leicester, UK.

A 35-year-old pregnant Caucasian woman at 27 weeks gestation presented with sudden onset painless loss of vision and a large floater in her left eye while doing yoga. She was found to have a dense vitreous haemorrhage with a small preretinal haemorrhage. Ultrasound imaging confirmed the haemorrhage and showed no other retinal damage. Read More

Presse Med 2017 Jul - Aug;46(7-8 Pt 1):789-790. Epub 2017 Jul 24.

University Toulouse Hospital, hôpital Pierre-Paul-Riquet, Ophthalmology Department, Toulouse, France. Electronic address:

Semin Ophthalmol 2018 22;33(4):525-546. Epub 2017 Jun 22.

a Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus , L. V. Prasad Eye Institute , Hyderabad , Telangana , India.

Purpose: Imaging technology has advanced by leaps and bounds in the recent past and has resulted in a much greater understanding of ocular diseases. The aim of this review article is to summarize optical coherence tomography (OCT) findings of various systemic conditions.

Method: A systematic literature search of the Medline/PubMed database was performed. Read More

Turk J Ophthalmol 2017 Jun 1;47(3):184-185. Epub 2017 Jun 1.

ICARE Eye Hospital and Postgraduate Institute, Ophthalmology Clinic, Uttar Pradesh, India.

J Fr Ophtalmol 2017 Jun 3;40(6):e215-e217. Epub 2017 Jun 3.

Service d'ophtalmologie, clinique Saint-Pierre, 9, avenue Reine-Fabiola, 1340 Ottignies, Belgique.

PLoS One 2017 23;12(3):e0174377. Epub 2017 Mar 23.

Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background: To investigate changes in the neural retina according to the presence of retinal nerve fiber layer (RNFL) defects in type 2 diabetes, and to determine the association between inner retina thickness and the severity of diabetic complications.

Methods: We studied non-glaucomatous patients with type 2 diabetes and control subjects Circumpapillary RNFL and macula ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured by spectral-domain optical coherence tomography. In patients with type 2 diabetes, a cardiovascular autonomic function test (AFT) was performed, which included the heart rate parameter of beat-beat variation-with deep breathing, in response to the Valsalva maneuver, and on postural change from lying to standing. Read More

Retina 2017 Jan;37(1):e1-e3

*LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat hospital, New York, New York;†Vitreous-Retina-Macula Consultants of New York, New York, New York;‡Ophthalmology, New York University School of Medicine, New York, New York;§Department of Ophthalmology, Hospital de Santa Maria, Lisbon, Portugal; and¶Department of Ophthalmology, Faculty of Medicine, Universidade de Lisboa, Lisbon, Portugal.

BMJ Case Rep 2016 Nov 23;2016. Epub 2016 Nov 23.

Vitreo-Retina, Uveitis and ROP Services, Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Premacular sub-internal limiting membrane (sub-ILM) haemorrhage is a known cause of sudden profound loss of vision. Neodymium-doped yttrium aluminium garnet (ND-YAG) posterior hyaloidotomy is an inexpensive, effective and safe treatment modality for rapid drainage of haemorrhage covering the macula. An 18-year-old male patient presented to us with a history of Nd-YAG posterior hyaloidotomy for Valsalva-related premacular bleed. Read More

Ophthalmic Genet 2016 12 23;37(4):441-444. Epub 2016 Mar 23.

b Eye Institute, Cleveland Clinic Abu Dhabi , Abu Dhabi , United Arab Emirates.

Purpose: To report two siblings with CRB1-related retinopathy who developed retinal hemorrhages following village traditional treatment of upward finger pressure against the soft palate ([Formula: see text]).

Methods: A retrospective case series.

Results: Two sisters were clinically diagnosed and genetically confirmed to have recessive CRB1-related retinal dystrophy. Read More

Case Rep Ophthalmol Med 2016 9;2016:4164198. Epub 2016 Oct 9.

Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

We would like to report two cases of preretinal haemorrhage from two different aetiology courses of bleeding being treated with intravitreal ranibizumab and its outcome. Our first case was a 39-year-old man with a diagnosis of severe aplastic anaemia that presented with bilateral premacular haemorrhages in both eyes. His right eye vision was 6/45 and it was counting finger in the left eye. Read More

Eur J Ophthalmol 2017 May 18;27(3):331-335. Epub 2016 Jul 18.

Department of Ophthalmology, Baskent University Hospital, Izmir - Turkey.

Purpose: To evaluate the alterations in mean central choroidal, central macular, and disk retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) during Valsalva maneuver among patients with high refractive errors.

Methods: A total of 60 high myopic (≥-6.0 D) and 50 high hyperopic (≥ + 3. Read More

Can J Ophthalmol 2016 Oct 1;51(5):e139-e141. Epub 2016 Jul 1.

Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Retin Cases Brief Rep 2017 Winter;11 Suppl 1:S49-S53

*Vitreous Retina Macula Consultants of New York, New York; †LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; ‡Department of Ophthalmology, Edward S. Harkness Eye Institute, College of Physicians and Surgeons, Columbia University, New York, New York; and §Department of Ophthalmology, New York University School of Medicine, New York, New York.

Purpose: To report a case of unilateral stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) in a young male showing structural changes induced by a Valsalva maneuver.

Methods: Case report of a 26-year-old oboist with SNIFR, including multimodal imaging. Eye-tracked spectral-domain optical coherence tomography (SD-OCT) was used to compare the retinal architecture at rest and during a Valsalva maneuver. Read More

Retin Cases Brief Rep 2018 Winter;12(1):48-49

Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.

Purpose: To describe the occurrence of a congenital contractile peripapillary staphyloma in association with a rhegmatogenous retinal detachment.

Methods: The clinical course of a 17-year-old patient with a contractile peripapillary staphyloma and undergoing pars plana vitrectomy for repair of an associated retinal detachment was studied.

Results: The left eye showed a peripapillary staphyloma which during the ophthalmoscopical examination revealed contractile movements after the presentation of a light stimulus to either eye. Read More

Postgrad Med J 2017 Mar 15;93(1097):174. Epub 2016 Sep 15.

Eye Centre, Pinderfields Hospital, Wakefield, UK.

Indian J Ophthalmol 2016 Jul;64(7):530-1

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Ginekol Pol 2016 ;87(3):217-21

Recently, a growing tendency for cesarean birth has been noted both, in Poland and worldwide. Non-obstetric problems constitute a large part of indications for cesarean section. Many ophthalmologists and obstetricians still believe that high myopia, the presence of peripheral retinal degenerations, history of retinal detachment surgery, diabetic retinopathy, or glaucoma are indications for surgical termination of pregnancy. Read More

Natl Med J India 2015 Nov-Dec;28(6):310

Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi,

Am J Trop Med Hyg 2016 06 4;94(6):1290-8. Epub 2016 Apr 4.

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Laboratory of Infectious Diseases Research, Universidad Peruana Cayetano Heredia, Lima, Peru; Combined Internal Medicine and Pediatrics Residency Program, Yale School of Medicine, New Haven, Connecticut; University of Utah, Salt Lake City, Utah; Universidad Católica Boliviana "San Pablo," Santa Cruz de la Sierra, Bolivia; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japonés, Santa Cruz de la Sierra, Bolivia; Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, New York; School of Psychology, University of Sydney, Sydney, Australia; Division of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California.

Autonomic dysfunction is common in Chagas disease and diabetes. Patients with either condition complicated by cardiac autonomic dysfunction face increased mortality, but no clinical predictors of autonomic dysfunction exist. Pupillary light reflexes (PLRs) may identify such patients early, allowing for intensified treatment. Read More

J Diabetes Res 2016 3;2016:6090749. Epub 2016 Feb 3.

Division of Metabolism, Department of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.

A well-established, comprehensive, and simple test battery was used here to re-evaluate risk factors for cardiovascular autonomic neuropathy (CAN) in type 2 diabetes. One hundred and seventy-four patients with type 2 diabetes were evaluated through the methods of deep breathing and Valsalva maneuver for correlation with factors that might influence the presence and severity of CAN. The Composite Autonomic Scoring Scale (CASS) was used to grade the severity of autonomic impairment, and CAN was defined as a CASS score ≥2. Read More

Saudi J Ophthalmol 2016 Jan-Mar;30(1):68-70. Epub 2015 Oct 30.

Bansara Eye Care Centre, Laitumkhrah, Shillong 793003, India.

This report describes the case of a 27-year-old lady who presented with sudden decrease in vision in the right eye for one week. She was suffering from constipation and had a history of straining while passing stools. She was found to have two large sub-internal limiting membrane haemorrhages with the classical double ring sign, which were drained using laser membranotomy, following which her vision rapidly improved. Read More

J Med Case Rep 2016 Feb 4;10:32. Epub 2016 Feb 4.

Wills Eye Hospital, Jefferson Medical College, 840 Walnut Street, Philadelphia, PA, 19107, USA.

Background: After a successful trabeculectomy, a sudden intraocular pressure decrease may alter the intracranial to intraocular pressure ratio and cause decompression retinopathy. Frequent Valsalva maneuvers may also play a role in its pathogenesis. This condition may manifest as multiple retinal hemorrhages, edema of the optic disc, macular edema, or a sudden decrease in visual acuity postoperatively. Read More

A A Case Rep 2015 Dec;5(12):231-3

From the *Marienhospital Vechta, gGmbH, Abteilung für Anästhesie und Intensivmedizin, Vechta, Germany; and †HELIOS Klinikum Wuppertal, Universitätsklinikum der Universität Witten/Herdecke, Wuppertal, Germany.

Sudden visual loss after general anesthesia is a rare and serious complication. Unilateral visual loss can be caused by an increase in pressure in the preretinal veins with subsequent rupture and hematoma formation. Our patient most likely experienced an increase in venous pressure as a consequence of temporarily increased intrapulmonary pressures during a sustained Valsalva maneuver shortly after tracheal intubation. Read More

Korean J Ophthalmol 2015 Dec 25;29(6):437-8. Epub 2015 Nov 25.

Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.

Cardiovasc Diabetol 2015 Oct 14;14:140. Epub 2015 Oct 14.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, #170 Jomaru-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 420-767, Republic of Korea.

Background: Whereas a few studies have reported associations of serum omentin levels with subclinical atherosclerosis in patients with diabetes, little information is available with respect to the associations of serum omentin levels and diabetic microvascular complications. The aim of this study was to investigate the relationships of serum omentin levels and vascular complications including cardiac autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM).

Methods: We recruited 97 patients who evaluated complications of diabetes. Read More

Clin Ophthalmol 2015 10;9:1417-20. Epub 2015 Aug 10.

Cincinnati Eye Institute, Cincinnati, OH, USA.

We report three cases of idiopathic macular telangiectasia type 2 with temporally decentered preretinal hemorrhage as the presenting sign. The preretinal blood obscured the telangiectatic vessels such that the diagnosis was only evident by fluorescein angiography of the fellow eyes, which had near-normal vision. The preretinal hemorrhage was associated with Valsalva maneuver in one patient and with type 3 subretinal neovascularization in one patient. Read More

Br J Ophthalmol 2016 Mar 20;100(3):389-94. Epub 2015 Aug 20.

Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Purpose: To describe novel underlying associations of classic acute macular neuroretinopathy (AMN).

Methods: Multimodal imaging case series evaluating patients with classic AMN lesions and previously unreported underlying aetiologies.

Results: Six patients were included (five women, one man, mean age 30±7 years). Read More

BMC Res Notes 2015 Mar 4;8:67. Epub 2015 Mar 4.

Womens health research center, school of medicine, Mashhad university of medical sciences, Mashhad, Iran.

Background: Valsalva retinopathy is a known medical condition which happens after valsalva maneuver. The aim of this study was to report a case of young asian pregnant female presented with acute visual loss due to the valsalva retinopathy, followed by spontaneous visual recovery.

Case Presentation: A case of 23 years-old pregnant Asian female with 31 weeks of gestation presented with history of a sudden decrease in vision in her left eye from seven hours prior to the visit. Read More

Case Rep Ophthalmol 2015 Jan-Apr;6(1):88-92. Epub 2015 Feb 28.

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

Purpose: The aim of this study is to describe a case of Valsalva-like retinopathy that occurred after ocular massage.

Case Presentation: A healthy 44-year-old Japanese female had massaged her eye with strong pressure several times. Subsequently, she noticed a loss in the left central vision. Read More

J Clin Anesth 2015 Jun 9;27(4):341-6. Epub 2015 Apr 9.

Retina Service, WK Kellogg Eye Center, Department of Ophthalmology & Visual Sciences, Department of Pathology, University of Michigan Medical School, VA Ann Arbor Healthcare System, 1000 Wall St, Brehm 8326, Ann Arbor, MI 4810. Electronic address:

Postoperative visual loss from any cause is potentially catastrophic. We present a case of Valsalva hemorrhagic retinopathy (VHR) as a rare cause of impaired vision after an apparently uneventful general anesthetic. Previously published cases of VHR, anesthetic related and otherwise, are reviewed and the phenomenon discussed. Read More

Diabet Med 2015 Nov 7;32(11):1470-8. Epub 2015 Apr 7.

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.

Aim: To determine if changes in pupillary response are useful as a screening tool for diabetes and to assess whether pupillometry is associated with cardiac autonomic neuropathy.

Methods: We conducted a cross-sectional study with participants drawn from two settings: a hospital and a community site. At the community site, individuals with newly diagnosed diabetes as well as a random sample of control individuals without diabetes, confirmed by oral glucose tolerance test, were selected. Read More