Preretinal Hemorrhage Caused by Valsalva Retinopathy and Terson Syndrome

Abstract

Preretinal hemorrhage as a cause of sudden vision loss is not often encountered in the clinical practice of an ophthalmologist. Diseases leading to preretinal hemorrhage include Valsalva retinopathy, Terson syndrome, hematologic disorders, trauma, and retinal macroaneurysms. Valsalva retinopathy is a specific type of retinopathy that occurs in somatically healthy people against the background of a sharp increase in intrathoracic or intra-abdominal pressure. Terson syndrome occurs with subarachnoid hemorrhages or intracerebral hemorrhages as a result of increased intracranial pressure. These pathologies are characterized by sudden unilateral, less often bilateral, loss of vision. Purpose: to present clinical cases of patients with preretinal hemorrhage caused by Valsalva retinopathy and Terson syndrome. Material and methods: clinical cases of three patients with preretinal hemorrhage caused by Valsalva retinopathy and Terson syndrome are presented. The patients were observed and treated at the S.Fyodorov Eye Microsurgery Federal State Institution, Novosibirsk Branch. Result and discussions: clinical cases demonstrate the development of preretinal hemorrhage after a sharp cough and sneezing, as well as after suffering a parenchymal-ventricular hemorrhage. All patients underwent Nd:YAG laser hyaloid puncture early after diagnosis with high functional results. Conclusion: in the presence of preretinal hemorrhage, to make a diagnosis of Valsalva retinopathy or Terson syndrome, special attention should be paid to obtaining an anamnesis to identify conditions associated with increased intrathoracic or intra-abdominal pressure, or possible subarachnoid, intracerebral hemorrhage in the past. The size and duration of hemorrhage are the most important factors in determining treatment options. Timely implementation of laser hyaloid puncture in the treatment of extensive preretinal hemorrhages is an effective and safe method of treatment, which allows one to obtain high functional results in the shortest possible time.