Valsalva retinopathy in pregnancy: a case report

Tara, Fateme; Sharifi, Mohammad Davood; Hoseini, Elnaz

doi:10.1186/s13104-015-1029-8

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…The same results were also demonstrated by previous reported studies and confirmed that there is no difference in distribution of HCV genotypes between male and female patients [ 15 , 31 ]. But our results were contradicted from previous reported study that HCV genotypes were not distributed with same pattern where as HCV genotype 1 is circulating in male subjects while genotype 4 in female patients [ 32 ].…”

Section: Discussioncontrasting

confidence: 99%

Prevalence of hepatitis-C virus genotypes and potential transmission risks in Malakand Khyber Pakhtunkhwa, Pakistan

Nazir

Jan

Ali

et al. 2017

Virol J

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BackgroundHepatitis C virus (HCV) is a leading cause of chronic liver disease and frequently progresses towards liver cirrhosis and Hepatocellular Carcinoma (HCC). This study aimed to determine the prevalence of HCV genotypes and their association with possible transmission risks in the general population of Malakand Division.MethodologySum of 570 serum samples were collected during March 2011 to January 2012 from suspected patients visited to different hospitals of Malakand. The suspected sera were tested using qualitative PCR and were then subjected to molecular genotype specific assay. Quantitative PCR was also performed for determination of pre-treatment viral load in confirmed positive patients.ResultsOut of 570 serum samples 316 sera were seen positive while 254 sera were found negative using qualitative PCR. The positive samples were then subjected to genotyping assay out of 316, type-specific PCR fragments were seen in 271 sera while 45 samples were found untypable genotypes. Genotype 3a was seen as a predominant genotype (63.3%) with a standard error of ±2.7%. Cramer’s V statistic and Liklihood-Ratio statistical procedures are used to measure the strength and to test the association, respectively, between the dependent variable, genotype, and explanatory variables (e.g. gender, risk, age and area/districts). The dependent variable, genotype, is observed statistically significant association with variable risk factors. This implies that the genotype is highly dependent on how the patient was infected. In contrast, the other covariates, for example, gender, age, and district (area) no statistical significant association are observed. The association between gender-age indicates that the mean age of female was older by 10.5 ± 2.3 years with 95% confidence level using t-statistic.ConclusionIt was concluded from the present study that the predominant genotype was 3a in the infected population of Malakand. This study also highlights the high prevalence rate of untypable genotypes which an important issue of health care setup in Malakand and create complications in therapy of infected patients. Major mode of HCV transmission is multiple uses and re-uses of needles/injections.Trial registrationISRCTN ISRCTN73824458. Registered: 28 September 2014

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Section: Discussioncontrasting

confidence: 99%

Prevalence of hepatitis-C virus genotypes and potential transmission risks in Malakand Khyber Pakhtunkhwa, Pakistan

Nazir

Jan

Ali

et al. 2017

Virol J

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“…The etiology for sudden onset unilateral vision disturbance has a wide differential, including anaemia, coagulopathies, hyper-viscosity, leukaemia's, vascular occlusive disease, elevation changes, HTN and vascular occlusive disease, and idiopathic [16]. Valsalva maneuvers have also been reported as resulting in subconjunctival haemorrhages, periorbital skin petechiae, and exophthalmos from orbital haemorrhage, [5,11] VR usually occurs in healthy adults in the context of strenuous activity including lifting, sexual intercourse, straining during constipation or labor, sneezing, coughing, or vomiting [6][7][8][9][10][11] It is appropriate to rule out possible systemic disease that may result in retinal haemorrhages [5,16]. Our patient was in her third trimester and she was referred from an outside hospital where she was getting routine care, so any residual sequelae could be followed up by her primary team.…”

Section: Discussionmentioning

confidence: 99%

“…Physiologic thrombocytopenia during pregnancy can increase potential for haemorrhage. Increased uterine size during pregnancy can elevate intra-abdominal pressures [9]. The additional and sudden increases in intra-abdominal pressures of vomiting as in Hyperemesis Gravidarum, can be enough compressive force to rupture superficial retinal capillaries [7].…”

Section: Vr and Pregnancymentioning

confidence: 99%

“…The haemorrhage that ensues can cause sudden-onset vision loss in a self-limiting, and welldescribed condition known as Valsalva Retinopathy (VR) [1,[3][4][5]. Pregnancy, due to common physiologic mechanisms, is a known risk factor for VR [6][7][8][9][10][11][12][13][14]. We present a case of VR in a young woman in her 36th week of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Valsalva Retinopathy in Pregnancy: A Case Report from the Emergency Department

Bryan¹,

Green²,

MenkinSmith³

2018

J Eye Dis Disord

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Introduction: Rapid increases in intraocular pressure can result in sudden-onset vision loss in a self-limiting condition known as Valsalva Retinopathy. Pregnancy is a known risk factor. Case Presentation:A pregnant woman presents to the Emergency Department with complaints of unilateral central vision loss after an episode of vomiting. Fundus exam of the left eye identified haemorrhages consistent with Valsalva Retinopathy. Conclusion: Superficial retinal capillaries can hemorrhage as a result of Valsalva maneuvers. Natural pregnancy changes with other stressors like vomiting can leave a woman at higher risk for Valsalva retinopathy. Valsalva Retinopathy patients can be discharged with close follow-up.

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“…Increased intrathoracic or intra-abdominal pressure during labour is transmitted to the eye and can cause a sharp rise in the intraocular venous pressure, which may rupture superficial retinal capillaries. [57][58][59] Women usually give a history of sudden visual blurring, usually central, following labour or any episode of straining, coughing or vomiting.…”

Section: Valsalva Maculopathymentioning

confidence: 99%

Ocular manifestations of pregnancy and labour: from the innocuous to the sight threatening

Patil

Ellabban

Patil

et al. 2020

The Obstetric & Gynaecologis

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Pregnancy may precipitate several physiological changes that can have ocular consequences; many of these are innocuous and require little more than reassurance for the patient. There are uncommon instances of new sight-threatening pathology that necessitate a prompt approach. Pregnant women presenting to the ophthalmologist with ocular symptoms can cause concern because alternative differentials may need to be considered; and the potential teratogenic or fetotoxic effects of investigations or treatment mean that management decisions may, in some cases, differ to those of the nonpregnant patient. Learning objectives To be aware of both physiological and pathological ocular changes that may occur during pregnancy. To develop a greater understanding of investigations and management of ophthalmic and neuro-ophthalmic disorders in pregnancy. To develop an understanding of referral pathways, enabling an optimal outcome for both mother and baby.

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Valsalva retinopathy in pregnancy: a case report

Cited by 9 publications

References 5 publications

Prevalence of hepatitis-C virus genotypes and potential transmission risks in Malakand Khyber Pakhtunkhwa, Pakistan

Prevalence of hepatitis-C virus genotypes and potential transmission risks in Malakand Khyber Pakhtunkhwa, Pakistan

Valsalva Retinopathy in Pregnancy: A Case Report from the Emergency Department

Ocular manifestations of pregnancy and labour: from the innocuous to the sight threatening

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