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Valsalva retinopathy associated with the choking game
Lawrence Y Ho1, Wael M Abdelghani
1Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Seminars in Ophthalmology
|June 15, 2007
Summary
Valsalva retinopathy, a dangerous condition causing vision loss, can occur after breath-holding activities. Prompt recognition is crucial due to potentially severe outcomes.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Vascular Emergencies
Background:
- High myopia is a risk factor for various retinal conditions.
- Valsalva maneuver involves forced expiration against a closed airway.
- Certain recreational activities can induce extreme Valsalva maneuvers.
Observation:
- A 41-year-old male with high myopia experienced sudden central vision loss in his left eye.
- Fundus imaging revealed macular hemorrhage, both intraretinal and subretinal.
- The patient reported acute vision loss following a breath-holding and forced exhalation activity for a euphoric sensation.
Findings:
- The clinical presentation and patient history strongly suggest Valsalva retinopathy.
- Optical coherence tomography confirmed intraretinal and subretinal macular hemorrhage.
- The event was directly linked to a self-induced Valsalva maneuver.
Implications:
- Valsalva retinopathy is a critical diagnosis to consider in patients with acute vision loss and a history of breath-holding.
- This condition, though rare, can lead to permanent visual impairment.
- Awareness of this association is vital for clinicians to prevent severe outcomes and counsel patients on risky behaviors.
