Valsalva retinopathy in pregnancy: SD-OCT features during and after Nd:YAG laser hyaloidotomy

Valsalva retinopathy can present as a sudden, dramatic loss of central vision due to the premacular location of the resultant subhyaloid hemorrhage. Certain vascular conditions predispose to the condition and occasional reports exist of Valsalva retinopathy in pregnancy. The authors describe a case of Valsalva retinopathy in a pregnant patient in terms of the physical features present that led to making the decision to treat by Nd:YAG laser hyaloidotomy as opposed to conservative management. Spectral-domain optical coherence tomography (SD-OCT) was able to demonstrate the physical features of the lesion prior to, immediately after, and weeks after treatment, and showed not only the dispersion of hemorrhage into the vitreous cavity from the subhyaloid space, but also that the subhyaloid cavity dimensions were unchanged despite release of the hemorrhage. SD-OCT visualized the actual hyaloidotomy site and its subsequent closure, which has not previously been reported in the literature.