Maculopathy: a rare association of the Valsalva manoeuvre (Valsalva maculopathy)

A 22-year-old man complained of sudden, painless loss of vision (vague scotoma in central vision) in his right eye. The patient became symptomatic following a session of weight training at a gymnasium the previous day. There was no history trauma. Medical, ocular and familial history were unremarkable. The inferior and temporal aspect of the haemorrhage was darker due to gravitation, but the rest of the fundus was normal. The appearance of the right fundus, combined with an associated unequivocal history of physical exertion, was consistent with a diagnosis of Valsalva maculopathy (holding breath while bench pressing). Systemic examination and all relevant blood tests were normal. Fluorescein angiography (FFA) was done which confirmed the diagnosis. The patient recovered a vision of 6/6 in his right eye after 2 months. FFA was again done, which showed no sequelae of the problem.