Valsalva retinopathy occurring after general anesthesia

Area of Science:

• Ophthalmology
• Neurosurgery
• Anesthesiology

Background:

• Ruptured intracranial aneurysms often require surgical intervention under general anesthesia.
• Valsalva retinopathy is a known, albeit rare, complication associated with increased intrathoracic pressure.

Observation:

• A 40-year-old male experienced sudden vision decrease in his left eye post-general anesthesia for a ruptured intracranial aneurysm.
• Ophthalmic examination revealed a retrohyaloid macular hemorrhage one month after surgery.

Findings:

• Initial treatment with Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser hyaloidotomy was unsuccessful in draining the hemorrhage.
• Subsequent pars plana vitrectomy successfully drained the macular hematoma, leading to improved visual acuity.

Implications:

• This case highlights Valsalva retinopathy as a potential, though uncommon, complication following general anesthesia.
• Vitrectomy serves as an effective treatment option for persistent retrohyaloid macular hemorrhages when conservative or laser treatments fail.