Valsalva maculopathy due to a retinal arterial macroaneurysm

The term Valsalva retinopathy refers to hemorrhage in and around the macula in response to a sudden rise in intrathoracic or intra-abdominal pressure. The increased intravenous pressure is felt to be transmitted to the retinal circulation with resulting retinal capillary rupture. Fluorescein angiography is generally normal following resolution of the hemorrhage. We have followed the evolution of an arterial macroaneurysm that presented initially as a case of Valsalva maculopathy.