Valsalva retinopathy in pregnancy. Should we treat?

Abstract

We report two cases of Valsalva retinopathy that have developed during the last trimester of preg-nancy with spontaneous resolution and improve-ment of visual acuity. A 26-year-old Caucasian woman at 37 weeks ges-tation presented to the eye casualty with a sudden history of reduced vision and floaters in the left eye following an episode of sneezing. Her visual acuity was 6/6 and 6/60 in her right and left eyes, respectively. Anterior segment examination was unremarkable. Pupil reactions were normal. Fundus examination of the right eye was normal. Fundus examination of the left eye showed a pre-macular and vitreous haemorrhage (Figure 1). The patient was reviewed 2 weeks after she had a normal vaginal delivery and her vision had spon-taneously improved to 6/6 in the left eye with near-total resolution of the retinal and vitreous haemorrhage. Case 2 A 34-year-old Afro-Caribbean woman at 37 weeks gestation presented to eye casualty because of sudden blurring of vision in the left eye following an episode of vomiting. Her visual acuity was 6/6 and counting fingers in the right and left eyes, respectively. Anterior segment examination was unremarkable. Fundus examination of the right eye was normal and in the left showed a premacular (sub-hyaloid) haemorrhage (Figure 2). Her blood pressure, full blood count, coagulation profile, fasting blood sugar, sickle cell tests were all normal. The patient was managed conserva-tively. The patient had an elective Caesarian section at 38 weeks. At 5-month follow-up, her corrected visual acuity improved to 6/6 with complete resolution of the subhyaloid haemorrhage.