Intraoperative optical coherence tomography guided removal of premacular hemorrhage in Valsalva retinopathy
BACKGROUND AND OBJECTIVE To describe spectral-domain optical coherence tomography (SD-OCT) findings following Nd:YAG laser membranotomy in premacular hemorrhage due to Valsalva retinopathy. PATIENTS AND METHODS Interventional case series of 7 eyes with premacular hemorrhage due to Valsalva retinopathy. Best-corrected Snellen visual acuity (BCVA) and color fundus photography were obtained before and after the laser treatment. SD-OCT scans were obtained at 1, 3, and 6 months following treatment. RESULTS SD-OCT revealed a convex dome-shaped cavity lined by a hyperreflective layer in all cases, which persisted until the end of follow-up. Two patients complained of metamorphopsia, although BCVA improved dramatically in all cases. The site of laser puncture was visible in 2 patients. No abnormality was detected in the underlying retinal layers. CONCLUSION SD-OCT reveals formation of a premacular cavity following laser puncture for premacular hemorrhage in Valsalva retinopathy, which may persist despite successful drainage of blood. This may later result in metamorphopsia in certain patients.