Nd:YAG Laser for Effective Treatment of Subhyaloid and Sub–Internal Limiting Membrane Hemorrhages Secondary to Valsalva Retinopathy: A Case Series
Yong Zheng Wai, Kar Yong Chong, Elicia Tze Zhing Chieng, Nurhayati Abdul Kadir, Lik Thai Lim, Wai Seng ChiangBackground
Subhyaloid and sub–internal limiting membrane (sub‐ILM) hemorrhages secondary to Valsalva retinopathy typically occur in young adults and can cause sudden, significant visual impairment. Spontaneous resolution may be prolonged, and delayed clearance can adversely affect visual recovery. Nd:YAG laser membranotomy has been proposed as an effective, minimally invasive treatment to facilitate rapid visual improvement.
Methods
This case series included three patients aged 24–27 years who presented with subhyaloid and sub‐ILM hemorrhages secondary to Valsalva retinopathy. The duration of symptoms prior to treatment ranged from 2 to 10 days. The mean horizontal and vertical diameters of the hemorrhages were 3615 and 3289 μ m, respectively. All patients underwent Nd:YAG laser membranotomy. The mean total laser energy applied was 79.7 mJ (range 11–185 mJ). Best‐corrected visual acuity (BCVA) and postoperative complications were assessed.
Results
Preprocedure BCVA ranged from 6/9 to 1/60. Rapid anatomical and functional improvement was observed in all cases following treatment. At 2 weeks after the procedure, BCVA improved to 6/9 in all patients. No complications such as macular hole formation or retinal detachment were noted during the follow‐up period.
Conclusion
Nd:YAG laser membranotomy appears to be a safe and highly effective treatment for subhyaloid and sub‐ILM hemorrhages secondary to Valsalva retinopathy, particularly in young patients requiring rapid visual recovery. Larger studies with longer follow‐up are needed to further evaluate long‐term outcomes and potential complications.