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Vitrectomy for Valsalva Retinopathy

Valsalva Retinopathy is a condition caused by sudden increase in intrathoracic or inraabdominal pressure that leads to increased venous pressure, which inturn leads to rupture of retinal capillary channels. I It is charactariazed by preretinal, sub-ILM and subhyaloid hemorrhage. In vast majority of patients it is absorbed spontaneously. Posterior laser hyaloidotomy using Yag laser is a well described procedure which helps to drain hemorrhage from premacular area. In rare cases where the premacular hemorrhage is large and doesn't show signs of resolution and posterior laser hyaloidotomy is not possible, vitrectomy may be necessary. Vitrectomy involves induction of posterior vitreous detachment, aspiration of premacular blood clots and peeling of ILM to remove hemorrhage trapped under the ILM. Visual prognosis is usually excellent as underlying retinal tissue is healthy unless hemorrhage is organized for long duration or intraoperative surgical trauma causes diminution of final visual acuity. This video describes technique of vitrectomy in such cases. We would like to point of importance of thorough peripheral vitrectomy in such cases, even though diseases is limited to posterior pole, as peripheral vitreous may be adherent to retina and may cause of late complications unless dealt with intraoperatively.