Vol. 3 No. 1 (2020): Articles in Press
Case Report

Acute vision loss in a patient with chronic esophageal stenosis

Joshua Paul
Department of Ophthalmology, Lewis Katz School of Medicine, Temple University
Yi Zhang
Department of Ophthalmology, Lewis Katz School of Medicine, Temple University
Justin Sun
Department of Ophthalmology, Lewis Katz School of Medicine, Temple University
Published April 7, 2020
Keywords
  • Choking,
  • ILM peeling,
  • Premacular hemorrhage,
  • Valsalva retinopathy

Abstract

Abstract:

Purpose: To describe a unique cause of Valsalva Retinopathy (VR) with an alternative surgical approach to chronic non-clearing pre-foveal hemorrhage.

Method: Case presentation.

Results: A 45-year-old African American female presented with acute vision loss from 20/20 to count fingers (CF) in her right eye. Ophthalmoscopy and ocular coherence tomography (OCT) showed old yellow-red pre-retinal opacityscuring the fovea. After 1 month of conservative management with no improvement, Pars Plana Vitrectomy (PPV) with posterior hyaloid membrane removal without ILM peeling was performed with the patient’s best-corrected visual acuity (BCVA) dramatically improved to 20/25.

Discussion: We raise the question regarding the role of ILM peeling in treating premacular hemorrhage. Even without ILM peeling, our patient’s hemorrhage resolved after the procedure. This suggests that PPV combined with posterior hyaloid removal is a safer and effective alternative to surgical treatment in patients with certain clinical conditions. In addition, we provide clear evidence to support the location of the hemorrhage in VR as both sub-hyaloid and sub-ILM.