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Outcomes of Double Frequency Nd:YAG Laser Membranotomy for Premacular Haemorrhage Secondary to Valsalva Retinopathy

Raja Narayanan, Jay Chhablani, Aditya Sudhalkar, and Padmaja Kumari

Purpose: To determine the outcomes of double frequency Nd:YAG laser membranotomy for premacular hemorrhage secondary to Valsalva retinopathy.
Methods: Retrospective case series of 24 consecutive patients with premacular hemorrhage of duration less than two months between Jan 2008 and Dec 2012 were included. Patients with any other vascular diseases such as diabetic retinopathy were excluded. The main outcome measure was the best-corrected visual acuity (BCVA) at final follow up.
Results: Among 24 patients, majority 16 (67%) were men and all had unilateral Valsalva retinopathy. All patients underwent laser membranotomy using the double frequency Nd:YAG laser on the same day of presentation. The mean age of subjects was 44.03 ± 17.33 years (14-78 years) and the mean duration of symptoms was 10.29 ± 11.7days. The mean follow-up duration was 4.72 ± 2.54 months. All patients presented with blindness or severe vision loss with a mean baseline visual acuity of 1.72 ± 0.58 logMAR (Snellen’s equivalent 20/1050; range 0.17-2.3). Significant improvement of visual recovery was noted in 91.66% of patients at 1 month (mean final BCVA 0.20 ± 0.56 logMAR (Snellen’s equivalent 20/30; range 0-2.3 logMAR). Twenty-two (91.66%) patients were successfully treated with laser alone. No complications were noted. Two patients underwent vitrectomy and achieved 20/20 visual acuity.
Conclusion: Prompt treatment using the frequency doubled Nd YAG laser appears to be safe and effective in achieving significant visual recovery in patients with premacular hemorrhage due to Valsalva retinopathy.