title: Persistent unsealed internal limiting membrane after Nd:YAG laser treatment for valsalva retinopathy.
abstract: BACKGROUND
  To report a long-term complication of unsealed and un-reattached internal limiting membrane in Valsalva retinopathy after neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser membranotomy.
  
  
  METHODS
  A 41-year-old man presenting with a massive premacular hemorrhage due to Valsalva retinopathy underwent Nd:YAG laser membranotomy. During follow-up, best-corrected visual acuity, retinal alteration and optical coherence tomography (OCT) outcomes were documented. One month after membranotomy, his visual acuity improved to 20/20 and the hemorrhage resolved completely. At an 8-month follow-up visit, the fundus showed progressive wrinkling of the internal limiting membrane with the laser perforation located in the center. OCT showed a persistent unsealed and un-reattached internal limiting membrane.
  
  
  CONCLUSIONS
  Not all patients with Valslava retinopathy with premacular hemorrhage are appropriate candidates for laser membranotomy, especially patients with sub- internal limiting membrane hemorrhage. The key point for observation is the interface between internal limiting membrane and retinal surface. The long-term consequences of unsealed internal limiting membrane after Nd:YAG laser membranotomy require further understanding.
authors.affiliation: Department of Ophthalmology, West China Hospital of Sichuan University, No, 37 Guoxue Xiang, Wuhou District, Chengdu, Sichuan Province 610041, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zou
authors.forename: Sheng
authors.initials: S
authors.lastname: Gao
authors.forename: Junjun
authors.initials: J
authors.lastname: Zhang
authors.forename: Meixia
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D019773:Epiretinal Membrane; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D053844:Lasers, Solid-State / Q000009:adverse effects*; D008297:Male; D012163:Retinal Detachment / Q000209:etiology*; D012166:Retinal Hemorrhage / Q000601:surgery*