title: [Early treatment with Nd:YAG laser for Valsalva retinopathy: results of five cases and literature review].
abstract: BACKGROUND
  According to the literature, the treatment of retinopathy of Valsalva (VR) by laser is recommended when the macular hemorrhage has not regressed after 3 weeks.
  
  
  METHODS
  We report five cases of VR treated early (≤ 24 hours) by Nd:YAG laser membranotomy (LM). Clinical examination was performed before and after LM (D1, D7, M1, M3 and M6). Optical coherence tomography (OCT) analysis was performed to determine the precise location of the macular hemorrhage.
  
  
  RESULTS
  Good visual recovery was obtained early by LM with a stable outcome at 6 months. The hemorrhage was located under the internal limiting membrane (ILM) and posterior hyaloid in two patients and only under the ILM in three patients.
  
  
  CONCLUSIONS
  The literature review and our study confirm the good functional results for patients treated by LM for VR. Furthermore, very few side effects are reported with this type of treatment compared with the natural course of the disease, which may certainly regress spontaneously, but carries a risk of secondary preretinal fibrosis. However, to obtain optimal efficacy, the treatment should be carried out as soon as possible, in order to avoid clotting of the hematoma, preventing any subsequent evacuation by laser.
  
  
  CONCLUSIONS
  LM for VR is an effective, safe and inexpensive technique compared to the surgical management of these patients presenting with a persistant premacular hematoma after a period of observation.
authors.affiliation: Service d'ophtalmologie, hôpital Nord, chemin de Bourrely, 13915 Marseille cedex 20, France; Équipe InViBe, institut de neurosciences de la Timone, 27, boulevard Jean-Moulin, 13385 Marseille, France. Electronic address: frederic.matonti@ap-hm.fr.
authors.forename: F
authors.initials: F
authors.lastname: Matonti
authors.forename: V
authors.initials: V
authors.lastname: Donadieu
authors.forename: L
authors.initials: L
authors.lastname: Hoffart
authors.forename: A
authors.initials: A
authors.lastname: Dornadin
authors.forename: S
authors.initials: S
authors.lastname: Nadeau
authors.forename: S
authors.initials: S
authors.lastname: Roux
authors.forename: D
authors.initials: D
authors.lastname: Denis
mesh_terms: D000328:Adult; D003371:Cough / Q000150:complications; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D012912:Sneezing / Q000502:physiology; D014636:Valsalva Maneuver / Q000502:physiology*; D014839:Vomiting / Q000150:complications; D055815:Young Adult
keywords: Hémorragie rétrohyaloïdienne; Membranotomie; Membranotomy; Nd:YAG; Nd:YAG laser; Optical coherence tomography; Retrohyaloid hemorrhage; Rétinopathie de Valsalva; Tomographie en cohérence optique; Traitement; Treatment; Valsalva retinopathy