AN 18-YEAR-OLD healthy white man reported a sudden decrease in central visual acuity in his right eye after physical exertion, probably combined with a Valsalva maneuver, while repairing his car.
He did not report other symptoms and was not taking systemic medications. Best-corrected visual acuity was 20/600 OD and 20/20 OS. Anterior segment examination and intraocular pressures were normal. Ophthalmoscopic examination of the right eye disclosed the presence of an anomalous retinal vein extending along the papillomacular bundle through the foveal avascular zone and temporally. A preretinal hemorrhage overlaid the fovea and partially obscured the underlying anomalous retinal vein (Figure 1).
de Crecchio G, Pacente L, Alfieri MC, Greco GM. Valsalva Retinopathy Associated With a Congenital Retinal Macrovessel. Arch Ophthalmol. 2000;118(1):147-148. doi:10.1001/archopht.118.1.146