Case Report
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World J Gastroenterol. Mar 21, 2014; 20(11): 3056-3058
Published online Mar 21, 2014. doi: 10.3748/wjg.v20.i11.3056
Valsalva retinopathy following esophagogastroduodenoscopy under propofol sedation: A case report
Ju-Hong Park, Min Sagong, Woohyok Chang
Ju-Hong Park, Min Sagong, Woohyok Chang, Department of Ophthalmology, Yeungnam University College of Medicine, Daegu 705-717, South Korea
Author contributions: Park JH and Chang W collected the patient’s clinical data; Park JH and Sagong M performed the literature search and wrote the manuscript; Chang W conceived the idea of the case report and performed the surgery. All authors approved the final manuscript.
Supported by The 2012 Yeungnam University Research Grant
Correspondence to: Woohyok Chang, MD, PhD, Department of Ophthalmology, Yeungnam University College of Medicine, 317-1, Daemyung-Dong, Nam-gu, Daegu 705-717, South Korea. changwh@ynu.ac.kr
Telephone: +82-53-6203440 Fax: +82-53-6205936
Received: October 11, 2013
Revised: December 10, 2013
Accepted: January 8, 2014
Published online: March 21, 2014
Processing time: 157 Days and 22.2 Hours
Abstract

We report a case of Valsalva retinopathy associated with esophagogastroduodenoscopy (EGD) under propofol sedation. A 43-year-old woman who had no previous history of systemic or ocular disease presented with a complaint of decreased vision in her left eye, which developed one day after EGD under propofol sedation. According to the referring physician, the patient had experienced multiple sustained Valsalva maneuvers during EGD. The fundus examination of the left eye showed a large preretinal hemorrhage surrounded by multiple small retinal hemorrhages in the posterior pole. One month later, fundus examination revealed a floating organized vitreous hemorrhage. The pars plana vitrectomy was performed to treat persistent vitreous hemorrhage. One month after vitrectomy, fundus examination showed normal retina and the patient’s vision recovered to 20/20. Valsalva maneuver can occur during EGD under sedation, and Valsalva retinopathy should be considered as a possible cause. Valsalva retinopathy should be included in the differential diagnosis when a patient complains of blurred vision following EGD.

Keywords: Esophagogastroduodenoscopy; Propofol; Sedation; Valsalva retinopathy

Core tip: This is the first report describing Valsalva retinopathy following esophagogastroduodenoscopy (EGD) under sedation. This case highlights Valsalva retinopathy induced by Valsalva maneuvers during EGD under incomplete propofol sedation, and that this ocular complication should be included in the differential diagnosis when a patient complains of sudden blurred vision following EGD.