Spectral-domain OCT evaluation of Nd:YAG laser treatment for Valsalva retinopathy

Purpose: To describe the spectral-domain optical coherence tomography (SD-OCT) findings in a patient with a premacular hemorrhage due to Valsalva retinopathy treated with Nd:YAG laser. Methods: Serial SD-OCT examinations were performed before and after Nd:YAG laser treatment to identify the cleavage plane of blood accumulation, as well as the exact location of the areas targeted by the laser spots and the different involvement of the affected retinal layers. Results: The SD-OCT scan above the level of settled blood showed that the cleavage plane was located under the internal limiting membrane (ILM). A raster box of 48 horizontal scans centered on the treatment area identified the two spots of ILM targeted by laser. The hyporeflective perforations appeared along an ILM still detached from the underlying retinal layers. Two months after treatment, the blood was completely reabsorbed. The ILM appeared reattached in the previously detached area. Only a mild thickening of the ILM remained visible at the laser-treated spots. Conclusions: SD-OCT evaluation of Nd:YAG laser treatment for Valsalva retinopathy confirmed the cleavage plane of the premacular hemorrhage. In addition, it revealed the exact location of the ILM disruptions caused by the laser spots, and the safety of the procedure, with no involvement of the underlying retinal layers