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      Henle Fibre Layer Haemorrhage after a Valsalva Manoeuvre

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          A male patient, 59 years of age, presented with sudden deterioration of visual acuity (VA) caused by a Henle fibre layer haemorrhage (HFLH) in our outpatient department. He reported being under treatment with acetylsalicylic acid and experienced a Valsalva manoeuvre before he observed reduced vision. Due to the impairment caused by the haemorrhage, disturbing the patient’s daily activities, intravitreal injection of recombinant tissue plasminogen activator combined with SF6 and bevacizumab was offered. After this procedure, the HFLH disappeared, VA improved from 20/40 to 20/20 (Snellen) 3 months after treatment and a typical hyperreflective vertical line was seen in optical coherence tomography.

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          Most cited references 8

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          Valsalva hemorrhagic retinopathy.

           Drake Duane (1971)
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            Considerations in the Understanding of Venous Outflow in the Retinal Capillary Plexus.

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              Association of Optical Coherence Tomography Angiography of Collaterals in Retinal Vein Occlusion With Major Venous Outflow Through the Deep Vascular Complex

              Analysis of collateral vessel formation following retinal vein occlusion may advance our understanding of the venous outflow anatomy in the macula.

                Author and article information

                Case Reports in Ophthalmology
                S. Karger AG
                January - April 2021
                06 April 2021
                : 12
                : 1
                : 105-109
                aVIROS – Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
                bNIHR Biomedical Research Center at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
                511373 Case Rep Ophthalmol 2021;12:105–109
                © 2021 The Author(s). Published by S. Karger AG, Basel

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                Figures: 4, Pages: 5
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