Posterior Hyaloidotomy by Nd:YAG Laser Application in a Patient with Postpartum Depression Caused by Valsalva Retinopathy

PURPOSE: The aim of this report is to present a case of premacular hemorrhage in a 37-week pregnant woman with concurrent presence of postpartum depression secondary to her ocular disease. METHODS: A 27-year-old woman in her 37th week of pregnancy presented with Valsalva retinopathy, which occurred in her left eye secondary to severe coughing. Her visual acuity was reduced to perception of hand motions, and she was agitated because of the loss of vision. The patient, who gave birth by cesarean section, was admitted for control examination 2 weeks after birth. No change was observed in premacular hemorrhage in control examination. However, the patient's relatives stated that the patient was very agitated and disinterested in her baby. For this reason, the patient was referred to the psychiatry clinic, and she was diagnosed with postpartum depression. The anatomical location of the premacular hemorrhage was determined by spectral domain optical coherence tomography. RESULTS: Neodymium yttrium aluminum garnet (Nd:YAG) laser hyaloidotomy was performed to her left eye on the same day. Rapid release of premacular hemorrhage into the vitreous cavity was observed immediately after Nd:YAG laser application. Two days after the application, the patient's visual acuity had improved to 20/20. The clinical improvement positively impacted on the patient's mood. CONCLUSION: In pregnant patients suffering from Valsalva retinopathy during the postpartum period, posterior hyaloidotomy by Nd:YAG laser can be implemented in terms of the patients’ own and their babies’ physical and mental health.