Sub-internal Limiting Membrane Cavity Following Valsalva Retinopathy Resembling Central Serous Chorioretinopathy

A 23‑year‑old male presented with a history of sudden onset painless diminution of vision in the left eye (LE) following bouts of vomiting 4 months ago. His vision had gradually improved over the previous 2 months. There was no history of steroid use. Visual acuity was 20/20 in both eyes. There was no intraocular inflammation. An oblique oval lesion measuring 5 × 4 disc diameters was observed at the posterior pole of the LE. On slit lamp biomicroscopy, it appeared to be an elevated neurosensory retina [Figure 1a]. There were no evident retinal vascular abnormalities or retinal neovascularization. The fundus fluorescein angiogram (FFA) showed subtle window defects at the lesion site, with blockage of fluorescence in the temporal and inferior margins [Figure 1b]. The areas of blocked fluorescence correlated with subtle preretinal brownish pigments [Figure 1a]. No leakage or pooling of dye consistent with central serous chorioretinopathy (CSCR) was evident. Spectral domain optical coherence tomography (SD‑OCT, RS‑3000, Nidek, Aichi, Japan)