Bilateral retinal hemorrhages following finger pressure against the soft palate (الترفيع) in recessive CRB1-related retinopathy

ABSTRACT

Purpose: To report two siblings with CRB1-related retinopathy who developed retinal hemorrhages following village traditional treatment of upward finger pressure against the soft palate ().

Methods: A retrospective case series.

Results: Two sisters were clinically diagnosed and genetically confirmed to have recessive CRB1-related retinal dystrophy. The family did not accept the condition as non-treatable and took both sisters for a traditional village therapy, consisting of several sessions of intense upward index finger pressure by the healer against the soft palate for each child. When examined following this therapy, both sisters had bilateral pre-retinal hemorrhages which were not present before the intervention and resolved without sequelae over the next several months.

Conclusions: The traditional village therapy may have compromised retinal venous outflow and/or provoked a Valsalva phenomenon, leading to the bilateral retinal hemorrhages. The fact that this occurred bilaterally and in both sisters supports the concept of relative vessel wall incompetence as part of CRB1-related retinopathy.

KEYWORDS:

• CRB1
• retinal dystrophy
• retinal hemorrhage
• retinopathy
• traditional therapy
• Valsalva

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.

Supplemental data for this article can be accessed on the publisher’s website at http://dx.doi.org/10.3109/13816810.2015.1126613.