{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:09:09Z","timestamp":1791248949604,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A variety of daily activities can intentionally or unintentionally cause the Valsalva manoeuvre, which induces a physiological response of elevated peripheral venous pressure. Studies have speculated that it may ultimately affect the choroidal anatomy. This is particularly important from a clinical point\u2010of\u2010view since patients occasionally hold their breath while undergoing macular optical coherence tomography (OCT). In this study, we systematically reviewed the literature to understand the impact of the Valsalva manoeuvre on the choroid and conducted meta\u2010analyses on the changes induced in the subfoveal choroidal thickness (SFCT) and the choroidal vascularity index (CVI). We searched 12 literature databases for studies in healthy participants undergoing Valsalva manoeuvre with choroidal OCT scans before and during the manoeuvre. Seven studies with a total of 444 eyes of 279 individuals were eligible for the review. The Valsalva manoeuvre led to a statistically significant but numerically small increase in the SFCT of 6.5\u2009\u03bcm (95% CI: 1.6\u201311.4\u2009\u03bcm; <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and a statistically significant increase in the CVI of 1.48 (95% CI: 1.23\u20131.73; <jats:italic>p<\/jats:italic>\u2009=\u20090.0002). Thus, the Valsalva manoeuvre has a measurable impact on the choroid, and we recommend careful observation of how the patient sits and behaves behind the OCT scanner while scanning in order to allow accurate measurements of the choroid for diagnosis and monitoring.<\/jats:p>","DOI":"10.1111\/aos.16793","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T14:20:18Z","timestamp":1730902818000},"page":"127-135","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of the Valsalva manoeuvre on the choroid: A systematic review with meta\u2010analyses"],"prefix":"10.1111","volume":"103","author":[{"given":"Andreas","family":"Arnold\u2010Vangsted","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Glostrup Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4111-2857","authenticated-orcid":false,"given":"Lars Christian","family":"Boberg\u2010Ans","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Innlandet Hospital Trust  Elverum Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse J\u00f8rgensen","family":"Cehofski","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elon H. C.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Lions Eye Institute  Perth Australia"},{"name":"Department of Ophthalmology Sir Charles Gairdner Hospital  Perth Australia"},{"name":"Department of Ophthalmology Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5019-0736","authenticated-orcid":false,"given":"Jakob","family":"Grauslund","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Odense University Hospital  Odense Denmark"},{"name":"Department of Ophthalmology Vestfold Hospital Trust  T\u00f8nsberg Norway"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8610-7455","authenticated-orcid":false,"given":"Michael Stormly","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Glostrup Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5304-0444","authenticated-orcid":false,"given":"Hans Christian","family":"Kiilgaard","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver Niels","family":"Klefter","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Glostrup Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3804-7296","authenticated-orcid":false,"given":"Marie","family":"Krogh 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