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

<i>Purpose</i>: To report two siblings with <i>CRB1</i>-related retinopathy who developed retinal hemorrhages following village traditional treatment of upward finger pressure against the soft palate (). <i>Methods</i>: A retrospective case series. <i>Results</i>: Two sisters were clinically diagnosed and genetically confirmed to have recessive <i>CRB1</i>-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. <i>Conclusions</i>: 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 <i>CRB1</i>-related retinopathy.【研究目的】：报告2例CRB1相关视网膜病变（CRB1-related retinopathy）姐妹，在接受乡村传统的向上压迫软腭手指按压疗法后出现视网膜出血。 【研究方法】：本研究为回顾性病例系列研究。 【研究结果】：经临床诊断与基因检测确认，两名姐妹均患有隐性遗传型CRB1相关视网膜营养不良。患儿家属不认可该病无法治愈的结论，遂带两名患儿接受乡村传统疗法：由治疗师为每名患儿开展多疗程高强度食指向上压迫软腭操作。治疗后检查显示，两姐妹均出现双侧视网膜前出血，该症状在治疗前未出现，且在后续数月内自行吸收，未遗留任何后遗症。 【研究结论】：该乡村传统疗法可能损害了视网膜静脉回流，或诱发了瓦尔萨尔瓦现象（Valsalva phenomenon），进而导致双侧视网膜出血。两名患儿均出现双侧病变这一情况，支持CRB1相关视网膜病变患者存在相对血管壁功能不全的学术观点。