case_images: PMC11074876_01
case_images: Multilayered retinal hemorrhages in the left eye. (a) Color fundus photograph (CFP) showed subretinal hemorrhage in the macular region, preretinal hemorrhage in the superotemporal arcade, and intraretinal flame-shaped hemorrhages around the optic disc. (b) Multilayered retinal hemorrhages had decreased autofluorescence sign. (c) Macular SD-OCT scan confirmed a thick intermediate-reflectivity hemorrhage in the subretinal space. (d) SD-OCT scan along the superotemporal arcade showed a shadowing effect of the preretinal hemorrhage located beneath the ILM.
case_images: CRIOPM2024-4865222.001.jpg
case_images: PMC11074876_01_CRIOPM2024-4865222.001.jpg
case_images: fig1
case_images: In OS, a color fundus photograph (Daytona Ultra-widefield Retinal Imaging, Optos Inc., Marlborough, United States) revealed subretinal hemorrhage in the posterior pole associated with a small oval-shaped preretinal hemorrhage in the superotemporal arcade, two small flame-shaped hemorrhages around superior half of the optic disc, and few intraretinal hemorrhages (Figure 1(a)). Autofluorescence (Daytona Ultra-widefield Retinal Imaging) revealed that hemorrhages were hypoautofluorescence (Figure 1(b)). Macular scanning confirmed the presence of a thick submacular hemorrhage in the OS, shadowing the choroid structures right below it (Figure 1(c)). SD-OCT scan along the superotemporal arcade showed a focal hemorrhage beneath the ILM with a shadowing effect of the underlying retina (Figure 1(d)).
case_images: Sequential pre- and postoperative follow-up of the left eye. (a, d) Preoperative CFP and SD-OCT demonstrated subretinal hemorrhage in the macular region. (b, e) Five days after surgery, BCVA was 20/100. (b) CFP showed air bubbles in the vitreous cavity and subretinal hemorrhage displacement to the inferior equator and periphery. (e) SD-OCT confirmed submacular hemorrhage displacement, with only a tiny hyperreflective material beneath the fovea. (c) Ten days after vitrectomy, BCVA improved to 20/40. There was no air in the vitreous cavity, and subretinal hemorrhage was located at the inferior periphery. (f) SD-OCT did not demonstrate any submacular hemorrhage at this point.
case_images: CRIOPM2024-4865222.002.jpg
case_images: PMC11074876_01_CRIOPM2024-4865222.002.jpg
case_images: fig2
case_images: Baseline multimodal evaluation and 5-day and 10-day sequential follow-up examination are demonstrated in Figure 2.
case_images: Multimodal evaluation of the left eye on the 30th postoperative day. (a) CFP showed resolution of submacular hemorrhage. SD-OCT macular scan revealed (b) slight irregularity in the subfoveal ellipsoid zone and (c) persistence of sub-ILM hemorrhage in the superotemporal arcade. (d) Fluorescein angiography demonstrated blockage by the sub-ILM hemorrhage. There were no signs of capillary exclusion or retinal arterial macroaneurysm. (e) Indocyanine green angiography did not show any signs of polypoidal choroidal vasculopathy or choroidal neovascularization.
case_images: CRIOPM2024-4865222.003.jpg
case_images: PMC11074876_01_CRIOPM2024-4865222.003.jpg
case_images: fig3
case_images: On the 30th postoperative day, BCVA improved to 20/30 and submacular hemorrhage had totally disappeared (Figure 3(a)). SD-OCT macular scanning showed a slightly irregular ellipsoid zone (Figure 3(b)); central macular thickness decreased to 285 mum. Sub-IML hemorrhage along the superotemporal arcade was still present (Figure 3(c)). Fluorescein angiography (FA) (Spectralis, Heidelberg, Germany) demonstrated blockage by the sub-ILM hemorrhage (Figure 3(d)). Indocyanine green angiography (ICGA) (Spectralis, Heidelberg, Germany) did not show any signs of polypoidal choroidal vasculopathy or choroidal neovascularization (Figure 3(e)).