case_images: PMC11828650_01
case_images: Baseline findings. (a) Initial Amsler grid testing revealed a paracentral scotoma in the right eye and (b) a larger central scotoma in the left eye. (c) Fundus examination of the right eye showed faint vitreous hemorrhage and several white spots with retinal hemorrhage at the macula; (d) the left eye displayed a thick hemorrhage at the central fovea. (e) OCT of the right eye demonstrated a hyperreflective inner retinal layer with a lamellar defect and focal detachment of the outer retinal layer. (f) OCT of the left eye revealed intra- and subretinal hemorrhages at the fovea.
case_images: CRIOPM2025-6664488.001.jpg
case_images: PMC11828650_01_CRIOPM2025-6664488.001.jpg
case_images: fig1
case_images: Amsler grid testing revealed a paracentral scotoma in the right eye (Figure 1(a)) and a larger central scotoma in the left eye (Figure 1(b)). Fundus examination of the right eye showed faint vitreous hemorrhage and several white spots with retinal hemorrhage at the macula (Figure 1(c)); the left eye displayed dense hemorrhage at the central fovea (Figure 1(d)). Spectral domain-optical coherence tomography (OCT) showed a juxtafoveal full-thickness hyperreflectivity with lamellar defect and focal subretinal detachment just on the nasal side of the fovea (Figure 1(e)). In the left eye, intra- and subretinal hemorrhages at the fovea were observed (Figure 1(f)).
case_images: Time course in the right eye. Two weeks after the initial examination, (a) OCT showed an FTMH nasal to the fovea; (b) fundus examination revealed several white spots and the FTMH at the macula. At the 1-year follow-up after two PPV procedures, (c) OCT confirmed closure of the FTMH, although a defect in the outer retinal layer persisted; (d) fundus examination showed residual white spots at the fovea; and (e) Amsler grid testing indicated distorted vision adjacent to the central scotoma.
case_images: CRIOPM2025-6664488.002.jpg
case_images: PMC11828650_01_CRIOPM2025-6664488.002.jpg
case_images: fig2
case_images: In the right eye, a full-thickness macular hole (FTMH) was detected on the nasal side of the fovea 2 weeks later on OCT (Figure 2(a)); BCVA was 0.5. Fundus examination revealed several white spots and an FTMH at the macula (Figure 2(b)). The FTMH remained closed, although a defect in the outer retinal layer persisted (Figure 2(c)). On fundus examination, white spots at the fovea remained visible (Figure 2(d)). The paracentral scotoma decreased in size and did not involve the fovea (Figure 2(e)).
case_images: Time course in the left eye. Two weeks after treatment, (a) OCT showed a reduction in the foveal hemorrhage; (b) fundus examination corroborated the decrease in foveal hemorrhage. Two months after the initial examination, (c) OCT showed resolution of the subretinal hemorrhages and identified a defect in the ellipsoid zone at the central fovea; (d) fundus examination confirmed the disappearance of intra- and subretinal hemorrhages at the fovea. One year after the initial examination, (e) OCT showed a persistent defect in the ellipsoid zone at the central fovea without residual subretinal hemorrhages; (f) fundus examination confirmed the absence of intra- and subretinal hemorrhages at the fovea; and (g) Amsler grid testing showed a decrease in the size of the central scotoma.
case_images: CRIOPM2025-6664488.003.jpg
case_images: PMC11828650_01_CRIOPM2025-6664488.003.jpg
case_images: fig3
case_images: OCT (Figure 3(a)) and fundus examination (Figure 3(b)). One month after the initial examination, BCVA in the left eye had improved to 0.7, and the foveal hemorrhage had completely resolved. Two months after the initial examination, OCT revealed the resolution of subretinal hemorrhages but identified a defect in the ellipsoid zone at the central fovea (Figure 3(c)). Fundus examination showed that intra- and subretinal hemorrhages at the fovea had resolved (Figure 3(d)). OCT confirmed the presence of an ellipsoid zone defect at the central fovea; no subretinal hemorrhages remained (Figure 3(e)). Fundus examination revealed no residual intra- or subretinal hemorrhages at the fovea (Figure 3(f)). Amsler grid testing indicated that the size of the central scotoma had further decreased (Figure 3(g)).