An atypical finding in an idiopathic unilateral frosted branch angiitis case: premacular hemorrhage

The authors describe a case of unilateral idiopathic acute frosted branch angiitis with premacular hemorrhage.

A 35-year-old woman was referred because of acute vision loss in her left eye during the puerperal period. Her initial visual acuity was 20/20 OD and 20/200 OS. The left eye presented severe sheathing of retinal vessels inferiorly, heavy perivascular intraretinal hemorrhages, and premacular hemorrhage. There was no evidence of vascular leakage in fluorescein angiography. All of the laboratory workup was negative for frosted branch angiitis (FBA). During the follow-up period, FBA resolved spontaneously within a few days, but the amount of premacular hemorrhage increased. Vitrectomy with internal limiting membrane peeling was performed at the third month, resulting in 20/25 vision and no recurrence of the disease during the 13-month follow-up.

This is an idiopathic case of acute FBA that exhibited spontaneous rapid regression of angiitis but was complicated by an unusual premacular hemorrhage.