Vitreomacular adhesion associated with foveal-sparing preretinal hemorrhage

To report two cases of central macular sparing of subhyaloid hemorrhages secondary to vitreomacular adhesion documented by spectral-domain ocular coherence tomography findings.

Review of two patients with subhyaloid hemorrhage secondary to proliferative diabetic retinopathy and a macroaneurysm were performed. Treatment was not performed in either patient for management of the hemorrhage, but the patient with proliferative diabetic retinopathy was treated with panretinal photocoagulation for peripheral neovascularization. Foveal sparing of the hemorrhage was documented clinically and on spectral-domain ocular coherence tomography.

In Case 1, the proliferative diabetic retinopathy was stabilized with 2 rounds of panretinal photocoagulation treatment, and the visual acuity improved to 20/20 in the affected left eye after 8 months of observation. In Case 2, the visual acuity returned to baseline at 20/60 after 4 months of observation.

Macular involvement of subhyaloid hemorrhages may cause visual impairment, but vitreomacular adhesion may block the hemorrhage from obstructing the fovea.