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MULTILAYERED OPTIC DISK HEMORRHAGE IN ADULTS WITHOUT A POSTERIOR VITREOUS DETACHMENT
Xuejing Chen1,2,3, Andrew Tye1,2, Chirag P Shah2
1Retina Service, New England Eye Center, Tufts Medical Center, Boston, Massachusetts.
Purpose:
To describe 2 cases of multilevel optic disk hemorrhages in adults without a posterior vitreous detachment.
Methods:
The findings on clinical examination, color fundus photography, fluorescein angiography, spectral domain optical coherence tomography at presentation and follow-up are presented.
Results:
Two patients ages 61 and 49 years presented with unilateral floaters secondary to microscopic vitreous hemorrhage. Their best-corrected visual acuities were 20/30 and 20/20, respectively. Fundus examination showed similar nasal crescent of peripapillary subretinal hemorrhage and superior flame hemorrhage. Fluorescein angiography for both patients showed blockage from hemorrhages without leakage. Spectral domain optical coherence tomography showed that the posterior hyaloid was attached at the macula and optic nerve for both patients. Both patients experienced spontaneous resolution of symptoms and signs.
Conclusion:
Previous reports of multilevel optic disk hemorrhages in adults variably suggested the necessity of a posterior vitreous detachment. This report illustrates that a posterior vitreous detachment confirmed on spectral domain optical coherence tomography is not a necessary prerequisite for this entity.
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