Intrapapillary Hemorrhage With Adjacent Peripapillary Subretinal Hemorrhage and Reduced Blood Flow in the Optic...

Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH), commonly observed in myopic eyes with tilted optic discs, typically resolves without treatment. Although IHAPSH cases have been rarely reported, no prior studies have assessed laser speckle flowgraphy (LSFG) in this context. We report a case of IHAPSH evaluated using LSFG. A 54-year-old woman presented with floater symptoms in her right eye upon awakening. She had no history of trauma or medication use. Her best corrected visual acuity (BCVA) was 1.2 in both eyes. Fundus examination and optical coherence tomography revealed a tilted disc with adjacent peripapillary subretinal hemorrhage surrounding the disc hemorrhage. After 1 month, the hemorrhages partially resolved without treatment, and complete resolution was observed after 3 months, with BCVA remaining at 1.2 in the affected eye. The mean blur rate obtained from LSFG showed mild improvement following a temporary decline in the affected eye but remained lower than that in the unaffected left eye. This case underscores the potential utility of LSFG in evaluating IHAPSH and suggests that reduced local blood flow around the disc following the initial disruption may prevent recurrence, even under conditions of elevated blood pressure.