Sub-retinal haemorrhage

Overview

Sub-retinal haemorrhage may be associated with lacquer cracks or choroidal neovascularisation in myopic maculopathy.

When associated with a lacquer crack, OCT shows a hypo-reflective break in the RPE-Bruch's membrane complex with a "volcanic"-like appearance. There are no signs of associated exudation present.

When associated with myopic CNV, the CNV presents on OCT as a hyper-reflective sub-retinal lesion usually with associated subretinal fluid. More information about myopic CNV is available by clicking on the tab at the bottom of this page.

Case Examples

  • Case 1

    A 59 year old Caucasian female with refraction -8.75/-0.5 x 22 and best corrected visual acuity of 6/15 (20/50) in the right eye.

    Fundus photo and red-free image (right eye)

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    Fundus photo and red-free image (right eye)

    A round red lesion is visible at the macula.

    Spectralis OCT line scan (right macula)

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    Spectralis OCT line scan (right macula)

    A break in the RPE-Bruch's membrane complex can be seen adjacent to a "volcanic" shaped hyper-reflective lesion. There are no signs of exudation although there is a foveoschisis visible. This presentation is consistent with a sub-retinal heamorrhage secondary to a lacquer crack.

Differential Diagnosis

Best Disease (Vitelliform stage)

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Blot Haemorrhage (Diabetic Retinopathy)

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References

Baba, T. Ohno‐Matsui, K. Yoshida, T. Yasuzumi, K. Futagami, S. Tokoro, T. Mochizuki, M. (2002), Optical coherence tomography of choroidal neovascularization in high myopia. Acta Ophthalmologica Scandinavica, 80:

Hochman MA, Seery CM, Zarbin MA. (1997) Pathophysiology and management of subretinal hemorrhage. Surv Ophthalmol. Nov-Dec;42(3):195-213.