First Author: K.Montes Leon COLOMBIA
Co Author(s): F. Rodriguez Alvira
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To describe the clinical findings an ancillary tests of two cases of young patients who developed foveal sub - internal limiting membrane (ILM) haemorrhage. Clinical cases of unusual presentation.
To report two cases of young patients who developed foveal sub - internal limiting membrane (ILM) haemorrhage not associated with trauma or Valsalva manoeuvres, with visual recovery after observation and treatment with topical NSAIDs.
Prospective, non-interventional case report. We describe two cases of painless unilateral decreased vision and central negative scotoma with foveal sub - ILM haemorrhage, and monitoring of natural evolution with BCVA and ancilliary diagnostic images (colour photo, fluorescein angiography, autofluorescence and macular spectral domain optical coherence tomography (SD-OCT)).
Both patients present foveal sub - ILM haemorrhage by SD-OCT with increased central foveal thickness, autofluorescence image described as hipoautofluorescent, and hypofluorescent blockage by angiography with anatomical and functional complete resolution after one month follow-up. Two patients, a 25-year old man and a 38-year old woman (a 28 weeks pregnant), with no medical history, complained decreased painless unilateral vision of right eye and central negative scotoma 15 days ago, not associated with trauma or Valsalva manoeuvres. Both had flu symptoms a week before the decreased visual acuity. Complete anatomical and morphologic resolution of sub - MLI haemorrhage occurs one month after disease started, with visual recovery in 20/20; we observe both patients due to the small size of the lesion and its foveal location.
The foveal sub - ILM haemorrhage is described as part of a Valsalva retinopathy, however, it presents as large haemorrhage with great visual impairment. Therapeutic options include expectant management or drainage of haemorrhage with neodymium YAG laser. The aetiology of small unilateral foveal sub - MLI haemorrhages in young patients has not been previously described in the literature. We provide new clinical information and images of the natural evolution of this pathology.