First Author: M.A.Sekeroglu TURKEY
Co Author(s): M.A. Anayol H. Tirhis P. Yilmazbas 0 0 0 0 0 0 0 0 0
Back to previous
To discuss the clinical course and management of a patient with sub-inner limiting membrane (ILM) hemorrhage following a labor
Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
We present a 30-year-old woman with sudden visual loss in her right eye following a term delivery. Best corrected visual acuity (BCVA) was hand movements on her right eye and fundoscopic examination revealed a sharply demarcated, circular and dome-shaped premacular hemorrhage. The diagnosis of sub-ILM hemorrhage was made depending on optic coherence tomography features. The fellow eye was completely normal.
Observation of the hemorrhage and systemic screening which revealed anemia was recommended initially. Treatment of the anemia was started meantime. Afterwards, pars plana vitrectomy with ILM peeling was plannned at second week as there was no spontaneous improvement of the hemorrhage, but the patient did not wanted to be operated. Fortunately BCVA showed significant improvement (20/400 at first month, 20/200 at second month, 20/40 at third month and 20/20 at fourth month) with spontaneous resolution of the hemorrhage.
Preretinal hemorrhages are usually located between ILM and posterior hyaloid. Rarely they can be located between the ILM and retinal nerve fiber layer. Premacular hemorrhage without spontaneous resorption should suggest sub-ILM hemorrhage. The patients with Sub-ILM hemorrhages are usually scheduled for pars plana vitrectomy with ILM peeling and aspiration of hemorrhage in order to avoid macular toxicity. But spontaneous resorption of sub-ILM hemorrhage is a rare occurrence and should be kept in mind in order to avoid surgical risks.