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Caryssa Ling Yan, Marten Erik Brelen, Haoyu Chen, Chi Pui Calvin Pang, Weiqi Chen; Spontaneous Intrapapillary Haemorrhage and Adjacent Peripapillary Subretinal Haemorrhage in Adolescents. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2034.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical features of 7 eyes of 7 adolescent patients with spontaneous intrapapillary haemorrhage with adjacent peripapillary subretinal haemorrhage (IHAPSH).
A retrospective case series of 7 patients who were all seen at the Joint Shantou International Eye Centre, between 2006 and 2014, was performed. The patient demographics, clinical history, vision, fundoscopic appearance and results of relevant investigations were collected.
7 eyes of 7 patients (4 male and 3 female) with IHAPSH with a median age at presentation of 15 years (mean 14.7, range 11-19). 4 cases presented in the right eye and 3 cases in the left eye. The presenting visual acuity ranged from 0.12 - 1.00. There were no obvious underlying causes or predisposing factors. 6 eyes had myopia ranging mild to moderate (–0.25 diopters (D) to –4.00D) and none had tilted discs. In 4 eyes, the subretinal haemorrhage was greater than 2 disc diameters. There was associated vitreous haemorrhage in 5 eyes. There were no posterior vitreous detachments in any of the eyes. Optic disc drusen was found in 1 eye. Visual field test showed an enlarged blind spot in 4 cases. Optical coherence tomography of the disc revealed optic disc swelling in 2 cases. Fluorescein angiography demonstrated leakage in the late phase of 3 eyes. At 2 to 24 months follow-up, the haemorrhage resolved in all 7 cases with vision recovering fully to 20/20. Visual field defect of enlarged blind spots improved with the resolution of intrapapillary and subretinal hemorrhages.
The condition of IHAPSH resolved spontaneously without intervention in all cases. There appeared to be no predisposing factors for the development of this condition. Previously reported risk factors such as straining (Valsalva), posterior vitreous detachment or unusual configuration of the disc were not seen in these cases. This is the first time a series of young adults have been reported with this condition all of whom presented in the same manner and had the same clinical outcomes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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