Hemorrhagic unilateral retinopathy: a report of multimodal imaging in three cases

Retin Cases Brief Rep. 2024 Mar 1. doi: 10.1097/ICB.0000000000001557. Online ahead of print.

Abstract

Purpose: To report three cases of hemorrhagic unilateral retinopathy, diagnosed by multimodal imaging.

Methods: Case report of 3 patients, 2 women and one man, aged 51, 74, and 52, respectively.

Results: Symptoms were acute floaters, blurred vision, or central scotoma, unilateral in all cases. The best-corrected visual acuity was 20/20 in the affected eye in 2 patients with a paracentral scotoma, and 20/160 in the third patient. Funduscopic examination revealed multiple unilateral posterior hemorrhages located in the Henle fiber layer in the macula and beneath the internal limiting membrane around the optic disc on spectral-domain optical coherence tomography (SD-OCT). Fluorescein angiography and indocyanine green angiography (ICGA) did not show any vascular abnormalities. SD-OCT angiography (SD-OCT-A) did not show any capillary drop-out or choroidal abnormalities. In all patients, the visual symptoms completely disappeared within a few weeks, with spontaneous regression of the hemorrhages.

Conclusion: Hemorrhagic unilateral retinopathy is a rarely reported and poorly understood disorder. ICGA and SD-OCT-A did not allow better understanding the condition. No etiology has been associated with this entity so far. The spontaneous resolution of the present cases confirmed the favorable visual prognosis of the condition.