[Clinical characteristics and pathogenesis of intracapillary hemorrhage with adjacent peripapillary subretinal hemorrhage].

OBJECTIVE

To study the clinical characteristics and pathogenesis of intracapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH).

METHODS

A retrospective review of 8 patients with IHAPSH. The demographical data of the patients, the symptoms, initial and final visual acuities, biomicroscopic findings, fundus photographs, and the results of various special examinations, including fluoresce in angiography, B-scan ultrasonography, optical coherence tomography (OCT) and CT were analyzed.

RESULTS

Fundus examination of 8 patients showed various changes of optic disc, including: a small and tilted optic disc with elevation and blurring of the nasal or superonasal edge. Hemorrhage of the optic disc was present in the cup and/or on the nasal edge, extended to the surface of the optic disc, the superficial layer of the retina and the subretinal space. Subretinal hemorrhage was located on the nasal, superior and inferior side of the optic disc. OCT examination showed an elevated optic nerve head with an enlarged nasal peripapillary subretinal space.

CONCLUSIONS

In the IHAPSH patient, bleeding may originate from the posterior ciliary artery that traverse the sclera window of the disc, passes through the space between the optic nerve and the scleral canal, reaches the edge of the optic disc and the subretinal space, penetrates into the optic nerve tissues anterior to the lamina cribrosa, reaches the optic cup and extends to the surface of the optic disc, the retina or the vitreous.