This 38YO male was hit by a stone in his left eye two days earlier. Vision was 20/20 in his normal OD and counting fingers OS.
Pseudocolor SLO imaging shows central macular greenish-brown subretinal blood surrounded by a rim of thinner red blood. OCT shows the hyperreflective blood with posterior shadowing. An in-office intravitreal C3F8 gas injection was performed, followed by face-down positioning. Six weeks later, the blood is virtually resolved except for some residual distal inferotemporal yellow devitalized subretinal blood. The causative choroidal rupture can be seen just temporal to the foveal center.
Learning Points:
An acute submacular hemorrhage following blunt trauma almost always indicates an underlying choroidal rupture as the source of the blood. The final vision is usually good unless the rupture extends through the macular center. These patients need long-term follow-up due to the increased risk of macular neovascularization.
