This 29YO 4-month pregnant female presented with acute vision loss. The internal limiting membrane (ILM) was detached throughout the entire macula, and an inferior-layered sub-ILM hemorrhage spared the macular center. Her hemoglobin was later found to be 11.
Learning Points:
Acute sub-ILM hemorrhage is most common following a Valsalva maneuver or trauma (which our patient denied), but can also happen spontaneously with anemia.
These hemorrhages virtually always resolve without sequelae, although the blood can be drained into the inferior vitreous by creating a small opening in the ILM using either a thermal or Nd:YAG laser.
