This healthy 52YO male noticed acute vision loss in his right eye two days earlier. He denied Valsalva or trauma. Vision was counting fingers in his right eye and 20/20 in his normal left eye. He has a history of untreated hypertension, and his BP in the office was 180/110.
Color imaging shows multifocal, mostly deep, retinal hemorrhages scattered throughout the right posterior pole. Some of these hemorrhages are radiating outwards from the macular center in Henle’s layer. A subhyaloid vs sub-ILM hemorrhage is also noted.
Learning Points:
Named by Kon Graversen et al (Retina 2014;34:483-489), hemorrhagic unilateral retinopathy presents with unilateral, deep intraretinal hemorrhages and sudden vision loss ranging from 20/20 to hand motion.
There are no associated systemic conditions, nor a history of trauma or Valsalva maneuver. It is most common in females. Vision usually recovers completely within 6 months.
We do not believe our patient’s findings were caused by his hypertension since they were unilateral and predominated by deeper retinal findings. Observation was recommended.
