This 20YO female presented with a history of headaches and recent floaters in her right eye. There was a history of idiopathic intracranial hypertension.
Color photography shows a swollen right nerve with overlying preretinal blood extending inferiorly. Fluorescein angiography showed no leakage. Unfortunately, further clinical information and follow-up are not available.
Learning Points:
Vitreous hemorrhage directly from papilledema is exceedingly rare, and the published literature on this specific complication is very limited. Prior reports attribute vitreous hemorrhage to papilledema in eyes with no other pathology. One report suggested that the breakthrough vitreous hemorrhage originated from the optociliary shunt vessels (Fraser et al, J Neuroophthalmology 2012;32:332-334). Our patient offers visual evidence that vitreous blood can arise directly from an edematous nerve.
