This patient presented with an acute layered sub-internal limiting membrane (ILM) hemorrhage due to a Valsalva maneuver. There is also a rim of blood along the circumference of the ILM detachment, which is most likely located in Henle’s layer, given its radiating deep retinal pattern.
Learning Points:
Sub-ILM hemorrhages most commonly follow a Valsalva maneuver or trauma, but can also happen spontaneously, as 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.
