This is a beautiful photograph of an acute sub-internal limiting membrane (ILM) hemorrhage, most commonly found following a Valsalva maneuver or trauma, but can also happen spontaneously, as with anemia.
OCT scanning shows marked hyperreflectivity from the sub-ILM blood with posterior shadowing.
Learning Points:
Sub-ILM 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.
