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Kon Graversen, Veronica A. MD*; Jampol, Lee M. MD; Meredith, Travis MD*; Landers, Maurice III MD*; Slakter, Jason MD§; Brucker, Alexander J. MD; Rabb, Maurice MD

doi: 10.1097/IAE.0b013e3182a48759
Original Study

Purpose: To evaluate the possible etiologies of a hemorrhagic unilateral retinopathy in healthy patients.

Methods: Retrospective case series and review of the literature. All patients underwent a detailed ophthalmologic evaluation and analyses of their medical histories.

Results: Eleven eyes of 10 patients with unexplained unilateral, predominantly deep, intraretinal hemorrhages were identified. All patients were women. Mean age of the subjects was 48.4 years (range, 25–83 years). The main complaint at presentation was sudden visual loss, with visual acuity ranging from 20/20 to hand motion. The mean follow-up was 17 months, and the 9 eyes with follow-up showed spontaneous resolution of the hemorrhages and marked improvement of vision. There was no history of Valsalva maneuver or strenuous exercise. The patients were healthy at presentation and during follow-ups as long as 84 months.

Conclusion: This series depicts the characteristics of a possible new entity with a review of the differential diagnosis. The visual outcome was excellent.

Intraretinal hemorrhages may be associated with many systemic and ocular conditions, including diabetes, hypertension, anemia, coagulopathies, Valsalva maneuvers, retinal vascular occlusions, shaken adult syndrome, high altitude, and exertion. This series describes otherwise healthy young adults with unilateral deep intraretinal hemorrhages of unknown etiology.

*Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;


Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;

§Vitreous-Retina-Macula Consultants of New York, New York, New York; and

Department of Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania.

Reprint requests: Veronica A. Kon Graversen, MD, Department of Ophthalmology, University of North Carolina at Chapel Hill, 9303 Fawn Lake Dr, Raleigh, NC 27617; e-mail:

None of the authors have any financial/conflicting interests to disclose.

Supported in part by unrestricted grants from Research to Prevent Blindness, Inc, New York, NY (Northwestern University/University of North Carolina at Chapel Hill).

© 2014 by Ophthalmic Communications Society, Inc.