Clinical presentation and optical coherence tomography findings of intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage.

Introduction: Case reports of intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH) have been increasing in recent years, and its relationship with myopia-associated optic disc changes has been suggested. In this study, we examined clinical features and fundus imaging (optical coherence tomography [OCT] and OCT angiography [OCTA]) of cases of IHAPSH. Method: We retrospectively studied 5 patients diagnosed with IHAPSH at our department in the last 8 years. Results: Mean onset age was 18.6 years (range, 12-30 years) with 1 male and 4 female patients. The affected eyes were 2 right and 4 left (1 case of bilateral involvement). Mean spherical equivalent was -5.38D (range, -1.75 to -7.0D), and mean axial length was 26.30mm (range, 24.73-27.34mm). Subretinal hemorrhage adjacent to the nasal-to-superior side of the optic nerve head, hemorrhage within optic disc and disc swelling were observed in all onset eyes. Vitreous hemorrhage was noted in 3 eyes. Peripapillary chorioretinal atrophy was observed in all cases, and disc structural abnormalities were detected in 3 eyes (optic disc drusen, tilted disc and small disc). OCT revealed peripapillary hyperreflective ovoid mass-like structures (PHOMS) in all cases. No obvious abnormal findings were observed in 4 cases that underwent OCTA imaging. Conclusion: Myopia-associated optic disc changes and disc structural abnormalities including PHOMS could be related to the onset of IHAPSH.