Clinical Profile and Outcomes of Three Patients Intrapapillary Hemorrhage with Adjacent Peripapillary Subretinal Hemorrhage: A Case Series

Objective. This case series aims to elucidate the clinical presentation, diagnostic imaging, and outcomes associated with intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH), highlighting the importance of recognizing this syndrome in young myopic individuals. Material and methods. We conducted a single-center, retrospective, observational case series including three patients diagnosed with IHAPSH over the past seven years. Diagnostic modalities included cycloplegic refraction, fundus fluorescein angiography and photographs, optical coherence tomography (OCT), ultrasonography, and visual field testing. Results. The study involved six eyes from three female patients aged 12 to 46. Two exhibited acute and one subacute visual symptoms. Myopic refraction ranged from −1.5 to −6.50 diopters, and initial visual acuity varied from 1.0 to counting fingers at 1 meter. Biomicroscopy showed no significant findings. OCT revealed peripapillary subretinal hemorrhages in two eyes and subretinal hemorrhage at the optic disk in another. Preretinal hemorrhage was also observed. Ultrasonography detected slight elevation at the optic disk head; no drusen were found. All hemorrhages resolved spontaneously without sequelae. Conclusion. Hemorrhages resolved spontaneously in all cases, affirming IHAPSH’s benign nature. Advanced imaging provided accurate diagnoses, distinguishing IHAPSH from others and emphasizing conservative management. No chronic sequelae were noted, and differential diagnosis prevented unnecessary treatments. Key words: myopia, optic disk, intrapapillary hemorrhage, peripapillary subretinal hemorrhages