title: Macular microstructures and prognostic factors in myopic subretinal hemorrhages.
abstract: OBJECTIVE
  To investigate microstructural changes and visual prognosis in myopic subretinal hemorrhages (mSH) without choroidal neovascularization (CNV).
  
  
  METHODS
  In this retrospective, observational case series, 13 consecutive eyes with mSH were followed for 6 months. The medical records, fluorescein angiography (FA), and spectral-domain optical coherence tomography (OCT) were reviewed. Fluorescein angiography confirmed the absence of CNV. The baseline and 6-month findings/parameters were investigated, including the maximal hemorrhagic height, intraretinal hyperscattering signal across the retina at 6 months (i.e., intraretinal hyperreflective sign), and integrity of the photoreceptor inner and outer segment (IS/OS) and external limiting membrane (ELM) lines.
  
  
  RESULTS
  The final visual acuity (VA) improved significantly (P = 0.001), and the hemorrhages resolved in 12 (92.3%) eyes by 6 months. The tops of the hemorrhages reached the outer nuclear layer (ONL) in three eyes (23.1%), internal limiting membrane (ILM) in five (38.5%), and between the two layers in five (38.5%). The intraretinal hyperreflective sign in all eyes extended into the ONL in five eyes (38.5%), to the ILM in four (30.8%), and between the two layers in four (30.8%). The location of the hyperreflective signs at 6 months coincided with the ruptured retinal layers at baseline in all eyes. The IS/OS line and the ELM were each intact in six (46.2%) eyes. The final VA was associated significantly with the IS/OS (P < 0.05) and ELM (P < 0.01) integrity.
  
  
  CONCLUSIONS
  The intraretinal hyperreflective sign, presumed to be scarring that enters through the disrupted outer retina, is correlated closely with photoreceptor function.
authors: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Tomoko
authors: T
authors: Asai
authors: Yasushi
authors: Y
authors: Ikuno
authors: Kohji
authors: K
authors: Nishida
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea / Q000648:ultrastructure*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications* / Q000175:diagnosis; D011379:Prognosis; D012166:Retinal Hemorrhage / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D055815:Young Adult
keywords: hemorrhage; myopia; optical coherence tomography