title: Multilayered optic disc hemorrhages in adolescents.
abstract: OBJECTIVE
  To describe the clinical characteristics of multilayered optic disc hemorrhages, which are defined as subretinal, superficial retinal, and subhyaloid or vitreous hemorrhages in adolescents.
  
  
  METHODS
  Case records of adolescents with acute multilayered optic disc hemorrhages were identified and evaluated retrospectively from 1994 to 2012. The appearance of the hemorrhages including the size, location, extension, and disc anatomy was recorded. Fluorescein angiography, visual field examination, and spectral-domain optical coherence tomography were performed in select cases.
  
  
  RESULTS
  Nine boys and 7 girls were included, with a mean age of 15.0 ± 2.6 years. No precipitating factor, such as involuntary Valsalva maneuver, was identified in the majority of patients (93.75%). All eyes were myopic with an average refraction of -4.64 ± 1.88 diopters. Fifteen (93.75%) of the affected optic discs were crowded and tilted with small cups. Peripapillary subretinal hemorrhages were all crescent in shape and located at the nasal disc. Eight (50%) eyes had marked subretinal blood extension exceeding 1 disc diameter away from the disc edge. Superficial flame hemorrhages were predominantly located in the superotemporal part of the disc. Spectral-domain optical coherence tomography of the disc showed vitreopapillary traction and obvious subretinal hemorrhage with increased thickness. All multilayered optic disc hemorrhages resolved spontaneously.
  
  
  CONCLUSIONS
  Multilayered optic disc hemorrhages in adolescents more commonly affect myopic eyes with crowded and tilted discs. The visual outcome is excellent.
authors.forename: Jiunn-Feng
authors.initials: JF
authors.lastname: Hwang
authors.forename: Chun-Ju
authors.initials: CJ
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D009216:Myopia / Q000175:diagnosis / Q000503:physiopathology; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000503:physiopathology; D012166:Retinal Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D014823:Vitreous Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult