Dual-layered premacular bleed

Figure 1: Ultrawide-field fundus photograph of the left eye showing premacular hemorrhage (Valsalva retinopathy). The bleed has a zonal distribution. Central haze is artifact because of posterior subcapsular cataractA 27-year-old otherwise healthy male developed Valsalva retinopathy in his left eye after an episode of vomiting and presented with premacular bleed (sudden vision loss). The corresponding subhyaloid space had three zones – uppermost zone of clear plasma, middle zone of denatured hemoglobin (yellow band), and lower zone of sedimented red blood cells [Fig. 1]. The figure clearly elicits the density of denatured cells being less than sedimented cells, thus floating on the latter and forming a dual layer in a closed subhyaloid space. A written informed consent has been obtained from the patient. Author’s contributions AAB- Manuscript preparation, data retreival; PP- concept, manuscript editing and review. Declaration of patient consent The author certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in this journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.