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LETTER TO THE EDITOR |
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Year : 2016 | Volume
: 64
| Issue : 12 | Page : 947 |
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Comment on: Bilateral macular hemorrhage due to megaloblastic anemia: A rare case report
Neha Goel
ICARE Eye Hospital and Post Graduate Institute, Noida, Uttar Pradesh, India
Date of Web Publication | 23-Jan-2017 |
Correspondence Address: Neha Goel 57, Sadar Apartments, Mayur Vihar Phase 1 Extension, New Delhi - 110 091 India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0301-4738.198852
How to cite this article: Goel N. Comment on: Bilateral macular hemorrhage due to megaloblastic anemia: A rare case report. Indian J Ophthalmol 2016;64:947 |
Sir,
I read with interest the article titled, “Bilateral macular hemorrhage due to megaloblastic anemia: A rare case report” by Vaggu and Bhogadi.[1] In the absence of optical coherence tomography (OCT) images being provided in this report, I request further clarification on how the authors have labeled the bilateral macular hemorrhage as sub-internal limiting membrane (sub-ILM).
The distinction between sub-ILM and subhyaloid hemorrhage is difficult to define clinically. Although glistening reflexes and surface striae may point toward the hemorrhage being sub-ILM, the reliability of ophthalmoscopy in locating the plane of hemorrhage has been challenged.[2] If the presence of the detached posterior hyaloid face in the area of the hemorrhage can be documented using ultrasonography or OCT, it suggests that the hemorrhage is sub-ILM and not subhyaloid.[3] If two layers are not picked up, the presence of a dome-shaped convex cavity on OCT, with a hyperreflective anterior layer corresponding to the ILM, suggests that the hemorrhage is sub-ILM.[4] Thus, the hemorrhage [1] should be referred to as “preretinal” or “premacular,” in the absence of evidence suggesting that it is sub-ILM.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | | |
1. | Vaggu SK, Bhogadi P. Bilateral macular hemorrhage due to megaloblastic anemia: A rare case report. Indian J Ophthalmol 2016;64:157-9. [ PUBMED] |
2. | Ulbig MW, Mangouritsas G, Rothbacher HH, Hamilton AM, McHugh JD. Long-term results after drainage of premacular subhyaloid hemorrhage into the vitreous with a pulsed Nd: YAG laser. Arch Ophthalmol 1998;116:1465-9. |
3. | Shukla D, Naresh KB, Kim R. Optical coherence tomography findings in valsalva retinopathy. Am J Ophthalmol 2005;140:134-6. |
4. | Goel N, Kumar V, Seth A, Raina UK, Ghosh B. Spectral-domain optical coherence tomography following Nd: YAG laser membranotomy in valsalva retinopathy. Ophthalmic Surg Lasers Imaging 2011;42:222-8. |
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