• In two patients with sickle cell disease (one hemoglobin SC and one hemoglobin SS), central retinal artery occlusions developed. In one case, the occlusion followed a retrobulbar injection of lidocaine hydrochloride. Although the central retinal artery reperfused in each patient, many secondary peripheral retinal arteriolar occlusions remained. During the subsequent days, multiple salmon-patch hemorrhages developed in the distribution of these occluded arterioles. In one patient, the salmon-patch hemorrhages evolved into atrophic schisis cavities. These unusual cases allowed us to document the origin of salmon-patch hemorrhages after peripheral retinal arteriolar occlusions. The development of the hemorrhages was a delayed phenomenon that occurred hours to days after the initial vascular occlusion. Reperfusion of the damaged ischemic vessels with a blowout of the wall of the vessels seems the most likely explanation for this phenomenon.
Jampol LM, Condon P, Dizon-Moore R, Serjeant G, Schulman JA. Salmon-Patch Hemorrhages After Central Retinal Artery Occlusion in Sickle Cell Disease. Arch Ophthalmol. 1981;99(2):237-240. doi:10.1001/archopht.1981.03930010239002