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Ophthalmic Images
December 10, 2020

Scattered Multilayered Retinal Hemorrhage Secondary to Anterior Chamber Paracentesis, Mimicking a Hematological Disorder

Author Affiliations
  • 1Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
  • 2Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
JAMA Ophthalmol. 2020;138(12):e202389. doi:10.1001/jamaophthalmol.2020.2389

A 44-year-old man presented with bilateral blurred vision for 1 day. Seven months prior to presentation, he had been diagnosed as having glaucomatocyclitic crisis (Posner-Shlossman syndrome) in both eyes after a herpes zoster infection. Bilateral anterior chamber paracentesis was performed for elevated intraocular pressure levels (61 mm Hg OD; 52 mm Hg OS) a day prior to presentation.

On ophthalmic examination, bilateral, multilayered retinal hemorrhages were noted (Figure, A). Multiple areas of blockage of fluorescein were noted on wide-angle fundus fluorescein angiography (Figure, B). The intraretinal hemorrhages were believed to be because of a rapid decrease in intraocular pressure level (ie, ocular decompression retinopathy).

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