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Photo Essay
April 2004

Petalloid Foveal Hemorrhage in a Patient With High Myopia

Arch Ophthalmol. 2004;122(4):660-661. doi:10.1001/archopht.122.4.660

A 21-year-old man with myopic degeneration was examined because of asudden onset of decreased vision in his right eye. He denied recent traumaor Valsalva maneuver. His ocular history was significant for high myopia (OD,−14.00 diopters [D]; OS, −16.00 D) and cryotherapy in both eyesfor peripheral tears associated with lattice degeneration.

On examination, visual acuity was 20/400 OD and 20/30 OS. Fundus examinationshowed tilted myopic discs with multiple lacquer cracks and irregular changesin the retinal pigment epithelium. A stellate intraretinal hemorrhage waspresent in the fovea of his right eye (Figure1). The hemorrhage was organized in a peculiar petalloid patternwith feathery distal edges, suggesting localization within the radially orientedHenle fiber layer. An optical coherence tomograph (Figure 2) showed areas of high backscattering and shadowing of theunderlying retinal pigment epithelium, consistent with hemorrhage in the intraretinalspace.

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