Retinal Hemorrhages
Hemorrhages in retina at various levels
May be present near optic disc or only in retinal periphery (sickle cell retinopathy ) Dot/blot hemorrhages Rupture of deep capillaries submerged within retina and caused by arteriolar, capillary, or venular incompetence Commonly associated with diabetes Flame hemorrhages Rupture on retinal nerve fiber layer of superficial pre-capillary arterioles, small veins Commonly associated with systemic hypertension, leukemia, severe anemia, thrombocytopenia, retinal vein occlusion, trauma Boat-shaped (pre-retinal) hemorrhages Rupture of large superficial retinal veins into space between retina and vitreous; sometimes these bleeds break into vitreous cavity Meniscus looks like rudder of boat Commonly associated with sudden increase in intracranial pressure, anemia, thrombocytopenia, trauma, vigorous headshaking in abused infants, retinal vein occlusion Subretinal hemorrhages Rupture of choroidal vessels under fovea in interface between choroid and retina Commonly associated with age-related macular degeneration Vitreous hemorrhages Rupture of superficial retinal vessels or vessels on fibrovascular stalk extending into vitreous Commonly associated with proliferative diabetic retinopathy, hypertension, trauma
Not much; black pigment can resemble hemorrhage
Most retinal hemorrhages can be spotted near optic disc, but there are many conditions where they are present only in retinal periphery, requiring viewing with special instruments
Retinal hemorrhages are critical indicators of diseases with vascular incompetence May be only sign of abusive head trauma, blood dyscrasia, diabetes, hypertension, sickle cell disease, lupus erythematosus, and other systemic diseases
