Sub-internal limiting membrane hemorrhage - presentation, management and prognosis - A case series

Macular sub-internal limiting membrane (sub-ILM) hemorrhages can cause significant visual loss requiring timely intervention. This case series analyzes eight patients using swept source optical coherence tomography (SS-OCT) imaging to guide treatment. Early presenting cases were treated with neodymium-yttrium-aluminum-garnet (Nd:YAG) laser membranotomy; delayed or complex cases underwent vitrectomy with ILM peeling. Laser was avoided when the dependent part of hemorrhage involved the macula. One laser-treated case showed a premacular cavity on follow-up. Visual outcomes were favorable overall, with OCT aiding in decision making by delineating hemorrhage characteristics. Early diagnosis and appropriate intervention, guided by OCT, are essential for optimal visual recovery and prevention of retinal toxicity.