Valsalva Retinopathy with Sub-ILM hemorrhages in the setting of pancytopenia and pneumonia

Valsalva Retinopathy with Sub-ILM hemorrhages in the setting of pancytopenia and pneumonia

TThis is a 62-year-old man with a history of diffuse large B-cell lymphoma who had undergone autologous bone marrow transplantation and noted vision loss after a coughing episode while admitted for pancytopenia and pneumonia. The photo was taken 1 month after onset of symptoms and demonstrates hemorrhages in multiple layers of the retina, but most prominently beneath the internal limiting membrane as demonstrated by spectral domain OCT (distinct from sub-hyaloid or pre-retinal hemorrhage). At 1 month, the red cells had taken on a pale white color. Initial vision was 20/70 OD and 20/40 OS improving to 20/20 OD and stable at 20/40 OS 3 months after onset of symptoms with observation.

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