Purpose: To describe the clinical features and present the results of diagnostic methods to define multilayered disc hemorrhages.

Methods: Patients with acute multilayered disc hemorrhages at presentation were identified and evaluated retrospectively from 1988 through 2011. We analyzed data including patient demographics, refraction, visual acuities, and fundus photographs. Results of available ancillary testing, including fluorescein angiography, optical coherence tomography, automated perimetry and computed tomography were discussed.

Results: 43 eyes of 41 patients are included. There are 24 right eyes and 19 left eyes. 26 are females and 15 are males, aged 10 to 73 years. All experienced an acute onset of visual symptoms. 39 eyes had mild to severe myopia (-0.25 to -13.75 D). The subretinal hemorrhage located nasally in 39 eyes, temporally in 1 eye and both in 3 eyes. 4 eyes of 2 patients were found simultaneously. VH was noted in all eyes. BCVA at presentation was 20/25 or better in 37 eyes. 5 eyes had worse vision due to dense VH. 1 eye had unrelated poor vision due to macular hole. Hemorrhage spontaneously resolved without treatment after 1-3 months. BCVA maintained or improved to 20/25 or better in all eyes except the 1 with macular hole. There have been no recurrences.

Conclusions: Multilayered disc hemorrhages affects patients of all ages and both genders, more common in female myopic eyes. The subretinal hemorrhages usually appear on the nasal aspect of tilted discs. Multilayered disc hemorrhages may be spontaneous or may be precipitated by acute disc edema, Valsalva maneuver, or vitreopapillary traction. The prognosis is favorable.

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