Background: To report four cases with interesting anatomical presentations of multilayer macular hemorrhages with preretinal hemorrhage possibly preventing subretinal involvement of the macular area.
Cases presentation: Observational study of four patients presenting with macular hemorrhages.
Results: Four patients with multilayer macular hemorrhage due to different causes, presented with a halo-shaped submacular hemorrhage coincident with the preretinal hemorrhage borders. After resolution, in all cases, the macular area underneath the preretinal hemorrhage was found to be spared.
Conclusion: We hypothesized that an extensive preretinal hemorrhage can exert a mechanical force pushing the subretinal hemorrhage towards the periphery, consequently protecting the macular area.
Keywords: Hemorrhages; Internal limiting membrane; Macular protection; Premacular hemorrhage; Preretinal hemorrhage; Retinal hemorrhages; Sub-ILM hemorrhage; Subretinal hemorrhages.