Abstract: Objective To evaluate and analysis the optical imaging characteristics of submacular hemorrhage in highly myopia with or without choroidal neovascularization by optical coherence tomography (OCT). Design Retrospective case series. Participants Forty-seven highly myopia patients (47 eyes) with submacular hemorrhage. Methods Fluorescence fundus angiography (FFA), fundus autofluorescence (FAF), OCT and best corrected visual acuity (BCVA) were performed on 47 highly myopia eyes with submacular hemorrhage. Main Outcome Measures Imaging of OCT and FAF, BCVA. Results  In the 47 eyes, 27 eyes with choroidal neovascularization (CNV) (CNV group), 20 eyes without choroidal neovascularization (simple hemorrhage group) according to FFA and ICGA.  The characteristics of OCT images in CNV group were spindle shape with strong or medium reflection, sticking out upwards from retinal pigment epithelial （RPE） layers. Simple submacular bleeding without CNV showed protruded medium reflection area under the neuroepithelial layer without disruption of RPE layer. In CNV group, the inner segment/ outer segment (IS/OS) line of photoreceptors was intact in OCT only in 3/27 eyes and destroyed in 24/27 eyes; However, in the simple hemorrhage group, the IS/OS line of photoreceptors was intact in 13/20 eyes and destroyed in 7/20 eyes (χ2=14.86，P=0.000). In the CNV group, hypoautofluorescence was present at the area of the bleeding combined with the hyperautofluorescence around it; in the simple hemorrhage group, hypoautofluorescence was present at the area of the bleeding. Conclusion Submacular hemorrhage in highly myopia eye could be divided into two forms: submacular hemorrhage with choroidal neovascularization and simple submacular bleeding, which can be differentiated by OCT and FAF. (Ophthalmol CHN, 2014, 23: 103-106)

Key words: highly myopia, submacular hemorrhage, optical coherence tomography, fundus autofluorescence, choroidal neovascularization