【摘要】 视盘内出血伴视盘旁视网膜下出血(intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage,IHAPSH)的病例报道较为少见。此病好发于患有轻、中度近视的中青年，且伴有视盘向倾斜或小视盘的患者，具有自限性，视力预后良好，无后遗症，而且很少复发。IHAPSH的眼底表现为视盘内出血、视盘旁视网膜下出血，严重者可出现玻璃体积血。文章报道一例IHAPSH，患者为26岁中度近视女性，主要症状为左眼无痛性视力下降伴眼前黑影飘动6 d。双眼最佳矫正视力均为1.0。眼底检查发现双眼视盘偏小，呈倾斜位，右眼视盘鼻侧见红色视网膜下出血灶；左眼视盘内及视盘鼻侧、上方、颞上方视网膜浅层出血，视盘鼻侧见边界清晰的新月形红色视网膜下出血。未进行特殊治疗，2个月后出血完全吸收。此病病因复杂多样，需与多种眼底疾病相鉴别，及时行眼科相关检查以排除其他原因导致的视盘水肿、视盘出血。文章通过文献回顾，总结其临床特征、发病机制、诊断、鉴别诊断、治疗及预后。更多还原

【Abstract】 Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage(IHAPSH) is rarely reported. IHAPSH commonly affects young myopic eyes with tilted optic discs and spontaneously resolves without treatment, with an excellent prognosis for vision recovery and very rarely recur. The fundus manifestations of IHAPSH are intrapapillary hemorrhage, peripapillary subretinal hemorrhage, or even with vitreous bleeding. An 26-year-old female with mild myopia presented with symptoms of blurry vision and black filamentous floaters for 6 days. Her BCVA was 1.0 in both eyes. Fundus examination showed that both discs appear small, and elevated in the nasal regions. Intrapapillary hemorrhage, peripapillary subretinal hemorrhage and vitreous hemorrhage were observed in the left eye, while only peripapillary subretinal hemorrhage was seen in the right eye. The hemorrhage was resolved spontaneously without any complication after 2 months. The etiology of IHAPSH is complex, and it should be differentiated from other causes of papilledema and disc hemorrhage. The clinical characteristics, pathogenesis, diagnosis, differential diagnosis, treatment and prognosis were summarized through the literature review.更多还原