Purpose: Among the great amount of etiologically heterogeneous group of general and specific eye diseases, a solitary, spontaneous, unilateral retinal hemorrhage restricted to the macula in young adults can be regarded as an entity. Methods: Twelve eyes were phakic, emmetropic (including minor non corrected astigmatic errors) and were seen over a period of 5 years. All patients had a complete ophthalmologic examination with special analysis of history of direct or indirect trauma, additional medical work-up to exclude hematological disorders, and fluorescein angiography examinations up to the complete blood resolution. Results: Hemorrhage is presented in 3 pictures: 1) Foveal microhemorrhage, 2) Drop-like hemorrhage limited to the avascular zone of the fovea, 3) Bag-like hemorrhage over the posterior pole. Initially, all patients had complains suggestive of positive central or paracentral scotomas with impaired visual acuity.The resolution of blood was spontaneous in 10 patients, after argon laser treatment in 2 patients. In all of them, the recovery of the visual acuity was complete. Possible pathogenetic mechanism such as Valsalva manoeuvre could be found in 3 cases only. Conclusions: Spontaneous macular hemorrhage is mostly idiopathic clinical entity in young adults with complete recovery of visual acuity.

        Key words: Idiopathic premacular hemorrhage, young adults, fluorescein angiography, spontaneous resolution of hemorrhage, argon laser coagulation