A 52-year-old woman reported a spontaneous decrease in visual acuity (VA) in her amblyopic left eye (LO). She had no history of premature birth or family history of ocular disease.
At the first examination, the best corrected VA was 1 in the right eye (OD) (-1 cylinder 150o +3 sphere; axial length 22.5mm) and 0.025 in the left eye (OI) (-0.75 cylinder 25o -13.25 sphere; axial length 25.3mm).
Biomicroscopic study of the OI identified the Mittendorf's spot located in the lower nasal quadrant of the posterior lens capsule and the anterior end of the AHP with haematic content inside. The oleophilic eye was normal. Horizontal corneal diameters measured 12mm in both eyes (AO) and applanation tonometry was 18mm Hg in AO.

Indirect ophthalmoscopy of the OI showed diffuse mild intravitreal haemorrhage. The path of the AHP could be followed from the optic nerve to the posterior crystalloid. The artery, fixed at both ends, moved freely with eye movements. The posterior vitreous was partially detached from the retina. There were no peripheral retinal abnormalities, no signs of vitreoretinal traction or retinal detachment. The fundus of the OD was normal.

The haemorrhage gradually resorbed over a week. The AHP could be distinguished more clearly allowing a better anatomical study. Optical coherence tomography (OCT) showed the morphological features of Bergmeister's papilla. From this, the AHP emerged showing a tubular structure with a hyporeflective interior.

B-mode ultrasound showed a linear hyperechogenic image with respect to the vitreous corresponding to the AHP and a partial posterior vitreous detachment. Doppler ultrasound demonstrated normal blood flow in the central retinal artery and posterior ciliary arteries but no active blood flow in the AHP.

The haemogram and specific coagulation tests were normal. The haemovitreous was completely reabsorbed and the patient recovered the 0.2 vision she had before the haemorrhage due to anisometropic amblyopia. There was no recurrence of bleeding in 6 months of follow-up.