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Repeated macular haemorrhage: case report A 32-year-old man developed repeated macular haemorrhage while receiving nutritional supplement containing eicosapentaenoic-acid/docosahexaenoic-acid and omega-3-fatty-acid [route not stated]. The man, who had myopia, presented to clinic for anti-vascular endothelial growth factor injection for treatment of the left eye paracentral scotoma in December 2012. Eight months prior to the presentation, he had presented with right eye paracentral scotoma that was diagnosed as choroidal neovascularisation (CNV). One month later, his right eye CNV became inactive, and his visual acuity had improved. Thereafter, choroidal neovascularization resolved. During presentation in December 2012, he developed difficulties while reading through the left eye, which was supported by imaging of a paracentral scotoma. Fundus examination showed a red subtle lesion nasal to the left fovea and spectral-domain optical coherence tomography (OCT) of the left eye demonstrated a dome shaped elevation in the ellipsoid area and interdigitation area nasal to the fovea. An investigation showed no evidence of CNV. A multifocal electroretinogram revealed decrease in the amplitude of N and P wave in the nasal parafoveal area, consistent with the haemorrhagic lesion. Three weeks later, another electroretinogram revealed that the amplitude had slightly improved. In January 2013, 8 weeks after the first left eye haemorrhage, OCT showed dome-shaped elevation and the left paracentral scotoma. However, he again developed a second paracentral scotoma, which was closer to the left fovea within 2 weeks in February 2013. Fundus photography showed new dot-like lesion, and spectral-domain OCT revealed newly formed dome shaped elevation in the ellipsoid area and interdigitation area nasal to the fovea. Upon investigation, it was noticed that he was taking fish oil nutritional supplement therapy with omega-3-fatty-acid [Omega-3] 1000mg daily capsule and eicosapentaenoic-acid/ docosahexaenoic-acid 600mg/400mg daily capsule. He self-initiated the supplement one month before the first left eye macular haemorrhage, and he was still taking the supplement at the time of the second macular haemorrhage in the left eye. An examination of intergrades of fish oil showed he had received high dose of the supplement containing eicosapentaenoic-acid/docosahexaenoicacid and omega-3-fatty-acid. It was concluded that repeated macular haemorrhage was secondary to fish oil nutritional supplement containing omega-3-fatty-acid and eicosapentaenoic-acid/docosahexaenoic-acid [time to reaction onset not stated]. Therapy was discontinued, and the haemorrhage resolved within next 8 weeks. No haemorrhage was noted thereafter. Retrospectively, blood investigation in April 2012, showed normal platelet level. However, decreased blood platelet level was noted in March 2013 after discontinuation of the fish oil supplement. Three months after discontinuation of the supplement, repeat blood test showed normalisation of platelet level. Li S-Y, et al. Fish