In which layer of the retina will you primarily see splinter (Drance) hemorrhages?

Splinter (Drance) hemorrhages are associated with the retinal nerve fiber layer, which is where these types of hemorrhages typically occur. These small, linear-shaped hemorrhages are often seen in conditions such as glaucoma and can result from damage to the nerve fibers or blood vessels within this layer.

In the context of Drance hemorrhages, the retinal nerve fiber layer contains the ganglion cell axons that are responsible for transmitting visual signals to the brain, and when these axons are subjected to stress or damage, they can lead to localized bleeding. The position and characteristic appearance of these hemorrhages in the retinal nerve fiber layer make it the primary location to identify them clinically.

The other layers, such as the inner nuclear layer or retinal pigment epithelium, do not typically exhibit Drance hemorrhages, as they are associated with different pathologies and do not contain the same arrangement of blood vessels or nerve fibers that result in this specific type of hemorrhage. Similarly, the choroid is a vascular structure located beneath the retina that supplies blood to the outer layers of the retina but is not where splinter hemorrhages manifest.