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To describe three cases of anemic retinopathy who demonstrated premacular hemorrhage with a “double-ring sign.”Three patients with anemia were found to have a premacular hemorrhage and a double-ring sign either at presentation or after laser membranotomy. Spectral domain optical coherence tomography was performed to ascertain the level of the hemorrhage.To the best of the author's knowledge, there is no report of a double-ring sign in anemic retinopathy. In two eyes, spectral domain optical coherence tomography revealed that the double-ring sign consisted of an outer subhyaloid and inner sub-internal limiting membrane hemorrhage. However, in the third case, spectral domain optical coherence tomography confirmed that the double-ring sign consisted of a sub-internal limiting membrane hemorrhage only.Spectral domain optical coherence tomography evaluation is essential to determine the level of hemorrhage in premacular hemorrhage with a double-ring sign. It may not always indicate concurrent occurrence of a subhyaloid and sub-internal limiting membrane hemorrhage, as was previously believed.