This patient has developed bleeding in the macula. The cause of the bleeding is choroidal neovascularization, that is, a net of new blood vessels that have burrowed from the choroid under the retina.
The gray portion lies under the retinal pigment epithelium. Surrounding the gray hemorrhage is a ring of red blood that has escaped into the retina. This patient has age-related macular degeneration, the commonest cause of choroidal neovascularization and submacular hemorrhage.
To learn more about retinal hemorrhages and their causes, check out Retinal Hemorrhages.