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OPHTHALMIC IMAGE
Year : 2023  |  Volume : 3  |  Issue : 1  |  Page : 249

Multimodal imaging of Henle fiber layer hemorrhage in retinal artery macroaneurysm


1 Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India
2 Department of Vitreo Retina, Netralayam, Kolkata, West Bengal, India

Date of Web Publication20-Jan-2023

Correspondence Address:
Rupak Roy
Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata - 700 099, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1999_22

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How to cite this article:
Sen A, Goel N, Tripathi AK, Dey A, Chattree S, Saurabh K, Roy R. Multimodal imaging of Henle fiber layer hemorrhage in retinal artery macroaneurysm. Indian J Ophthalmol Case Rep 2023;3:249

How to cite this URL:
Sen A, Goel N, Tripathi AK, Dey A, Chattree S, Saurabh K, Roy R. Multimodal imaging of Henle fiber layer hemorrhage in retinal artery macroaneurysm. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Feb 7];3:249. Available from: https://www.ijoreports.in/text.asp?2023/3/1/249/368201



We have described Henle fiber layer (HFL) hemorrhage[1],[2],[3] for the first time in a case of retinal arterial macroaneurysm (RAM) in a 61-year-old female whose right fundus showed macular preretinal and subretinal hemorrhage having a radial pattern and feathery margin. Multicolor composite image (MCI) accentuated the visibility of HFL hemorrhage [Figure 1]a. Indocyanine green angiography (ICGA) showed a hot spot along the inferotemporal branch characteristic of RAM [Figure 1]b. Infrared image of the same showed the level of the upper border of hemorrhage [Figure 1]c, with the corresponding optical coherence tomography (OCT) showing the characteristic segmented pattern of hyperreflective retinal hemorrhage in the HFL, separated by hyporeflective oblique lines [Figure 1]d. Identification of hemorrhage in this layer can provide further insight into the diagnosis and management of such patients.
Figure 1: (a) Multicolor image of the right eye showing preretinal and subretinal hemorrhage, and arrows showing the feathery margins of the HFL hemorrhage. (b) ICGA showing RAM in the inferotemporal branch of retinal artery. (c) Infrared image of the same shows the level of the scan at the upper border of hemorrhage (green line). (d) OCT showing characteristic segmented pattern of hyperreflective retinal hemorrhage in the HFL, separated by hyporeflective oblique lines corresponding to [Figure 1]c. HFL = Henle fiber layer, ICGA = indocyanine green angiography, OCT = optical coherence tomography, RAM = retinal arterial macroaneurysm

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Baumal CR, Sarraf D, Bryant T, Gui W, Muakkassa N, Pichi F, et al. Henle fibre layer haemorrhage: Clinical features and pathogenesis. Br J Ophthalmol 2021;105:374-80.  Back to cited text no. 1
    
2.
Rahimy E, Vander J. I see a seashell in my right eye. JAMA Ophthalmol 2014;132:1413.  Back to cited text no. 2
    
3.
Leisser C, Huemer JC, Findl O. HenleFibre layer haemorrhage after a valsalvamanoeuvre. Case Rep Ophthalmol 2021;12:105-9.  Back to cited text no. 3
    


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