DR. BRISTI MAJUMDAR

DR.RUPAK ROY, DR. KUMAR SAURABH

Abstract

Henle fibre layer hemorrhage (HFLH) has been seen in various retinal vascular disorders but never in RAM. We have described a case of HFLH in Retinal Arterial Macroaneurysm (RAM) in a 61 year old, one-eyed, hypertensive female who complained of sudden onset blurring of vision in right eye since 6 days. Fundoscopy showed preretinal and subretinal haemorrhage at the macula with radial pattern and feathery margin. Multicolor composite image enhanced the visibility of HFLH. ICGA showed a hot spot characteristic of RAM. OCT showed segmented pattern of hyperreflective haemorrhage in the Henlefibre layer, separated by hyporeflective oblique lines.

In RAM, the haemorrhage probably lies in the superficial vascular plexus with subsequent tracking of blood into the Henle’s layer- a mechanism not involving the deep capillary plexus. Identification of this can thus provide further insight into the diagnosis and management of such cases. Thus, we have described HFLH for the first time in RAM.