Most nonpathological eyes present a small area of hyperreflective Henle's fiber layer on pupil-centered optical...

Henle's fiber layer (HFL) is hyporeflective and indistinct on pupil-centered optical coherence tomography (OCT). However, a small area of HFL is also found to be hyperreflective on pupil-centered OCT. This study characterized the hyperreflective HFL of healthy eyes on pupil-centered OCT and investigated the possible physiological and functional relationship of hyperreflective HFL.

Subjects with different degrees of ametropia underwent a complete ophthalmologic examination, including binocular function by synoptophore and Titmus test, ocular axial length, refractions, and pupil-centered OCT angiography coupled with OCT. The area of hyperreflective HFL was manually plotted and calculated using the Optovue AngioVue system technology. The possible ocular physiological and functional relationship with the area of hyperreflective HFL was investigated.

A total of 111 subjects (222 eyes) without other ocular diseases were enrolled, of which 164 eyes (74%) presented hyperreflective HFL. The average area of hyperreflective HFL was 0.71 ± 0.07 mm². The area of hyperreflective HFL was significantly related to spherical diopters (P = 0.032). The average binocular area of hyperreflective HFL was 1.38 ± 0.17 mm². The binocular area of hyperreflective HFL was significantly related to the angle of superposition and far stereoacuity (P = 0.013 and 0.038, respectively).

Most healthy eyes present a small area of hyperreflective HFL, which might be due to alternation of the orientation of some Henle fibers by ametropia during the development of visual function postpartum. The small area of hyperreflective HFL may serve as a marker in identifying the boundary of HFL on OCT.