Evaluating fingerprint-like patterns in the healthy Henle fiber layer using enface OCT imaging

Area of Science:

• Ophthalmology
• Optical Coherence Tomography (OCT)
• Retinal Imaging

Background:

• Enface OCT imaging can reveal a unique "fingerprint-like" pattern within the Henle fiber layer (HFL).
• This pattern has been observed in various macular disorders, leading to assumptions about its pathological nature.

Purpose of the Study:

• To investigate the frequency and characteristics of the fingerprint pattern in healthy eyes.
• To identify factors influencing the visibility of this pattern, particularly in relation to imaging parameters.

Main Methods:

• Two masked graders assessed the fingerprint pattern's presence and prominence (0-3 scale) in enface OCT images of 66 healthy eyes.
• Retinal tilt angles and curvature were measured to evaluate the impact of incident light angle on pattern visibility.
• Inter-grader agreement (Cohen's kappa) and pattern distribution across quadrants were analyzed.

Main Results:

• High inter-grader agreement (kappa = 0.71) was achieved for assessing the fingerprint pattern.
• Over 70% of healthy eyes showed evidence of the pattern (score ≥1).
• Pattern prominence differed significantly across quadrants, being lowest in the temporal quadrant; scan tilt and retinal curvature did not predict prominence.

Conclusions:

• The fingerprint-like pattern in the HFL is present in healthy eyes, not exclusively in disease states.
• The lack of correlation with incident light angle suggests intrinsic HFL characteristics influence pattern visibility.
• This finding challenges previous assumptions and opens avenues for understanding HFL structure.