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ANGULAR SIGN OF HENLE FIBER LAYER HYPERREFLECTIVITY IN CONTUSION MACULOPATHY: A Multimodal Imaging Analysis
Bradley S Gundlach1, Adrian Au1, Prithvi Ramtohul2,3,4
1Stein Eye Institute, University of California, Los Angeles, California.
Retina (Philadelphia, Pa.)
|August 26, 2025
Summary
The angular sign of Henle fiber layer (HFL) hyperreflectivity (ASHH) is a key OCT finding in blunt eye trauma, indicating photoreceptor disruption and variable visual outcomes. Early identification aids in predicting persistent structural changes.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Ocular Trauma
Background:
- Blunt ocular trauma can cause contusion maculopathy, affecting vision.
- The Henle fiber layer (HFL) is susceptible to injury in such cases.
Purpose of the Study:
- To characterize the multimodal imaging features of the angular sign of HFL hyperreflectivity (ASHH) in contusion maculopathy.
- To assess baseline and follow-up findings and visual outcomes.
Main Methods:
- Multimodal imaging (including OCT) was performed on 11 eyes from 10 patients post-blunt ocular trauma.
- Clinical and imaging data were collected at baseline and follow-up.
Main Results:
- ASHH, appearing as hyper-reflective lesions along the HFL, was identified using OCT.
- Visual acuity improved from logMAR 0.59 to 0.43.
- Outer retinal changes, including RPE disruption and EZ attenuation, were observed, with a macular hole in one case.
Conclusions:
- ASHH is a distinct OCT sign of acute contusion maculopathy following blunt injury.
- It signifies photoreceptor disruption and HFL alterations.
- Associated RPE changes correlate with persistent abnormalities and variable visual prognosis.
