Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer
This case report describes a simple hemorrhage (SH) presenting as radial hemorrhage in Henle’s fiber layer (HFL) in a patient with high myopia. A 26-year-old girl with high myopia was referred to our center for sudden onset of decreased vision and a central scotoma in the right eye (OD). Best correc...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2021-05-01
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| Series: | Case Reports in Ophthalmology |
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| Online Access: | https://www.karger.com/Article/FullText/510626 |
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| author | Marco Mazzola Laura Premoli Cristian Metrangolo Jennifer Cattaneo Elias Premi Simone Donati Claudio Azzolini |
| author_facet | Marco Mazzola Laura Premoli Cristian Metrangolo Jennifer Cattaneo Elias Premi Simone Donati Claudio Azzolini |
| author_sort | Marco Mazzola |
| collection | DOAJ |
| description | This case report describes a simple hemorrhage (SH) presenting as radial hemorrhage in Henle’s fiber layer (HFL) in a patient with high myopia. A 26-year-old girl with high myopia was referred to our center for sudden onset of decreased vision and a central scotoma in the right eye (OD). Best corrected visual acuity (BCVA) was 20/100 OD. Fundus examination showed a stellate intraretinal hemorrhage in the fovea of the OD. The hemorrhage was organized in a peculiar petaloid pattern with feathery distal edges, suggesting localization within the radially oriented HFL. The presence of both choroidal neovascularization and microvascular abnormalities consistent with macular telangiectasia type 2 (MacTel 2) were excluded. Based on these findings, a diagnosis of myopic SH was made. At 4-month follow-up BCVA OD spontaneously improved to 20/40, without any treatment been ever administered to the patient. Spectral-domain optical coherence tomography OD showed reabsorption of the hemorrhage and almost complete restoration of the foveal architecture. The intraretinal location and spread of the hemorrhage into the HFL in our patient are an unusual presentation of SH, which vividly highlights the anatomy of the fovea. Since fibers in HFL are quite delicate and loosely arranged, this layer is very susceptible to deposition of transudates, exudates, hemorrhage, and other products. Radial hemorrhage in HFL has been originally reported in 4 patients as complication of MacTel 2. It has been previously postulated that it may represent a characteristic finding in MacTel 2 that may develop as a result of microvascular abnormalities of the deep retinal capillary plexus. On the contrary, our data suggest that radial hemorrhage in the HFL does not represent a characteristic finding of MacTel 2, but must rather be considered a non-specific sign with multiple possible etiologies. |
| first_indexed | 2024-12-19T12:32:20Z |
| format | Article |
| id | doaj.art-14e8d8a309674d19abf8976dad96e948 |
| institution | Directory Open Access Journal |
| issn | 1663-2699 |
| language | English |
| last_indexed | 2024-12-19T12:32:20Z |
| publishDate | 2021-05-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Ophthalmology |
| spelling | doaj.art-14e8d8a309674d19abf8976dad96e9482022-12-21T20:21:16ZengKarger PublishersCase Reports in Ophthalmology1663-26992021-05-0112244645010.1159/000510626510626Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber LayerMarco Mazzola0https://orcid.org/0000-0001-5756-5254Laura Premoli1Cristian Metrangolo2Jennifer Cattaneo3Elias Premi4Simone Donati5Claudio Azzolini6Ophthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, ItalyOphthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, ItalyOphthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, ItalyOphthalmology Clinic, Department of Neuroscience, ASST Ovest Milanese, Legnano, ItalyOphthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, ItalyOphthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, ItalyOphthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, ItalyThis case report describes a simple hemorrhage (SH) presenting as radial hemorrhage in Henle’s fiber layer (HFL) in a patient with high myopia. A 26-year-old girl with high myopia was referred to our center for sudden onset of decreased vision and a central scotoma in the right eye (OD). Best corrected visual acuity (BCVA) was 20/100 OD. Fundus examination showed a stellate intraretinal hemorrhage in the fovea of the OD. The hemorrhage was organized in a peculiar petaloid pattern with feathery distal edges, suggesting localization within the radially oriented HFL. The presence of both choroidal neovascularization and microvascular abnormalities consistent with macular telangiectasia type 2 (MacTel 2) were excluded. Based on these findings, a diagnosis of myopic SH was made. At 4-month follow-up BCVA OD spontaneously improved to 20/40, without any treatment been ever administered to the patient. Spectral-domain optical coherence tomography OD showed reabsorption of the hemorrhage and almost complete restoration of the foveal architecture. The intraretinal location and spread of the hemorrhage into the HFL in our patient are an unusual presentation of SH, which vividly highlights the anatomy of the fovea. Since fibers in HFL are quite delicate and loosely arranged, this layer is very susceptible to deposition of transudates, exudates, hemorrhage, and other products. Radial hemorrhage in HFL has been originally reported in 4 patients as complication of MacTel 2. It has been previously postulated that it may represent a characteristic finding in MacTel 2 that may develop as a result of microvascular abnormalities of the deep retinal capillary plexus. On the contrary, our data suggest that radial hemorrhage in the HFL does not represent a characteristic finding of MacTel 2, but must rather be considered a non-specific sign with multiple possible etiologies.https://www.karger.com/Article/FullText/510626eye diseaseimagingmacula/retina/vitreousmaculopathymyopiaophthalmoscopysimple hemorrhageradial hemorrhagehenle fiber layer hemorrhagemyopic hemorrhageretina |
| spellingShingle | Marco Mazzola Laura Premoli Cristian Metrangolo Jennifer Cattaneo Elias Premi Simone Donati Claudio Azzolini Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer Case Reports in Ophthalmology eye disease imaging macula/retina/vitreous maculopathy myopia ophthalmoscopy simple hemorrhage radial hemorrhage henle fiber layer hemorrhage myopic hemorrhage retina |
| title | Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer |
| title_full | Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer |
| title_fullStr | Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer |
| title_full_unstemmed | Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer |
| title_short | Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer |
| title_sort | myopic simple hemorrhage presenting as radial hemorrhage in henle s fiber layer |
| topic | eye disease imaging macula/retina/vitreous maculopathy myopia ophthalmoscopy simple hemorrhage radial hemorrhage henle fiber layer hemorrhage myopic hemorrhage retina |
| url | https://www.karger.com/Article/FullText/510626 |
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