Stellate figure in the macula: visualization in the Henle fiber layer on optical coherence tomography

Abstract

Shinji Makino, Meri Watanabe, Hironobu TampoDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanAbstract: A 21-year-old woman complaining of a sudden visual disturbance in her left eye was referred to our hospital. The best-corrected visual acuity (BCVA) in the left eye was 0.3. Fundus examination revealed tortuous retinal veins, soft exudates, and retinal edema. Optical coherence tomography showed that the macular thickness was increased to 685 µm. We diagnosed the condition as a central retinal vein occlusion. Systemic administration of an antiplatelet agent was initiated. The BCVA improved to 0.6, the retinal edema dramatically resolved, and the macular thickness was reduced to 318 µm 1 week later. Furthermore, the reduced retinal edema had transformed to many spokes in a wheel of exudates, a so-called “stellate figure”s, in the macula. On optical coherence tomography, hyper-reflective substances were detected in the Henle fiber layer. One month later, the BCVA improved to 1.0. Changes in microstructural findings and visual acuity were analogous during the recovery of macular edema in our patient.Keywords: stellate figure in the macula, Henle fiber layer, central retinal vein occlusion, macular edema, optical coherence tomography