Angular Sign of Henle Fiber Layer Hyperreflectivity in Presumed Acute Retinal Pigment Epitheliitis.

Purpose: To describe a presumed case of acute retinal pigment epitheliitis (ARPE) which presented as an angular sign of Henle fiber layer hyperreflectivity (ASHH). Methods: We report a 27-year-old male with ARPE and ASHH suggestive of Henle fiber layer ischemia. Results: A 27-year-old male patient came with complaints of black spot in the left eye. There was a yellow lesion seen inferotemporal to the fovea, and multimodal imaging was suggestive of ARPE with ASHH. ARPE is an acute disorder affecting the ellipsoid and interdigitation zone which is seen on optical coherence tomography as ASHH sign, suggesting inflammatory insult to the photoreceptors. He was treated with oral steroids which led to the resolution of the lesion. Conclusion: ARPE may result in the inflammatory insult of photoreceptors.