The importance of optical coherence tomographic sectioning in a case with unilateral subtle visual disturbance related to a vertical intraretinal hyperreflective line.

Abstract

A 60-year-old otherwise healthy man presented with the complaint of missing letters while reading with his right eye. Best-corrected visual acuity (BCVA) was 10/10 in both eyes. Slit-lamp examination was unremarkable, and the intraocular pressure was within normal range bilaterally. Multimodal imaging was performed, and spectral domain and swept source optical coherence tomography (OCT) revealed a foveolar vertically oriented intraretinal hyperreflective line (IHL) in the right eye. Microperimetric examination revealed a lower fixation stability and macular integrity in the right eye compared to the left. The patient recalled an episode of a severe blow to his head a few years before. The intraretinal hyperreflective line is an optical coherence tomographic finding that is often detectable only with careful tomographic sectioning. The present case underscores the importance of careful OCT sectioning and multimodal imaging to elucidate the cause of even subtle visual disturbances.