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We describe the case of a 6-year-old boy who presented with blurry vision of the right eye over 2 months. On examination, his visual acuity was 20/300 OD and 20/20 OS. Pupils did not show a relative afferent papillary defect. The cycloplegic refraction OD was −6.50 +0.25 ×180 and +0.50 sphere OS. His anterior segment examination was unremarkable. Fundus OD displayed prominent MNFs (Fig. 1A). His findings are consistent with the syndrome of MNFs, myopia, and amblyopia.
Fig. 1Fundus examination OD revealed prominent peripapillary myelinated retinal nerve fibres extending along the inferotemporal arcade without foveal involvement (A). Spectral-domain optical coherence tomography (B) clearly shows thickened hyper-reflective inner retinal nerve fibre layer located inferior to the fovea.