Advertisement

Myelinated retinal nerve fibre, myopia, and amblyopia syndrome

Published:April 18, 2017DOI:https://doi.org/10.1016/j.jcjo.2017.01.021
      In 1856, Virchow first described myelinated retinal nerve fibres (MNFs) as “chalk-white spots” around the optic disk.
      • Virchow V.R.
      Zur pathologischen anatomic der netzaut und des scherven.
      The prevalence of MNFs is about 1% based on the autopsy study.
      • Straatsma B.R.
      • Foos B.Y.
      • Heckenlively J.R.
      • Taylor G.N.
      Myelinated retinal nerve fibers.
      The relationship among MNFs, myopia, and amblyopia is complex, and the visual prognosis is variable.
      • Tarabishy A.B.
      • Alexandrou T.J.
      • Traboulsi E.I.
      Syndrome of myelinated retinal nerve fibers, myopia, and amblyopia: A review.
      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. 1
      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.

      References

        • Virchow V.R.
        Zur pathologischen anatomic der netzaut und des scherven.
        Virchows Arch Pathol Anat. 1856; 10: 170-193
        • Straatsma B.R.
        • Foos B.Y.
        • Heckenlively J.R.
        • Taylor G.N.
        Myelinated retinal nerve fibers.
        Am J Ophthalmol. 1981; 91: 25-38
        • Tarabishy A.B.
        • Alexandrou T.J.
        • Traboulsi E.I.
        Syndrome of myelinated retinal nerve fibers, myopia, and amblyopia: A review.
        Surv Ophthalmol. 2007; 52: 588-596