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 Table of Contents  
PHOTO ESSAY
Year : 2017  |  Volume : 12  |  Issue : 1  |  Page : 122-123

Unilateral myelinated retinal nerve fibers


1 Department of Ophthalmology, Ipswich Hospital NHS Trust, University of Cambridge, Suffolk, UK
2 Cornea and Cataract Service, Moorfields Eye Hospital, London, UK

Date of Submission11-Mar-2016
Date of Acceptance18-Oct-2016
Date of Web Publication15-Feb-2017

Correspondence Address:
Georgios D Panos
Department of Ophthalmology, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD
UK
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2008-322X.200170

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How to cite this article:
Panos GD, Gatzioufas Z. Unilateral myelinated retinal nerve fibers. J Ophthalmic Vis Res 2017;12:122-3

How to cite this URL:
Panos GD, Gatzioufas Z. Unilateral myelinated retinal nerve fibers. J Ophthalmic Vis Res [serial online] 2017 [cited 2017 Mar 22];12:122-3. Available from: http://www.jovr.org/text.asp?2017/12/1/122/200170


  Presentation Top


A 5-year-old boy presented to our clinic for a routine check-up. Best corrected visual acuity was 20/20 and 20/60 in the right and left eyes, respectively. Cycloplegic refraction revealed +0.50 −0.50 × 179° in the right eye and −6.50 −0.75 × 171° in the left eye. The left eye had an exotropia of 14 prism diopters. Anterior segment examination was normal in both eyes. On dilated funduscopy, the right eye was normal [Figure 1]a; while in the left eye, there was an extensive myelination of the retinal nerve fibers [Figure 1]b. Full correction of the refractive error in the left eye was prescribed and patching of the right eye for 2 hours daily was recommended. The usage of contact lens was suggested for maximal results and in order to reduce the aniseikonia. One year later, visual acuity of the left eye improved to 20/40.


  Discussion Top


Unilateral extensive myelinated retinal nerve fibers are known to be associated with high myopia and consequent amblyopia.[1],[2],[3] Refractive amblyopia can be treated by correcting the refractive error early with glasses or contact lenses.[4],[5] In some cases, patching of the fellow eye is necessary.[5] Complete eye examination including funduscopy and cycloplegic refraction at 6 months and then at 3 years of age is crucial for the timely diagnosis and treatment of amblyopia.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

 
  References Top

1.
Tarabishy AB, Alexandrou TJ, Traboulsi EI. Syndrome of myelinated retinal nerve fibers, myopia, and amblyopia: A review. Surv Ophthalmol 2007;52:588-596.  Back to cited text no. 1
    
2.
Moradian S, Karim S. Unilateral myelinated retinal nerve fiber layer associated with axial myopia, amblyopia and strabismus. J Ophthalmic Vis Res 2009;4:264-265.  Back to cited text no. 2
    
3.
Naghib J. Triad of myelinated retinal nerve fibers, axial myopia and amblyopia. J Ophthalmic Vis Res 2010;5:284-285.  Back to cited text no. 3
    
4.
Roberts CJ, Adams GG. Contact lenses in the management of high anisometropic amblyopia. Eye 2002;16:577-579.  Back to cited text no. 4
    
5.
Taylor K, Powell C, Hatt SR, Stewart C. Interventions for unilateral and bilateral refractive amblyopia. Cochrane Database Syst Rev 2012;4:CD005137.  Back to cited text no. 5
    


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