Overview
Myelinated nerve fibres appear as a grey-white patches that follow the trajectory of the retinal nerve fibre layer. It exhibits feathery edges and obscures the underlying retinal detail. Myelinated nerve fibres are typically present from birth, usually unilateral and remain stable over time. Rarely, they can develop and/or progress in childhood or adolescence and may even regress in some case reports.
During normal development, myelination of the nerve fibres starts at the lateral geniculate body, progress towards the eye and terminate at the lamina cribosa. The abnormal continuation of this myelination through the lamina cribosa and into the retinal nerve fibre layer is what causes myelinated nerve fibres.
Case Examples
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Case 1
A 32 year old Caucasian female with best corrected visual acuity of 6/6 (20/20) in the right eye and 6/6-2 (20/20-2) in the left.
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Case 2
A 45 year old Caucasian female who is asymptomatic and reports good general health with best corrected visual acuity of 6/6 (20/20) in the left eye.
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Case 3
An asymptomatic 24 year old Caucasian female who reports having good general health.
Differential diagnosis
References
Funnell, C., George, N. & Pai, V. Familial myelinated retinal nerve fibres. Eye 17, 96–97 (2003).
Gentile RC, Torqueti-Costa L, Bertolucci (2002) A Loss of myelinated retinal nerve fibres in diabetic retinopathyBritish Journal of Ophthalmology 86:1447.