Association of extensive myelinated nerve fibers and high degree myopia: Case report

Abstract

Unilateral extensive myelination of the peripapillary nerve fibers may be associated with anisometropic myopia, strabismus, and reduced vision. Myelination of optic nerve fibers terminate at lamina cribrosa. Yet in some patients, myelination progresses into the peripapillary retinal nerve fibers and may affect the visual acuity. In this report, we described 4 patients. All patients presented extensive peripapillary myelinated nerve fibers associated with myopic anisometropia. After routine ophthalmic and orthoptic examinations, all patients underwent treatment for amblyopia through correction with spectacles, contact lenses, and the occlusion of the good eye. Corrected visual acuity improved in 1 patient, but 3 patients had no increase in visual acuity despite treatment with full cycloplegic refraction and appropriate patching. Probably because of structural abnormalies of the macula, visual results are often disappointing with appropriate correction of the refractive error and occlusion.

Keywords

• Posterior open globe injuries
• posterior to rectus insertion
• zone III open globe injuries
• Glaucoma severity
• juvenile glaucoma
• juvenile-onset primary open angle glaucoma
• visual field defects
• Diabetic retinopathy
• renal transplant
• visual outcome
• Gujarati
• logMAR
• repeatability
• validity
• visual acuity
• Multiple sclerosis
• optic neuritis
• optical coherence tomography
• retinal nerve fi ber layer
• visual functions
• Axon diameter
• electron microscopy
• nerve fiber layer
• oligodendrocytes
• pathology
• Frequency doubling technology perimetry
• pediatric visual field testing
• standard automated perimetry
• Central corneal thickness
• glaucoma
• pachymetry
• 20G Silicone rod
• monocanalicular stent
• canalicular laceration repair
• Coat′s like response
• pigmented paravenous chorioretinal atrophy
• Retinochoroiditis radiata
• Dacryocystectomy
• oculosporidiosis
• Rhinosporidium
• Infectious scleritis
• microbial scleritis
• ocular infection
• scleritis
• Congenital ectropion
• congenital eyelid imbrication syndrome
• congenital floppy eyelid syndrome
• congenital lax upper eyelid syndrome
• down syndrome
• Inner retinal layer thickness
• optic nerve hypoplasia
• outer retinal layer thickness
• retinal nerve fiber layer thickness
• spectral domain optical coherence tomography
• Abducens nerve palsy
• hyperhomocysteinemia
• isolated abducens nerve palsy
• nontraumatic
• Inverted internal limiting membrane flap technique
• macular hole
• macular hole surgery
• Ocular
• positron emission tomography
• tuberculosis
• High myopia
• myelination
• reduced vision