J Clin Ophthalmol Eye Disord | Volume 1, Issue 2 | Case Report | Open Access
Hardik A Parikh1, John W Simon2* and Naomi Falk2
1Department of Ophthalmology and Visual Science, Rutgers, New Jersey Medical School, Newark, NJ, USA
2Department of Ophthalmology/Lions Eye Institute, Albany Medical College, Albany, NY, USA
*Correspondance to: John W Simon
Fulltext PDFIntroduction: Myelinated Retinal Nerve Fibers (MRNF) is typically unilateral and associated with high axial myopia, intractable amblyopia, and poor visual outcomes. Cases without myopia have not yet been reported. We report three cases, one bilateral, without myopia, with excellent visual outcomes.
Methods: Retrospective, observational case-control study. Case Reports: I) A 2-year-old boy with pseudostrabismus had MRNF OU. Uncorrected visual acuity (VA) was 20/30 OD and 20/60 OS at age 4. OD patching was instituted, at first 5 hours weekly but increased to half-time at age 5. At last follow-up, his VA measured 20/25 OD and 20/30+ OS.II) A 5-year-old girl with Down syndrome had MRNF for 360 degrees OS, extending in an arcuate fashion around the vascular arcades. Hyperopic correction was prescribed with homatropine 5% twice daily OD. After 4 months, the VA measured 20/50 OU and the homatropine was discontinued. At age 8 10/12, VA was 20/30 OD and 20/40 OS.III) A 9-year-old girl had "intraocular abnormality" OD discovered by her optometrist, who prescribed reading glasses. Examination showed uncorrected VA of 20/20 at distance and near. MRNF were noted for 4 clock hours in the OS. Glasses were discontinued. Eighteen months later, her VA measured 20/20 OU.
Discussion: Maculae were normal in all cases. We recommend a trial of refractive correction, patching or penalization, where indicated, in children with MRNF.
Conclusion: MRNF without myopia are consistent with excellent visual outcomes.
Parikh HA, Simon JW, Falk N. Excellent Visual Outcomes in Children with Myelinated Nerve Fibers and Without Myopia. J Clin Ophthalmol Eye Disord. 2017; 1(3): 1011.