Myelinated Retinal Nerve Fibers (MRNF)

Yuli Handayani, MD; Danang Dwinaryono, MD; Tri Wahyu Widayanti, MD; Hartono, MD

Dept. of Ophthalmology Gadjah Mada Univesity / Dr. Sardjito General Hospital
Yogyakarta, Indonesia

Purpose and Background : This report describes a case of a myelinated retinal nerve fibers (MRNF) at Dr. Sardjito General Hospital, Yogyakarta. MRNF is a rare case of congenital anomaly of the ocular fundus.

Method : A case report

Results : A 13th years old patient that visited our clinic with blurred vision on his left eye, gradually, with no other symptom. Visual acuity of the right eye was 6/6 with no abnormality. Visual acuity of the left eye was 1/60 and with pinhole became 3/60, with no pathologic findings in the anterior segment. Fundus examination showed striated, opaque, white appearance of myelinated nerve layer at superotemporal and superonasal quadrants, continuous from the optic nerve head to macula. There were also esotropia, hidh myopia (S-14D) and amblyopia. Visual field examination revealed very severe depression, more severe depression at the central field extending to blind spot. We tried to give S-10 D to the left eye and occluded the normal eye for 2 hours per day. The evaluation will be performed every 1 month.

Conclusion : MRNF were asymptomatic, non progressive, various degree of vision decreased associated with myopia, amblyopia, and nystagmus. The management and observation of MNRF are still in progress.