Abstract / Summary
Myelinated retinal nerve fibers are an uncommon congenital retinal anomaly that is usually benign and discovered incidentally.When extensive, however, they may be associated with severe ipsilateral myopia, anisometropia, and amblyopia with limited visual potential.We report the case of a 20-year-old woman with longstanding decreased visual acuity in the right eye.Ophthalmological examination revealed extensive peripapillary myelinated retinal nerve fibers extending across the posterior pole, associated with severe ipsilateral myopia of -18.50 diopters and profound amblyopia.Best-corrected visual acuity was counting fingers at 3 m in the right eye and 20/20 in the left eye.Optical coherence tomography confirmed hyperreflective thickening corresponding to the myelinated retinal nerve fibers and showed marked myopic changes.The combination of extensive myelination, severe anisometropia, and longstanding amblyopia represents an unfavorable prognostic profile for visual recovery.Early recognition, accurate refractive correction, and timely amblyopia management during childhood are essential to maximize visual potential.