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Myelinated Retinal Nerve Fiber Layer

      The axons of the retinal ganglion cells compose the retinal nerve fiber layer, located in the inner (closest to the vitreous) retina. These axons coalesce at the optic disc and traverse the scleral canal to become the optic nerve. Posterior to the globe, the axons of the optic nerve become myelinated by supporting oligodendrocytes. Within the retina, however, myelination of these axons is present in only about 0.5% of autopsy eyes and has the appearance of a feathery, white opacity in the inner retina.
      • Straatsma B.R.
      • Foos R.Y.
      • Heckenlively J.R.
      • Taylor G.N.
      Myelinated retinal nerve fibers.
      In one-third of cases, the area of myelination is contiguous with the optic disc, as shown in this case in an asymptomatic 58-year-old man (Figure). Myelination of the retinal nerve fiber layer interferes with transmission of light to the underlying photoreceptors, reducing visual sensitivity in the corresponding areas of the visual field. If the area of myelination is extensive, this condition can sometimes be associated with myopia, amblyopia, and strabismus.
      • Lam A.K.
      • Pang P.C.
      The effect of myelination on perimetry and retinal nerve fibre analysis.
      Figure thumbnail gr1
      FigureThe feathery, white appearance of myelination of the retinal nerve fiber layer in the right eye of an asymptomatic 58-year-old man.

      References

        • Straatsma B.R.
        • Foos R.Y.
        • Heckenlively J.R.
        • Taylor G.N.
        Myelinated retinal nerve fibers.
        Am J Ophthalmol. 1981; 91: 25-38
        • Lam A.K.
        • Pang P.C.
        The effect of myelination on perimetry and retinal nerve fibre analysis.
        Clin Exp Optom. 2000; 83: 4-11