This 47YO female presented with two distinct patches of myelinated nerve fiber layer (NFL) along the distal temporal arcades in the right eye. Her ocular examinations were otherwise normal.
Learning Points:
Myelinated NFL is a relatively uncommon and usually isolated finding present at birth. Most patients are asymptomatic, although some may have a corresponding relative scotoma. Myelination can progress in about 10% of cases and can also resolve following retinal ischemic events.
Myelinated NFL occurs when retinal nerve fibers develop a myelin sheath, which usually stops posterior to the lamina cribrosa. The myelination may represent an oligodendrocytic choristoma (see Rao et al Retina 2019;39:1125-1132).
