This 9YO girl presented with bilateral optic nerve myelination. The patient had no visual complaints and had 20/20 vision in both eyes.
Learning Points:
Myelinated NFL is a relatively uncommon, unilateral or bilateral, 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.
