Rare association of extensive myelinated retinal nerve fibers with vascular abnormalities and vitreous hemorrhage: A case report.

PURPOSE: To report a rare case of unilateral extensive myelinated retinal nerve fibers (MRNFs) associated with retinal vascular changes, including diffusely sclerosed vessels, complicated by vitreous hemorrhage (VH).

OBSERVATIONS: A 39-year-old woman, with no history of systemic disease, presented with a 2-day history of sudden blurred vision in the right eye. She had a history of anisometropic amblyopia in the same eye. Fundus examination of the right eye revealed vitreous hemorrhage and extensive, flame-shaped MRNFs radiating from a crowded optic disc and involving the superior and inferior arcades. Sclerosed vessels, both venous and arterial, were observed in the superior nasal quadrant. Fluorescein angiography revealed vascular abnormalities, including telangiectasia and subtle neovascularization. After conservative management and retinal photocoagulation, visual acuity improved from 1/60 to 6/60.

CONCLUSIONS AND

IMPORTANCE

This case highlights the rare association of extensive MRNFs with vascular complications, underlining the importance of multimodal imaging and timely intervention.