Jornal de Oftalmologia Clínica e Experimental
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Myelinated Retinal Nerve Fibers in Children: OCT Imaging, Refractive Error and Vision

Scott O’Brien, Derek T Sprunger, Maria E Lim and Jingyun Wang

Purpose: To characterize peripapillary retinal nerve fiber layers (RNFL’s) and macular retinal structure in children with unilateral myelinated retinal nerve fibers (MRNFs). We also investigated the correlation between MRNF abnormalities and refractive error/visual acuity.
Methods: Twelve children (7-13 years old) with MRNFs were included. Fourier domain optical coherence tomography was used to image both the peripapillary RNFL and the macular retinal structures in 6 patients. Using the instrument’s segmentation software, global RNFL thickness and central subfield thickness (CST) of the macula were analyzed. Planimetry was used to quantify the MRNF area observed on fundus photography. Visual acuity and cycloplegic refractive errors (spherical equivalent) were also recorded. Results from the MRNF-affected eye were compared with the fellow eye.
Results: The global RNFL thickness of the eyes with MRNFs (152 ± 13.9 μm) was significantly higher than the fellow eyes (114.3 ± 15.2 μm) (P=0.003). The global RNFL thickness of the fellow eye was in normal range, and no significant differences were detected in macular CST between the eyes with MRNFs and fellow eyes (P=0.403). The MRNF area was significantly correlated with the spherical equivalent of the affected eye (P=0.002). In addition, the interocular difference of RNFL thickness between eyes was significantly correlated with anisometropia (P=0.03).
Conclusions: Eyes with MRNFs show a significantly thicker global peripapillary RNFL trend as compared to the fellow eye, and the area of MRNFs is correlated with the development of myopia and anisometropia, but not correlated to visual acuity.