Search results (148 results)

Apr 18 2025 by DR Rohit Gupta

The **myelinated nerve fibers of the optic disc** (also known as **medullated nerve fibers**) are retinal nerve fibers that retain their myelin sheath as they pass through the optic nerve head. Normally, retinal nerve fibers are unmyelinated to allow for light transparency, but in some cases, myelination extends anteriorly into the retina, appearing as a striking white, feathery patch on the optic disc or peripapillary retina. ### **Key Features:** 1. **Appearance:** - Dense, white, striated patches with feathery edges. - Typically located at the superior or inferior pole of the optic disc. - May obscure retinal vessels underneath. 2. **Clinical Significance:** - Usually **benign** and asymptomatic. - **Congenital** (present at birth or early childhood). - Rarely associated with **visual field defects** (e.g., scotomas corresponding to the area of myelination). - Occasionally linked with **high myopia** or **amblyopia** if extensive. 3. **Pathophysiology:** - Failure of oligodendrocytes or Schwann cells to stop myelination at the lamina cribrosa. - Normally, myelination stops at the optic nerve head, but in this condition, it extends into the retina. 4. **Diagnosis:** - **Fundoscopy:** Classic white, feathery appearance. - **Optical Coherence Tomography (OCT):** Shows thickened retinal nerve fiber layer (RNFL). - **Visual Field Testing:** May detect defects if large. 5. **Differential Diagnosis:** - Optic disc edema - Cotton wool spots - Retinoblastoma (rarely, but must be ruled out in children) 6. **Management:** - No treatment required if asymptomatic. - Monitor for amblyopia in children. - Rare cases with significant visual impairment may need further evaluation. ### **Fun Fact:** Myelinated nerve fibers are seen in **~0.5-1%** of the population and are usually an incidental finding.

Photographer: Dr Rohit gupta

Imaging device: Samsung S21

Condition/keywords: Medulated Nerve fibre, Medullated Nerve fibres, myelinated nerve fibers, Myelinated Nerve Fibres, optic disc drusen

Apr 7 2025 by Gustavo Uriel Fonseca Aguirre

B-mode ultrasound of a vitrectomized eye reveals emulsified silicone oil in the vitreous cavity, retinal detachment, and calcification of the retina and optic nerve head.

Photographer: Gustavo U. Fonseca Aguirre, Hospital Conde de Valenciana, Ciudad de México

Condition/keywords: calcification, Retina detachment, vitrectomy

Oct 10 2024 by Philip Conkling, MD

Fundus photograph of infant with persistent fetal vasculature demonstrating large stalk emanating from the optic nerve head.

Condition/keywords: persistent fetal vasculature (PFV), persistent hyperplastic primary vitreous (PHPV)

Sep 24 2024 by Gustavo Uriel Fonseca Aguirre

A 14-year-old male with a history of blunt ocular trauma in the right eye presented partial avulsion of the optic nerve head and submacular hemorrhage that was managed with neumatic displacement.

Photographer: Gustavo U. Fonseca Aguirre, Fundación Hospital Nuestra Señora de la Luz, Ciudad de México

Condition/keywords: optic nerve head avulsion

Aug 8 2024 by Hemanth Murthy, MBBS, MD, FASRS

Multicolor image of left eye of 53 year female patient with decreased vision in left eye. Patient gives history of multiple joint swellings with multiple dental procedures due to calcification of the roots. She had type2 MNV demonstrated on OCT and OCTA. Her blood reports showed elevated serum phosphorus (6.4 mg/dl) with normal serum calcium, vitamin D and parathyroid hormone. Her fibroblast growth factor 23 was markedly elevated(>1500RU/ml).

Photographer: Mr Veda Vyas

Condition/keywords: Optic disc drusen and Angiod streaks

Aug 8 2024 by Hemanth Murthy, MBBS, MD, FASRS

Multicolor image of right eye of 53 year female patient with decreased vision in left eye. Patient gives history of multiple joint swellings with multiple dental procedures due to calcification of the roots. She showed type2 MNV on OCT and OCTA. Her blood reports showed elevated serum phosphorus (6.4 mg/dl) with normal serum calcium, vitamin D and parathyroid hormone. Her fibroblast growth factor 23 was markedly elevated(>1500RU/ml).

Photographer: Mr Veda Vyas

Condition/keywords: Optic disc drusen and Angiod streaks

Aug 8 2024 by Hemanth Murthy, MBBS, MD, FASRS

Autofluorescence image of left eye of 53 year female patient with decreased vision in left eye. Patient gives history of multiple joint swellings with multiple dental procedures due to calcification of the roots. She showed type 2 MNV in left eye on OCT and OCTA. Her blood reports showed elevated serum phosphorus (6.4 mg/dl) with normal serum calcium, vitamin D and parathyroid hormone. Her fibroblast growth factor 23 was markedly elevated(>1500RU/ml).

Photographer: Mr Veda Vyas

Condition/keywords: Optic disc drusen and Angiod streaks

Jul 27 2024 by Gokcen Deniz Gulpinar Ikiz

7 Year old girl presented with blurred vision on the left eye, with intermittent esotopia. She had been followed conservatively for intermittent esotropia on the left eye, recently advised for patching of the right eye. The vision is 1.0 on the right eye and 0.4 (Snellen) on the left eye. Anterior segment is natural bilaterally, except 20 PD esotropia on the left eye, with alternation and fixation. Refraction was +0.25 +0.25 x180 and +1.00-1.50 x60 on the right and left eyes respectively. Dilated fundus examination was natural on the right eye. However, there was a fibrotic stalk originating from the optic nerve head extending to the vitreous, terminating in the middle of the vitreous cavity, in a spider web configuration. Which also causes nasal dragging of the macula, leading to partial shallow detachment of the fovea nasally. Vitrectomy is advised for the left eye, with lens preserving approach, to preserve the current functional potential and the anatomy of the globe in long term.

Photographer: Gokcen Deniz Gulpinar Ikiz, Special Eye Clinic

Condition/keywords: amblyopia, posterior PFV, vitrectomy

May 28 2024 by Nishikant J Borse, MS, FMRF, FASRS

65-year-old female was referred for disc edema. An Autofluorescence Imaging was done which showed the autofluorescence of the optic nerve head drusen.

Photographer: Dr Nishikant Borse , Insight eye Clinic , Mumbai

Imaging device: Topcon Triton

Condition/keywords: Autofluorescence imaging of Optic Disc Drusen

May 28 2024 by Nishikant J Borse, MS, FMRF, FASRS

65-year-old female was referred for disc edema. An Autofluorescence Imaging was done which showed the autofluorescence of the optic nerve head drusen.

Photographer: Dr Nishikant Borse , Insight eye Clinic , Mumbai

Imaging device: Topcon Triton

Condition/keywords: Autofluorescence imaging of Optic Disc Drusen

Feb 20 2024 by BENITO VERGARA, MD

Fundus image of a 63-year-old woman with fibrotic vascular tissue proliferation that starts at the optic nerve head through the inferior temporal arcade, with the formation of new vessels in both nasal arcades and obliteration of peripheral vessels.

Photographer: Benito Vergara Flores, Asociación Para Evitar la Ceguera en México, I.A.P.

Imaging device: Zeiss Clarus 700

Condition/keywords: fibrotic neovascularization

Feb 14 2024 by Virginia Gebhart

61 year old female with a suspicious choroidal nevus involving the optic nerve head. Patient asymptomatic, will continue to observe.

Photographer: Virginia Gebhart

Imaging device: Topcon TRC 50DX

Condition/keywords: choroidal nevus, nevus

Feb 12 2024 by NIDHI PANWAR, MD FNB FICO

Fundus photograph of 43 year old male, hypertensive on medication, came for routine check up, and has been diagnosed to have poor vision left eye since childhood, denies any history of trauma. Vision left eye 6/18, Anterior segment normal, Fundus left eye shows excavated ,funnel-shaped optic nerve head, with central tuft of glial tissue obscuring the cup . The retinal vessels were seen emanating from the edge of disc in radial manner. In addition, the sectoral nasal retina shows localized area of hyperpigmented bony spicules like lesions. However, no history of nyctalopia or any other neurological disorder could be obtained.

Photographer: Nidhi Panwar, NMC Royal hospital, Sharjah , UAE

Imaging device: OPTOMAP

Condition/keywords: Morning Glory Anomaly, optic disc excavation

Oct 10 2023 by Navneet Mehrotra, DNB

melanocytoma of the optic nerve head in a 48 year old female diagnosed on routine examination

Photographer: Dharti, Retina Care , Ahmedabad

Imaging device: Nidek RS 330

Condition/keywords: benign pigmented lesion, melanocytoma

Sep 14 2023 by Ben Serar

Fundus photograph showing a yellowish-white nodule at the superior margin of the optic disc in a case of Optic nerve head drusen.

Condition/keywords: Optic nerve head drusen

Sep 14 2023 by Ben Serar

Fundus photograph showing yellowish-white nodules at the optic disc causing blurring of the disc margins in a case of Optic nerve head drusen.

Condition/keywords: Optic nerve head drusen

Sep 14 2023 by Ben Serar

Fundus photograph of the RE showing fibrous tuft of tissue attached to the optic nerve head indicating presence of Bergmeister papilla.

Condition/keywords: Bergmeister papilla

Apr 12 2023 by Ahmed Abbas Hashmi, OD

Left eye fundus of a 53-year-old male patient with advanced gyrate atrophy of the choroid and retina with macular sparing. Optic nerve head is healthy.

Photographer: Ahmed Abbas Hashmi

Imaging device: Topcon TRC-NW8F

Condition/keywords: chorioretinal atrophy

Apr 3 2023 by Gustavo Aguirre Suarez

Fundus photograph of a 36-year-old female with a lesion dependent on the optic nerve head with subretinal extension, elevated, about 1.5 disc diameters, dark brown to black in color, involving more than three quarters of the neuroretinal ring towards the inferonasal area.

Photographer: Dr. Gustavo Aguirre-Suarez

Imaging device: Zeiss Visucam 500

Condition/keywords: melanocytic lesion, Melanocytoma

Dec 26 2022 by Vaidehi Sathaye

Fundus Photograph of RE of a 32 year old female with Optic nerve head drusen

Photographer: Dr. Vaidehi Sathaye

Imaging device: Mirante

Condition/keywords: drusen of optic disc

Dec 26 2022 by Vaidehi Sathaye

Fundus Photograph of LE of a 32 year old female with Optic nerve head drusen

Photographer: Dr. Vaidehi Sathaye

Imaging device: Mirante

Condition/keywords: drusen of optic disc

Dec 26 2022 by Vaidehi Sathaye

FAF photograph of LE of a 32 year old female with Optic nerve head drusen

Photographer: Dr. Vaidehi Sathaye

Imaging device: Mirante

Condition/keywords: drusen of optic disc

Dec 26 2022 by Vaidehi Sathaye

FAF photograph of RE of a 32 year old female with Optic nerve head drusen

Photographer: Dr. Vaidehi Sathaye

Imaging device: Mirante

Condition/keywords: drusen of optic disc

Aug 5 2022 by Kavitha Duraipandi, MD DNB FICO FRCS

A 20 year old patient referred to the clinic with blurred disc margins to rule out papilledema.

Photographer: Natalie Fox- Bussell

Condition/keywords: optic nerve drusen, optical coherence tomography (OCT)

Aug 5 2022 by Kavitha Duraipandi, MD DNB FICO FRCS

A 20 year old patient referred to the clinic with blurred disc margins to rule out papilledema.

Photographer: Natalie Fox- Bussell

Condition/keywords: Blue autofluroscence, Heidelburg Spectralis