Retinal myelinated nerve fibers and their association with anomalous retinal vasculature and vitreous hemorrhage

Abstract

Background/Purpose: Anomalous retinal vessels may develop in a region of myelinated nerve fibers, and these vessels may cause vitreous hemorrhages. Methods: The clinical histories of five patients with retinovascular abnormalities in or around a patch of myelinated nerve fibers are presented. None of the reported patients had other evi­dence of systemic disease. The cases were traced by a retrospective study conducted at the Department of Ophthalmology, SIMS andServicesHospital,Lahore between December 2004 and November 2012. Results: Retinal vascular abnormalities ranged from mild telangiectasia to frank neovascularization. Age at diagnosis ranged from 18 to 62 years. Vitreous hemorrhages occurred in all five patients. Laser photocoagulation was applied in all five patients. Conclusion: We suggest that the abnormal structure of the myelinated nerve fibers and the thickened nerve fiber layer of the affected portions of retina may play a role in the onset of retinal vascular abnormalities and eventually cause telangiectasis, neovascularization, and vitreous hemorrhages. This suggestion is based on the absence of other causes of neovascularization or vitreous hemorrhage in all five patients, and on the relatively young age of the patients. Key words: Myelinated nerve fibers, neovascularization, retinal vascular abnormalities, telangiectasis, vitreous hemorrhage, axial myopia, branch artery and vein occlusion.