June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Myelinated Retinal Nerve Fibers associated Local Scleral Excavation and Induced Axial Myopia: Investigation using Spectral-domain Optical Coherence Tomography
Author Affiliations & Notes
  • Baek-Lok Oh
    Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seognam, Republic of Korea
  • Jeong-Min Hwang
    Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seognam, Republic of Korea
  • Se Joon Woo
    Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seognam, Republic of Korea
  • Footnotes
    Commercial Relationships Baek-Lok Oh, None; Jeong-Min Hwang, None; Se Joon Woo, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2329. doi:
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      Baek-Lok Oh, Jeong-Min Hwang, Se Joon Woo; Myelinated Retinal Nerve Fibers associated Local Scleral Excavation and Induced Axial Myopia: Investigation using Spectral-domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2329.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To report findings of spectral domain optical coherent tomography (SD-OCT) of myelinated nerve fibers (MNF) and propose a mechanism for axial myopia associated with MNF.

 
Methods
 

In this retrospective observational case series, 12 eyes from 12 patients (6 children and 6 adults) with MNF over 2 disc diameters underwent a full ophthalmologic examination including SD-OCT. The distribution of MNF in the fundus photography was compared with the regional excavation of the scleral excavation in vertical or horizontal scan and circular scan centered on the optic disc of SD-OCT.

 
Results
 

In all cases, SD-OCT visualized MNF as hyperreflective thickening of retinal nerve fibers and there were no morphologic abnormalities in the photoreceptor layers in the fovea. In eyes with temporally extended MNF, the tilting of Bruch’s membrane in vertical scans of SD-OCT was significantly associated with the major distribution of myelination (P < 0.001). The slope of Bruch’s membrane was much smaller in the adult group than in the child group (P = 0.008). The area of MNF in fundus photography and focal scleral excavation in the peripapillary circular SD-OCT scan images were significantly correlated (P <0.001).

 
Conclusions
 

Localized scleral excavation inducing axial myopia was strongly associated with the distribution of MNF especially in children, which indicates MNF itself or confined retinal areas with visual deprivation by MNF may directly induce axial myopia via local trophic effects on the underlying sclera in early life.

 
 
Fundus photography and reconstructed 3-dimensional images of spectral domain optical coherence tomography of fundus with myelinated nerve fibers. Sectioning planes are indicated with black lines.
 
Fundus photography and reconstructed 3-dimensional images of spectral domain optical coherence tomography of fundus with myelinated nerve fibers. Sectioning planes are indicated with black lines.
 
 
Examples of quantitative analysis of the association of the area of myelinated nerve fibers measured by fundus photography (A, F) and the depth of the internal limiting membrane or Bruch’s membrane near the optic disc (B, G; white arrows) measured in circular 3.4 mm-diameter scans centered on the optic disc of spectral domain optical coherence tomography along clock-hours. E, J. The correlation between the modified area of the myelinated nerve fibers (MNF length) and the depth of the internal limiting membrane or Bruch’s membrane (the scleral excavation) was statistically significant (P < 0.001).
 
Examples of quantitative analysis of the association of the area of myelinated nerve fibers measured by fundus photography (A, F) and the depth of the internal limiting membrane or Bruch’s membrane near the optic disc (B, G; white arrows) measured in circular 3.4 mm-diameter scans centered on the optic disc of spectral domain optical coherence tomography along clock-hours. E, J. The correlation between the modified area of the myelinated nerve fibers (MNF length) and the depth of the internal limiting membrane or Bruch’s membrane (the scleral excavation) was statistically significant (P < 0.001).
 
Keywords: 605 myopia • 677 refractive error development • 757 visual development: infancy and childhood  
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