Sellami D, Bouacida W, Maalej A, Ben Amor S, Châabouni M, Kamoun B, Feki J
Service d'Ophtalmologie, CHU Habib Bourguiba, Sfax, Tunisie.
J Fr Ophtalmol. 2008 Jan;31(1):e2. doi: 10.1016/s0181-5512(08)70334-6.
The prevalence of myelinated retinal nerve fibers is 0.3%-0.6% of eyes. Although they often constitute benign lesions, they are rarely associated with retinal vascular abnormalities including preretinal neovascularization.
A 31-year-old patient, with no previous pathological antecedents, consulted us for myodesopsia in her left eye. The exam found a visual acuity of 10/10 and a normal anterior segment in the two eyes. At the ophthalmoscopic examination of the left eye, we noted myelinated nerve fibers in the inferotemporal quadrant that were associated with a temporal neovascular bouquet covering area of 1.5 optic disks. A small amount of intravitreal hemorrhage was found. The ophthalmoscopic examination of the right eye was normal. The treatment consisted in sector-based photocoagulation with argon laser and cryotherapy.
The source of neovascularization in the myelinated retinal nerve fibers was discussed. Underlying retinal ischemia is the most probable mechanism. The treatment was based on sector-based or panretinal photocoagulation.
Preretinal neovascularization is a rare complication of myelinated nerve fibers. The earlier the care is given, the more complications can be avoided.
有髓鞘视网膜神经纤维在眼部的患病率为0.3%-0.6%。尽管它们通常构成良性病变，但很少与包括视网膜前新生血管形成在内的视网膜血管异常相关。
一名31岁患者，既往无病理病史，因左眼飞蚊症前来就诊。检查发现双眼视力均为10/10，眼前节正常。在左眼的眼底检查中，我们注意到颞下象限有髓鞘神经纤维，伴有一个覆盖1.5个视盘区域的颞侧新生血管丛。发现少量玻璃体积血。右眼的眼底检查正常。治疗包括用氩激光进行扇形光凝和冷冻疗法。
对有髓鞘视网膜神经纤维中新生血管形成的来源进行了讨论。潜在的视网膜缺血是最可能的机制。治疗基于扇形或全视网膜光凝。
视网膜前新生血管形成是有髓鞘神经纤维的一种罕见并发症。治疗越早，越能避免更多并发症。
