Choudhary Ayushi, Kathare Rupal, Gandhi Priyanka, Yadav Naresh Kumar, Prabhu Vishma, Bavaskar Snehal, Chhablani Jay, Venkatesh Ramesh
Department of Retina and Vitreous, Narayana Nethralaya, Rajaji Nagar, Bengaluru. Karnataka, India.
University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, Pittsburg, PA, USA.
Eur J Ophthalmol. 2025 Mar;35(2):689-694. doi: 10.1177/11206721241272182. Epub 2024 Aug 6.
To study cases diagnosed of myelinated retinal nerve fibres (MRNF) continuous with the optic disc and describe the plausible pathogenic mechanism for the ocular features in Straatsma syndrome.
This retrospective observational study includes clinically diagnosed MRNF cases. MRNF, myopia, and amblyopia defined Straatsma syndrome. MRNF were classified into three types based on location: type 1 in the superior retina, type 2 in the superior and inferior retina, and type 3 in the inferior retina. MRNF size was measured on Optomap (Optos, Daytona, UK) images and posterior staphyloma location was noted. Demographics and best-corrected refractive error in logMAR units was recorded. Descriptive statistics and Spearman's corelation test were used to analyse MRNF size's relationship to refractive error and logMAR visual acuity.
The study included a total of 19 MRNF eyes from 18 patients. Seventeen (89%) eyes had Straatsma syndrome. Median age was 23.50 [range: 4-75] years. One (6%) patient exhibited bilateral presentation. The median logMAR visual acuity was 0.4 log units (interquartile range: 0.18-1.20) and mean refractive error was -7.21 ± 5.32. Type 2 MRNF ( = 14,74%) was the commonest. Average MRNF size was 34.37 ± 40.73 sq.mm. Posterior staphyloma was noted in 17 eyes, all in close MRNF association. Significant positive corelation was noted between logMAR visual acuity and MRNF size ( = 0.5, = 0.028).
Large size MRNF corelated with poor visual acuity in the study. The paper explains the possible pathogenetic mechanisms for the ocular findings seen in MRNF.
研究诊断为与视盘相连的有髓神经纤维（MRNF）的病例，并描述斯特拉茨马综合征眼部特征可能的致病机制。
这项回顾性观察研究纳入临床诊断为MRNF的病例。MRNF、近视和弱视定义为斯特拉茨马综合征。根据位置将MRNF分为三种类型：视网膜上方为1型，视网膜上下方为2型，视网膜下方为3型。在Optomap（英国代托纳Optos公司）图像上测量MRNF大小，并记录后巩膜葡萄肿的位置。记录人口统计学数据以及以对数最小分辨角（logMAR）为单位的最佳矫正屈光不正。采用描述性统计和Spearman相关性检验分析MRNF大小与屈光不正及logMAR视力的关系。
该研究共纳入18例患者的19只患MRNF的眼。17只眼（89%）患有斯特拉茨马综合征。中位年龄为23.50岁[范围：4 - 75岁]。1例（6%）患者为双眼受累。中位logMAR视力为0.4 log单位（四分位间距：0.18 - 1.20），平均屈光不正为-7.21±5.32。2型MRNF最常见（n = 14，74%）。MRNF平均大小为34.37±40.73平方毫米。17只眼中发现有后巩膜葡萄肿，均与MRNF密切相关。logMAR视力与MRNF大小之间存在显著正相关（r = 0.5，P = 0.028）。
在本研究中，较大尺寸的MRNF与视力差相关。本文解释了MRNF中所见眼部表现可能的致病机制。
