Myelinated nerve fiber layer

Contributor: Jesse Vislisel, MD

Photographer: Stefani Karakas, CRA(bottom image), Brice Critser, CRA(top image)

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Myelination of the optic nerve fibers normally begins at the lateral geniculate body and ceases at the lamina cribrosa. However, in some individuals areas of the retinal nerve fiber layer can also become myelinated. Classically, this finding is unilateral and peripapillary in location, appearing as a white, flame-shaped area with feathered borders as seen in the top photo. The bottom photo shows a less common presentation affecting a more extensive distribution of the peripheral nerve fibers. Note how the nerve fibers temporal to the macula respect the horizontal raphe, a concept not easily visualized under normal conditions.

Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.