Fibre à myéline: diagnostic différentiel de l’œdème papillaire

This study reports the case of a 32-year-old female patient with no particular history, treated for myopia since school age. Routine ocular examination showed visual acuity value 10/10, clear cornea, anterior chamber, good depth, with normal iris texture and color and clear lens in both eyes with intraocular pressure 16 mmHg in the right eye and 14 mmHg in the left eye. Fundus examination showed papillary excavation 3/10 in the left eye with a whitish stain poorly limited and contiguous edge blurred at the nasal side of the papilla evoking myelinated fiber, the fellow eye was unremarkable. Retinal fluorescein angiography showed no delayed filling or signs of early or late leakage eliminating papilloedema. Myelinated fibers are asymptomatic benign lesions which may be detected, often incidentally, during fundus examination and which can be associated with a refractive error such as myopia. They should be considered as differential diagnosis of papillary edema.