Atrophy of myelinated retinal nerve fibers after acute optic neuropathy

A 45-year-old man with extensive myelinated retinal nerve fibers had an attack of anterior ischemic optic neuropathy. Serial fundus photographs documented the loss of myelin. Visual acuity in the affected eye decreased to 6/90 (20/300) and color perception was markedly reduced. The visual fields in the affected eye showed dense superior and inferior arcuate scotomas and central depression. These findings were unchanged nine months later, but the areas of myelinated nerve fibers had become smaller.