Georgios D Panos1, Zisis Gatzioufas2. 1. Department of Ophthalmology, Ipswich Hospital NHS Trust, University of Cambridge, Ipswich, Suffolk, UK. 2. Cornea and Cataract Service, Moorfields Eye Hospital, London, UK.
Dear Editor,We would like to thank Dr. Mohan for his comments and for sharing his interesting case with us.We fully agree that extended retinal nerve myelination combined with high myopia is associated with treatment refractory amblyopia. However, the literature reports positive treatment outcomes in a number of cases of myopia and amblyopia related to unilateral myelinated nerve fibers.[12] According to Hittner and Antoszyk, the status of the macula is the main prognostic factor for final visual outcomes in these cases.[1] This observation is also supported by Kodama et al.[3]In our case, funduscopy did not reveal any obvious macular or optic nerve pathology. Moreover, the baseline best corrected visual acuity was 20/60, which is significantly higher than in the case reported by Dr. Mohan with the patient only being able to count fingers close to face. We believe that the absence of obvious macular and optic disc anomalies is the reason that our patient recovered partially after treatment with glasses and patching of the fellow eye.