Purpose <p>We present a case of widespread myelinated retinal nerve fibers combined with macular hole retinal detachment, in which the extent of myelinated nerve fibers progressively diminished after vitrectomy.</p> Methods <p>To review the case data of a 37-year-old female patient with progressive loss of vision in left eye for over 2&#xa0;months, who was diagnosed with widespread myelinated retinal nerve fibers in the left eye combined with macular hole retinal detachment, and underwent vitrectomy combined with silicone oil tamponade in the left eye, and had the silicone oil removed three months after retinal reattachment.</p> Results <p>During the observation period, the patient’s retina was reattached, the macular hole was sealed, visual function improved, and the area of myelinated nerve fibers decreased.</p> Conclusion <p>Widespread myelinated nerve fibers in the retina can be associated with retinal detachment; vitrectomy and retinal laser surgery may lead to alterations in retinal blood supply and atrophy of the nerve fiber layer, resulting in a reduction in the extent of myelinated nerve fibers in the retina.</p>