Myopic tilted disc: Mechanism, clinical significance, and public health implication

Abstract

Myopic tilted disc is a common structural change of myopic eyes. With advancing ocular imaging technology, the associated structural changes of the eye, particularly the optic nerve head, have been extensively studied. These structural changes may increase patients’ susceptibility to axonal damage and the risk of developing serious optic neuropathies including glaucoma. They also lead to diagnostic difficulties of disease suspects and treatment dilemmas of patients, which implicate clinical practice and subsequently the health care system. In the context of the mounting prevalence of myopia worldwide and its implications to irreversible visual impairment and blindness, it is essential to gain a thorough understanding of the structural changes of myopia. Myopic tilted disc has been extensively investigated by different study groups. However, generalizing the knowledge could be difficult because of the variable definitions of myopic tilted disc utilized in these studies and the complexities of the changes. The current review aimed to clarify the concepts and discuss various aspects of myopic tilted disc, including the definitions, association with other myopia-related changes, mechanism of tilted disc development, structural and functional changes, and clinical implications.

Assessment interocular symmetry of peripapillary vessel density in young myopes with optical coherence tomographic angiography

“…Various studies have investigated the impact of myopic tilted disc on structural change of optic nerve. Fan et al found that eyes with torted disc exhibited thicker temporal retinal and RNFL and more temporally positioned superior peak of RNFL [ 20 ], and during the myopic shift, the tilting and rotation of optic disc may be accompanied by nasal bulging and kinking of retinal nerve fibers [ 21 ]. Therefore, it could result in vessel density of the inside optic disc and temporal quadrant does not descend.…”

Peripapillary hyperreflective ovoid mass-like structures: multimodal imaging and associated diseases

“…PHOMS corresponded to the early abnormal visual field and 46.7% of affected eyes had persistent visual field defects after refractive correction, possibly due to damaged axoplasmic transport caused by prolonged bending of nerve fibers ( 8 ). In addition to TDS, an acquired tilted disc caused by scleral stretching is also a feature of myopia ( 44 ). Lyu et al ( 45 ) reported for the first time that PHOMS were significantly associated with the degree of myopia and the magnitude of ONH tilt angle in children.…”