Population prevalence of tilted optic disks and the relationship of this sign to refractive error

Jung

2014

Eye

Purpose To determine the morphologic features of the optic disc and the location of visual field (VF) defect in relation to posterior staphyloma in normal tension glaucoma (NTG) eyes with myopia. Methods One hundred and thirty-four NTG patients with myopia were enrolled. B-scan ultrasonography was performed in enrolled patients. Disc tilt ratio, disc torsion, and area of peripapillary atrophy were measured from disc photographs. Patients were classified according to the presence of posterior staphyloma and its location: staphyloma involving the optic disc, staphyloma involving either the supero-temporal side of the optic disc or the infero-temporal side of the optic disc. The relationship between the location of the posterior staphyloma and that of the VF defect was analyzed. Results Among 134 eyes, 74 eyes (55.2%) had posterior staphyloma on B-scan ultrasonography. Mean torsion degree was significantly greater in eyes with staphyloma involving the temporal side of the optic disc (19.78±18.001) compared with eyes with staphyloma involving the optic disc (4.65±4.921, P ¼ 0.001). The frequency of the location of VF damage differed significantly between eyes with staphyloma involving the supero-temporal side and those involving the infero-temporal side of the optic disc (P ¼ 0.008), which was not significant in eyes with staphyloma involving the optic disc (P ¼ 0.813).Conclusions Optic disc torsion was a prominent finding in myopic NTG eyes when posterior staphyloma was located temporal to the optic disc. The location of posterior staphyloma was related to the direction of disc torsion and the location of VF defect.

Section: Subjectsmentioning

confidence: 99%

Posterior staphyloma is related to optic disc morphology and the location of visual field defect in normal tension glaucoma patients with myopia

Jung

2014

Eye

“…PPA is more frequently and more extensively observed in patients with glaucoma than in normal subjects in Caucasians 10,11 (no data available in Japanese) and associated with glaucomatous damage. [12][13][14] Because myopia is more likely associated with PPA, 5,6 and more frequent in Japan, 7 the influence of PPA on the measurement of the RNFL is of practical concern, especially in Japanese patients with OAG. In the current study, PPA fell on the small circle (default setting) in 119 (43%) of 280 OAG eyes, suggesting that accurate GDx measurement may be often disturbed because of PPA in Japanese OAG eyes when using the small circle.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] However, one of the remaining drawbacks of SLP is that RNFL measurements are inaccurate when peripapillary atrophy (PPA) fell on the measurement circle ( Figure 1). As PPA is more frequent in myopic eyes 5,6 and myopia is much more common among Japanese, 7 it is supposed that PPA is commonly accompanied with Japanese patients of open-angle glaucoma (OAG).…”

Section: Introductionmentioning

confidence: 99%

Performance of GDx VCC in eyes with peripapillary atrophy: comparison of three circle sizes

Kunimatsu

Tomidokoro

Saito

et al. 2006

Eye

Purpose A scanning laser polarimetry (GDx VCC) equips three different sized measurement circles. In eyes with peripapillary atrophy (PPA), the GDx measurement becomes inaccurate when the circle falls on PPA. The aim of this study was to evaluate performance of the three circles of GDx measurement in eyes with PPA. Methods Three different sized circles were compared regarding frequency of PPA, which fell on each circle in 282 open-angle glaucoma (OAG) eyes, reproducibility of GDx parameters in 24 normal and 22 OAG eyes, and ability to detect glaucoma in 50 normal and 50 OAG eyes. Results PPA was observed in 230 (82%) of 282 OAG eyes. PPA fell on the small circle (default setting), medium, and large circles in 119 (43%), 38 (14%), and 12 (4%) of the 280 OAG eyes. Reproducibility of GDx parameters was not significantly different among three circles in normal eyes (P40.05), whereas coefficients of reproducibility of TSNIT average (P ¼ 0.006) and superior average (P ¼ 0.035) were smaller in the smaller circles in OAG eyes. GDx parameters significantly correlated (Po0.001), but were significantly different (Po0.05) between the small and medium circles. The area under receiver operating characteristic curves for dividing OAG from normal eyes using GDx parameters was similar between the small and medium circles.Conclusions If the medium circles were used, obstructing influences of PPA on GDx measurement could be avoided more often in Japanese OAG eyes with similar reproducibility and comparable ability to detect glaucoma compared to those with the default small circle.

“…The 'tilted' optic disc anomaly occurs in less than 2% of the population: 46 minor degrees are probably more common. The features include optic disc dysversion and/or torsion, an astigmatic refractive error, which may be corneal with the steepest corneal curve in the same axis as the tilt and the apparent length of the oval disc equivalent to amount of astigmatism 47 (Figure 6).…”

Section: Tilted Discs and Situs Inversusmentioning

confidence: 99%

“…47 Abnormalities of the optic nerve and chiasm D Taylor defects. 46 The appearance of tilting is made evident by rotation of the superior pole of the disc, angulation of the optic cup axis inferonasally, and elevation of the supero-temporal neuroretinal rim. Situs inversus is a defect in which the vessels emerging from the (often small) optic disc are so distorted that, together with the appearance resulting from an associated tilt, the disc appears to be rotated through approximately 1801.…”

Section: Tilted Discs and Situs Inversusmentioning

confidence: 99%

Developmental abnormalities of the optic nerve and chiasm

Taylor¹

2007

Eye

Developmental anomalies of the optic nerve are an important and growing cause of lifelong visual handicap and they are often associated with systemic abnormalities. This review focuses on the ocular and systemic aspects of developmental anomalies arising from defects of fetal fissure closure and retinal ganglion cell development, and covers some other optic-disc anomalies that have systemic significance.