Article

Characterization of Retinal Nerve Fiber Layer in Nonglaucomatous Eyes With Tilted Discs

Archives of ophthalmology (Impact Factor: 4.49). 01/2010; 128(1):141-2. DOI: 10.1001/archophthalmol.2009.340
Source: PubMed
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    ABSTRACT: This study was performed to investigate the peripapillary retinal nerve fiber layer (RNFL) and optic nerve head (ONH) characteristics, as determined using a spectral-domain optical coherence tomography (OCT), in eyes with situs inversus of the optic disc. The peripapillary RNFL and the ONH were assessed in 12 eyes belonging to 6 subjects with situs inversus of the optic disc (situs inversus group) and 24 eyes in 12 age-matched, sex-matched, and refractive error-matched healthy subjects (control group) by using OCT. The average, quadrant, and clock-hour RNFL thicknesses (clock-hour 9 on the scan represented the temporal side of the optic disc in both eyes), the superior/inferior RNFL peak locations, and ONH characteristics such as disc area, rim area, cup-to-disc ratio, vertical cup-to-disc ratio, and cup volume were obtained. The differences in RNFL and ONH characteristics between the 2 groups were analyzed. The situs inversus group had a thicker RNFL in the clock-hour sectors 3 and 4, a thinner RNFL in the clock-hour sectors 7, 8, and 11, and more nasally located superior and inferior RNFL peak locations than the control group (P≤0.001). The situs inversus group had a smaller cup-to-disc area ratio, smaller vertical cup-to-disc ratio, and a lesser cup volume than the control group (P<0.01). Eyes with situs inversus of the optic disc showed different peripapillary RNFL and ONH characteristics from those without this abnormality. These findings should be considered when assessing eyes with situs inversus of the optic disc.
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    ABSTRACT: This study was performed to evaluate the retinal nerve fiber layer (RNFL) and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT). Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD)-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standar d protocol for RNFL assessment was performed. SD-OCT indicated significantly lower superotemporal (p<0.001), superonasal (p=0.001), and global (p=0.005) RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001). This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups.
    Arquivos Brasileiros de Oftalmologia 12/2014; 77(6):368-72. DOI:10.5935/0004-2749.20140092 · 0.44 Impact Factor
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    ABSTRACT: PURPOSE:: The tilted optic disc is associated with peripapillary choroidal and retinal nerve fiber layer (RNFL) changes as well as visual field defects, often leading to diagnostic difficulties due to similarities with glaucomatous discs. We studied the peripapillary RNFL of the tilted optic disc by comparing values obtained with spectral-domain (SD) and time-domain (TD) optical coherence tomography (OCT) in order to identify characteristic RNFL patterns verified by both OCT devices, and also to determine whether SD-OCT offers any diagnostic advantage over TD-OCT. METHODS:: Prospective case-control study of 16 individuals with tilted optic discs (27 eyes) and an age-matched control group (10 individuals, 20 eyes). Each case was subjected to ophthalmological examination and automated perimetry. Tilt orientation was classified based on observation of optic disc photographs, and angle of disc torsion was calculated with image processing software. RNFL measurements were obtained with TD-OCT and SD-OCT. Peripapillary choroid thickness was measured with SD-OCT. The findings were related with optic disc morphology and automated perimetry results. RESULTS:: Stratus OCT results showed significantly lower superior RNFL (P<0.001) on the tilted group, whereas Spectralis indicated significantly lower superotemporal (P<0.001), superonasal (P=0.001), temporal (P=0.01), and global (P=0.01) RNFL on the tilted disc group. A significant correspondence was found between elevated disc rim and location of RNFL defect on the Spectralis (P=0.004). On the tilted group, peripapillary choroidal thickness was significantly thicker adjacent to the elevated rim (P<0.001). No correspondence was found between tilt orientation, peripapillary RNFL, or choroidal thickness and location of perimetric defects. CONCLUSIONS:: Our results provide a clinical characterization of the main tilted disc morphologies and are valuable for correctly differentiating a tilted disc from a myopic glaucomatous disc. RNFL assessment by Spectralis OCT seems to be more susceptible to altered disc morphologies. The peripapillary RNFL changes found on titled disc cases could not predict the location of visual field defects.
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