Cohen Salomon Yves, Vignal-Clermont Catherine, Trinh Liem, Ohno-Matsui Kyoko
Ophthalmic Center of Imaging and Laser, Paris, France; Department of Ophthalmology, Intercity Hospital and University of Paris Est, Creteil, France.
Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France.
Prog Retin Eye Res. 2022 May;88:101020. doi: 10.1016/j.preteyeres.2021.101020. Epub 2021 Nov 17.
Tilted disc syndrome (TDS) is considered a congenital anomaly due to a delayed closure of the embryonic fissure. It is characterized by an oblique orientation of the axis of the optic disc, associated with other posterior pole anomalies such as inferior crescent, situs inversus and inferior staphyloma. The aim of this review was to summarize the data supporting the current hypotheses for the pathogenesis of TDS, and its anatomical and functional clinical consequences. Recent imaging techniques, such as magnetic resonance imaging, wide-field fundus imaging, and 2- and 3-D optical coherence tomography have provided a new perspective on TDS and its complications. Different abnormalities have previously been reported, both in the anterior and posterior segments. The focus was on vision-threatening chorioretinal changes or complications, including choroidal neovascularization and serous retinal detachments and their therapeutic options. Based on clinical observations, assumptions were proposed to understand the occurrence of complications such as chorioretinal degenerative changes, choroidal neovascularization and polypoidal choroidal vasculopathy, macular serous retinal detachment, myopic foveoschisis and chorioretinal folds. These hypotheses could be referred to as the curvature "breaking point" hypothesis, the uneven growth "tractional" hypothesis, the "container-content" imbalance hypothesis, and the "choroidal funnel" hypothesis. Because these complications could also occur in other contexts, understanding the pathogenesis of TDS complications could help to understand their pathophysiology.
倾斜盘综合征（TDS）被认为是一种由于胚胎裂闭合延迟导致的先天性异常。其特征为视盘轴呈倾斜方向，并伴有其他后极部异常，如下方新月形、 situs inversus和下方葡萄肿。本综述的目的是总结支持当前TDS发病机制假说及其解剖学和功能性临床后果的数据。近期的成像技术，如磁共振成像、广角眼底成像以及二维和三维光学相干断层扫描，为TDS及其并发症提供了新的视角。此前已报道了前部和后部节段的不同异常情况。重点关注威胁视力的脉络膜视网膜改变或并发症，包括脉络膜新生血管形成和浆液性视网膜脱离及其治疗选择。基于临床观察，提出了一些假设来理解诸如脉络膜视网膜退行性改变、脉络膜新生血管形成和息肉样脉络膜血管病变、黄斑浆液性视网膜脱离、近视性黄斑劈裂和脉络膜视网膜皱褶等并发症的发生。这些假设可被称为曲率“断点”假说、不均衡生长“牵拉”假说、“容器 - 内容物”失衡假说和“脉络膜漏斗”假说。由于这些并发症也可能在其他情况下发生，了解TDS并发症的发病机制有助于理解其病理生理学。
