Department of Ophthalmology, University of Health Sciences, Istanbul, Turkey; Beyoglu Eye Training and Research Hospital, İstanbul, Turkey.
Clin Exp Optom. 2023 Nov;106(8):845-851. doi: 10.1080/08164622.2023.2171772. Epub 2023 Feb 23.
In myopic eyes, the optic disc may become tilted and rotated, making glaucoma diagnosis more difficult.
To determine the presence of tilted optic disc, the degree of optic disc rotation, and their effects on the angular location of superotemporal and inferotemporal retinal nerve fibre layer (RNFL) peaks in healthy myopic Caucasians.
Non-glaucomatous healthy myopic Caucasian eyes with an axial length > 24 mm were evaluated. ImageJ was used to quantify optic disc tilt and torsion on red-free fundus photography. The RNFL was scanned using spectral-domain optical coherence tomography. The angle of the superotemporal and inferotemporal peaks with the vertical-horizontal meridian was measured.
Fifty-four eyes of 54 individuals were evaluated. The axial length was correlated with the angular location for both the superotemporal (r = -0.549, p < 0.001) and inferotemporal (r = -0.415, p = 0.002) RNFL peaks; they were placed more temporally in eyes with higher axial lengths. For each 1 mm increase in axial length, the angle between the superotemporal peak and the temporal horizontal meridian decreased by 3.976°, and the angle between the inferotemporal apex and the temporal horizontal meridian decreased by 3.028°. The angle between the inferotemporal peak and the temporal horizontal meridian decreased by 0.231° for each 1° increase in optical disc torsion (R = 0.09 Regression coefficient = -0.231, p = 0.027).
The temporal shift of superior and inferior peaks, the thickening of temporal and nasal RNFL, the presence of tilted optic disc, and optic disc rotation may cause misinterpretation of the RNFL in myopic Caucasians. When evaluating peripapillary RNFL thickness in myopic individuals, it would be better to consider these to avoid misinterpretation.
在近视眼中，视盘可能会倾斜和旋转，从而使青光眼的诊断更加困难。
为了确定近视的白种人健康眼中视盘倾斜的存在、视盘旋转的程度以及它们对视神经纤维层（RNFL）上颞上和颞下峰在角位的影响。
评估轴向长度> 24mm 的非青光眼性近视白种人健康眼。使用 ImageJ 对自发荧光眼底摄影中的视盘倾斜和扭转进行量化。使用谱域光学相干断层扫描扫描 RNFL。测量颞上和颞下峰与垂直-水平子午线的角度。
评估了 54 名个体的 54 只眼。轴向长度与颞上（r=-0.549，p<0.001）和颞下（r=-0.415，p=0.002）RNFL 峰的角位均相关；在轴向长度较高的眼中，它们更偏颞侧。轴向长度每增加 1mm，颞上峰与颞水平子午线的夹角减小 3.976°，颞下尖与颞水平子午线的夹角减小 3.028°。视盘扭转每增加 1°，颞下峰与颞水平子午线的夹角减小 0.231°（R=0.09 回归系数=-0.231，p=0.027）。
颞上和颞下峰的移位、颞侧和鼻侧 RNFL 的增厚、视盘倾斜和视盘旋转的存在可能导致对近视白种人的 RNFL 产生误解。在评估近视个体的视盘周围 RNFL 厚度时，最好考虑到这些因素，以避免误解。
