Nonaka Kyosuke, Maruko Ichiro, Kakehashi Mizuha, Kawai Moeko, Hasegawa Taiji, Iida Tomohiro
Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Graefes Arch Clin Exp Ophthalmol. 2025 Mar;263(3):699-704. doi: 10.1007/s00417-024-06686-5. Epub 2024 Nov 22.
To observe the choroidal vasculature in patients with tilted disc syndrome (TDS) using en face optical coherence tomography (OCT) and to evaluate the symmetry of the choroidal vascular pattern in the macular area.
En face OCT was performed using a Plex Elite 9000 (Zeiss) with a 12 × 12 mm image of the macula, which was flattened with retinal pigment epithelium and segmented into choroidal layers. The middle/large choroidal vessels were evaluated for vertical symmetry qualitatively by the retina specialist coauthors and quantitatively by binarization analysis of choroidal vessel density and mean vessel diameter.
The 2 cases and 4 eyes (19.0%) that were difficult to segment due to the severe slope of the macular area were excluded. Of the 17 eyes in the remaining 13 cases, asymmetric middle/large choroidal vessels were observed in all eyes. Vessel density (P = 0.01) and mean vessel diameter (P < 0.01) of the choroidal middle/large vessels were significantly higher in the superior than in the inferior choroidal segmentation. Serous retinal detachment was observed in 4 eyes, all asymmetric cases.
Vertical asymmetry of the middle and large choroidal vessels is observed in most TDS patients. Circulatory imbalance due to choroidal vascular abnormalities in TDS may be one of the causes of serous retinal detachment.
What is known: Tilted disc syndrome is the congenital disease with ocular morphologic abnormalities associated with incomplete closure of the embryonic fissure of the eye at the inferior optic nerve head Vertical cross-sectional optical coherence tomography images revealed that the choroid above the macula in tilted disc syndrome is relatively thickened, whereas the choroid within the inferior staphyloma is thinning.
Evaluation of choroidal vascularity in tilted disc syndrome by en face optical coherence tomography revealed qualitatively and quantitatively highly dense choroidal vessels in the superior region, with larger diameter choroidal vessels than in the inferior region, and vertical asymmetry with an upward predominance. Choroidal circulatory imbalance due to vertical asymmetry of the choroidal vessels may be one of the causes of serous retinal detachment in tilted disc syndrome.
使用正面光学相干断层扫描（OCT）观察倾斜盘综合征（TDS）患者的脉络膜血管系统，并评估黄斑区脉络膜血管模式的对称性。
使用Plex Elite 9000（蔡司）进行正面OCT检查，获取黄斑区12×12毫米的图像，该图像以视网膜色素上皮进行扁平化处理，并分割为脉络膜层。视网膜专科共同作者对中/大脉络膜血管的垂直对称性进行定性评估，并通过脉络膜血管密度和平均血管直径的二值化分析进行定量评估。
由于黄斑区严重倾斜而难以分割的2例4眼（19.0%）被排除。在其余13例的17眼中，所有眼睛均观察到中/大脉络膜血管不对称。脉络膜中/大血管的血管密度（P = 0.01）和平均血管直径（P < 0.01）在脉络膜上半部分分割中显著高于下半部分分割。4眼中观察到浆液性视网膜脱离，均为不对称病例。
大多数TDS患者中观察到中、大脉络膜血管的垂直不对称。TDS中脉络膜血管异常导致的循环失衡可能是浆液性视网膜脱离的原因之一。
已知内容：倾斜盘综合征是一种先天性疾病，伴有眼部形态异常，与视神经乳头下方眼球胚胎裂闭合不全有关。垂直截面光学相干断层扫描图像显示，倾斜盘综合征中黄斑上方的脉络膜相对增厚，而下方葡萄肿内的脉络膜变薄。
通过正面光学相干断层扫描评估倾斜盘综合征中的脉络膜血管情况，定性和定量显示上半部分区域脉络膜血管高度密集，血管直径大于下半部分区域，且存在向上为主的垂直不对称。脉络膜血管垂直不对称导致的脉络膜循环失衡可能是倾斜盘综合征中浆液性视网膜脱离的原因之一。
