Tilted disc syndrome in Congolese patients

To determine the frequency of tilted disc syndrome and its associations with ocular parameters in Congolese patients.

We performed a cross-sectional and descriptive analysis of the data from patients diagnosed with tilted disc syndrome. Data were collected between January 2005 and August 2008 in a general ophthalmology practice. Patients received a complete ophthalmic examination that included measurement of visual acuity, refraction, slit-lamp biomicroscopy, Goldmann applanation tonometry, examination of the visual field using the Goldmann perimeter and ophthalmoscopy. The diagnosis of tilted disc syndrome was based on ophthalmoscopic findings and fundus photographs.

Out of 4600 patients seen during the study period, 30 (57 eyes) had a diagnosis of tilted disc syndrome, giving a frequency of 0.6%. The mean age of the patients was 42+/-15 years (SD) (range, 16-66 years). Twelve (40%) of the patients were men and 18 (60%) were women. TDS was bilateral in 95% of cases. Mean VA was 0.02+/-0.17 logMAR (range, 0.5 to-0.18). The refractions (in spherical equivalents) varied from -11.00 to +1.5 diopters (mean, -2.27+/-4.47 D). Refractive astigmatism varied from 0 D to 2.5 D (mean, 0.73+/-0.80 D). Myopia was found in 50% and astigmatism greater than 0.5 D in 42% of eyes. Mean intraocular pressure was 13.7+/-5mmHg. Superior temporal or temporal visual field defects were found in 75% of eyes. Of 30 patients with TDS, a 25-year-old female patient had TDS associated with oculocutaneous albinism, pseudoxanthoma elasticum, and epicanthus.

This study confirmed that TDS affects all ethnic populations and can also occur in the sub-Saharan region. It is found more in females and is associated with myopia. This study shows that TDS demonstrates similar findings to those found previously in Caucasians and Asians.