Retinal Nerve Fiber Layer Protrusion Associated with Tilted Optic Discs.

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Tilted optic discs are associated with various visual field defects and optic nerve head (ONH) pathologies.
• Understanding the morphological characteristics of tilted optic discs is crucial for diagnosing and managing related conditions.

Purpose of the Study:

• To identify novel retinal nerve fiber layer (RNFL) anomalies in tilted optic discs using optical coherence tomography (OCT).
• To investigate the association of a newly observed RNFL protrusion with other morphological and functional parameters.

Main Methods:

• Retrospective review of 215 adult patients with tilted optic discs from a diagnostic imaging center.
• Assessment of gross anatomical ONH features using stereoscopic fundus photography.
• Detailed morphological analysis of retinal layers with OCT and statistical evaluation.

Main Results:

• A dome-shaped, hyperreflective RNFL bulge was identified in 17 eyes with tilted optic discs.
• This RNFL protrusion significantly correlated with smaller optic disc size, congenital disc tilt, and rim/parapapillary elevation.
• Follow-up data on the natural changes of this feature were inconclusive.

Conclusions:

• This study reports a previously unassessed RNFL protrusion associated with tilted optic discs.
• The feature is linked to congenital crowded, small optic discs and shows inter-patient variability.
• This research is a foundational step in understanding tilted disc morphology and associated functional deficits.