Pre- and juxtapapillary arterial loops in eyes with tilted disc syndrome and inferior staphyloma

To report and discuss the association between pre- or juxtapapillary arterial loops and tilted disc syndrome (TDS).

Three patients, aged 43-59 years, with both conditions were examined in a tertiary referral center, and underwent fluorescein angiography, optical coherence tomography (OCT) and/or OCT-angiography. They all presented with a typical inferior staphyloma associated with TDS and anomalies of insertion of retinal vessels. The vascular malformation consisted in one acquired arterial loop or cilioretinal collateral circulation occurring after central artery occlusion, and two more complex pre- and juxtapapillary arterial loops. In all cases, the vascular loops extended inferiorly, in the area of the staphyloma.

We hypothesized that the local anatomical changes in the peripapillary area, observed in eyes with TDS and inferior staphyloma, could have promoted the occurrence and/or extent of the arterial loops.