Asymmetric choroidal vascular pattern in tilted disc syndrome

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Tilted disc syndrome (TDS) is a congenital condition characterized by ocular abnormalities, including optic nerve head malformations.
• Previous studies using cross-sectional OCT indicated thickened superior choroids and thinned inferior choroids in TDS patients.

Purpose of the Study:

• To investigate choroidal vasculature in TDS using en face OCT.
• To assess the symmetry of the choroidal vascular pattern in the macular region of TDS patients.

Main Methods:

• En face OCT imaging of the macula (12x12 mm) was performed.
• Choroidal layers were segmented, and middle/large choroidal vessels were analyzed for vertical symmetry, density, and diameter.

Main Results:

• All analyzed eyes (17/17) with TDS exhibited asymmetric middle/large choroidal vessels.
• Superior choroidal segmentation showed significantly higher vessel density and mean vessel diameter compared to the inferior segmentation.
• Serous retinal detachment was observed in 4 eyes, all of which had asymmetric choroidal vasculature.

Conclusions:

• Most TDS patients display vertical asymmetry in their middle and large choroidal vessels.
• Choroidal vascular abnormalities and resulting circulatory imbalance in TDS may be a cause of serous retinal detachment.