Tilted disc in eyes with fovea plana

Graefes Arch Clin Exp Ophthalmol. 2023 Nov;261(11):3159-3164. doi: 10.1007/s00417-023-06161-7. Epub 2023 Jun 23.

Abstract

Purpose: To report the association of tilted disc (TD) with fovea plana.

Methods: Monocentric retrospective study of consecutive eyes diagnosed with fovea plana, assessed by spectral-domain optical coherence tomography. Analysis of the medical charts and imaging findings of patients to collect demographics, the visual acuity, and the clinical context. The presence of associated conditions was checked by two independent readers in order to classify fovea plana as isolated or part of other conditions.

Results: Twenty-one patients, 9 men and 12 women, aged 12 to 91 years, were included. Fovea plana was isolated and asymptomatic in 10 (47.6%) patients. In 6 (28.5%) patients, fovea plana was associated with ocular albinism and/or nystagmus. In 6 (28.5%) patients, fovea plana was associated with an obliquity of the optic disc typical of TD, isolated (5 cases), or associated with nystagmus (1 case).

Conclusion: An association between TD and fovea plana had been reported only once in the literature and had been considered likely coincidental. However, this association could be more common than initially reported and suggests a common pathological process in eye development during embryogenesis.

Keywords: Fovea plana; Nystagmus; Oculocutaneous albinism; Tilted disc syndrome.