title: Spectral domain optical coherence tomography analysis of macular changes in tilted disk syndrome.
abstract: OBJECTIVE
  To evaluate the prevalence of macular complications in tilted disk syndrome by spectral domain optical coherence tomography (OCT).
  
  
  METHODS
  A monocentric retrospective study of consecutive patients with tilted disk syndrome, whose eyes were examined by spectral domain OCT (Cirrus; Zeiss) and fundus photography.
  
  
  RESULTS
  Fifty consecutive patients (39 women and 11 men; age range, 41-96 years) with uni- or bilateral tilted disk syndrome were enrolled. All affected eyes (n = 92) were imaged by spectral domain OCT and fundus photography. Fluorescein and/or indocyanine green angiography were performed in 33 patients (66%). Macular anomalies or complications were observed in 71 eyes (77.1%). Specifically, retinal pigment epithelial changes were described in 34 eyes (36.9%), choroidal neovascularization in 24 eyes (26%), and macular serous retinal detachment in 16 eyes (17.3%). Epiretinal membrane in 9 eyes (9.7%), myopic foveoschisis in 5 eyes (5.4%), and lamellar macular hole in 3 eyes (3.2%) were also detected relatively frequently by spectral domain OCT. Surprisingly, fovea plana was observed in 5 eyes (5.4%). Eleven eyes, complicated by choroidal neovascularization, were treated with ranibizumab, with a mean visual gain of 7.9 letters on Early Treatment Diabetic Retinopathy Study chart.
  
  
  CONCLUSIONS
  Tilted disk syndrome can be associated with potentially severe macular complications. Spectral domain OCT allowed the recognition of additional macular changes associated with tilted disk syndrome, such as epiretinal membranes, myopic foveoschisis, and fovea plana.
authors.affiliation: Ophthalmology Center for Imaging and Laser, 11 Rue Antoine Bourdelle, Paris, France. sycsyc75@gmail.com
authors.forename: Salomon Y
authors.initials: SY
authors.lastname: Cohen
authors.forename: Lise
authors.initials: L
authors.lastname: Dubois
authors.forename: Sylvia
authors.initials: S
authors.lastname: Nghiem-Buffet
authors.forename: Franck
authors.initials: F
authors.lastname: Fajnkuchen
authors.forename: Corinne
authors.initials: C
authors.lastname: Delahaye-Mazza
authors.forename: Gabriel
authors.initials: G
authors.lastname: Quentel
authors.forename: Alain
authors.initials: A
authors.lastname: Gaudric
authors.forename: Ramin
authors.initials: R
authors.lastname: Tadayoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005124:Eye Abnormalities / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D005602:France / Q000453:epidemiology; D005654:Fundus Oculi; D006801:Humans; D015994:Incidence; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000002:abnormalities*; D010781:Photography; D012164:Retinal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D013577:Syndrome; D041623:Tomography, Optical Coherence / Q000379:methods*