title: Nasalised distribution of peripapillary retinal nerve fibre layers in large discs.
abstract: To describe the distribution pattern of the peripapillary retinal nerve fibre layer (RNFL) and major retinal vessel positions in patients with a large disc.
  
  
  
  The medical records of patients with a large disc and those of normal controls were reviewed retrospectively. Comprehensive ophthalmic examinations including Cirrus HD-optical coherence tomography (OCT) and Heidelberg Retinal Tomography III (HRT III) were performed. We divided patients into two groups (large disc group and control group) using an HRT-measured disc size of 2.5 mm2as a reference point. We extracted RNFL thicknesses at 256 points with OCT, measured major retinal vessel positions and compared them between the two groups.
  
  
  
  In total, 97 eyes of 97 patients were included, with 60 patients in the large disc group and 37 patients in the control group. All patients were free of any glaucomatous change. We observed nasal shifting of the second superior and inferior peaks in the large disc group compared with the controls. The superior major temporal retinal arteries in patients with large disc also showed significant nasal displacement.
  
  
  
  We could observe nasalisation of the peripapillary RNFL and superior retinal artery in patients with a large disc. As this phenomenon may lead to false positive results in OCT-based RNFL thickness maps, results from our study may help prevent misdiagnosis of glaucoma and improve the sensitivity and specificity of glaucoma detection.
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Han
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Changwon
authors.initials: C
authors.lastname: Kee
mesh_terms: D005260:Female; D005901:Glaucoma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Large optic disc