Congenital tilting of the optic nerve with situs inversus

Congenital tilting of the optic nerve with situs inversus

Category(ies): Neuro-ophthalmology

Contributor: Ben J. Janson, MD

Photographer: Andrea Hoback

These color fundus photographs demonstrate optic nerves that are tilted to the degree of facing nasally. The retinal vessels also emerge from the nasal aspect of the disc and course nasally before turning temporally (situs inversus). The patient was asymptomatic, 20/20 in both eyes, had -8 diopters of myopia in both eyes with a normal visual field. Tilting of the optic nerve can vary in severity and is commonly associated with myopia as the optic nerve enters the sclera obliquely. Often the patient is asymptomatic, but in some cases tilted discs can be associated with superotemporal visual field defects that do not respect the midline.[1,2]

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Reference:

1. Brodsky MC. Congenital optic disc anomalies. In: Yanoff M, Duker JS, editors. Ophthalmology. 4th ed. Elsevier; 2014; Chapter 9.5; p871-874.

2. Taylor DS. Congenital anomalies of the optic discs. In: Lambert SR, Lyons CJ, editors. Taylor and Hoyt's Pediatric Ophthalmology and Strabismus. 5th ed. Elsevier; 2017; chapter 53; p562-580.

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