Visual field assessment in high myopia with and without tilted optic disc

Background: The aim was to evaluate the effect of the tilted optic disc on the visual field in highly myopic eyes.

Methods: A total of 58 eyes from 58 highly myopic individuals underwent detailed ophthalmic examination and were categorised into two groups according to the presence of a tilted optic disc. The visual field of 20 eyes (mean age of 28.95 ± 7.22 years) with tilted optic discs were compared with 38 eyes (mean age of 27.87 ± 6.08 years) of control subjects without tilted optic discs using the 30-2 SITA standard protocol with a Humphrey Field Analyzer - HFA II-i. Optic disc tilt was assessed from retinal photographs exported to Adobe Photoshop software. Disc ovality was assessed using the ratio of minimum to maximum disc diameter. A ratio of up to 0.80 was considered a tilted optic disc.

Results: Foveal threshold sensitivity showed no statistically significant difference between tilted and non-tilted groups (35.16 ± 2.71 dB versus 35.37 ± 2.35 dB, p = 0.76). The mean deviation was -3.29 ± 2.03 dB in the tilted group and -3.49 ± 2.56 dB in the non-tilted group (p = 0.77). Additionally, there were no significant differences in the average deviation between the two groups in four quadrants and four hemifields; however, the lowest average deviation was observed in the superotemporal quadrant in the tilted group (-4.54 ± 3.16 dB). In the non-tilted group, 29 per cent had no visual field defect, 24 per cent had an arcuate scotoma and 20 per cent had generalised depression. In the tilted group, 30 per cent had an arcuate scotoma, 30 per cent had generalised depression and 13 per cent had no visual field defect. Other visual field defects occurred at frequencies less than 15 per cent in both groups.

Conclusions: The investigation of visual field patterns may be more appropriate than quantitative indices (for example, total mean deviation, foveal threshold sensitivity, average deviation) to assess the visual field in highly myopic patients with tilted optic discs.