Purchase this article with an account.
Cameron F. Parsa, Anand B. Kumar; Cyclorotation Of The Retinal Vascular Arcades: An Accessory Sign Of Ocular Torsion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4872.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The widely used disc-macula relationship for identification and quantification of ocular torsion possesses inherent shortcomings in certain clinical scenarios, such as when the macula is still noted to be within what is noted to be a wide physiological range of "normal" with respect to the optic disc, and particularly when such cyclorotational changes may be bilateral. An accessory technique of fundus examination using additional, vascular cues to assist in assessing torsion, is hereby proposed.
Observational study with review of literature and reanalysis of published photographs.
Retinal blood vessels are now recognized to share common guidance signals with ganglion cell axons, and therefore develop in close correspondence with retinal axonal pathways. The readily visible vascular arcades may thus serve as surrogate structures to indicate the axis of rotation of the retina and eye. "Zooming out" at the time of the funduscopic examination to view overall vascular patterns, or assessing the axis of the main temporal arteries or veins as they emerge from the optic disc provides additional information to the standard optic disc-macula relationship.
A heightened awareness of the axis of tilt of the retinal vascular arcades can serve as an accessory, as well as direct, means to provide additional pertinent information regarding ocular cyclorotations. This can be of particular utility when the fovea itself is difficult to identify, when optic disc anomalies are present, or when despite the presence of pathologic cyclorotations, the fovea is nonetheless located in a wide region with respect to the optic disc regarded in the general population as "normal."
This PDF is available to Subscribers Only