T-Shaped Pigmentary Changes in Tilted Disk Syndrome

Purpose Many complications associated with tilted disk syndrome may occur in the area bordering on the inferior staphyloma, including macular pigmentary changes, choroidal neovascularization, macular serous retinal detachment, polypoidal choroidal vascular anomalies, and radially orientated chorioretinal folds. The purpose of the present article is to describe an additional complication, Tshaped pigmentary changes, orientated radially from the border of the inferior staphyloma, in eyes with tilted disk syndrome.. Methods Retrospective series of 6 eyes of 6 patients (3 men and 3 women) aged from 35 to 67 years. All eyes were studied by fluorescein angiography. Results All 6 eyes exhibited pigmentary changes located along the border of the staphyloma, and also radially to it, giving a particular T-shaped pattern of pigmentary changes. These changes were visible as either a linear strip or a triangular or oval-shaped area. Three eyes had a documented history of subretinal leakage that mimicked central serous chorioretinopathy, a well-known complication of tilted disk syndrome. Conclusions T-shaped pigmentary changes may develop in the course of tilted disk syndrome, and should be added to the list of this syndrome's possible retinal complications. These changes may indicate the presence of chronic leakage in the area around the superior border of the inferior staphyloma (Eur J Ophthalmol 2009; 19: 876–9).