BACKGROUND Myopic tilted disc, observed as an oval disc, has been alleged to be a funduscopic en-face manifestation of excessive optic nerve head (ONH) sloping or tilting. Here, we report the case of a myopic child showing a developing oval disc in fundus photos during axial elongation, but without progressive tilting in spectral-domain optical coherence tomography (SD-OCT) images. CASE PRESENTATION By merging B-scan SD-OCT images of the ONH and macula, the curvature of the posterior pole, including both the fovea and ONH, was reconstructed and compared before and after 2 years of axial elongation. Despite the marked increase of disc ovality, the posterior polar curvature was rarely changed. The preponderance of optic disc change was induced by the shift of the temporal disc margin in the nasal direction. This shifting alone imitated an increase of tilt angle but one that was still far smaller than the required degree of tilt for ONH-tilt-based disc ovality. To clarify, we calculated the required extent of axial elongation to obtain a substantial degree of ONH tilt when considering the adjacency of the fovea and the ONH. Without a focal increase of posterior polar curvature, which is to say posterior staphyloma, such change is not possible until the axial length increases extraordinarily. CONCLUSION The most prominent change in the development of myopic tilted disc, which change gives it an oval appearance and imitates a tilt when measured, is actually not a tilt but rather a shift of the temporal disc margin.

中文翻译：

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病例报告：什么使近视斜盘呈椭圆形？

背景技术近视斜盘被观察为椭圆形盘，据称是过度视神经头（ONH）倾斜或倾斜的眼底镜面表现。在这里，我们报告了一个近视儿童的案例，该儿童在眼轴伸长期间在眼底照片中显示出发育中的椭圆形盘，但是在光谱域光学相干断层扫描（SD-OCT）图像中没有进行性倾斜。案例介绍通过合并ONH和黄斑的B扫描SD-OCT图像，重建并比较了2年轴向伸长前后后极的曲率，包括中央凹和ONH。尽管椎间盘椭圆度明显增加，但后极曲率很少改变。视盘改变的优势是由颞椎间盘边缘向鼻方向的移动引起的。仅此移动就模拟了倾斜角的增加，但仍远小于基于ONH倾斜的圆盘椭圆度所需的倾斜度。为了明确起见，我们在考虑到中央凹和ONH的邻接度时，计算了获得轴向ONH倾斜度所需的轴向伸长程度。如果没有后极曲率的局灶性增加，也就是说后葡萄球菌，则这种改变是不可能的，除非轴向长度异常增加。结论近视斜盘发展中最显着的变化是使椭圆形外观并在测量时模仿倾斜，实际上不是倾斜而是暂时性椎间盘边缘移位。当考虑到中央凹和ONH的邻接时，我们计算了轴向伸长的程度，以获得相当大的ONH倾斜度。如果没有后极曲率的局灶性增加，也就是说后葡萄球菌，则这种改变是不可能的，除非轴向长度异常增加。结论近视斜盘发展中最显着的变化是使椭圆形外观并在测量时模仿倾斜，实际上不是倾斜而是暂时性椎间盘边缘移位。当考虑到中央凹和ONH的邻接时，我们计算了轴向伸长的程度，以获得相当大的ONH倾斜度。如果没有后极曲率的局灶性增加，也就是说后葡萄球菌，则这种改变是不可能的，除非轴向长度异常增加。结论近视斜盘发展中最显着的变化是使椭圆形外观并在测量时模仿倾斜，实际上不是倾斜而是暂时性椎间盘边缘移位。除非轴向长度异常增加，否则这种更改是不可能的。结论近视斜盘发展中最显着的变化是使椭圆形外观并在测量时模仿倾斜，实际上不是倾斜而是暂时性椎间盘边缘移位。除非轴向长度异常增加，否则这种更改是不可能的。结论近视斜盘发展中最显着的变化是使椭圆形外观并在测量时模仿倾斜，实际上不是倾斜而是暂时性椎间盘边缘移位。