视盘倾斜综合征(tilted disc syndrome, TDS)是一种以视盘形态和位置异常为主要特征的先天性眼底异常。其典型表现为视盘呈椭圆形、向下或向鼻侧倾斜，并伴随着周围脉络膜和视网膜色素上皮的发育异常。这些解剖结构的改变对患者的视功能产生深远的影响，并可能导致一系列眼部并发症的发生，如视盘旁高反射卵圆样团块状结构、脉络膜血管病变以及黄斑区病变等。在TDS的诊断过程中，通常依赖于眼底检查、光学相干断层扫描以及视野检查等多种方法的结合，以全面评估视盘的形态和功能。尽管TDS的研究已有多年，但其确切的发病机制尚不完全明确。现有研究表明，遗传因素、发育异常以及环境因素可能在TDS的发生中发挥重要作用。此外，TDS与其他眼部疾病之间的关系也是当前研究的热点问题。例如近视性视盘倾斜、视盘水肿、青光眼、视神经肿瘤等疾病在临床上常常需要与其进行鉴别诊断，以确保患者能够获得准确的诊断和适当的治疗。文章旨在全面回顾TDS的研究进展，包括其定义、流行病学特征、病理生理机制、相关视功能异常、诊断方法以及相关并发症，以期使临床医生更好地理解这一疾病的特征和机制，从而为患者的临床管理和治疗方案提供更为全面的指导。

Tilted disc syndrome (TDS) is a congenital retinal abnormality characterized primarily by the abnormal shape and position of the optic disc. Its typical presentation includes an oval-shaped optic disc that is tilted downward or nasally, accompanied by developmental anomalies of the surrounding choroid and retinal pigment epithelium. These anatomical changes can have profound effects on the visual function of patients and may lead to a range of ocular complications, such as peripapillary hyper reflective ovoid mass-like structures (PHOMS), choroidal vascular lesions, and macular region pathologies. In the diagnostic process of TDS, a combination of methods is typically employed, including fundus examination, optical coherence tomography (OCT), and visual field testing, to comprehensively assess the morphology and function of the optic disc. Despite years of research on TDS, its exact pathogenesis remains not fully understood. Existing studies suggest that genetic factors, developmental abnormalities, and environmental influences may play significant roles in the occurrence of TDS. Furthermore, the relationship between TDS and other ocular diseases is also a current area of research interest. For instance, conditions such as myopic tilted disc, optic edema, papilledema and optic nerve tumors often require differential diagnosis in clinical practice to ensure that patients receive accurate diagnoses and appropriate treatments. This review aims to provide a comprehensive overview of the research progress on TDS, including its definition, epidemiological characteristics, pathophysiological mechanisms, associated visual function abnormalities, diagnostic methods, and related complications. The goal is to enhance clinical understanding of the features and mechanisms of this condition, thereby providing more comprehensive guidance for the clinical management and treatment strategies for patients.

目的：比较重力液流与主控液流2种灌注方式下行白内障超声乳化手术对青光眼患者视盘血流的影响。方法：采用随机数字表法将患者分为2组，分别为重力液流灌注组和主控液流灌注组。记录术中超声乳化累积释放能量(cumulative dissipated energy，CDE)，术后1天、1周、1个月和3个月患者最佳矫正视力(best corrected visual acuity，BCVA)、眼压、视盘血流密度及视网膜神经纤维层厚度。结果：主控液流灌注组术中CDE小于重力液流灌注组(5.6±1.3 vs 6.3±1.2，P=0.034)。术后1天重力液流灌注组视盘周围血管密度(circumpapillary vascular density，cpVD)、整个图像血管密度(whole en face image vessel density，wiVD)和视盘内血管密度(inside disc vascular density，inside disc VD)均高于主控液流灌注组(P<0.05)，其余时间点差异无统计学意义(P>0.05)。术后1周和1个月重力液流灌注组视网膜神经纤维层厚度大于主控液流灌注组(P<0.05)，术后1天和3个月未见明显差异。结论：相较于传统的重力液流灌注，主控灌注能够在青光眼患者白内障超声乳化手术中减少超声能量的使用，术后早期可减轻由术中高眼压引起的视盘炎症性充血，可以减轻对视网膜神经纤维层的影响。

Objective: To compare the influence of active versus passive phacoemulsification fluidics systems on optic disc blood flow in patients with glaucoma. Methods: Patients were divided into 2 groups by a random number table method, namely the active fluidics system group and the passive fluidics system group. The intraoperative cumulative dissipated energy (CDE) was recorded, and the best corrected visual acuity (BCVA), intraocular pressure, optic disc blood flow density and retinal nerve fiber layer thickness were measured at the follow-up of 1 day, 1 week, 1 month and 3 months. Results: During phacoemulsification, CDE in the active fluidics system group was lower than that in the passive fluidics system group (5.6±1.3 vs. 6.3±1.2, P=0.034). One day after the surgery,the circumpapillary vessel density (cpVD), whole image vessel density (wiVD) and inside disc vascular density(inside disc VD) in the passive fluidics system group were higher than those in the active fluidics system group(P<0.05), and the differences were not statistically significant at the rest of the follow-ups (P>0.05).The retinal nerve fiber layer in passive fluidics system group was thicker than that in active fluidics system group at the follow-ups of 1 week and 1 month (P<0.05), and the difference was not statistically significant at the follow-up ofs 1 day and 3 months. Conclusion: Compared with the traditional passive fluidics system, the active fluidics system can reduce the CDE during phacoemulsification surgery. It can reduce the inflammatory congestion of the optic disc caused by intraoperative high intraocular pressure on the early postoperative stage. In addition, it can also protect retinal nerve fiber layer.