Cyclodeviation of the retinal vascular arcades: an accessory sign of ocular torsion

Assessment of ocular torsion via fundus examination is an important tool for diagnosis and management of cyclorotational disorders. The widely used disc–macula relationship for quantification of ocular torsion possesses inherent limitations, which restricts its use in some clinical scenarios. An accessory technique of fundus examination for assessing torsion is hereby proposed using vascular cues. Retinal blood vessels share common guidance signals with ganglion cell axons and are now recognised to follow retinal axonal pathways. Identification of the axis of the retinal vascular arcades can serve as a direct and accessory means to provide additional pertinent information regarding ocular cyclorotations.