Figure 4.

Optic nerve crescents in children with Down syndrome. (A) Oval and tilted optic disc with a temporal crescent (black arrows) in a child with Down syndrome and myopia. (B) Choroidal crescent located temporally (black arrows) in a small, tilted disc from a child with Down syndrome and high myopia. (C) Small temporal crescent (black arrows) in a child with Down syndrome and hyperopia. (D) Small, tilted disc with vascular tortuosity. A scleral crescent is located below the disc and extends nasally (black arrows). (E) Tilted disc with situs inversus of the vessels (striped arrows). A large choroidal crescent is evident below the disc and extending into the nasal area (between the black arrows). Peripapillary atrophy is noted at the temporal margin of the disc (white arrows). (F) Tilted disc in which the scleral crescent, although wider below the disc, takes an annular form. Situs inversus, in which the vessels emerge nasally, is also evident (striped arrows). (G) Choroidal crescent, located below the disc with inferonasal and temporal extension (black arrows), in a child with Down syndrome and hyperopia. The disc appears equally tilted in this case. (H) Tilted and torted optic disc of a child with Down syndrome with myopic astigmatism. A choroidal crescent is evident below the disc (black arrows) along with a large zone of temporal peripapillary atrophy (white arrow). Note the bean-shaped optic disc in this case. (I) A smaller choroidal crescent, located below the disc and nasally, in a child with Down syndrome and hyperopia. In the upper and central rows, the optic discs have no physiological cupping.