AbstractPurpose To characterize optic disc tilt and torsion in normal tension glaucoma(NTG) patients with myopia and evaluate the relationship between optic disc tilt and torsion with the location of visual field(VF) defectMethods Patients were divided into myopic NTG group (spherical equivalent(SE)≥‐2.0 diopters(D) or axial length(AL)≥24.0 mm) and non‐myopic NTG group (SE<‐0.5 D or AL<24.0 mm). Disc tilt, torsion, and area of peripapillary atrophy(PPA) were measured from disc photographs. Patients were further divided into superior and inferior defect groups according to the location of the VF defect in the pattern deviation map. Logistic regression analysis was used to determine the relationship between tilt ratio, torsion degree, and the VF defect location.Results Among 225 NTG eyes, 166(73.8%) were myopic eyes. The myopic NTG group was significantly younger(42.85 years) than the non‐myopic NTG group(60.73 years). Disc tilt(45.8%) and torsion(75.9%) were significantly more prevalent in the myopic NTG group. PPA area was larger in the myopic NTG group(P=0.057). VF defect location was significantly different between the two groups, with superior defects more prevalent in the myopic NTG group(69.9%, P<0.001). Torsion degree was significantly different in the superior defect group(18.45 degrees) compared to the inferior defect group(‐3.81 degrees, P = 0.001). Torsion degree was the only factor related to VF defect location in both univariate(P=0.001) and multivariate logistic regression(P=0.014) analysis.Conclusion Korean NTG patients had a high prevalence of myopia and young age. Optic disc tilt and torsion were highly prevalent in Korean NTG patients with myopia. The direction of the optic disc torsion may predict the location of damage.