Case Report: Fibroglial Retinal Tissue in Contractile Morning Glory Disc Anomaly

Abstract

The purpose of the present case is to describe a patient with tractional retinal detachment (RD) associated with contractile morning glory: a 17-year-old female, with a history of failed surgery for RD when she was 2 years old in her right eye (OD), nystagmus, and a limited visual acuity in the left eye (OS). The slit lamp examination showed phthisis bulbi in OD and the anterior segment was unremarkable in OS. Dilated fundus examination revealed a tractional RD in the posterior pole and peripapillary and preretinal fibrosis without evidence of intravitreal dispersion of retinal pigment epithelial cells. After surgery treatment, the RD resolved and the posterior segment showed a staphylomatous excavation around the optic disc anomaly with irregular contractions that folded the macular area. This were unrelated to light, breathing, or eye movements. Although morning glory disc anomaly is associated with RD, the early diagnosis can reverse structural changes. In this case, the rare association with contractile movements was found posterior to the pars plana vitrectomy after all the fibroglial epiretinal tissue was removed.

Internal limiting membrane packing for treatment of morning glory syndrome with rhegmatogenous retinal detachment

“…Other references on MGS-RD suggest that removal of the fibroglial tissue that causes traction is critical for preventing recurrent RD. 12 We use triamcinolone acetonide to assist PVD because the posterior vitreous and macula are strongly adherent in younger patients. During the first PPV, despite our careful surgical procedures, a small hole was formed during the PVD process.…”