Morning Glory Syndrome: Clinical, Computerized Tomographic, and Ultrasonographic Findings

Abstract

Objective: To evaluate the ophthalmic, radiologic, and ultrasonographic findings in morning glory syndrome. Patients and Methods: Retrospective review of patients' charts. Results: Twenty-one patients were included. Visual acuity was 20/200 or better in 50% of the eyes. Three eyes developed a retinal detachment. When computerized tomography of the orbit demonstrated peripapillary scleral staphyloma and intraocular calcifications, this correlated with poor visual acuity. Computerized tomography of the brain revealed abnormalities in three asymptomatic patients. B-scan ultrasonography demonstrated retinal tissue overhanging the peripapillary scleral staphyloma. Conclusions: Morning glory syndrome has a spectrum of severity, with most patients retaining useful vision. Orbital and cerebral computerized tomography scan as well as B-scan ultrasonography may help with diagnosis and management. J Pediatr Ophthalmol Strabismus 2005;42:290295.

Morning Glory Disc Anomaly in childhood – a population‐based study

“…Two of the patients (17%) had a BCVA of ≥0.5, whereas a majority, 75%, had a BCVA of ≥0.05. Previous data on BCVA in 14 MGDA eyes in a retrospective study showed similar figures with a BCVA of ≥0.5 in 21% of the patients and a BCVA of ≥0.05 in 57% of the patients (Harasymowycz et al 2005). In another study, Cennamo and co-workers reported 11 patients with a VA ≥0.5 in 27% and ≥0.05 in 55%, which supports the previous figures (Cennamo et al 2010).…”

“…As one patient in the study may have an optic nerve glioma on the ipsilateral side, one may raise the question of its co-occurrence with MGDA. The connection is strengthened by a case report with ipsilateral optic nerve glioma (Bandopadhayay et al 2012), yet another study argues that an optic nerve affected by MGDA may look confusingly similar to an optic nerve glioma (Harasymowycz et al 2005). This therefore warrants caution and attentiveness when examining neuroradiological imaging in MGDA patients.…”

“…The prevalence of morning glory disc anomaly (MGDA) is unknown with the vast majority of cases reported to be unilateral and more common in females (Steinkuller 1980;Lee & Traboulsi 2008) (Table 1). MGDA is characterized by an enlarged optic disc with peripapillary pigmentations, a radiating pattern of retinal blood vessels and a central glial tuft (Brodsky 1994;Harasymowycz et al 2005), resulting in a best-corrected visual acuity (BCVA) ranging between counting fingers and 0.1 (Brodsky 1994). Long-term complications include the risk of retinal detachment (Lee & Traboulsi 2008).…”

Morning glory disc anomaly and ipsilateral sporadic optic pathway glioma

“… 3 Vision is usually poor with only 30% of patients achieving an acuity of 20/40 or better. 4 Since the role of amblyopia may be significant, patching of the contralateral eye should be attempted. In our case, visual acuity has improved with patching but not normalized.…”

Congenital Optic Nerve Anomalies

“…159 Patients with MGDA are usually referred to an ophthalmologist for unilateral strabismus or leukocoria. 159,163,164 They typically have poor visual acuity, with only 30% of patients achieving an acuity of 20/40 or better in the affected eye, 163 and afferent pupillary defects are common. 159 Abnormal retinal arteries from the periphery of the disc with a distinctly straight course may be present.…”