Morning glory disk anomaly—more than meets the eye

doi:10.1016/j.jaapos.2009.05.015

Journal of American Association for Pediatric Ophthalmology and Strabismus

Volume 13, Issue 4, August 2009, Pages 333-334

https://doi.org/10.1016/j.jaapos.2009.05.015 Get rights and content

References (20)

F. Chew et al.
47XYY and morning glory syndrome—A unique association
J AAPOS
(2009)
P. Kindler
Morning glory syndrome: Unusual congenital optic disk anomaly
Am J Ophthalmol
(1970)
W.B. Beyer et al.
Morning glory syndrome: A functional analysis including fluorescein angiography, ultrasonography, and computerized tomography
Ophthalmology
(1982)
N. Choudhry et al.
Spontaneous resolution of retinal detachment in morning glory disk anomaly
J AAPOS
(2009)
J.E. Loo et al.
Morning glory disk anomaly: A computerized analysis of contractile movements with implications for pathogenesis
J AAPOS
(2009)
M. Handman
Erbliche, vermutlich angeborene zentrale gliose Entartung des Sehnerven mit besonderer Beteiligung der Zentralgefasse
Klin Montasbl Augenheilkd
(1929)
C. Pedler
Unusual coloboma of the optic nerve entrance
Br J Ophthalmol
(1961)
E.I. Traboulsi et al.
The spectrum in the morphology of the so-called “morning glory disc anomaly.”
J Pediatr Ophthalmol Strabismus
(1988)
S. Pollock
The morning glory disc anomaly: Contractile movement, classification, and embryogenesis
Doc Ophthalmol
(1987)
T. Loddenkemper et al.
Pituitary stalk duplication in association with moya moya disease and bilateral morning glory disc anomaly—Broadening the clinical spectrum of midline defects
J Neurol
(2008)

There are more references available in the full text version of this article.

Cited by (9)

Visual Loss: Optic Neuropathies
2018, Liu, Volpe, and Galetta's Neuro-Ophthalmology: Diagnosis and Management
The diagnosis of optic neuropathy is usually considered under two circumstances: (1) when visual loss is associated with an anomalous, swollen, or pale optic disc or (2) when the fundus examination is normal but deficits in acuity, color, and visual field are accompanied by an afferent pupillary defect. In each of these situations the examiner must rely upon historical information, examination findings, and diagnostic testing first to confirm the presence of optic nerve dysfunction, then to determine its etiology.
An understanding of optic nerve anatomy is important when approaching patients with optic nerve dysfunction, and this chapter reviews this topic. Typical clinical features of optic neuropathies are then detailed. The subsequent discussion suggests an approach to patients with an optic neuropathy and outlines a strategy used to distinguish the various optic neuropathies. The features (presentation, examination, and management) of the different causes of optic nerve dysfunction are then addressed.
Morning glory disc anomaly with an ipsilateral enlargement of the optic nerve pathway
2017, European Journal of Paediatric Neurology
Citation Excerpt :
The association with a basal encephalocoele, with midfacial anomalies that can result in secondary panhypopituitarism, is well known.14 Other reported cerebral associations include agenesis of the corpus callosum, brain atrophy, cyst of the optic nerve sheath, optic nerve atrophy, the absence of the optic chiasm and/or craniofacial clefting.6,13 Vascular malformations of the brain are present in up to 40% of patients with morning glory disc anomaly and could result in significant morbidity and mortality from cerebrovascular incidents.15
To report three patients with an unilateral morning glory disc anomaly in association with an ipsilateral mild thickening of the optic nerve.
Three children with a morning glory disc anomaly underwent a magnetic resonance imaging (MRI) of the brain. Ophthalmological, genetic and MRI findings at follow-up are reported. A literature search on the association of morning glory anomaly in association with optic nerve glioma is reported.¹
Three children with an unilateral morning glory anomaly and ipsilateral poor visual acuity were found to have an ipsilateral mild optic nerve enlargement on brain MRI. At serial MRI scanning, there was no progression of this finding.
The morning glory disc anomaly is a rare congenital malformation of the optic disc. It can be associated with central nervous system abnormalities. The association with an optic nerve glioma has been described once before.¹ Our three cases confirm the possible association between a morning glory disc anomaly and an ipsilateral optic nerve enlargement. Serial MRI showed no growth at follow-up. The awareness of this association by the ophthalmologists is important.
Imaging of Pediatric Orbital Diseases
2015, Neuroimaging Clinics of North America
Citation Excerpt :
MGDA has 3 distinctive MR imaging findings: (1) funnel-shaped appearance of the optic disc with elevation of the adjacent retinal surface; (2) abnormal tissue associated with the ipsilateral distal intraorbital optic nerve, effacing the adjacent perioptic nerve subarachnoid space; and (3) lack of the usual enhancement at the lamina cribrosa associated with the funnel-shaped defect at the optic papilla (Fig. 9).16 Identification of MGDA at imaging should prompt a search for associated intracranial abnormalities, including midline craniofacial and skull base defects, vascular abnormalities, and cerebral malformations.19,20 In particular, brain MR imaging and internal carotid artery MRA should be performed because of an association with transphenoidal basal encephalocele and congenital steno-occlusive change of the internal carotid arteries (moyamoya disease) in these patients.20
Optic nerve abnormalities in children: A practical approach
2011, Journal of AAPOS
Citation Excerpt :
Associated facial and central nervous system anomalies include hypertelorism, cleft lip and cleft palate, basal encephaloceles (most commonly transsphenoidal), agenesis of the corpus callosum, and Moyamoya disease. MRI, magnetic resonance angiography, or computed tomography angiography of the intracranial circulation is usually recommended for all patients with morning glory disk anomaly.16-18 Optic nerves in healthy newborn children have been reported to usually have a cup/disk ratio of <0.3 based on clinical observation.19
Evaluation of children with optic nerve abnormalities is challenging. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, and genetic testing are helpful in the diagnosis and management of these patients. Importantly, many optic nerve problems are not isolated but occur in association with systemic and central nervous system anomalies. The ophthalmologist thus plays a critical role in recognizing patients who warrant systemic and neurologic assessment.
Case Report: Fibroglial Retinal Tissue in Contractile Morning Glory Disc Anomaly
2021, Case Reports in Ophthalmology
Delayed presentation of morning glory disc anomaly and transsphenoidal encephalocele: A management dilemma
2019, Neuro-Ophthalmology

View all citing articles on Scopus

See accompanying reports on pages 403-407.

View full text

EditorialMorning glory disk anomaly—more than meets the eye

J AAPOS

Am J Ophthalmol

Ophthalmology

Spontaneous resolution of retinal detachment in morning glory disk anomaly

J AAPOS

Morning glory disk anomaly: A computerized analysis of contractile movements with implications for pathogenesis

J AAPOS

Erbliche, vermutlich angeborene zentrale gliose Entartung des Sehnerven mit besonderer Beteiligung der Zentralgefasse

Klin Montasbl Augenheilkd

Unusual coloboma of the optic nerve entrance

Br J Ophthalmol

The spectrum in the morphology of the so-called “morning glory disc anomaly.”

J Pediatr Ophthalmol Strabismus

The morning glory disc anomaly: Contractile movement, classification, and embryogenesis

Doc Ophthalmol

Pituitary stalk duplication in association with moya moya disease and bilateral morning glory disc anomaly—Broadening the clinical spectrum of midline defects

J Neurol

Editorial
Morning glory disk anomaly—more than meets the eye