Editors' note: Teaching NeuroImages: Morning glory disc anomaly

Abstract

In the article “Teaching NeuroImages: Morning glory disc anomaly,” Dr. Poillon et al. presented a case of a 7-month-old girl with strabismus who was diagnosed with a morning glory disc anomaly (MGDA) in the right eye and found to have a glial tuft at the optic nerve insertion. In response, Drs. Karimi and Sanjari argue that the image depicted appears to be a peripapillary staphyloma and not MGDA. They note the importance of making this distinction because vision can be preserved aside from an enlarged blind spot in the setting of a peripapillary staphyloma. Replying to these comments, Drs. Lecler and Poillon acknowledge the importance of differentiating between the 2 conditions but highlight 2 important features that supported their diagnosis of MGDA—the radial aspect of the retinal vessels on fundoscopy and the presence of abnormal tissue at the optic nerve insertion on ultrasound and MRI—neither of which would be expected with a peripapillary staphyloma. They note that their diagnosis was confirmed by the French National Center of Reference for MGDA and report that a retinal detachment occurred in the first year of follow-up, further supporting the diagnosis. In the article “Teaching NeuroImages: Morning glory disc anomaly,” Dr. Poillon et al. presented a case of a 7-month-old girl with strabismus who was diagnosed with a morning glory disc anomaly (MGDA) in the right eye and found to have a glial tuft at the optic nerve insertion. In response, Drs. Karimi and Sanjari argue that the image depicted appears to be a peripapillary staphyloma and not MGDA. They note the importance of making this distinction because vision can be preserved aside from an enlarged blind spot in the setting of a peripapillary staphyloma. Replying to these comments, Drs. Lecler and Poillon acknowledge the importance of differentiating between the 2 conditions but highlight 2 important features that supported their diagnosis of MGDA—the radial aspect of the retinal vessels on fundoscopy and the presence of abnormal tissue at the optic nerve insertion on ultrasound and MRI—neither of which would be expected with a peripapillary staphyloma. They note that their diagnosis was confirmed by the French National Center of Reference for MGDA and report that a retinal detachment occurred in the first year of follow-up, further supporting the diagnosis.