Abstract
Establishing the diagnosis of morning glory disc anomaly is crucial to appropriate patient treatment. Although typically made clinically, the diagnosis is not always straightforward, especially in circumstances where physical examination is limited. The goal of this study was to define the spectrum and frequency of orbital findings in a series of patients with funduscopically-confirmed morning glory disc anomaly by using MR imaging. MR imaging demonstrated 3 findings in all patients: 1) funnel-shaped morphologic pattern of the posterior optic disc with elevation of the adjacent retinal surface; 2) abnormal tissue associated with the distal intraorbital segment of the ipsilateral optic nerve, with effacement of the regional subarachnoid spaces; and 3) discontinuity of the uveoscleral coat. These findings were not observed in any of the unaffected globes of the study patients. In summary, these consistent and characteristic findings of morning glory disc anomaly should allow for accurate differentiation from other ocular anomalies and have the potential to guide appropriate management of this patient population.
Highlights
Consistent orbital findings included the following features: 1) funnel-shaped morphologic pattern of the optic disc associated with elevation of the adjacent retinal margins, 2) abnormal tissue associated with the distal intraorbital segment of the ipsilateral optic nerve, 3) effacement of the regional subarachnoid spaces on the basis of this soft tissue, and 4) discontinuity of the normal uveoscleral coat at the optic nerve insertion
Persistence of the craniopharyngeal canal was observed in 1 patient; in this case, there was mildly anomalous positioning of this fat was remote from the optic disc and was not clearly confined to the nerve sheath
It is worth noting that, a detailed description of the MR imaging findings in optic nerve coloboma is beyond the scope of our methodology, retinal elevation, soft tissue in the distal aspect of the optic nerve, and optic nerve sheath fat have not been reported in association with this entity.[23,24]
Summary
Consistent orbital findings included the following features: 1) funnel-shaped morphologic pattern of the optic disc associated with elevation of the adjacent retinal margins, 2) abnormal tissue associated with the distal intraorbital segment of the ipsilateral (to the MGDA) optic nerve, 3) effacement of the regional subarachnoid spaces on the basis of this soft tissue, and 4) discontinuity of the normal uveoscleral coat at the optic nerve insertion.
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