Morning glory disc anomaly explained

The morning glory disc anomaly (MGDA) is a congenital deformity resulting from failure of the optic nerve to completely form in utero.^[1] The term was coined in 1970 by Kindler, noting a resemblance of the malformed optic nerve to the morning glory flower.^[2] The condition is usually unilateral.^[3]

Presentation

Complications

Serous retinal detachment can occur in the affected eye.

Associated conditions

Although the finding itself is rare, MGDA can be associated with midline cranial defects and abnormal carotid circulation, such as carotid stenosis/aplasia or progressive vascular obstruction with collateralization (also known as moyamoya disease).^[4] The vascular defects may lead to ischemia, stroke, or seizures and so a finding of MGDA should be further investigated with radiographic imaging.

Diagnosis

On fundoscopic examination, there are three principal findings comprising the anomaly:^[5]

1. an enlarged, funnel-shaped excavation in optic disc
2. an annulus or ring of chorioretinal pigmentary changes surrounding the optic disc excavation
3. a central glial tuft overlying the optic disc

See also

• Coloboma of optic nerve

Notes and References

1. Magrath. GN. Cheeseman EW . Sarrica RA . Morning Glory Disc Anomaly. Pediatric Neurology. 2013. 49. 6. 517. 10.1016/j.pediatrneurol.2013.05.015.
2. Kindler. Morning glory syndrome: unusual congenital optic disk anomaly. Am J Ophthalmol. 1970. 69. 3. 376–84. 10.1016/0002-9394(70)92269-5.
3. Web site: Barnard. Simon. An Introduction to Diseases of the Optic nerve. 30 May 2014.
4. Quah. BL. Hamilton J . Blaser S . Morning glory disc anomaly, midline cranial defects and abnormal carotid circulation: an association worth looking for. Pediatr Radiol. 2005. 35. 5. 525–528 . 10.1007/s00247-004-1345-y. etal.
5. Auber. AE. O’Hara M. Morning glory syndrome. MR imaging. Clin Imaging. 1999. 23. 152–158. 10.1016/s0899-7071(99)00118-7.