Morning glory disc anomaly
{{Short description|Congenital deformity of the optic nerve}}
The morning glory disc anomaly (MGDA) is a congenital deformity resulting from failure of the optic nerve to completely form in utero.{{cite journal|last=Magrath|first=GN|author2=Cheeseman EW |author3=Sarrica RA |title=Morning Glory Disc Anomaly|journal=Pediatric Neurology|year=2013|volume=49|issue=6|page=517|doi=10.1016/j.pediatrneurol.2013.05.015}} The term was coined in 1970 by Kindler, noting a resemblance of the malformed optic nerve to the morning glory flower.{{cite journal|last=Kindler|title=Morning glory syndrome: unusual congenital optic disk anomaly|journal=Am J Ophthalmol|year=1970|volume=69|issue=3|pages=376–84|doi=10.1016/0002-9394(70)92269-5}} The condition is usually unilateral.{{cite web|last=Barnard|first=Simon|title=An Introduction to Diseases of the Optic nerve|url=http://www.academy.org.uk/lectures/barnard3.htm|accessdate=30 May 2014}}
Presentation
=Complications=
=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).{{cite journal|last=Quah|first=BL|author2=Hamilton J |author3=Blaser S |title=Morning glory disc anomaly, midline cranial defects and abnormal carotid circulation: an association worth looking for|journal=Pediatr Radiol|year=2005|volume=35|issue=5|pages=525–528 |doi=10.1007/s00247-004-1345-y|display-authors=etal}} The vascular defects may lead to ischemia, stroke, or seizures and so a finding of MGDA should be further investigated with radiographic imaging.
Diagnosis
File:Morning glory syndrom OCT.png
On fundoscopic examination, there are three principal findings comprising the anomaly:{{cite journal|last=Auber|first=AE|author2=O’Hara M|title= Morning glory syndrome. MR imaging|journal=Clin Imaging|year=1999|volume=23|pages=152–158|doi=10.1016/s0899-7071(99)00118-7|url=https://zenodo.org/record/1260123}}
- an enlarged, funnel-shaped excavation in optic disc
- an annulus or ring of chorioretinal pigmentary changes surrounding the optic disc excavation
- a central glial tuft overlying the optic disc
