Morning Glory Disc Anomaly Associated with Ipsilateral Optic Nerve and Chiasm Thickening: Three Cases and Review of the Literature

Abstract

Several extraorbital findings have been described in morning glory disc anomaly (MGDA), including optic pathway abnormalities. We want to emphasize the importance of looking for ipsilateral optic nerve and chiasm thickening in MGDA-affected patients because we think that it may be a relevant common associated finding to date not stressed by anyone. We report three cases of clinically diagnosed unilateral MGDA in which magnetic resonance imaging revealed enlargement of the ipsilateral optic nerve and chiasm. A literature analysis was made and previously reported MGDA cases, and case series were checked, looking for described, or misunderstood similar magnetic resonance imaging findings. Three other cases with very similar prechiasmatic optic nerve and chiasm findings were identified from the literature. Two further cases are discussed as possibly characterized by similar misinterpreted magnetic resonance features. Our study broadens the constellation of intra- and extraorbital findings of MGDA. Though magnetic resonance imaging is not sufficient to determine the neuropathological substrate of this finding, clinicians and radiologists should be aware of the possible association of MGDA with ipsilateral thickening of the optic nerve and chiasm, to properly plan the clinical and imaging follow-up.

Keywords

morning glory disc anomaly - optic nerve - MRI

Note

No grant support has been given for this study.

• References

• 1 Kindler P. Morning glory syndrome: unusual congenital optic disk anomaly. Am J Ophthalmol 1970; 69 (03) 376-384
• 2 Ellika S, Robson CD, Heidary G, Paldino MJ. Morning glory disc anomaly: characteristic MR imaging findings. AJNR Am J Neuroradiol 2013; 34 (10) 2010-2014
• 3 Auber AE, O'Hara M. Morning glory syndrome. MR imaging. Clin Imaging 1999; 23 (03) 152-158
• 4 Morioka M, Marubayashi T, Masumitsu T, Miura M, Ushio Y. Basal encephaloceles with morning glory syndrome, and progressive hormonal and visual disturbances: case report and review of the literature. Brain Dev 1995; 17 (03) 196-201
• 5 Dutton GN. Congenital disorders of the optic nerve: excavations and hypoplasia. Eye (Lond) 2004; 18 (11) 1038-1048
• 6 Haik BG, Greenstein SH, Smith ME, Abramson DH, Ellsworth RM. Retinal detachment in the morning glory anomaly. Ophthalmology 1984; 91 (12) 1638-1647
• 7 Lenhart PD, Lambert SR, Newman NJ. , et al. Intracranial vascular anomalies in patients with morning glory disk anomaly. Am J Ophthalmol 2006; 142 (04) 644-650
• 8 Pierre-Filho PdeT, Limeira-Soares PH, Marcondes AM. Morning glory syndrome associated with posterior pituitary ectopia and hypopituitarism. Acta Ophthalmol Scand 2004; 82 (01) 89-92
• 9 Minotto I, Abdala N, Miachon AA, Spinola e Castro AM, Imamura P, Nogueira RG. Basal encephalocele associated with morning glory syndrome: case report. Arq Neuropsiquiatr 2007; 65 (4A): 988-991
• 10 Ceynowa DJ, Wickström R, Olsson M. , et al. Morning glory disc anomaly in childhood - a population-based study. Acta Ophthalmol 2015; 93 (07) 626-634
• 11 Bandopadhayay P, Dagi L, Robison N, Goumnerova L, Ullrich NJ. Morning glory disc anomaly in association with ipsilateral optic nerve glioma. Arch Ophthalmol 2012; 130 (08) 1082-1083
• 12 Traboulsi EI. Morning glory disk anomaly--more than meets the eye. J AAPOS 2009; 13 (04) 333-334
• 13 Manschot WA. Morning glory syndrome: a histopathological study. Br J Ophthalmol 1990; 74 (01) 56-58
• 14 Poukens V, Glasgow BJ, Demer JL. Nonvascular contractile cells in sclera and choroid of humans and monkeys. Invest Ophthalmol Vis Sci 1998; 39 (10) 1765-1774
• 15 Borghei-Razavi H, Shibao S, Schick U. Prechiasmatic transection of the optic nerve in optic nerve glioma: technical description and surgical outcome. Neurosurg Rev 2017; 40 (01) 135-141
• 16 Wan MJ, Ullrich NJ, Manley PE, Kieran MW, Goumnerova LC, Heidary G. Long-term visual outcomes of optic pathway gliomas in pediatric patients without neurofibromatosis type 1. J Neurooncol 2016; 129 (01) 173-178
• 17 Ottenhausen M, Bittigau P, Koch A, Lankes E, Schulz M, Thomale UW. Hamartoma of the optic nerve in a young child—case report and review of the literature. Childs Nerv Syst 2015; 31 (08) 1401-1406
• 18 Giannini C, Reynolds C, Leavitt JA. , et al. Choristoma of the optic nerve: case report. Neurosurgery 2002; 50 (05) 1125-1128
• 19 Spencer A, Lee J, Prayson RA. Optic nerve choristoma. Ann Diagn Pathol 2005; 9 (02) 93-95