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Ní Leidhin C, Erickson JP, Bynevelt M, Lam G, Lock JH, Wang G, Mankad K, Taranath A, Mason M, Lakshmanan R, Shipman P, Warne RR. (What's the story) morning glory? MRI findings in morning glory disc anomaly. Neuroradiology 2024; 66:1225-1233. [PMID: 38717474 DOI: 10.1007/s00234-024-03375-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/01/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Morning glory disc anomaly (MGDA) is a rare congenital ophthalmologic disorder. Historically it has been diagnosed fundoscopically, with little in the literature regarding its imaging findings. The purpose of this study is to further characterize the orbital and associated intracranial magnetic resonance imaging (MRI) findings of MGDA in our tertiary pediatric center. METHODS A retrospective review was performed of fundoscopically-diagnosed cases of MGDA, that had been referred for MRI. All MRI studies were scrutinized for orbital and other intracranial abnormalities known to occur in association with MGDA. RESULTS 18 of 19 cases of MGDA showed three characteristic MRI findings: funnel-shaped morphology of the posterior optic disc, abnormal soft tissue associated with the retrobulbar optic nerve, and effacement of adjacent subarachnoid spaces. The ipsilateral (intraorbital) optic nerve was larger in one patient and smaller in six. The ipsilateral optic chiasm was larger in two patients and smaller in one. CONCLUSION This study represents a comprehensive radiological-led investigation into MGDA. It describes the most frequently-encountered MRI findings in MGDA and emphasizes the importance of MRI in this cohort, i.e., in distinguishing MGDA from other posterior globe abnormalities, in assessing the visual pathway, and in screening for associated intracranial abnormalities - skull base/cerebral, vascular, and facial. It hypothesizes neurocristopathy as an underlying cause of MGDA and its associations. Caliber abnormalities of the ipsilateral optic nerve and chiasm are a frequent finding in MGDA. Optic pathway enlargement should not be labeled "glioma". (239/250).
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Affiliation(s)
- Caoilfhionn Ní Leidhin
- Department of Medical Imaging, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia.
| | - Jonathan P Erickson
- Department of Medical Imaging, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
| | - Michael Bynevelt
- Department of Medical Imaging, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
| | - Geoffrey Lam
- Department of Ophthalmology, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
| | - Jane H Lock
- Department of Ophthalmology, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
| | - George Wang
- Department of Biostatistics, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Kshitij Mankad
- Department of Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London, England, UK
| | - Ajay Taranath
- Department of Medical Imaging, Women's and Children's Hospital, Adelaide, SA, Australia
| | - Michael Mason
- Department of Medical Imaging, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
| | - Rahul Lakshmanan
- Department of Medical Imaging, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
- Centre for Neuromuscular and Neurological Disorders (Perron Institute), University of Western Australia Medical School, Perth, WA, Australia
| | - Peter Shipman
- Department of Medical Imaging, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
| | - Richard R Warne
- Department of Medical Imaging, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
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Wotipka EK, Karowadia KM, Davila PA, Laylani NA, Lee AG. Progressive Vision Loss in an Adult With Congenital Optic Nerve Coloboma, Hydrocephalus, and Basal Encephalocele. J Neuroophthalmol 2024; 44:e236-e237. [PMID: 36693126 DOI: 10.1097/wno.0000000000001806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Evan K Wotipka
- McGovern Medical School (EW), University of Texas (Houston), Houston, Texas; University of Texas Medical Branch (KK), Galveston, Texas; Department of Ophthalmology (PAD, NAL, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa; and School of Engineering Medicine (AGL), Texas A&M University, Houston, Texas
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Persisting embryonal infundibular recess (PEIR) and transsphenoidal-transsellar encephaloceles: distinct entities or constituents of one continuum? Childs Nerv Syst 2022; 38:1059-1067. [PMID: 35192025 DOI: 10.1007/s00381-022-05467-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/29/2022] [Indexed: 11/03/2022]
Abstract
Persisting embryonal infundibular recess (PEIR) is a very rare anomaly of the floor of the third ventricle in which the embryonic morphology of the infundibular recess (IR) persists. The exact underlying mechanism of development of PEIR is unknown, and the anomaly has been reported as an isolated finding or in association with other conditions. On the other hand, trans-sphenoidal encephaloceles are the rarest form of basal encephaloceles. The trans-sphenoidal trans-sellar encephalocele (TSE) is the least common variant in which the pituitary gland, pituitary stalk, optic pathways, parts of the third ventricle and IR may be present within the encephalocele. We recently treated one patient with TSE. Based on the observed morphological similarity of the IR in our patient and in the published cases of PEIR, we reviewed the literature in order to validate the hypothesis that PEIR and TSE may possibly belong to one spectrum of malformations. Across the published reports, the morphology of the IR in TSE is very closely similar to PEIR. Moreover, radiological, patho-anatomical, and embryological evidence is in support to our hypothesis that PEIR and TSE are most likely the two extremes of the same continuum of malformations.
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Muns SM, González MP, Villegas VM, de la Vega G, Ventura CV, Berrocal AM. Unilateral morning glory disc anomaly in a patient with prenatal Zika virus exposure. Int J Retina Vitreous 2020; 6:36. [PMID: 32765899 PMCID: PMC7395399 DOI: 10.1186/s40942-020-00240-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/25/2020] [Indexed: 11/21/2022] Open
Abstract
Background To report a case of morning glory disc anomaly (MGDA) in a pediatric patient with prenatal Zika virus (ZIKV) exposure. Case presentation A 3-year-old male with prenatal exposure to ZIKV, confirmed by real-time polymerase chain reaction testing during the second trimester of pregnancy, was evaluated due to visual loss. Physical examination was remarkable for unilateral MGDA. Neuroimaging showed a base of skull encephalocele through the floor of the sella and callosal dysgenesis. Conclusions This is the first report to suggest an association between prenatal ZIKV exposure and MGDA. Prenatal ZIKV exposure may be associated to a wider pathologic spectrum than previously reported.
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Affiliation(s)
- Sofía M Muns
- Department of Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067 USA
| | - Mónica P González
- Department of Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067 USA
| | - Victor M Villegas
- Department of Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067 USA.,Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136 USA.,Department of Surgery, Ponce Health Sciences University, Ponce, PR 00732-7004 USA
| | | | - Camila V Ventura
- Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil.,Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil
| | - Audina M Berrocal
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136 USA
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