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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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Gerrie SK, Rajani H, Branson HM, Lyons CJ, Marie E, Frayn CS, Hughes ECM, Navarro OM. Pediatric orbital lesions: ocular pathologies. Pediatr Radiol 2024; 54:876-896. [PMID: 38321238 DOI: 10.1007/s00247-024-05869-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
Orbital pathologies can be broadly classified as ocular, extra-ocular soft-tissue (non-neoplastic and neoplastic), osseous, and traumatic. In part 1 of this orbital series, the authors will discuss the differential diagnosis and key imaging features of pediatric ocular pathologies. These include congenital and developmental lesions (microphthalmos, anophthalmos, persistent fetal vasculature, coloboma, morning glory disc anomaly, retinopathy of prematurity, Coats disease), optic disc drusen, infective and inflammatory lesions (uveitis, toxocariasis, toxoplasmosis), and ocular neoplasms (retinoblastoma, retinal hamartoma, choroidal melanoma, choroidal nevus). This pictorial review provides a practical approach to the imaging work-up of these anomalies with a focus on ocular US as the first imaging modality and additional use of CT and/or MRI for the evaluation of intracranial abnormalities. The characteristic imaging features of the non-neoplastic mimics of retinoblastoma, such as persistent fetal vasculature and Coats disease, are also highlighted.
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Affiliation(s)
- Samantha K Gerrie
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
- Department of Radiology, University of British Columbia, Vancouver, Canada.
| | - Heena Rajani
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Helen M Branson
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Christopher J Lyons
- Department of Ophthalmology, BC Children's Hospital, Vancouver, Canada
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Eman Marie
- Department of Diagnostic Imaging, McMaster Children's Hospital, McMaster University, Hamilton, Canada
| | - Cassidy S Frayn
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Emily C M Hughes
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Oscar M Navarro
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
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Iñiguez Soto M, Cárdenas Lamas LJ, Nava Castañeda A, Martínez Ríos JG, de la Torre Álvarez LM. Congenital mature orbital teratoma: A case report. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00085-3. [PMID: 37247665 DOI: 10.1016/j.oftale.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/20/2023] [Indexed: 05/31/2023]
Abstract
Teratomas are gonadal or extragonadal neoplasms, derived from the three embryonic tissues, composed of germ cells of the neuroectoderm, mesoderm and ectoderm. Congenital orbital teratoma (OCT) commonly affects the left orbit, primarily affecting women over men at a ratio of 2:1. We present the case of a female patient of 9 days of extrauterine life with a left mature congenital orbital teratoma. The orbit and oculoplastic service performed an orbital exenteration and total resection of the tumor mass.
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Affiliation(s)
- M Iñiguez Soto
- Servicio de Órbita y Oculoplástica, Unidad Oftalmológica de Alta Especialidad, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
| | - L J Cárdenas Lamas
- Servicio de Oftalmología Pediátrica y Estrabismo, Unidad Oftalmológica de alta Especialidad, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
| | - A Nava Castañeda
- Servicio de Oculoplàstica, Instituto de Oftalmología Fundación Conde de Valenciana IAP
| | - J G Martínez Ríos
- Unidad Oftalmológica de Alta Especialidad, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
| | - L M de la Torre Álvarez
- Unidad Oftalmológica de Alta Especialidad, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
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Saal-Zapata G, Rodríguez R, Rodriguez-Calienes A, Cordero R. Contralateral catheterization of the ophthalmic artery to deliver intra-arterial chemotherapy in retinoblastoma. Neuroradiol J 2021; 34:370-372. [PMID: 34121503 DOI: 10.1177/19714009211024632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Retinoblastoma is the most frequent ocular malignancy in the pediatric population and intra-arterial chemotherapy has emerged as the first-line treatment of this entity with cure rates ranging from 33-100%, depending on the severity of the disease. We present the case of an advanced retinoblastoma in a pediatric patient who underwent intra-arterial chemotherapy through a contralateral route due to unsuccessful catheterization of the ophthalmic artery. The patient was diagnosed with a class D retinoblastoma which underwent the catheterization of the ophthalmic artery through the contralateral internal carotid and through the anterior communicating artery. In this case, intra-arterial chemotherapy administration was successfully delivered without complications. Contralateral routes for intra-arterial chemotherapy are safe and allow adequate penetration of the chemotherapeutic drugs in cases where a well-developed anterior communicating artery is present.
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Affiliation(s)
| | - Rodolfo Rodríguez
- Department of Interventional Neurosurgery, Clinica Angloamericana, Peru
| | | | - Raúl Cordero
- Department of Oncological Ophthalmology, Clinica Angloamericana, Peru
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