Morning glory disc anomaly associated with keratoconus: a case report
Acieh Eshaghi1 , Sepehr Roozdar1 *
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Abstract: Morning Glory Disc Anomaly (MGDA) is a congenial optic disc malformation that is characterized by an enlarged and funnel shaped excavation that surrounds the optic disc which is filled with glial tissue. MGDA usually occurs unilaterally and is more common in females. Although no specific genetic disorder is found, MGDA may be present in some systemic abnormalities or syndromes including trans-sphenoidal encephalocele, agenesis of corpus callosum, absent optic chiasm, cerebrovascular anomalies, renal agenesis and PHACE syndrome (Posterior fossa malformations, Facial hemangiomas, Arterial anomalies, Cardiac anomalies and aortic coarctation and Eye anomalies). MGDA may be associated with serous retinal detachment which is hypothesized to be due to communication of subarachnoid and subretinal space. No other established ophthalmic association is reported. Here we will present an 8 years old girl with unilateral MGDA and concurrent ipsilateral keratoconus (KC).
Methods: Case presentation
Results: An 8 years old girl with known MGDA of the left eye was referred to the cornea clinic for evaluation of high refractive astigmatism of the same eye. She was previously treated for left sensory exotropia by left lateral rectus muscle recession and was being treated for amblyopia. Best corrected visual acuity in the the right eye was 20/20 with +1.00 D refraction while was counting finger at 3 meters with -5.00 -5.00 x 160 refraction in the left eye. Slit lamp examination of the cornea was unremarkable. Scissoring reflex was present in the left eye in retinoscopy. Pentacam of the left eye revealed inferior steepening in axial curvature map, abnormal measurements in anterior and posterior elevation maps, inferotemporal displacement of thinnest point which was 469 µm and abnormal big D in Belin/Ambrosio display. Thus, with the diagnosis of KC in the left eye, the patient was planned for performing corneal collagen crosslinking (CXL) of the left eye to prevent further progression of the corneal disease.
Conclusion: Concurrent ophthalmic involvements should be considered in MGDA patients due to their additive impact on visual rehabilitation and prognosis.
