Pedro Neves_SCIENTIFIC POSTER 2015

Introduction:

Morning Glory Syndrome is a non-hereditary optic nerve malformation, most frequently unilateral and in women, rarely affecting black patients. The optic disk is abnormally excavated and funnel-shaped, with an hypopigmented neuroretinal rim and radially-oriented vessels. Up to one third of patients present with a retinal detachment, and this syndrome may be associated with other craniofacial abnormalities. The authors present an atypical cl inical case of a male black patient with a bilateral morning glory syndrome involving the entire macula, with a history of bilateral retinal detachment and no other malformations.

Case Report:

The authors present the case of a 29-year old black man from Angola, with a history of a Morning Glory syndrome diagnosed 11 years ago, after presenting to the emergency department with recent complaints of decreased visual acuity in the left eye. When questioned, the patient reported having a decreased visual acuity since childhood. Examination was remarkable for a cataract and complete retinal detachment in the left eye, with a markedly escavated, pale, funnel-shaped optic disc in the contralateral eye, with the depression extending to the macular area. The findings were compatible with morning-glory syndrome, with macular involvement. The patient was submitted to an extracapsular cataract extraction and 20G vitrectomy, with silicone oil tamponade. The retina remained stable from then on, but with a visual acuity below 0.5/10. On that same year, the patient underwent phacoemulsification of the cataract in the right eye. 3 years later, the patient returned to our department, this time with complaints of loss of vision in the right eye, also presenting with a retinal detachment. The procedure of choice was a 23G vitrectomy, with silicone oil tamponade. To this date, the patient has 0.5/10 vision in the right eye and light-perception in the left eye, but surprisingly leads a highly functional life.

Conclusions:

Morning glory syndrome is a disorder with a wide spectrum of presentations and severity, as illustrated by our case. Severe cases may present with a complete macular involvement, as well as retinal detachment. This disease has potentially devastating visual complications, and patients require a close follow up and counselling to quickly diagnose retinal complications and provide early intervention.

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