Evaluation of morning glory syndrome with spectral optical coherence tomography and echography

Abstract

Purpose: To evaluate eyes affected by morning glory syndrome (MGS) with spectral-domain optical coherence tomography (SD OCT) and echography.

Design: Prospective case series.

Participants: Nineteen patients (22 eyes) with MGS observed at the Eye Department, University of Naples Federico II, Naples, Italy.

Methods: All patients underwent a complete ophthalmologic examination that included best-correct visual acuity, fundus photography, and echography. Nine patients underwent SD OCT and high-frequency B-scan echography (20 MHz).

Main outcome measures: Spectral-domain optical coherence tomography and echographic findings in MGS.

Results: Spectral-domain optical coherence tomography revealed retinal detachment in the conus area of 5 eyes: 4 with noncontractile MGS (NCMGS) and 1 with contractile MGS (CMGS). There was evidence of a retinal break in only 2 cases. All 5 eyes had an abnormal communication between the subarachnoid space and the subretinal space. Spectral-domain optical coherence tomography did not reveal differences between CMGS and NCMGS. Echographic examination did not reveal any anatomic abnormalities of the optic nerve or orbit.

Conclusions: Spectral-domain optical coherence tomography provides more information than echography about the posterior pole, whereas echographic examination is the only technique that can confirm the anatomic integrity of the optic nerve in the orbital wall. Retinal detachment in MGS generally is ascribed to abnormal communication between the subretinal and subarachnoid or vitreous compartments. These data suggest that myopialike retinal detachment without a retinal break may result from tissue stretching around the peripapillary conus.