Optical Coherence Tomography in a Morning Glory Disc Anomaly with a Peripapillary Choroidal Neovascular Membrane

Abstract

The purpose of this case report is to describe the optical coherence tomography (OCT) features of a peripapillary choroidal neovascular membrane (PPCNVM) in an eye with morning glory disc anomaly (MGDA). A PPCNVM appears as a hyper-reflective mass in the peripapillary area. It should be distinguished from peripapillary hyper-reflective ovoid mass-like structures, which are markers of axoplasmic flow stasis. This case report describes the distinguishing features between the two. The presence of intraretinal cystic spaces are indicative of an active PPCNVM. In conclusion, MGDA can be associated with PPCNVM and OCT can be used in its detection.

Keywords: Optical coherence tomography; congenital optic disc anomaly; morning glory disc anomaly; peripapillary choroidal neovascular membrane; peripapillary hyper-reflective ovoid mass-like structures.

Figure 1.

Fundus photograph of the left eye showing a morning glory disc anomaly.

Figure 2.

Enhanced depth imaging optical coherence tomography showing a peripapillary neurosensory detachment, a glial tissue tuft on the disc surface (vertical arrow) and a choroidal neovascular membrane (CNVM) with intraretinal cystic spaces (horizontal arrow). The internal reflectivity differences between the peripapillary CNVM and the peripapillary hyper-reflective ovoid mass-like structures (PHOMS) are also depicted.

Figure 3.

Enhanced depth imaging optical coherence tomography with the yellow dotted line showing the peripapillary hyper-reflective ovoid mass-like structures (PHOMS), which are an extension of the inner retinal layers and the blue dotted line showing the peripapillary choroidal neovascular membrane (CNVM), which is an extension of the outer retinal layer with the choroid.