Morning glory syndrome: a histopathological study.

Manschot, W. A.

doi:10.1136/bjo.74.1.56

Cited by 54 publications

(35 citation statements)

References 13 publications

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“…MGS has been described in association with hypermature congenital cataract in a 7-week-old child. 6 However, co-existent corneal and crystalline lens abnormalities of surface ectodermal origin and drainage angle abnormalities of neural crest origin suggest a syndrome of widespread anterior segment dysgenesis rather than isolated MGS in this case. While most investigators argue that MGS and optic disc colobomas are distinct entities, others place them at opposite ends of a continuum to explain MGS with atypical ocular and craniofacial features.…”

Section: Discussionmentioning

confidence: 67%

“…1 It may result in mild 2 or severe 2-5 visual impairment and may be unilateral 3,4,6,7 or bilateral. 3,4,7 MGS is more common in females.…”

Section: Discussionmentioning

confidence: 99%

“…It may be associated with a number of ocular manifestations, such as non-rhegmatogenous retinal detachment 8 and optic nerve contractility, 2 implying continuity with the subarachnoid space, as well as systemic manifestations such as basal encephalocoele and hypopituitarism in some cases. 1,4 Several hypotheses have been offered to explain the embryological pathogenesis of MGS 1 : A primary disorder of posterior segment mesenchyme accounting for scleral ectasia, 6 vascular, adipose tissue, and smooth muscle anomalies, and prepapillary glial tuft Failure of closure of the fetal fissure; a variant of optic nerve coloboma 3 Dysgenesis of the terminal optic stalk with failure of closure and persistent conical excavation of the optic nerve head 9 Primary neuroectodermal dysgenesis with central gliosis Histopathological examination of ocular specimens with MGS document the absence of the lamina cribrosa and scleral ectasia but normal retinal pigment epithelium, suggesting a mesenchymal rather than a neuroectodermal origin of MGS. 6 The unique optic disc contractions observed in some MGS cases are produced by heterotopic smooth muscle derived from mesenchyme, further supporting this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, MGS has been found in association with posterior lenticonus 12 and persistent primary vitreous, which may result in spontaneous posterior capsular rupture 6 with the onset of hypertensive uveitis. Spontaneous rupture may also occur in cases of hypermature cataract with both anterior and posterior dislocation described.…”

Section: Discussionmentioning

confidence: 99%

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Cryptic Uveitis in a Patient with Morning Glory Syndrome

Yusuf

Burke

Bates

2013

Ocular Immunology and Inflammation

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Background: A 71-year-old female presented on 3 occasions with escalating pain in a congenitally blind eye. Examination revealed hypertensive uveitis with morning glory optic disc dysplasia and absence of a crystalline lens. There was no previous intraocular surgery or trauma. Intensive anti-hypertensive agents and topical steroids did not control intraocular pressure (IOP) or inflammation. Results: Dilated fundus examination on the third clinical review revealed a luxated cataractous lens on the retina. Pars plana vitrectomy and fragmatome lensectomy controlled inflammation and IOP, with resolution of ocular pain. Discussion: This is an exceptional case of phacogenic uveitis with secondary glaucoma occurring years after spontaneous crystalline lens luxation in a patient with morning glory syndrome. The embryological pathogenesis of morning glory syndrome and the significance of accelerated cataractogenesis and zonular weakness are discussed. Hypertensive uveitis with unexplained absence of a crystalline lens in a blind eye must prompt suspicion of delayed phacogenic uveitis following asymptomatic lens luxation.

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Section: Discussionmentioning

confidence: 67%

“…1 It may result in mild 2 or severe 2-5 visual impairment and may be unilateral 3,4,6,7 or bilateral. 3,4,7 MGS is more common in females.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cryptic Uveitis in a Patient with Morning Glory Syndrome

Yusuf

Burke

Bates

2013

Ocular Immunology and Inflammation

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“…Speculations about the embryology of MGDA point to a mesectodermal dysgenesis of the optic nerve occurring in the first trimester of the foetus (Dempster et al 1983, Trablousi & O'Neill 1988, Manshot 1990, Villalonga Gornéz et al 1995, Leitch & Winter 1996. Vasculogenesis in the embryo also takes place in the first trimester (Reese et al 1993, Larsen 1993.…”

Section: Discussionmentioning

confidence: 99%

Capillary haemangiomas in association with morning glory disc anomaly

Holmström

Taylor

1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose and method: Capillary haemangiomas in children are usually isolated, but may have systemic associations. This accords with our finding of ocular malformations, especially ''morning glory disc anomaly'' (MGDA), in three children which are described. Results: All three children had extensive capillary haemangiomas in combination with MGDA in one eye. One of the children also had microphthalmos in one eye and a partial agenesis of the corpus callosum. Another child had sclerocornea in one eye and congenital heart defects. Conclusion: An association of extensive capillary haemangiomas with MGDA is described. The embryological timing of such defects as well as investigation of the children is discussed. Extensive haemangiomas have not previously, to our knowledge, been described in association with MGDA.

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Thromboembolism and Congenital Malformations

Parsa

Robert²

2013

JAMA Ophthalmol

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To propose a pathophysiologic mechanism to unify a variety of disparate sporadic congenital malformations. Methods: Inductive and deductive analyses to correlate malformation laterality with asymmetries in thoracic anatomy, critical analysis of malformations with female predominance, and concepts of hydrodynamic pressure gradients in vascular growth were applied to the ensuing development of guiding tissue scaffolds for cellular proliferation, differentiation, and apoptosis. Results: Duane syndrome may develop following a focal vascular insult to the sixth nerve trunk with axonal degeneration, allowing for substitutive innervation from third nerve axons to the lateral rectus muscle. Causative fibrin clots may originate from the venous system and paradoxically migrate through physiological right-toleft shunts, or they may arise directly from the heart. Hence, the unilateral, left-sided, and female predominance of Duane syndrome results from the asymmetry in the thoracic anatomy and from thrombosis risk factors. Embolic occlusions may also alter local hemody-namic pressure gradients, leading to the compensatory enlargement and persistence of the fetal vasculature and may dysregulate tissue growth. Within the eye, this results in forms of Peters anomaly, unilateral congenital cataracts, and the morning glory disc anomaly, all in the vascular territory of the carotid arteries that also share a propensity for left-sided involvement in girls. Most aberrant misinnervation phenomena (eg, jaw-winking syndrome, crocodile tear syndrome, Brown syndrome, and congenital fibrosis syndrome) and, by extrapolation, the hypoplasia or dysgenesis of noncephalic anatomical structures (including limbs) may be similarly explained. Such malformations will occur more frequently under thrombogenic conditions, such as those induced by thalidomide. Conclusions: Fibrin emboli and focal hypoperfusion may explain the development of many sporadic congenital malformations.

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Morning glory syndrome: a histopathological study.

Cited by 54 publications

References 13 publications

Cryptic Uveitis in a Patient with Morning Glory Syndrome

Cryptic Uveitis in a Patient with Morning Glory Syndrome

Capillary haemangiomas in association with morning glory disc anomaly

Thromboembolism and Congenital Malformations

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