This is a retrospective review of the medical records of 85 eyes / 74 patients diagnosed as morning glory syndrome (MGS) in the clinic between November 2009 and November 2012. Twenty two eyes of 19 patients diagnosed as having MGS associated with persistent hyperplastic primary vitreous (PHPV) were included in this study (25.88% of all the MGS eyes). Microphthalmia was diagnosed if the axial length of the eye was less than at least two standard deviations (SDs) below the mean for the age of the patient. All patients were recommended to have cranial magnetic resonance imaging (MRI) and MR angiography (MRA) or computerised tomography (CT) scan. Only eight patients underwent examinations due to financial constraints. Nineteen of 22 eyes (86.36%) had associated findings including cataracts (10 eyes), secondary glaucoma (eight eyes), corneal leucoma or oedema (eight eyes), retinal detachment (eight eyes), strabismus (three eyes) and nystagmus (two eyes). Lensectomy and / or vitrectomy were performed in patients with complications of glaucoma, cataract and retinal detachment by the same retinal surgeon. Of eight patients who had cranial MRI/MRA or CT examination, three patients showed abnormalities; one patient was found to have widening of the cerebral fissures of the bilateral temporal lobes, one patient showed an abnormal dilated branch of the middle cerebral artery in the left hemisphere and the other patient showed an abnormal signal in the grey matter of the frontal and occipital lobes. The authors postulated that there might be the coexistence of a genetic link between the PHPV and MGS.

Clinical characteristics and treatment of 22 eyes of morning glory syndrome associated with persistent hyperplastic primary vitreous.
Fei P, Zhang Q, Li J, Zhao P.
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Jonathan Chan

Royal Hallamshire Hospital, Sheffield, UK.

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