Case #8 – “Morning Glory” Disc Coloboma

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References:J. H. Fingert, R. A. Honkanen, S. P. Shankar, et al. 2007 Familial Cavitary Optic Disk Anomalies: Identification of a Novel Genetic Locus Am J Opthalmol; 143:795-800P. Kindler 1970 Morning Glory Syndrome: Unusual Congenital Optic Disk Anomaly Am J Opthalmol 376-382C. Y. Gregory-Evans, M. J. Williams, S. Halford et al. 2004 Ocular Coloboma: a reassessment

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Paul R. Bernstein, OD Dr. Paul Bernstein received his Doctor of Optometry degree from State University of New York College of Optometry in 1987. Shortly thereafter, Dr. Paul was appointed to the professional staff at the S.U.N.Y. College of Optometry where he served as an assistant clinical professor. Dr. Paul is also involved in

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Jerome Sherman, OD, FAAO Jerome Sherman, O.D., is perhaps optometry's most prolific writer, publishing over 650 clinical articles, research manuscripts, book chapters and two CDs. He is senior author of three books that were published in 2007, and has delivered over three thousand lectures both nationally and internationally. He has served as a

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The following is a list of links to the companies and contributors of Cavitary Optic Disc Anomalies: http://www.lulu.com/content/hardcover-book/photoreceptor-integrity-line-as-revealed-by-spectral-domain-oct/5738467 http://www.lulu.com/content/paperback-book/ophthalmic-ultrasonography-bscan-for-beginners/1239046

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Comments and Conclusions Ocular colobomas are malformations resulting from defects in the closure of the optic cup fissure during embryogenesis, which may lead to structural defects in an inferonasal location involving the iris, ciliary body, lens, choroid, retina and optic nerve.1 The most frequently observed ocular coloboma is seen in the inferonasal quadrant3 such

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Histological Section as Compared to the OCT ImageAlthough the photoreceptor integrity line, or the PIL (defined as the junction between the inner and outer segments) is barely visible in most histological sections, it is highly prominent in normal SD OCTs. The PIL, as shown above, should be continuous throughout the entire scan in normal eyes.

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Here we are comparing our patient's congenital disc anomaly to another patient who has a somewhat similar disc appearance, but profound vision loss. VA reduction, as reported by Kindler, is part of the morning glory disc syndrome. Figure A: Typical morning glory syndrome- vessels are radiating from peripheral optic nerve head.

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As noted earlier, the term morning glory disk anomaly was first used by Kindler to describe a group of abnormal optic nerve features that have the appearance of a morning glory flower.2 Images obtained from: http://www.flowers.vg/flowers/morningglory.htm

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Cavitary Optic Disc Anomalies - Optic Pit Figure A: Optic pit in the typical temporal location OS. Figure B: Optic pit in typical temporal location OD. which led to the accumulation of macular fluid and subsequent laser treatment. Figure C: Optic pit is temporal OS but also superior within the disc.

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