Morning Glory Syndrome or Bindweed Flower Papilla Syndrome

Introduction: Morning Glory Syndrome (MGS) is a rare anomaly of the optic nerve characterized by a flower-shaped excavation in the optic disc. This anatomical peculiarity is of growing interest due to its impact on vision and the therapeutic challenges it presents. Despite research advances, gaps persist, requiring thorough exploration to better understand this rare condition. We present the case of a young girl. Observation: A 7-year-old girl presented with persistent deterioration of vision in the right eye since birth. Visual acuity was counting fingers at 2 meters in the right eye and 10/10 in the left eye. Biomicroscopy was normal in both eyes, and fundus examination revealed a funnel-shaped excavation at the optic disc of the right eye, associated with central glial proliferation, thin blood vessels in a radial distribution, and atrophy of the neuroretinal rim. Additional tests confirmed the diagnosis of isolated unilateral Morning Glory Syndrome in the right eye. Combined treatment included appropriate optical correction and functional rehabilitation. Regular ophthalmological follow-up over a one-year period was established to monitor visual acuity evolution, optic disc stability, and detect any potential complications. The reserved prognosis was marked by the absence of ocular complications and maintenance of initial visual acuity in the right eye. Conclusion: The positive response to management underscores the importance of an integrated approach, early diagnosis, therapeutic adherence, and personalized strategies.

Prophylactic juxtapapillary laser photocoagulation in pediatric morning glory syndrome

AIM:To determine the anatomic and visual outcomes of prophylactic juxtapapillary laser photocoagulation treatment alone in the prevention of retinal detachment(RD)in a cohort of pediatric patients diagnosed with morning glory syndrome(MGS).METHODS:A total of 24 eyes of 22 consecutive patients aged 0-15 y diagnosed with MGS treated with prophylactic juxtapapillary laser photocoagulation alone were reviewed.Data including demographics,ocular examination,anatomic and visual outcomes,following treatment and complications were collected.RESULTS:Two patients had bilateral laser treatment and 20 had monocular laser treatment.The age at treatment of 13(59.1%)patients was less than 12 mo.The presenting symptoms included strabismus(6/22,27.3%),decreased vision(2/22,9.1%),and routine fundus screening(14/22,63.6%).Fifteen(68.2%)patients underwent cranial magnetic resonance imaging(MRI)examinations,and 3 of those 15(20.0%)had abnormal findings in the nervous system.Based on preoperative wide-field fundus photography and B-scan echography,all(100.0%)eyes had no obvious RD.On postoperative 1 mo and 6 mo and the following follow-ups,the anatomic outcomes of all eyes remained stable.The mean follow-up duration was 27.7±17.5 mo.No severe complications were found.Preoperative visual acuity acquired from 2(9.1%)patients ranged from light perception to 20/200.Postoperative acuity acquired from 11(50.0%)patients ranged from light perception to 20/125.CONCLUSION:The preliminary anatomic and visual outcomes of prophylactic juxtapapillary laser treatment alone in pediatric MGS patients are relatively stable in a short-term follow-up.Further long-term clinical observation will be needed to confirm its efficacy and safety.

The Clinical Characteristics and Imaging Findings of Morning Glory Syndrome

To investigate the features of CT, ultrasonography and fundus fluorescein angiography （FFA） of morning glory syndrome, the data on CT, A/B-scan ultrasonography and fundus fluorescein angiography （FFA） were retrospectively analyzed in 8 cases of morning glory syndrome （MGS）. Among those cases, 6 were examined with CT, 4 with FFA and 8 with A/B-scan ultrasonography. Results showed that the characteristics of CT, A/B-scan ultrasonography and FFA in MGS included： （1） The attachment spot of optic nerve became thin and vitreous body protruded to the posterior wall of eyeball with a spherical shape on CT image; （2） in the early period of FFA, hypofluorescence appeared on the optic, the abnormal arteriae and veins around the optic papilla were displayed clearly and in the late period, optic disc was stained with fluorescein; （3） on B-scan ultrasonogram, the vitreous cavity extended to the posterior pole and optic papilla, and projected to the basal part of muscle cones and thus the posterior part of vitreous cavity looked like an upside-down bottleneck. Sometimes the echogenic band of retinal detachment could also be seen. On A-scan ultrasonogram, both vitreous cavity and bottleneck showed no ultrasonic echoes and presented a base line without any evident wave crest. It is concluded that CT, A /B-scan ultrasonography and FFA could show the imageological features of MGS from different aspects, which helps clinicians to differentiate it from other diseases such as optic disc coloboma. CT and A /B-scan ultrasonography, in particular, are considered to be reliable imageological methods for the accurate diagnosis of MGS and are superior to the traditional techniques.

Effect of Complete Feed Feeding Level and Morning Glory on Growing Pig Performance

A total of 60 castrated male pigs (Yorkshire x Duroc, initially 17.36 kg) were used in a 42-day trial to evaluate the effect of complete feed feeding level and morning glory on growth performance of growing pigs. Pigs were allotted to pens and randomly assigned to three dietary treatments: A) completed feed fed ad libitum;B) complete feed fed at 75% of intake of treatment A, and C) treatment B with ad libitum availability of morning glory. The design was a completely randomized design (CRD) with five pens (replications) of each treatment with four pigs per pen. Average daily feed intake (dry matter basis) was higher (P < 0.001) for pigs fed treatment A (1420 g/d) compared to treatment B (1048 g/d) as expected, with treatment C intermediate (1178 g/d;1048 g/d complete feed + 130 g/d morning glory). Average daily weight gain of pigs fed ad libitum was greater (P < 0.001) than pigs restricted fed with pigs which provide morning glory intermediate (871, 674 and 714 g, respectively). Feed efficiency improved (P < 0.024) for pigs fed the restricted feed level compared to pigs fed complete feed ad libitum or pigs restricted fed but provided morning glory (1.63, 1.56 and 1.65, respectively). For economics, feeding complete feed ad libitum improved (P < 0.001) income over feed cost compared to restricted feeding or providing morning glory (USD 41.48, 33.42, and 33.89/pig, respectively). In conclusion, feeding growing pigs a complete diet ad libitum resulted in the greatest growth rate and profitability. Offering morning glory (Ipomoea. aquatica) to pigs fed a restricted level of complete feed did improve final body weight, but the extra cost of feeding morning glory offset this advantage resulting in similar profitability on an income over feed cost basis.

Morning Glory Syndrome in Two (02) Malians: Case Report from IOTA-University Hospital

Background: First described by Handmann in 1929, the “Morning Glory Syndrome” is a rare congenital anomaly of the optic papilla whose notable ophthalmoscopic sign is papillary excavation associated with other ocular and/or non-ocular anomalies. Purpose: The main purpose of this study is to report 2 cases of this rare congenital papilla anomaly in 2 young Malian adults diagnosed in the IOTA-University Hospital respectively in January and May 2020. Materials and methods: In our study, we have included two cases of male gender. Results: In the 1st case the defect concerned both papillae. It is also associated with other ocular malformations (bilateral macular reshaping and unilateral cataract), without associated cerebral defects. In the 2nd case, only one papilla was affected by the malformation and there was an absence of associated malformations of other ocular and cerebral structures. Discussion: The Morning Glory Syndrome is part of the group of congenital defects of the optic nerve. It is often referred to as ectasia coloboma of the optical papilla or bindweed flower-like optical papilla because of its similarity to the tropical flower known as “bindweed”. Its exact pathogenesis remains unknown, but it is linked to the poor development of the posterior sclera and lamina cribrosa during gestation. Conclusion: Morning Glory Syndrome through papillary excavation and other associated ocular and/or cerebral malformations may be a threat to vision.

Xanthophyll Cycle and Inactivation of Photosystem Ⅱ Reaction Centers Alleviating Reducing Pressure to Photosystem Ⅰ in Morning Glory Leaves under Short-term High Irradiance

Under 30-min high irradiance （1500μmol m^-2 s^-1）, the roles of the xanthophyll cycle and D1 protein turnover were investigated through chlorophyll fluorescence parameters in morning glory （Ipomoea setosa） leaves, which were dipped into water, dithiothreitol （DTT） and lincomycin （LM）, respectively. During the stress, both the xanthophyll cycle and D1 protein turnover could protect PSI from photoinhibition. In DTT leaves, non-photochemical quenching （NPQ） was inhibited greatly and the oxidation level of P700 （P700^＋） was the lowest one. However, the maximal photochemical efficiency of PSII （Fv/Fm） in DTT leaves was higher than that of LM leaves and was lower than that of control leaves. These results suggested that PSI was more sensitive to the loss of the xanthophyll cycle than PSII under high irradiance. In LM leaves, NPQ was partly inhibited, Fv/Fm was the lowest one among three treatments under high irradiance and P700^＋ was at a similar level as that of control leaves. These results implied that inactivation of PSII reaction centers could protect PSI from further photoinhibition. Additionally, the lowest of the number of active reaction centers to one inactive reaction center for a PSII cross-section （RC/CSo）, maximal trapping rate in a PSll cross-section （TRo/CSo）, electron transport in a PSll cross-section （ETo/CSo） and the highest of 1-qP in LM leaves further indicated that severe photoinhibition of PSII in LM leaves was mainly induced by inactivation of PSII reaction centers, which limited electrons transporting to PSh However, relative to the LM leaves the higher level of RC/CSo, TRo/CSo, Fv/Fm and the lower level of 1-qP in DTT leaves indicated that PSI photoinhibition was mainly induced by the electron accumulation at the PSI acceptor side, which induced the decrease of P700^＋ under high irradiance.

Birth Defects of the Child Optic Disc: Diagnostic Challenges and Prospects for Care

Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular complication and maintenance of visual stability in the right eye. The prognosis seemed favorable. Conclusion: Congenital optic disc anomalies in children exhibit great clinical variability and require an individualized diagnostic and therapeutic approach.

Late Diagnosis of Congenital Optic Disc Abnormalities

Purpose: To show epidemiological and imaging aspects of congenital optic disc abnormalities diagnosed late. Method: It was a retrospective study, including all patients with congenital optic disc abnormalities diagnosed at a late age between January 2020 and October 2022 at the eye center of Abass Ndao Hospital. Complete ophthalmological examination was performed with eye imaging according to the cases. Results: 09 patients (10 eyes) were diagnosed with congenital optic disc abnormalities. The mean age was 29 years, with a sex ratio of 0.8. Three patients had consulted for unilateral decreased visual acuity since childhood, two for sudden vision loss and in four cases the diagnosis was fortuitous. Visual acuity was ranged from 1/200 to 20/20. Fundus examination showed myelinated retinal nerve fibers in four eyes, optic disc pit in three eyes including two complicated by maculopathy, two cases of morning glory syndrome and a case of pseudoduplication of the optic disc. Optical coherence tomography, ocular ultrasound B and OCT-Angiography were performed according to the cases. Conclusion: Congenital optic disc abnormalities are often diagnosed late. They are potentially amblyogenic and complications are not rare, worsening the visual prognosis. Their screening should be systematic by ophthalmological examination in newborns.