VITREORETINAL SURGERY FOR RHEGMATOGENOUS RETINAL DETACHMENT IN A PATIENT WITH MORNING GLORY SYNDROME: A CASE REPORT (CLINICAL CASES)

Abstract

Morning glory syndrome (MGS) is a rare congenital optic disc anomaly characterized by a funnel-shaped disc, central glial tissue, and peripapillary pigmentation. It is often unilateral, associated with high myopia, amblyopia, and developmental malformations, with a prevalence of approximately 3.6 per 100,000. Retinal detachment, occurring in 26-40% of cases, is a major complication, predominantly serous but also tractional or rhegmatogenous.

Purpose – to present the results of vitreoretinal surgery in a patient with MGS complicated by retinal detachment and choroidal detachment.
A 35-year-old male patient with a history of high myopia since childhood (OD: (–)15 D; OS: (–)10 D) and amblyopia presented with acute vision loss in the right eye Best-Corrected Visual Acuity (BCVA): 20/2000) over 2 months. History included bilateral scleroplasty and left-eye phakic lens implantation with laser photocoagulation. B-scan ultrasonography revealed rhegmatogenous retinal and choroidal detachment. The patient underwent 25-gauge vitrectomy with endolaser photocoagulation around an 11 o’clock disc-margin break, subretinal fluid aspiration, and silicone oil (5700 cSt) tamponade. Two months later, silicone oil removal, cataract phacoemulsification with intraocular lens (IOL) implantation, and gas–air tamponade was performed. At 6 months after silicone oil removal, the retina was reattached, with OD BCVA improving to 20/100.

Conclusion
Morning glory syndrome with retinal detachment poses surgical challenges, including absent posterior vitreous detachment (PVD), dense fibrotic tissue, and long axial length. Early ophthalmological diagnosis and timely surgical treatment allow a good anatomical outcome in the postoperative period.