J Korean Ophthalmol Soc.
2024 Mar;65(3):257-260. 10.3341/jkos.2024.65.3.257.
A Case of Moyamoya Disease in Morning Glory Syndrome
- Affiliations
-
- 1Department of Pediatrics, Keimyung University, School of Medicine, Daegu, Korea
- 2Department of Ophthalmology, Keimyung University, School of Medicine, Daegu, Korea
- KMID: 2553404
- DOI: http://doi.org/10.3341/jkos.2024.65.3.257
Abstract
- Purpose
We report a diagnosis of Moyamoya disease based on brain magnetic resonance imaging (MRI) and brain magnetic resonance angiography (MRA) performed in a child diagnosed with morning glory syndrome.
Case summary
A 6-year-old boy visited the hospital with a chief complaint of exodeviation of his left eye that started at 1 year of age. The corrected visual acuity was 20/30 in the right eye and 20/400 in the left. The Krimsky test showed exotropia of 35 prism diopters (PD) for near vision and 30 PD for distance. Fundus photography showed an enlarged optic disc with funnel-shaped excavation in the left eye. With a diagnosis of morning glory syndrome accompanied by exotropia, the patient underwent brain MRI and brain MRA. The patient had no neurological symptoms such as headache and muscle weakness. Moyamoya disease was diagnosed, as brain MRI and MRA showed tiny tortuous vessels forming collateral vessels from the lenticulostriatal arteries, left posterior cerebral artery, and left middle meningeal artery, which originated from the external carotid artery.
Conclusions
Moyamoya disease can occur in children with morning glory disease. Brain MRI and MRA can help to diagnose Moyamoya disease. Caution is needed because transient ischemic attack, cerebral infarction, and cerebral hemorrhage may occur in patients with Moyamoya disease.
