Patient Presentation: A 41-year-old woman presented with 3 days of acute painless decrease in vision OD. She denied flashes, floaters or a visual field deficit. There was no trauma. The patient denied any relevant past medical or ocular history. She did however note that an optometrist once mentioned she had an atypical optic nerve. Best corrected distance visual acuity was 20/200 OD and 20/20 OS. There was a right RAPD.
Fundoscopy and OCT macula were done and shown below:
Question 1: Which of the following describes the main findings of this right eye OCT macula?
Question 2: Based on the patient’s history, OCT, and fundus findings, what is the most likely diagnosis?
Fundus autofluorescence photos were taken and are shown below. Note the juxtapapillary hypo-autofluorescence in keeping with the excavation of the optic nerve due to RPE loss/atrophy, as well as the hyper-autofluorescence at the macula reflecting the accumulation of subretinal fluid. The left eye is provided as well for reference.
Question 3: Which of the following are NOT typical complications of this condition?
Question 4: What workup do ALL patients with this condition require?
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To identify fundus findings and OCT imaging of Morning Glory Syndrome
To understand the associated complications of Morning Glory Syndrome and the recommended workup