The pathogenesis of retinal detachment with morning glory disc and optic pit

A child with nonrhegmatogenous retinal detachment associated with morning glory disc underwent first a vitrectomy and then, some months later, an optic nerve sheath fenestration. The latter procedure led to retinal reattachment. It also produced a biopsy specimen that confirmed the perineural herniation of poorly differentiated retinal tissue in this condition, similar to that in congenital pit of the optic nerve. It demonstrated continuity of the vitreous cavity with the perineural space, both histologically and by the fact that gas injected through the pars plana into the vitreous cavity bubbled out the window in the optic nerve sheath. The authors suggest that morning glory disc and optic pit share similar anatomic features, differing more in degree than in kind, and that the porous nature of the poorly differentiated tissue herniated around the optic nerve into the subarachnoid space in these conditions makes several sources of subretinal fluid possible.