Walsh & Hoyt: Excavated Optic Disc Anomalies

Excavated optic disc anomalies include optic disc coloboma, morning glory disc anomaly, peripapillary staphyloma, megalopapilla, and optic pit. Recently, two new excavated optic disc anomalies have been associated with periventricular leukomalacia (see above) and the vacant optic disc associated with papillorenal syndrome. In the morning glory disc anomaly and peripapillary staphyloma, an excavation of the posterior globe surrounds and incorporates the optic disc, while in the other conditions, the excavation is contained within the optic disc. Pollock (165) has detailed the clinical features that distinguish the excavated optic disc anomalies. He emphasized that the terms morning glory disc, optic disc coloboma, and peripapillary staphyloma are often transposed in the literature, causing tremendous confusion regarding their diagnostic criteria, associated systemic findings, and pathogenesis. From his analysis, it is clear that optic disc colobomas, morning glory optic discs, and peripapillary taphylomas are distinct anomalies, each with its own specific embryologic origin, and not simply clinical variants along a broad phenotypic spectrum.