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      Moyamoya Disease Associated With Morning Glory Disc Anomaly and Other Ophthalmic Findings: A Mini-Review

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          Abstract

          Moyamoya disease (MMD) is a chronic cerebrovascular disease that frequently results in intracranial ischemia or hemorrhage. Its concurrence with varying ophthalmic findings is relatively rare yet may lead to irreversible blindness. We performed a search and review of the literature to characterize the relevance of MMD (excluding moyamoya syndrome) and ophthalmic findings. As a result, a total of 38 articles identified from PubMed and Web of Science were included in this mini-review. Patients with MMD sometimes present with decreased visual acuity or visual field defects before the onset of symptomatic cerebrovascular dysfunction. The most predominant ophthalmic condition in MMD patients is the morning glory disc anomaly (MGDA). Deficiency during neuroectodermal genesis and subsequent mesodermal changes may be responsible for the association between these two diseases. Thus, it may be beneficial for patients with MGDA to receive cerebral vascular examinations as the precaution against life-threatening intracranial angiopathy. Other ophthalmic findings reported in cases of MMD include retinal vascular occlusion, optic disc pallor, cortical blindness, etc. For most of the patients with MMD, retinal examinations would be recommended to prevent potential loss of vision. It is essential for both neurologists and ophthalmologists to be aware of the correlation between cerebrovascular diseases such as MMD and ocular manifestations to achieve a comprehensive diagnosis.

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          Most cited references50

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          Moyamoya disease and moyamoya syndrome.

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            Epidemiology, diagnosis and treatment of moyamoya disease.

            Moyamoya disease (MMD) is a type of chronic cerebrovascular occlusion disease, which frequently occurs in East Asian populations, including pediatric and adult patients, and may lead to ischemic or hemorrhagic stroke, headache, epilepsy or transient ischemic attack. To date, the underlying mechanisms of MMD have remained to be fully elucidated, but certain studies have indicated that genetic factors may be an important component of its development. Cerebral angiography is the best approach for diagnosing MMD. However, with technological advances, non-invasive techniques are increasingly used to accurately evaluate MMD. MMD is commonly treated via surgery, and an increasing number of patients are benefitting from the intra- and extra-cranial revascularization. The present article provides a comprehensive review of MMD on the basis of previous research.
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              Epidemiology of moyamoya disease in Taiwan: a nationwide population-based study.

              Previous studies have shown regional and temporal variations in epidemiological features of moyamoya disease, but population-based studies in regions other than Japan are limited. We investigated the incidence and patients characteristics of moyamoya disease during 12 years in Taiwan using claims databases of a universal health insurance system.
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                Author and article information

                Contributors
                Journal
                Front Neurol
                Front Neurol
                Front. Neurol.
                Frontiers in Neurology
                Frontiers Media S.A.
                1664-2295
                15 May 2020
                2020
                : 11
                : 338
                Affiliations
                [1] 1Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine , Hangzhou, China
                [2] 2Department of Neurosurgery, Zhongnan Hospital of Wuhan University , Wuhan, China
                Author notes

                Edited by: Michael S. Lee, University of Minnesota Twin Cities, United States

                Reviewed by: Essam Mohamed Elmatbouly Saber, Benha University, Egypt; Michael C. Brodsky, Mayo Clinic, United States

                *Correspondence: Jin-cao Chen chenjincao2012@ 123456hotmail.com

                This article was submitted to Neuro-Ophthalmology, a section of the journal Frontiers in Neurology

                †These authors have contributed equally to this work

                Article
                10.3389/fneur.2020.00338
                7242724
                32499749
                270e83ac-77d9-4aab-aa10-9d079966c368
                Copyright © 2020 Wang, Zhou, Ye, Song, Yu, Chen and Yao.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 21 January 2020
                : 07 April 2020
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 52, Pages: 8, Words: 5931
                Categories
                Neurology
                Mini Review

                Neurology
                moyamoya disease,morning glory disc anomaly,neuro-ophthalmology,ocular findings,review
                Neurology
                moyamoya disease, morning glory disc anomaly, neuro-ophthalmology, ocular findings, review

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