Abstract
Purpose
Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are novel and not well characterized findings occurring in several disorders of the optic nerve. The aim of this study is to present two cases of tilted disc syndrome (TDS) and one case with optic disc drusen undergoing a multimodal imaging approach.
Methods
In this case series, a qualitative evaluation of the OCTA findings in regions with PHOMS was performed.
Results
Structural OCT revealed the presence of PHOMS. OCTA identified the presence of a vascular complex within this hyperreflective structure.
Conclusions
Assuming that PHOMS are thought to correspond to herniating nerve fibers or be secondary to axoplasmic stasis, this vascular complex may represent a displacement of the deeper vessels deputed at the irroration of the optic nerve into the retina or, alternatively, might be secondary to an increase in vascular endothelial growth factor (VEGF) levels and a subsequent development of neovessels.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Ohno-Matsui K. Pathologic myopia. Asia-Pacific J Ophthalmol. 2016;5:415–23.
Shinohara K, Moriyama M, Shimada N, Nagaoka N, Ishibashi T, Tokoro T, et al. Analyses of shape of eyes and structure of optic nerves in eyes with tilted disc syndrome by swept-source optical coherence tomography and three-dimensional magnetic resonance imaging. Eye. 2013;27:1233–42.
Lam BL, Morais CG, Pasol J. Drusen of the optic disc. Curr Neurol Neurosci Rep. 2008;8:404.
Spencer WH. Drusen of the optic disk and aberrant axoplasmic transport. The XXXIV Edward Jackson memorial lecture. Am J Ophthalmol. 1978;85:1–12.
Carta A, Mora P, Aldigeri R, Gozzi F, Favilla S, Tedesco S, et al. Optical coherence tomography is a useful tool in the differentiation between true edema and pseudoedema of the optic disc. PLoS ONE. 29;13:e0208145.
Bassi ST, Mohana KP. Optical coherence tomography in papilledema and pseudopapilledema with and without optic nerve head drusen. Indian J Ophthalmol. 2014;62:1146.
Pichi F, Romano S, Villani E, Lembo A, Gilardoni F, Morara M, et al. Spectral-domain optical coherence tomography findings in pediatric tilted disc syndrome. Graefe’s Arch Clin Exp Ophthalmol. 2014;252:1661–7.
Malmqvist L, Bursztyn L, Costello F, Digre K, Fraser JA, Fraser C, et al. The optic disc drusen studies consortium recommendations for diagnosis of optic disc drusen using optical coherence tomography. J Neuro-Ophthalmol. 2018;38:299–307.
Lee KM. Peripapillary hyperreflective ovoid mass-like structures: is it optic disc drusen or not? J Neuro-Ophthalmol. 2018;38:567–8.
Malmqvist L, Bursztyn L, Costello F, Digre K, Fraser JA, Fraser C, et al. Peripapillary hyperreflective ovoid mass-like structures: is it optic disc drusen or not?: response. J Neuro-Ophthalmol. 2018;38:568–70.
Wang DD, Leong JCY, Gale J, Wells AP. Multimodal imaging of buried optic nerve head drusen. Eye. 2018;32:1145–6.
Sibony PA, Kupersmith MJ. Paton’s folds revisited: wrinkles, folds and creases in papilledema. Investig Ophthalmol Vis Sci. 2016;57:4553.
Tso MO. Pathology and pathogenesis of drusen of the optic nervehead. Ophthalmology. 1981;88:1066–80.
Borrelli E, Sadda SR, Uji A, Querques G. Pearls and pitfalls of optical coherence tomography angiography imaging: a review. Ophthalmol Ther. 2019;8:215–26.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Borrelli, E., Barboni, P., Battista, M. et al. Peripapillary hyperreflective ovoid mass-like structures (PHOMS): OCTA may reveal new findings. Eye 35, 528–531 (2021). https://doi.org/10.1038/s41433-020-0890-4
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41433-020-0890-4
This article is cited by
-
Peripapillary hyperreflective ovoid mass-like structures (PHOMS) in patients with acute Leber’s hereditary optic neuropathy
Graefe's Archive for Clinical and Experimental Ophthalmology (2024)
-
Diagnostic dilemma of papilledema and pseudopapilledema
International Ophthalmology (2024)
-
Prevalence of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in suspected papilloedema in children
Eye (2023)
-
Retinal imaging with optical coherence tomography in multiple sclerosis: novel aspects
Wiener Medizinische Wochenschrift (2022)
