Imaging features of peripapillary hyperreflective ovoid mass-like structure

Peripapillary hyperreflective ovoid mass-like structure (PHOMS) is a novel imaging feature newly defined in recent years in the study of optic disc drusen (ODD).In OCT images, it shows an oval hyper-reflective signal on the Bruch membrane around the optic papilla, ring or crescent non-fluorescence in autofluorescence, and light gray peripapillary elevations around the optic disc in non-red infrared images.There is no conclusive evidence as to whether PHOMS is a subtype or precursor of ODD.Histopathologically, PHOMS might correspond to the lateral bulging or herniation of distended axons into the peripapillary retina.Since there may be different pathological properties between PHOMS and ODD in histology, there are different imaging features in multimodal imaging.To make the diagnosis of ODD more accurate, the Optic Disc Drusen Studies Consortium recommends that PHOMS be distinguished from ODD.PHOMS is mainly differentiated from ODD and perioptic vessels on OCT.It can be seen in many diseases such as ODD, optic papilledema, non-arteritis anterior ischemic optic neuropathy, multiple sclerosis, central retinal vein occlusion, pediatric tilted disc syndrome, isolated optic neuritis and optic atrophy, and is an important cause of pseudopapilloedema in children.This article summarizes the origin, imaging features, differential diagnosis and related diseases of PHOMS, to increase domestic researchers’ understanding of the structure of PHOMS, enhance the differential diagnosis between PHOMS and ODD, and provide a reference for clinical research and diagnosis.

KEYWORDS:

Peripapillary hyperreflective ovoid mass-like structure;Optic disc drusen;Enhanced-depth imaging OCT

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