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Peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children
Ye Jin Ahn1, Yoo Yeon Park1, Sun Young Shin2
1Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Insights
Children with peripapillary hyperreflective ovoid mass-like structures (PHOMS) have smaller scleral canals and may have buried optic disc drusen. Large PHOMS are associated with reduced optic disc vessel density.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Optical Coherence Tomography (OCT) Imaging
Background:
- Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are observed in children.
- The structural characteristics and vascularity of PHOMS in pediatric eyes require further investigation.
Purpose of the Study:
- To analyze structural characteristics and perifoveal/peripapillary vasculature using OCT in children with PHOMS.
- To compare these findings with those in normal pediatric subjects.
Main Methods:
- Spectral domain-OCT and swept-source OCT were used to evaluate 45 children (84 eyes) with blurry disc margins.
- Patients were grouped based on the presence and size of PHOMS, excluding eyes with visible optic disc drusen (ODD).
- Foveal avascular zone (FAZ) and vessel densities in the macula and optic disc area were assessed, along with peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell and inner plexiform layer (mGCIPL) thickness.
Main Results:
- Eyes with PHOMS sometimes exhibited coexisting buried ODD.
- A significantly smaller scleral canal diameter was found in PHOMS-positive eyes compared to controls.
- Reduced vessel density in the papillary, peripapillary, and optic nerve head regions was observed in the large PHOMS group compared to controls.
Conclusions:
- Children with PHOMS possess smaller scleral canals and may have associated buried ODD.
- Significant reductions in optic disc area vessel density are noted in children with large PHOMS compared to healthy controls.
Background:
To analyse structural characteristics and perifoveal/peripapillary vasculature by OCT in children with peripapillary hyperreflective ovoid mass-like structures (PHOMS) and compare the results with those of normal subjects.
Methods:
Forty-five patients (84 eyes) under 18 years old with blurry disc margin were evaluated with spectral domain-OCT and swept course-OCT. Patients were divided into four groups, according to presence of PHOMS and then the size of the existing PHOMS. Eyes with visible optic disc drusen (ODD) were not included. Foveal avascular zone (FAZ) and vessel densities from macula and optic disc area were assessed and potential associations between vessel density and structural parameters, such as peripapillary retinal nerve fibre layer (pRNFL), and macular ganglion cell and inner plexiform layer (mGCIPL) thickness, were analysed.
Results:
Among 45 patients (eighty-four eyes), coexisting buried ODD were found only in eyes with PHOMS. The scleral canal diameter was significantly smaller in PHOMS positive eyes compared to control eyes. Vessel density measurements from the papillary, peripapillary and optic nerve head (ONH) regions in the large PHOMS group were significantly lower compared to the control group (papillary; P = 0.014, peripapillary; P = 0.001, ONH; P = 0.046). FAZ area and macular vessel densities showed no difference compared to normal eyes in all three PHOMS groups. pRNFL and mGCIPL thickness did not differ among four groups and correlations were also not significant.
Conclusions:
Children with PHOMS have smaller scleral canal and can entail buried ODD. Vessel densities of optic disc area in large PHOMS eyes are significantly lower than in normal eyes.
