Peripapillary hyperreflective ovoid mass-like structures: multimodal imaging and associated diseases

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Medical Imaging

Background:

• Peripapillary hyperreflective ovoid mass-like structures (PHOMS) were previously misclassified as optic disc drusen.
• Emerging evidence suggests PHOMS represent herniated optic nerve fibers, signifying axoplasmic stasis.

Purpose of the Study:

• To differentiate PHOMS from optic disc drusen.
• To elucidate the multimodal imaging characteristics and pathophysiological mechanisms of PHOMS.
• To explore the association of PHOMS with various ocular and neurological conditions.

Main Methods:

• Review of multimodal imaging findings in patients with PHOMS.
• Analysis of pathophysiological mechanisms related to axoplasmic stasis.
• Correlation of PHOMS presence with a spectrum of diseases and healthy controls.

Main Results:

• PHOMS are identified as distinct structures, not a subtype of optic disc drusen.
• PHOMS correlate with laterally bulging herniation of optic nerve fibers.
• PHOMS are observed across diverse conditions including optic neuropathies and papilledema.

Conclusions:

• PHOMS are novel anatomical structures indicative of axoplasmic stasis.
• Understanding PHOMS is crucial for diagnosing and managing various optic nerve disorders.
• Further research into PHOMS may reveal new diagnostic and therapeutic avenues.