Peripapillary hyperreflective ovoid mass-like structures with cystoid macular edema: a case report

Area of Science:

• Ophthalmology
• Optic Nerve Imaging
• Retinal Diseases

Background:

• Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are newly identified lesions around the optic disc.
• These structures were previously misdiagnosed, highlighting the need for better identification methods.
• Understanding PHOMS is crucial for monitoring optic nerve health.

Observation:

• A case study involved a young female with blurred vision and bilateral "C-shaped donut" protrusions around the optic discs.
• Optical Coherence Tomography (OCT) revealed homogenous hyperreflective lesions, with hypoautofluorescence and hypoechogenicity.
• Cystoid macular edema (CME) was concurrently diagnosed in both eyes.

Findings:

• The patient was diagnosed with PHOMS and CME.
• Systemic glucocorticoid therapy led to a visual acuity of 0.0 logMAR in both eyes and CME recovery within 4 months.
• The PHOMS lesions remained unchanged post-treatment.

Implications:

• This is the first reported case of PHOMS associated with CME.
• PHOMS may serve as potential biomarkers for axoplasmic stasis in various optic nerve diseases.
• Further research attention is warranted for PHOMS due to their clinical significance.