Association Between Peripapillary Hyperreflective Ovoid Mass-Like Structures and Optic Nerve Head Morphology in Eyes...

Peripapillary hyper-reflective ovoid mass-like structures (PHOMS) are commonly observed in optic disc swelling of various etiologies, but the factors contributing to their formation have not been fully elucidated. This study aimed to investigate the association between the presence of PHOMS and optical coherence tomography (OCT) parameters in eyes with optic disc edema secondary to various diseases.

This retrospective study included patients who underwent orbital and head MRI to determine the underlying cause of optic disc edema at the Department of Ophthalmology, Kyoto University Hospital, between April 2018 and March 2024. The data of the patients with optic disc edema detected using swept-source OCT were included in the analysis. The scleral canal diameter (SCD), peripapillary choroidal thickness, and optic nerve head height were measured. The background characteristics and OCT parameters of the eyes with and without PHOMS were compared. The associations between PHOMS and OCT parameters were determined using univariable and multivariable regression analyses based on generalized estimation equations.

Fifty-one eyes of 41 patients (22 males and 19 females) were included in this study. PHOMS were detected in 26 eyes (51%). Multivariable regression analysis revealed a trend toward an association between narrower SCD and increased risk of PHOMS, but the association was not statistically significant (β = -0.0028; 95% confidence interval, -0.49 to 0.91; P = 0.067).

Narrower SCDs in eyes with optic disc edema were associated with a higher risk of developing PHOMS. The structural characteristics of the optic disc may play an important role in the development of PHOMS in eyes with secondary optic disc edema.