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Macular Choroidal Neovascularization in Peripapillary Hyperreflective Ovoid Mass-Like Structures (PHOMS): case
Ana Bárbara Dias Lopes Urzedo1, Kenzo Hokazono
1Department of Ophthalmology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba-PR, Brazil.
Retinal Cases & Brief Reports
|June 26, 2026
Summary
Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are an OCT finding. This case report describes a rare association of PHOMS with macular type 2 choroidal neovascularization, successfully treated with anti-VEGF therapy.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are observed on optical coherence tomography (OCT).
- PHOMS are typically associated with axoplasmic stasis resulting from retinal nerve fiber layer herniation at the optic nerve head.
- While various systemic and ocular associations exist, macular choroidal neovascularization (CNV) is an uncommon finding with PHOMS.
Purpose of the Study:
- To document a case of PHOMS co-occurring with macular type 2 CNV.
- To highlight the diagnostic utility of OCT and OCT-angiography in identifying these conditions.
- To report the clinical outcome following treatment for this rare association.
Main Methods:
- A case report methodology was employed.
- Optical coherence tomography (OCT) B-scan was used to visualize PHOMS on the optic nerve head.
- OCT-angiography was utilized to detect macular type 2 CNV.
Main Results:
- A 36-year-old woman presented with acute vision loss.
- OCT revealed PHOMS, and OCT-angiography confirmed macular type 2 CNV.
- Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection led to significant visual improvement.
Conclusions:
- PHOMS is an OCT finding linked to axoplasmic stasis.
- Macular type 2 CNV is a rare but significant association with PHOMS.
- Anti-VEGF therapy demonstrated efficacy in managing this rare presentation.
