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The following is a summary of “Characterization of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in a broad spectrum of neurological disorders,” published in the December 2024 issue of Ophthalmology by Gernert et al. 

Researchers conducted a retrospective study to investigate the extent to which disease-specific differences are reflected in peripapillary hyperreflective ovoid mass-like structures (PHOMS) observed in ophthalmological and neurological diseases.  

They analyzed individuals with various neurological disorders, including neuroimmunological diseases (NI, N=237), epilepsy (EPI, N=153), movement disorders (MD, N=44), intracranial hypertension (IH, N=13), and inborn errors of metabolism (IEM, N=90). The prevalence, location, volume, and intensity of PHOMS were examined and the volume was correlated with demographic data and other optical coherence tomography (OCT) parameters.  

The results showed that PHOMS were identified in 7% of the examined eyes. The PHOMS were present across all cohorts, with the majority located nasally. The median volume of PHOMS was 0.06mm³. However, individuals with IH exhibited significantly larger PHOMS volumes compared to those with NI, P =0.009, EPI, P=0.038, and MD, P =0.027). After excluding patients with IH, PHOMS volume positively correlated with the opening of the Bruch membrane and negatively with the cohort’s age. The intensity of PHOMS was similar to that of the optic nerve.  

Investigators concluded that larger PHOMS volumes in individuals with IH suggested a potential link to increased intracranial pressure, though it remained unclear if this applied to other neurological disorders with PHOMS, highlighting the need for consideration of PHOMS in future non-ophthalmologic studies due to their impact on OCT parameters. 

Source: aaojournal.org/article/S0161-6420(24)00777-2/fulltext