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Peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children



To analyse structural characteristics and perifoveal/peripapillary vasculature by OCT in children with peripapillary hyperreflective ovoid mass-like structures (PHOMS) and compare the results with those of normal subjects.


Forty-five patients (84 eyes) under 18 years old with blurry disc margin were evaluated with spectral domain-OCT and swept course-OCT. Patients were divided into four groups, according to presence of PHOMS and then the size of the existing PHOMS. Eyes with visible optic disc drusen (ODD) were not included. Foveal avascular zone (FAZ) and vessel densities from macula and optic disc area were assessed and potential associations between vessel density and structural parameters, such as peripapillary retinal nerve fibre layer (pRNFL), and macular ganglion cell and inner plexiform layer (mGCIPL) thickness, were analysed.


Among 45 patients (eighty-four eyes), coexisting buried ODD were found only in eyes with PHOMS. The scleral canal diameter was significantly smaller in PHOMS positive eyes compared to control eyes. Vessel density measurements from the papillary, peripapillary and optic nerve head (ONH) regions in the large PHOMS group were significantly lower compared to the control group (papillary; P = 0.014, peripapillary; P = 0.001, ONH; P = 0.046). FAZ area and macular vessel densities showed no difference compared to normal eyes in all three PHOMS groups. pRNFL and mGCIPL thickness did not differ among four groups and correlations were also not significant.


Children with PHOMS have smaller scleral canal and can entail buried ODD. Vessel densities of optic disc area in large PHOMS eyes are significantly lower than in normal eyes.

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Fig. 1: Example results of a normal, small peripapillary hyperreflective ovoid mass-like structures (PHOMS), medium PHOMS and large PHOMS eyes, respectively.
Fig. 2: PHOMS with optic disc drusen on SS-OCT.


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The authors thank all the patients for participating in this study.


This study was supported by a National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT, MSIT) (NRF-2019R1C1C1009503).

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All authors contributed to the design and execution of this work, and all approved of this regarding submission.

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Correspondence to Sun Young Shin.

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Ahn, Y.J., Park, Y.Y. & Shin, S.Y. Peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children. Eye 36, 533–539 (2022).

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