Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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

Eye volume 36, pages 533–539 (2022)Cite this article

Subjects

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

Buy

All prices are NET prices.

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.

References

  1. Kamin DF, Hepler RS, Foos RY. Optic nerve drusen. Arch Ophthalmol. 1973;89:359–62.

    CAS  Article  Google Scholar 

  2. Spencer WH. XXXIV Edward Jackson Memorial Lecture: drusen of the optic disc and aberrant axoplasmic transport. Ophthalmology. 1978;85:21–38.

    CAS  Article  Google Scholar 

  3. Mullie MA, Sanders MD. Scleral canal size and optic nerve head drusen. Am J Ophthalmol. 1985;99:356–9.

    CAS  Article  Google Scholar 

  4. Wilkins JM, Pomeranz HD. Visual manifestations of visible and buried optic disc drusen. J Neuroophthalmol. 2004;24:125–9.

    Article  Google Scholar 

  5. Katz BJ, Pomeranz HD. Visual field defects and retinal nerve fiber layer defects in eyes with buried optic nerve drusen. Am J Ophthalmol. 2006;141:248–53.

    Article  Google Scholar 

  6. Roh S, Noecker RJ, Schuman JS, Hedges TR 3rd, Weiter JJ, Mattox C. Effect of optic nerve head drusen on nerve fiber layer thickness. Ophthalmology. 1998;105:878–85.

    CAS  Article  Google Scholar 

  7. Chang MY, Pineles SL. Optic disk drusen in children. Surv Ophthalmol. 2016;61:745–58.

    Article  Google Scholar 

  8. Sato T, Mrejen S, Spaide RF. Multimodal imaging of optic disc drusen. Am J Ophthalmol. 2013;156:275–82.e1.

    Article  Google Scholar 

  9. Silverman AL, Tatham AJ, Medeiros FA, Weinreb RN. Assessment of optic nerve head drusen using enhanced depth imaging and swept source optical coherence tomography. J Neuroophthalmol. 2014;34:198–205.

    Article  Google Scholar 

  10. Lee KM, Hwang JM, Woo SJ. Optic disc drusen associated with optic nerve tumors. Optom Vis Sci. 2015;92:S67–75.

    Article  Google Scholar 

  11. Bassi ST, Mohana KP. Optical coherence tomography in papilledema and pseudopapilledema with and without optic nerve head drusen. Indian J Ophthalmol. 2014;62:1146–51.

    Article  Google Scholar 

  12. Lee KM, Woo SJ, Hwang JM. Morphologic characteristics of optic nerve head drusen on spectral-domain optical coherence tomography. Am J Ophthalmol. 2013;155:1139–47.e1.

    Article  Google Scholar 

  13. Slotnick S, Sherman J. Disc drusen. Ophthalmology. 2012;119:652.

    Article  Google Scholar 

  14. Malmqvist L, Bursztyn L, Costello F, Digre K, Fraser JA, Fraser C, et al. The optic disc drusen studies consortium recommendations for diagnosis of optic disc drusen using optical coherence tomography. J Neuroophthalmol. 2018;38:299–307.

    Article  Google Scholar 

  15. Spaide RF, Klancnik JM Jr., Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol. 2015;133:45–50.

    Article  Google Scholar 

  16. Lee KM, Woo SJ, Hwang JM. Differentiation of optic nerve head drusen and optic disc edema with spectral-domain optical coherence tomography. Ophthalmology. 2011;118:971–7.

    Article  Google Scholar 

  17. Traber GL, Weber KP, Sabah M, Keane PA, Plant GT. Enhanced depth imaging optical coherence tomography of optic nerve head drusen: a comparison of cases with and without visual field loss. Ophthalmology. 2017;124:66–73.

    Article  Google Scholar 

  18. Malmqvist L, Sibony PA, Fraser CL, Wegener M, Heegaard S, Skougaard M, et al. Peripapillary ovoid hyperreflectivity in optic disc edema and pseudopapilledema. Ophthalmology. 2018;125:1662–4.

  19. Auw-Haedrich C, Staubach F, Witschel H. Optic disk drusen. Surv Ophthalmol. 2002;47:515–32.

    Article  Google Scholar 

  20. Lee KM, Woo SJ, Hwang JM. Peripapillary hyperreflective ovoid mass-like structures: is it optic disc drusen or not? J Neuroophthalmol. 2018;38(4):567–8.

  21. Savino PJ, Glaser JS, Rosenberg MA. A clinical analysis of pseudopapilledema. II. Visual field defects. Arch Ophthalmol. 1979;97:71–5.

    CAS  Article  Google Scholar 

  22. Gili P, Flores-Rodriguez P, Martin-Rios MD, Carrasco Font C. Anatomical and functional impairment of the nerve fiber layer in patients with optic nerve head drusen. Graefe’s Arch Clin Exp Ophthalmol. 2013;251:2421–8.

    Article  Google Scholar 

  23. Casado A, Rebolleda G, Guerrero L, Leal M, Contreras I, Oblanca N, et al. Measurement of retinal nerve fiber layer and macular ganglion cell-inner plexiform layer with spectral-domain optical coherence tomography in patients with optic nerve head drusen. Graefe’s Arch Clin Exp Ophthalmol. 2014;252:1653–60.

    Article  Google Scholar 

  24. Cennamo G, Tebaldi S, Amoroso F, Arvanitis D, Breve M, Cennamo G. Optical coherence tomography angiography in optic nerve drusen. Ophthalmic Res. 2018;59:76–80.

    Article  Google Scholar 

Download references

Acknowledgements

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

Funding

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).

Author information

Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Ye Jin Ahn, Yoo Yeon Park & Sun Young Shin

Authors
  1. Ye Jin Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoo Yeon Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sun Young Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

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

Corresponding author

Correspondence to Sun Young Shin.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Ahn, Y.J., Park, Y.Y. & Shin, S.Y. Peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children. Eye 36, 533–539 (2022). https://doi.org/10.1038/s41433-021-01461-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-021-01461-w

Search

Advanced search

Quick links