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Are PHOMS a clinical sign of optic neuritis?



Assess the prevalence and evolution of PHOMS in optic neuritis.


We analysed the medical files of 126 patients included in the OCTON cohort. Patients’ medical files, digital retinal images and OCT examinations were reviewed, searching for optic nerve head oedema and PHOMS at the initial presentation and during the follow-up.


We included 102 patients in the final analysis. Twenty-nine (29) eyes had optic nerve head oedema at the initial presentation. PHOMS were found to be present in 8 eyes affected with optic neuritis. All cases of PHOMS were associated with optic nerve head oedema. All the PHOMS decreased in size and disappeared with the improvement of the oedema.


Our results show that PHOMS is not a common sign of optic neuritis. We didn’t observe any case of PHOMS in the absence of optic nerve head oedema in eyes with optic neuritis. PHOMS seem to be a rare sign of optic neuritis associated to optic nerve head oedema, and they tend to disappear with the improvement of the optic nerve head oedema. We suggest that the presence of PHOMS in optic neuritis eyes with no optic nerve oedema should be a considered warning sign.

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Fig. 1: Flow chart of the study.
Fig. 2: Optical coherence tomography image of a PHOMS found in a left eye affected by optic neuritis.
Fig. 3: Optical coherence tomography image of an eye affected with PHOMS and its resolution.

Data availability

The datasets generated during and/or analysed during the current study are not publicly available due to the privacy of medical files but are available from the corresponding author on reasonable request.


  1. 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 

  2. Pichi F, Romano S, Villani E, Lembo A, Gilardoni F, Morara M, et al. Spectral-domain optical coherence tomography findings in pediatric tilted disc syndrome. Graefes Arch Clin Exp Ophthalmol. 2014;252:1661–7.

    Article  Google Scholar 

  3. Petzold A, Biousse V, Bursztyn L, Costello F, Crum A, Digre K, et al. Multirater validation of peripapillary hyperreflective ovoid mass-like structures (PHOMS). Neuroophthalmology. 2020;44:1–2.

    Article  Google Scholar 

  4. Fraser JA, Sibony PA, Petzold A, Thaung C, Hamann S, ODDS Consortium. Peripapillary hyper-reflective ovoid mass-like structure (PHOMS): an optical coherence tomography marker of axoplasmic stasis in the optic nerve head. J Neuroophthalmol. 2021;41:431–41.

    Article  Google Scholar 

  5. Petzold A, Coric D, Balk LJ, Hamann S, Uitdehaag BMJ, Denniston AK, et al. Longitudinal development of peripapillary hyper-reflective ovoid masslike structures suggests a novel pathological pathway in multiple sclerosis. Ann Neurol. 2020;88:309–19.

    Article  Google Scholar 

  6. Deschamps R, Shor N, Vignal C, Guillaume J, Boudot de la Motte M, Salviat F, et al. Prospective longitudinal study on prognostic factors of visual recovery and structural change after a first episode of optic neuritis. Eur J Neurol. 2022;29:2781–91.

    Article  Google Scholar 

  7. Gala F. Magnetic resonance imaging of optic nerve. Indian J Radiol Imaging. 2015;25:421–38.

    Article  Google Scholar 

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The authors would like to thank David Pena-Guzman, PhD, for his advice and contribution in finalising the manuscript.

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Authors and Affiliations



AA, MP, RD, CV, and RH: design and conduct of the study. AA: data collection. AA and RH: data analysis and interpretation. AA and RH: writing of the manuscript. AA, MP, RD, CV, and RH: critical review and final approval of the manuscript.

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Correspondence to Ahmed Aziria.

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The authors declare no competing interests.

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Aziria, A., Philibert, M., Deschamps, R. et al. Are PHOMS a clinical sign of optic neuritis?. Eye (2023).

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