PHOMS : Neuro-ophthalmology's Challenge

PHOMS can mimic various optic disc diseases, potentially leading to misdiagnosis in clinical settings. Understanding its pathogenesis and clinical signs is crucial for differentiating it from other conditions. This episode discusses the differential diagnoses and how to identify them through imaging techniques. References 1) Heath Jeffery, R. C., & Chen, F. K. (2023). Peripapillary hyperreflective ovoid mass-like structures: Multimodal imaging-A review. Clinical & experimental ophthalmology, 51(1), 67–80. https://doi.org/10.1111/ceo.14182 2)Fraser, J. Alexander MD; Sibony, Patrick A. MD; Petzold, Axel MD, PhD; Thaung, Caroline MB, ChB, DPhil; Hamann, Steffen MD, PhD;  for the ODDS Consortium. Peripapillary Hyper-reflective Ovoid Mass-like Structure (PHOMS): An Optical Coherence Tomography Marker of Axoplasmic Stasis in the Optic Nerve Head. Journal of Neuro-Ophthalmology 41(4):p 431-441, December 2021. | DOI: 10.1097/WNO.0000000000001203 3)Maalej, R., Bouassida, M., Picard, H., Clermont, C. V., & Hage, R. (2024). Are Peripapillary Hyperreflective Ovoid Mass-like Structures with an Elevated Optic Disc Still a Diagnosis Dilemma?. Ophthalmology, S0161-6420(24)00555-4. Advance online publication. https://doi.org/10.1016/j.ophtha.2024.09.007 4)Malmqvist, L., Bursztyn, L., Costello, F., Digre, K., Fraser, J. A., Fraser, C., Katz, B., Lawlor, M., Petzold, A., Sibony, P., Warner, J., Wegener, M., Wong, S., & Hamann, S. (2018). The Optic Disc Drusen Studies Consortium Recommendations for Diagnosis of Optic Disc Drusen Using Optical Coherence Tomography. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 38(3), 299–307. https://doi.org/10.1097/WNO.0000000000000585 5)Lyu, I.J., Park, KA. & Oh, S.Y. Association between myopia and peripapillary hyperreflective ovoid mass-like structures in children. Sci Rep 10, 2238 (2020). https://doi.org/10.1038/s41598-020-58829-3.