Association of peripapillary hyper‐reflective ovoid masslike structures and disease duration in primary progressive multiple sclerosis

Wicklein, Rebecca; Wauschkuhn, Josephine; Giglhuber, Katrin; Kümpfel, Tania; Hemmer, Bernhard; Havla, Joachim; Knier, Benjamin

doi:10.1111/ene.15056

Cited by 11 publications

(19 citation statements)

References 12 publications

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“…With this novel finding and the previous observation of axonal swelling in some patients with MS, the authors suggested PHOMS may be a late sign of axonal damage in patients with MS [12,39]. Another study of patients with MS found a significant association of PHOMS with longer disease duration and higher Expanded Disability Status Scale in patients with primary progressive MS, but not patients early relapsing–remitting MS [34 ▪▪ ]. These results suggest that PHOMS may potentially serve as a marker of disease severity and prognosis.…”

Section: Other Pathologies Associated With Peripapillary Hyperreflect...mentioning

confidence: 63%

An overview of peripapillary hyperreflective ovoid mass-like structures

Chapman

Heidary

Gise

2022

Current Opinion in Ophthalmology

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Purpose of reviewThe purpose of this review is to provide an overview of the ophthalmic findings associated with peripapillary hyperreflective ovoid mass-like structures (PHOMS) in both adult and pediatric patients.Recent findingsPHOMS have recently been identified in a number of different ophthalmic disease entities ranging from nonpathologic to pathologic, including but not limited to anatomic abnormalities (tilting in myopia), optic nerve head drusen, optic disc edema from inflammation (optic neuritis, white dot syndromes), vascular insults (ischemic optic neuropathy, retinal vascular occlusion), and papilledema. The mechanism underlying the formation of PHOMS has not been fully elucidated although it has been hypothesized that PHOMS occur secondary to axoplasmic stasis from crowding at the optic nerve head.SummaryAlthough the clinical significance of the presence of PHOMS remains unclear, PHOMS are associated with several disease processes. Understanding the mechanism behind their formation and their impact on optic nerve head structure and visual function may be relevant in patients with optic nerve head pathology. The presence of PHOMS may also correlate with disease severity and duration. Future studies to evaluate whether the formation of PHOMS may be useful as an early indicator of disease or a prognostic tool are warranted.

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Section: Other Pathologies Associated With Peripapillary Hyperreflect...mentioning

confidence: 63%

An overview of peripapillary hyperreflective ovoid mass-like structures

Chapman

Heidary

Gise

2022

Current Opinion in Ophthalmology

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“…All retinal scans were performed using a SPECTRALIS spectral domain (SD) OCT with automated eye tracking (OCT2-Module, Heidelberg Engineering as described before [ 3 , 6 ]). Retinal layer segmentation was performed by the Heyex v2.5.5 (LMU) and Heyex v2.5.4 (TUM) software.…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, as a very new OCT marker, PHOMS have already been investigated in various neurological diseases including multiple sclerosis (MS). Here, a prevalence of PHOMS positivity was shown in 16–18% of patients [ 2 , 3 ]. However, data on the prevalence of PHOMS in other inflammatory cerebral nervous system (CNS) disorders are lacking and little is known about the PHOMS frequency in adult healthy controls (HC).…”

Section: Introductionmentioning

confidence: 99%

Peripapillary hyper-reflective ovoid mass-like structures (PHOMS) in AQP4-IgG-positive neuromyelitis optica spectrum disease (NMOSD) and MOG-IgG-associated disease (MOGAD)

Gernert¹,

Wicklein

Hemmer

et al. 2022

J Neurol

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Background Peripapillary hyperreflective ovoid mass-like structures (PHOMS) have recently been described as new optical coherence tomography (OCT) marker. It is not yet clear whether the occurrence of PHOMS is disease-specific or disease-spanning. PHOMS have been described in 16–18% of patients with multiple sclerosis (MS). Currently, no data on the prevalence of PHOMS in other demyelinating diseases including aquaporine-4-IgG-positive neuromyelitis optica spectrum disease (AQP4 + NMOSD) or myelin oligodendrocyte glycoprotein-IgG-associated disease (MOGAD) are reported. Methods We performed a cross-sectional, retrospective spectral domain OCT study evaluating the frequency of PHOMS in AQP4 + NMOSD (n = 47) and MOGAD (n = 44) patients. To test the association with retinal neuroaxonal damage, we compared demographic and clinical data as well as retinal layer thicknesses between eyes with vs. eyes without PHOMS. Results PHOMS were detected in 17% of AQP4 + NMOSD and 14% of MOGAD patients. Intra-cohort analysis revealed that AQP4 + NMOSD patients with PHOMS were significantly older [mean (years): 57.5 vs. 50.0; p value = 0.04]. We found no association of PHOMS with retinal neuroaxonal degeneration. In addition, in subjects with only one eye affected by PHOMS compared with the unaffected fellow eye, no differences in retinal parameters were observed (n = 4). Conclusions In summary, we found PHOMS in 17% of AQP4 + NMOSD and 14% of MOGAD patients. This is comparable to the prevalence of published MS PHOMS data. Therefore, a disease-specific occurrence of PHOMS is unlikely. Interestingly, PHOMS do not seem to depend on retinal neuroaxonal degeneration.

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“…A recent paper described peripapillary hyper-reflective ovoid mass-like structures (PHOMS) as a novel OCT finding that might be noted in people with early MS. Their presence suggests disease progression; however, more research is needed to support these results [ 39 ].…”

Section: Optical Coherence Tomography In Multiple Sclerosismentioning

confidence: 99%

Optical Coherence Tomography and Optical Coherence Tomography with Angiography in Multiple Sclerosis

et al. 2022

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Multiple sclerosis (MS) is an inflammatory and neurodegenerative, potentially disabling disease of the central nervous system. OCT (Optical Coherence Tomography) and OCT-A (Optical Coherence Tomography with Angiography) are imaging techniques for the retina and choroid that are used in the diagnosis and monitoring of ophthalmological conditions. Their use has recently expanded the study of several autoimmune disorders, including MS. Although their application in MS remains unclear, the results seem promising. This review aimed to provide insight into the most recent OCT and OCT-A findings in MS and may function as a reference point for future research. According to the current literature, the retinal nerve fibre layer (RNFL) and ganglion cell-inner plexiform complex (GC-IPL) are significantly reduced in people with MS and are inversely correlated with disease duration. The use of OCT might help distinguish between MS and neuromyelitis optica spectrum disorders (NMOSD), as the latter presents with more pronounced thinning in both the RNFL and GC-IPL. The OCT-A findings in MS include reduced vessel density in the macula, peripapillary area, or both, and the enlargement of the foveal avascular zone (FAZ) in the setting of optic neuritis. Additionally, OCT-A might be able to detect damage in the very early stages of the disease as well as disease progression in severe cases.

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Association of peripapillary hyper‐reflective ovoid masslike structures and disease duration in primary progressive multiple sclerosis

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 11 publications

References 12 publications

An overview of peripapillary hyperreflective ovoid mass-like structures

An overview of peripapillary hyperreflective ovoid mass-like structures

Peripapillary hyper-reflective ovoid mass-like structures (PHOMS) in AQP4-IgG-positive neuromyelitis optica spectrum disease (NMOSD) and MOG-IgG-associated disease (MOGAD)

Optical Coherence Tomography and Optical Coherence Tomography with Angiography in Multiple Sclerosis

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