Abstract

Volume.126 Number.7

Original article : Case report

A Case of Peripapillary Hyperreflective Ovoid Mass-like Structures (PHOMS) with Optic Disc Hemorrhage
Teruaki Tokuhisa1, Takaaki Hayashi1, Reimi Nishijima1, Tadashi Nakano2
1 Department of Ophthalmology, The Jikei University School of Medicine, Katsushika Medical Center
2 Department of Ophthalmology, The Jikei University School of Medicine

Purpose: We report a patient with peripapillary hyperreflective ovoid mass-like structures (PHOMS) who had optic disc hemorrhage in the right eye.
Case: A 12-year-old female visited our department with complaints of floater and optic disc hemorrhage in her right eye. She had bilateral optic disc swelling and hemorrhage spreading radially from the optic disc in her right eye, and was diagnosed with intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH). A detailed neurosurgical examination showed no abnormalities, and then we suspected pseudopapilledema. Optic disc hemorrhage was spontaneously absorbed, and the optic disc swelling also improved. Subsequent optical coherence tomography (OCT) revealed PHOMS, which are oval-shaped high-intensity lesions, all around the optic disc in both eyes. The PHOMS were more clearly observed on the nasal side compared to the temporal side, and were located on the vitreous side of the Bruch membrane opening (BMO) and the lateral side of the optic nerve head. On the other hand, the PHOMS at the temporal side were located from the BMO toward the center of the optic nerve head. OCT angiography (OCTA) revealed flow signals within the PHOMS. Late-phase fluorescein angiography also showed hyperfluorescent images on the part of temporal and nasal sides of the optic nerve head in both eyes.
Conclusions: To our knowledge, this is the first case report of PHOMS in a female child in Japan. IHAPSH may be associated with the presence of PHOMS.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 642-650, 2022.

Key words
Peripapillary hyperreflective ovoid mass-like structures (PHOMS), Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH), Pseudopapilledema, Optical coherence tomography (OCT), OCT angiography (OCTA)
Reprint requests to
Teruaki Tokuhisa, M. D. Department of Ophthalmology, The Jikei University School of Medicine, Katsushika Medical Center. 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan