Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Longitudinal Development of Peripapillary Hyper-Reflective Ovoid Masslike Structures Suggests a Novel Pathological Pathway in Multiple Sclerosis

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. MRI in Neuromuscular Diseases: An Emerging Diagnostic Tool and Biomarker for Prognosis and Efficacy

    Research output: Contribution to journalReviewpeer-review

  2. Optic Disc Classification by Deep Learning versus Expert Neuro-Ophthalmologists

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. A New Glycogen Storage Disease Caused by a Dominant PYGM Mutation

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Neuroinflammatory markers associate with cognitive decline after major surgery: findings of an explorative study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Early Intrathecal T Helper 17.1 Cell Activity in Huntington Disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Ipsilateral Recurrence of Optic Disc Drusen-Associated Anterior Ischemic Optic Neuropathy in a 15-Year-Old Boy

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Optic disc drusen diagnosed by optical coherence tomography in a 3-year-old child

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Multiplexed optical coherence tomography imaging of optic disc drusen

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Optic Disc Classification by Deep Learning versus Expert Neuro-Ophthalmologists

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Axel Petzold
  • Danko Coric
  • Lisanne J Balk
  • Steffen Hamann
  • Bernard M J Uitdehaag
  • Alastair K Denniston
  • Pearse A Keane
  • David P Crabb
View graph of relations

OBJECTIVE: Peripapillary hyper-reflective ovoid masslike structures (PHOMS) are a new spectral domain optical coherence tomography (OCT) finding.

METHODS: This prospective, longitudinal study included patients (n = 212) with multiple sclerosis (MS; n = 418 eyes), 59 healthy controls (HCs; n = 117 eyes), and 267 non-MS disease controls (534 eyes). OCT and diffusion tensor imaging were used.

RESULTS: There were no PHOMS in HC eyes (0/117, 0%). The prevalence of PHOMS was significantly higher in patients with MS (34/212, p = 0.001) and MS eyes (45/418, p = 0.0002) when compared to HCs (0/59, 0/117). The inter-rater agreement for PHOMS was 97.9% (kappa = 0.951). PHOMS were present in 16% of patients with relapsing-remitting, 16% of patients with progressive, and 12% of patients with secondary progressive disease course (2% of eyes). There was no relationship of PHOMS with age, disease duration, disease course, disability, or disease-modifying treatments. The fractional anisotropy of the optic radiations was lower in patients without PHOMS (0.814) when compared to patients with PHOMS (0.845, p = 0.03). The majority of PHOMS remained stable, but increase in size and de novo development of PHOMS were also observed. In non-MS disease controls, PHOMS were observed in intracranial hypertension (62%), optic disc drusen (47%), anomalous optic discs (44%), isolated optic neuritis (19%), and optic atrophy (12%).

INTERPRETATION: These data suggest that PHOMS are a novel finding in MS pathology. Future research is needed to determine whether development of PHOMS in MS is due to intermittently raised intracranial pressure or an otherwise impaired "glymphatic" outflow from eye to brain. ANN NEUROL 2020;88:309-319.

Original languageEnglish
JournalAnnals of Neurology
Volume88
Issue number2
Pages (from-to)309-319
Number of pages11
ISSN0364-5134
DOIs
Publication statusPublished - Aug 2020

    Research areas

  • Adult, Female, Follow-Up Studies, Humans, Longitudinal Studies, Magnetic Resonance Imaging/trends, Male, Middle Aged, Multiple Sclerosis/complications, Optic Disk/diagnostic imaging, Prospective Studies, Retrospective Studies, Tomography, Optical Coherence/trends

ID: 61987412