Peripapillary Hyperreflective Ovoid Mass-like Structures (PHOMS) in Children: The Copenhagen Child Cohort 2000 Eye Study

center dot PURPOSE: To determine the prevalence of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in a population-based child cohort and to study their associ-ation with other optic nerve head features and myopia.center dot DESIGN: Observational, population-based cohort study of 1407 children aged 11-12 years.center dot METHODS: Optical coherence tomography scans of op-tic nerve heads were graded for PHOMS, disc tilt, prelam-inar hyperreflective lines, and scleral canal diameter and investigated for associated prenatal and ocular parame-ters. Children with optic disc drusen or optic disc edema were excluded.center dot RESULTS: PHOMS were found in 8.9% of children. The location of PHOMS was predominantly in the super-onasal section of the optic disc. Myopia and optic nerve head tilt were more common in children with PHOMS than in children without PHOMS ( P < .001 and P < .001, respectively). Prelaminar hyperreflective lines were found in 17.9% of children with PHOMS compared to 7.3% of children without PHOMS ( P < .001). Prelami-nar hyperreflective lines with and without PHOMS were associated with a shorter axial length of the eye ( P < .001). There were no prenatal factors associated with PHOMS. Prelaminar hyperreflective lines were associ-ated with higher birth weight and continued maternal smoking during pregnancy ( P = .01 and P = .02, respec-tively).center dot CONCLUSIONS: PHOMS had a prevalence of 8.9% in healthy children without optic disc drusen or op-tic disc edema and was associated with increasing myopic refraction and the presence of a tilted op-tic nerve head and prelaminar hyperreflective lines.Given the high prevalence of PHOMS, they should not unreservedly be taken as evidence of optic neu-ropathy. (Am J Ophthalmol 2023;245: 212-221. (c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ ))

Automated summary

This study examined the prevalence of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in a population-based child cohort and explored their association with other optic nerve head features and myopia.