PMID- 32616868
OWN - NLM
STAT- MEDLINE
DCOM- 20210705
LR  - 20221206
IS  - 1476-5454 (Electronic)
IS  - 0950-222X (Print)
IS  - 0950-222X (Linking)
VI  - 35
IP  - 4
DP  - 2021 Apr
TI  - Peripapillary hyperreflective ovoid mass-like structures-a novel entity as 
      frequent cause of pseudopapilloedema in children.
PG  - 1228-1234
LID - 10.1038/s41433-020-1067-x [doi]
AB  - BACKGROUND: Optic nerve head drusen (ONHD) are considered the most common cause 
      for pseudopapilloedema in children. We aimed to investigate and further 
      characterize a new type of optic nerve head lesion on enhanced depth imaging 
      optical coherence tomography (EDI-OCT) named peripapillary hyperreflective ovoid 
      mass-like structures (PHOMS), and ONHD in asymptomatic children with 
      pseudopapilloedema. METHODS: Retrospective cohort study including 64 eyes from 32 
      patients with pseudopapilloedema due to PHOMS and/or ONHD. Mean age was 9.0 +/- 3.1 
      years. PHOMS and ONHD were identified and classified on EDI-OCT and infrared 
      images. Ultrasound images were classified for the presence of hyperechogenic 
      structures of the optic nerve head. RESULTS: On EDI-OCT, PHOMS were detected in 
      63 out of 64 eyes (98.4%). In 60 eyes (93.8%), small hyperreflective foci inside 
      the PHOMS were present. In all cases, we identified a new ring sign visible on 
      infrared images, corresponding clearly to the edge of the PHOMS as seen on 
      EDI-OCT. On ultrasound, we describe a new feature of PHOMS appearing as small 
      hyperechogenic structures without posterior shadowing. In 13 eyes (20.3%), ONHD 
      were present on EDI-OCT and ultrasound. CONCLUSION: This is the first study 
      showing that PHOMS are the most common cause for pseudopapilloedema in children. 
      PHOMS is a new entity of optic nerve head lesions. It might be a precursor of 
      buried optic nerve head drusen, which can lead to visual field defects, 
      haemorrhages and CNV. This study offers new tools to identify and follow-up these 
      lesions early in childhood using EDI-OCT.
FAU - Mezad-Koursh, Daphna
AU  - Mezad-Koursh D
AUID- ORCID: 0000-0002-7799-9022
AD  - Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Klein, Ainat
AU  - Klein A
AD  - Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Rosenblatt, Amir
AU  - Rosenblatt A
AD  - Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Teper Roth, Sharon
AU  - Teper Roth S
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Neudorfer, Meira
AU  - Neudorfer M
AD  - Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Loewenstein, Anat
AU  - Loewenstein A
AD  - Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Iglicki, Matias
AU  - Iglicki M
AD  - Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina.
FAU - Zur, Dinah
AU  - Zur D
AUID- ORCID: 0000-0003-1147-444X
AD  - Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 
      dinahzur@gmail.com.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 
      dinahzur@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20200702
PL  - England
TA  - Eye (Lond)
JT  - Eye (London, England)
JID - 8703986
RN  - Pseudopapilledema
SB  - IM
CIN - Eye (Lond). 2022 Oct;36(10):2068. PMID: 35066578
MH  - Child
MH  - Child, Preschool
MH  - *Eye Diseases, Hereditary/diagnostic imaging
MH  - Humans
MH  - *Optic Disk Drusen/diagnostic imaging
MH  - *Optic Nerve Diseases
MH  - Retrospective Studies
MH  - Tomography, Optical Coherence
PMC - PMC8115042
COIS- The authors declare that they have no conflict of interest.
EDAT- 2020/07/04 06:00
MHDA- 2021/07/06 06:00
PMCR- 2022/04/01
CRDT- 2020/07/04 06:00
PHST- 2020/01/01 00:00 [received]
PHST- 2020/06/23 00:00 [accepted]
PHST- 2020/06/20 00:00 [revised]
PHST- 2020/07/04 06:00 [pubmed]
PHST- 2021/07/06 06:00 [medline]
PHST- 2020/07/04 06:00 [entrez]
PHST- 2022/04/01 00:00 [pmc-release]
AID - 10.1038/s41433-020-1067-x [pii]
AID - 1067 [pii]
AID - 10.1038/s41433-020-1067-x [doi]
PST - ppublish
SO  - Eye (Lond). 2021 Apr;35(4):1228-1234. doi: 10.1038/s41433-020-1067-x. Epub 2020 
      Jul 2.