Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Data Integration for Future Medicine (DIFUTURE) Consortium, Munich, Germany.
Eur J Neurol. 2021 Dec;28(12). doi: 10.1111/ene.15056. Epub 2021 Aug 25.
Peripapillary hyper-reflective ovoid masslike structures (PHOMS) are a novel finding during retinal optical coherence tomography in patients with multiple sclerosis (MS). To date, there are no data on the occurrence of PHOMS in early MS. The aim of this study was to investigate the frequency of PHOMS in patients with first diagnosed early relapsing-remitting MS (RRMS) and to search for associations of PHOMS with disease patterns in different MS subtypes.
This was a cross-sectional analysis in two different cohorts: cohort 1, consisting of early RRMS patients (n = 349); cohort 2, consisting of patients with primary progressive MS (PPMS) (n = 66) and RRMS (n = 65).
Peripapillary hyper-reflective ovoid masslike structures were detected in 18.3% of patients with early RRMS. The occurrence of PHOMS was not associated with age, disease duration and disability. Investigating clinical patterns and the occurrence of PHOMS (cohort 2), an association of PHOMS with higher Expanded Disability Status Scale measures (PHOMS 4.9, 3.7-6.1; no PHOMS 3.5, 3.0-5.3; p = 0.03) and longer disease durations (PHOMS 6.5 years, 1.9-11.0; no PHOMS 1.0 years, 0.0-4.0, p = 0.0007) was found in patients with PPMS but not RRMS. After p value adjustment, the disease duration appeared to be more relevant (β = 0.16, p = 0.06).
Peripapillary hyper-reflective ovoid masslike structures were found in 18% of patients with early MS. The presence of PHOMS might be associated with disease progression only in PPMS but not RRMS, suggesting that PHOMS might be embedded in neurodegenerative processes.
多发性硬化症（MS）患者视网膜光学相干断层扫描时出现视盘周围高反射卵圆形团块样结构（PHOMS）是一种新的发现。迄今为止，尚无早期 MS 患者发生 PHOMS 的相关数据。本研究旨在调查首次诊断为早期复发缓解型多发性硬化症（RRMS）患者中 PHOMS 的发生率，并寻找 PHOMS 与不同 MS 亚型疾病模式之间的关联。
这是两个不同队列的横断面分析：队列 1，由 349 例早期 RRMS 患者组成；队列 2，由原发性进展型 MS（PPMS）（n=66）和 RRMS（n=65）患者组成。
早期 RRMS 患者中 18.3%检测到视盘周围高反射卵圆形团块样结构。PHOMS 的发生与年龄、疾病持续时间和残疾无关。在研究临床模式和 PHOMS 的发生（队列 2）时，发现 PHOMS 与更高的扩展残疾状态量表（EDSS）评分（PHOMS 4.9，3.7-6.1；无 PHOMS 3.5，3.0-5.3；p=0.03）和更长的疾病持续时间（PHOMS 6.5 年，1.9-11.0；无 PHOMS 1.0 年，0.0-4.0，p=0.0007）相关，这仅见于 PPMS 患者，而 RRMS 患者则不然。在调整 p 值后，疾病持续时间似乎更为相关（β=0.16，p=0.06）。
在 18%的早期 MS 患者中发现了视盘周围高反射卵圆形团块样结构。PHOMS 的存在可能仅与 PPMS 而不是 RRMS 的疾病进展相关，这表明 PHOMS 可能嵌入了神经退行性过程中。
