Xie Xiao, Liu Tingting, Wang Wenqi, Tian Ge, Wang Jinyan, Guan Jitian, Chen Meng, Wang Xunchang, Zhou Qingjun
The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, China.
Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China.
Front Med (Lausanne). 2022 Feb 9;9:796667. doi: 10.3389/fmed.2022.796667. eCollection 2022.
To observe and analyze the clinical and multi-mode imaging features of eyes with PHOMS, and to introduce two cases of PHOMS which underwent multi-mode imaging.
Retrospective clinical observational study. A total of 26 patients (37 eyes) with hyperreflective structures surrounded by hyporeflective edges around the optic discs who were examined and diagnosed at Shandong Eye Hospital between January 2019 and June 2021 were included in the study. Among these patients, 12 were male and 14 were female. Fifteen were monocular. The average age was 39 years. All patients underwent the following examinations: Best-corrected visual acuity (BCVA), intraocular pressure examinations, slit-lamp anterior segment examinations, indirect ophthalmoscopy, visual field examinations, fundus color photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA). Some of the patients were examined with fundus fluorescein angiography (FFA). Clinical data and imaging characteristics from the OCT, OCTA, and FFA were analyzed retrospectively.
We found the hyperreflective structures surrounded by hyporeflective edges around the optic discs in 37 eyes. EDI-OCT results revealed hyperreflective structures surrounded by hyporeflective edges around the optic discs in all eyes. Typical hyperreflexia lesions occurred around the optic disc, located subretinally and above Bruch's membrane. OCTA revealed that the highly reflective perioptic material also had vascular structures.
EDI-OCT of PHOMS showed hyperreflective structures surrounded by hyporeflective edges around all of the optic discs. Infra-red photography showed temporal hyperreflexia. These characteristics can be seen in a variety of diseases and may be a relatively common feature revealed by EDI-OCT scanning. These characteristics may also be seen in elderly patients as well as children. PHOMS may be found in optic disc drusen (ODD), tilted disc syndrome (TDS), optic neuritis, ischemic optic neuropathy, and in white dot syndromes. Few patients may be developed into macular neovascularization (MNV). In order to improve the accuracy and robustness of the conclusions and provide better clinical guidance, we need to conduct more comprehensive research in the subsequent clinical work.
观察并分析疑似病理性高反射性黄斑周围病变（PHOMS）患者眼睛的临床及多模式成像特征，并介绍两例接受多模式成像检查的PHOMS患者。
回顾性临床观察研究。纳入2019年1月至2021年6月期间在山东眼科医院检查并诊断为视盘周围存在低反射边缘环绕的高反射结构的26例患者（37只眼）。其中男性12例，女性14例。15例为单眼发病。平均年龄39岁。所有患者均接受了以下检查：最佳矫正视力（BCVA）、眼压检查、裂隙灯眼前节检查、间接检眼镜检查、视野检查、眼底彩色照相、眼底自发荧光（FAF）、光学相干断层扫描（OCT）以及光学相干断层扫描血管造影（OCTA）。部分患者还接受了眼底荧光血管造影（FFA）检查。对OCT、OCTA和FFA的临床数据及成像特征进行回顾性分析。
我们在37只眼中发现视盘周围存在低反射边缘环绕的高反射结构。增强深度成像光学相干断层扫描（EDI-OCT）结果显示所有眼中视盘周围均存在低反射边缘环绕的高反射结构。典型的高反射病变发生在视盘周围，位于视网膜下及布鲁赫膜上方。OCTA显示高反射的视盘周围物质也有血管结构。
PHOMS的EDI-OCT显示所有视盘周围均存在低反射边缘环绕的高反射结构。红外照相显示颞侧高反射。这些特征可见于多种疾病，可能是EDI-OCT扫描显示的相对常见特征。这些特征在老年患者及儿童中也可能出现。PHOMS可见于视盘玻璃膜疣（ODD）、倾斜盘综合征（TDS）、视神经炎、缺血性视神经病变以及白点综合征。少数患者可能发展为黄斑新生血管（MNV）。为提高结论的准确性和可靠性并提供更好的临床指导，我们需要在后续临床工作中开展更全面的研究。
