Peripapillary hyperreflective ovoid mass-like structures—a novel entity as frequent cause of pseudopapilloedema in children
Autor: | Dinah Zur, Ainat Klein, Matias Iglicki, Daphna Mezad-Koursh, Anat Loewenstein, Meira Neudorfer, Sharon Teper Roth, Amir Rosenblatt |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
medicine.diagnostic_test genetic structures business.industry Ultrasound Pseudopapilloedema Drusen medicine.disease eye diseases Article Visual field Lesion 03 medical and health sciences Ophthalmology 0302 clinical medicine Optical coherence tomography 030221 ophthalmology & optometry Optic nerve Medicine Ovoid sense organs medicine.symptom business 030217 neurology & neurosurgery |
Zdroj: | Eye (Lond) |
Popis: | 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. |
Databáze: | OpenAIRE |
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