目的:观察和分析PHOMS患者的临床和多模式影像学特征,并介绍两例进行多模式成像的PHOMS。
方法:回顾性临床观察性研究。2019年1月至2021年6月在山东眼科医院进行检查和诊断的共有26例患者(37只眼),这些患者的高反射结构被视盘周围的低反射边缘包围。在这些患者中,男性12人,女性14人。15个是单眼的。平均年龄为39岁。所有患者均接受以下检查:最佳矫正视力(BCVA),眼压检查,裂隙灯眼前节检查,间接检眼镜,视野检查,眼底彩色摄影,眼底自发荧光(FAF),光学相干断层扫描(OCT),光学相干断层扫描血管造影(OCTA)。一些患者接受了荧光素眼底血管造影(FFA)检查。OCT的临床数据和影像学特征,OCTA,和FFA进行回顾性分析。
结果:我们在37只眼睛的视盘周围发现了被低反射边缘包围的超反射结构。EDI-OCT结果显示,所有眼睛的视盘周围都被低反射边缘包围的高反射结构。典型的反射亢进病变发生在视盘周围,位于皮下和布鲁赫膜上方。OCTA显示高反射周光材料也具有血管结构。
结论:PHOMS的EDI-OCT显示所有视盘周围被低反射边缘包围的高反射结构。红外摄影显示颞部反射亢进。这些特征可以在多种疾病中看到,并且可能是EDI-OCT扫描所揭示的相对常见的特征。这些特征也可以在老年患者以及儿童中看到。PHOMS可能存在于视盘玻璃疣(ODD)中,椎间盘倾斜综合征(TDS),视神经炎,缺血性视神经病变,在白点综合症中。很少有患者可能发展为黄斑新生血管(MNV)。为了提高结论的准确性和稳健性,提供更好的临床指导,我们需要在后续的临床工作中进行更全面的研究。
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.