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Association of Peripapillary Hyper-Reflective Ovoid Masslike Structures and Disease Duration in Primary Progressive Multiple Sclerosis.

Eur J Neurol. 2021 Aug 9. doi: 10.1111/ene.15056. Epub ahead of print. PMID: 34374178.

Authors/Editors: Wicklein R, Wauschkuhn J, Giglhuber K, Kümpfel T, Hemmer B, Havla J, Knier B.
Publication Date: 2021


Background: Peripapillary hyper-reflective ovoid masslike structures (PHOMS) are a novel finding during retinal optical coherence tomography (OCT) in patients with multiple sclerosis (MS). To date, there is 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 firstly diagnosed early relapsing remitting MS (RRMS) and to search for associations of PHOMS with disease patterns in different MS subtypes.

Methods: 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).

Results: PHOMS 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), we saw an association of PHOMS with higher expanded disability status scale (EDSS) 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) in patients with PPMS but not RRMS. After p-value adjustment, the disease duration appeared to be more relevant (ß=0.16, p=0.06).

Conclusion: We found PHOMS in 18% of patients with early MS. Presence of PHOMS might be associated with disease progression only in PPMS but not RRMS, suggesting that PHOMS might be embedded in neurodegenerative processes.

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