[关键词]
[摘要]
视盘周围卵状团块样强反射结构(PHOMS)是2018年基于光相干断层扫描增强深部成像(EDI-OCT)提出的新定义。其位于视盘之外、Bruch膜开口(BMO)处上方、卵形、是与视网膜神经纤维层的反射相似的团块状均质结构。既往认为该结构是埋藏型视盘玻璃疣，目前主流观点倾向于PHOMS是视盘周围神经纤维轴突的膨出，提示视神经纤维轴浆流受阻。本文通过PHOMS这一概念提出的原因，辨析了其与视盘玻璃疣(ODD)之间关系，探讨了可能的组织病理机制，总结PHOMS在眼底多模影像上与其他影像特征之间的区别，分析PHOMS在不同疾病中的临床表现及可能的病理生理机制，这对更好地理解神经眼科相关疾病，如近视视神经病变、视神经炎有着重要的意义。此外，本文还提出PHOMS未来可能的研究方向，以获得对PHOMS及其相关疾病的新认识。
[Key word]
[Abstract]
Peripapillary hyper-reflective ovoid mass-like structure(PHOMS)is a new finding in 2018, which is based on the enhanced-depth imaging optical coherence tomography(EDI-OCT). A PHOMS is peripapillary in location, situated just above the lip of Bruch membrane open(BMO), and it is an ovoid, mass-like homogeneous structure similar to the hyper-reflectiveretinal nerve fiber layer. Although previously assumed to represent a form of buried optic disc drusen(ODD), the prevailing view is that PHOMS is the bulge of the axons of optic nerve fibers and a marker of axoplasmic stasis in the optic nerve fibers. This article describes the reasons for the concept of PHOMS, identifies its relationship with ODD, and discusses the possible histopathological mechanisms. In addition, we detail the differences between PHOMS on fundus multimodal images and other imaging features and explore the clinical manifestations and possible pathophysiological mechanisms of PHOMS in different diseases, which are important for a better understanding of neuro-ophthalmic related diseases such as myopic optic neuropathy and optic neuritis. Furthermore, we propose possible future research directions for PHOMS to gain new insights into PHOMS and its related diseases.
[中图分类号]
[基金项目]
武汉市中心医院学科基金项目(No.2021XK017)
