目的：分析合并视盘周围强反射卵圆形肿块样结构(PHOMS)患眼临床特征及多模式影像特征。

方法：回顾性观察研究。收集2020年1月至2024年3月于南京医科大学眼科医院检查确诊合并PHOMS患者35例56眼。所有患者均行眼底照相、荧光素眼底血管造影、自发荧光、光学相干断层扫描和B超检查。

结果：PHOMS见于不同年龄段，发病隐匿，常因眼科检查时被发现。因视物模糊来院诊断屈光不正者较多。眼底照相上视盘边界模糊，鼻侧隆起更为显著，呈“C”形光晕。自发荧光检查未见明显异常荧光，荧光素眼底血管造影检查示造影早期、中期未见明显异常荧光。光学相干断层扫描示不同扫描部位视盘不同程度隆起，视盘鼻侧垂直扫描PHOMS结构形态显示最佳，可见突入视网膜神经纤维层下、Bruch膜上，边界清晰卵圆形稍强反射结构，对下方脉络膜无遮挡效应，隆起程度越高、体积越大。B超检查所有患眼可见眼球后壁视盘前隆起结构，其内无强信号回声。

结论：PHOMS存在于近视患者，大部分患者无症状，部分患者表现为黑影飘动及一过性视力下降，视盘鼻侧强反射卵圆形肿块样结构是OCT上最典型表现。

METHODS: Retrospective observation study. Totally 35 patients(56 eyes)with PHOMS that diagnosed in the Affiliated Eye Hospital of Nanjing Medical University from January 2020 to March 2024 were included in the study. All patients underwent fundus photography, fundus fluorescein angiography, fundus autofluorescence, optical coherence tomography, and B-ultrasound.

RESULTS:PHOMS occurred across diverse age groups, with an insidious onset often detected incidentally during routine ophthalmic examinations. More patients came to hospital for refractive errors due to blurred vision The boundary of the optic disc is blurred on fundus photography, and the nasal eminence is more significant, showing a “C” shaped halo. No obvious abnormal fluorescence was observed on fundus autofluorescence and fundus fluorescein angiography during different periods. An elevated appearance in vary degrees with more prominent in the nasal parts was showed on different OCT scans. Vertical scanning on the nasal side of the optic disc showed the best PHOMS structure, which could be seen under the retinal nerve fiber layer and on the Bruch membrane, with sharply marginated hyper-reflective ovoid mass-like structures, and no shielding effect on the choroid. The higher the elevation, the larger the volume. Ocular B-mode ultrasound showed a pre-optic disc bulge on the posterior wall of the eyeball, and there was no strong signal echo in it.

CONCLUSION:PHOMS can be found frequently in myopic patients and often asymptomatic. Transient vision loss and floaters may occur in symptomatic cases. The most typical OCT feature is a nasally located hyper-reflective ovoid structure with distinct margins.