The Observation of Peripapillary Hyperreflective Ovoid Mass-Like Structures in Adolescents by Swept-Source Optical Coherence Tomography Angiography.

Purpose: To present the swept-source optical coherence tomography angiography (SS-OCTA) characteristics of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in healthy adolescents and evaluate the effects of PHOMS on peripapillary structural and microvascular parameters.

Methods: A total of 218 eyes of 117 healthy adolescents were included. SS-OCTA images centered on the optic nerve head (ONH) were captured on eyes included. Structural characteristics of the ONH were compared between adolescents with or without PHOMS. After a propensity score matching was conducted, the alterations of peripapillary structures and capillaries in adolescents with PHOMS were analyzed.

Results: PHOMS were found in 33.5% of the adolescent eyes. OCTA showed blood flow signals within all PHOMS. Large ONH tilt angle and small cup-to-disc ratio were independent risk factors for PHOMS (P < 0.001), and they were closely related to the size of PHOMS (P < 0.01). Thickened peripapillary retinal nerve fiber layer and elevated radial peripapillary capillary vessel density were observed in adolescents with PHOMS, especially in those with large PHOMS (all P < 0.05).

Conclusions: PHOMS, complex structures containing nerve fibers and vascular networks, were common in adolescents. The presence of PHOMS in healthy individuals was closely related to the structural features of ONH. PHOMS were usually accompanied by congested and dilated nerve fibers and radial peripapillary capillaries.

Translational relevance: This study provides new insights into the composition of PHOMS and their effects on peripapillary structures and capillaries.