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Neuro-Ophthalmology Volume 44, 2020 - Issue 6
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Letter to the Editor

Multirater Validation of Peripapillary Hyperreflective Ovoid Mass-like Structures (PHOMS)

Axel Petzolda Moorfields Eye Hospital NHS Foundation Trust and the National Hospital for Neurology and Neurosurgery, Queen Square, Institute of Neurology, University College London, London, UK;b Neurology and Ophthalmology, Amsterdam UMC, Locatie VUMC, Amsterdam, NetherlandsCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-0344-9749
ORCID Icon,
Valerie Bioussec Ophthalmology, Emory University, Atlanta, Georgia, USA
,
Lulu Bursztynd Western University, London, Ontario, Canada
,
Fiona Costelloe Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
,
Alison Crumf Utah System of Higher Education, Salt Lake City, Utah, USA
,
Kathleen Digreg Department of Neurology-Ophthalmology and Visual Science, John Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
,
Clare Fraserh Save Sight Institute, The University of Sydney, Sydney, North South Wales, AustraliaORCID Iconhttps://orcid.org/0000-0002-0379-7743
ORCID Icon,
J. Alex Fraseri Department of Clinical Neurological Sciences and Department of Ophthalmology, Western University, London, Ontario, Canada
,
Bradley Katzf Utah System of Higher Education, Salt Lake City, Utah, USA
,
Neringa Jurkutej Institute of Ophthalmology, UCL, London, UK
,
Nancy Newmank Department of Neuro-Ophthalmology, Emory University, School of Medicine, Atlanta, Georgia, USA
,
Jette Lautrup-Battistinil Copenhagen University Hospital Glostrup, Denmark
,
Mitchell Lawlorh Save Sight Institute, The University of Sydney, Sydney, North South Wales, Australia
,
Petra Liskovam Ophthalmology, Charles University, Prague, Czech Republic
,
Birgit Lorenzn Ophthalmology, Justus Liebig University, Giessen, Germany
,
Lasse Malmqvisto Ophthalmology, Rigshospitalet Glostrup, Denmark
,
Jason Peragalloc Ophthalmology, Emory University, Atlanta, Georgia, USA
,
Patrick Sibonyp Stony Brook University, Stony Brook, New York, USA
,
Prem Subramanianq Sue Anschutz-Rodgers UC Health Eye Center, University of Colorado School of Medicine, Aurora, Colorado, USA
,
Robert Rejdakr Department of General Opthalmology, Medical University, Lublin, PolandORCID Iconhttps://orcid.org/0000-0003-3321-2723
ORCID Icon,
Katarzyna Nowomiejskar Department of General Opthalmology, Medical University, Lublin, Poland
,
Valerie Touitous Groupe Hospitalier La Pitié Salpêtrière-Charles Foix, DHU Vision Et Handicaps, Paris, France
,
Judith Warnert Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
,
Marianne Wegenero Ophthalmology, Rigshospitalet Glostrup, Denmark
,
Sui Wongu Moorfields Eye Hospital City Road Campus, London, UK
,
Patrick Yu-Wai-Manv Cambridge University, Cambridge, UK;w Moorfields Eye Hospital NHS, Foundation Trust, Medical Retina, London, UK
&
Steffen Hamannx Ophthalmology, ODDS Consortium and ERN-EYE Rigshospitalet Glostrup, Denmark
 show all
Pages 413-414 | Received 07 Mar 2020, Accepted 22 Apr 2020, Published online: 16 Jul 2020
 
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ABSTRACT

Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are a new retinal optical coherence tomography (OCT) finding. The Optic Disc Drusen Studies Consortium had made recommendations to distinguish PHOMS from true optic disc drusen (ODD) in 2018. While publications on PHOMS have increased since then, the accuracy of the definition of PHOMS and reliability of detection is unknown. In this multi-rater study, we demonstrate that the 2018 definition of PHOMS resulted in a poor multi-rater kappa of 0.356. We performed a Delphi consensus process to develop a consistent and refined definition of PHOMS with clear principles around the nature of PHOMS and how they differ from normal anatomy. Fifty explanatory teaching slides, provided as supplementary material, allowed our expert group of raters to achieve a good level of agreement (kappa 0.701, 50 OCT scans, 21 raters). We recommend adopting the refined definition for PHOMS.

KEYWORDS:

Supplemental data for this article can be accessed online at http://dx.doi.org/10.1080/01658107.2020.1760891.

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