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

Axel Petzold; Valerie Biousse; Lulu Bursztyn; Fiona Costello; Alison Crum; Kathleen Digre; Clare Fraser; J Alex Fraser; Bradley Katz; Neringa Jurkute; Nancy Newman; Jette Lautrup-Battistini; Mitchell Lawlor; Petra Liskova; Birgit Lorenz; Lasse Malmqvist; Jason Peragallo; Patrick Sibony; Prem Subramanian; Robert Rejdak; Katarzyna Nowomiejska; Valerie Touitou; Judith Warner; Marianne Wegener; Sui Wong; Patrick Yu-Wai-Man; Steffen Hamann

doi:10.1080/01658107.2020.1760891

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

Neuroophthalmology. 2020 Jul 16;44(6):413-414. doi: 10.1080/01658107.2020.1760891. eCollection 2020.

Authors

Axel Petzold^{1

2}, Valerie Biousse³, Lulu Bursztyn⁴, Fiona Costello⁵, Alison Crum⁶, Kathleen Digre⁷, Clare Fraser⁸, J Alex Fraser⁹, Bradley Katz⁶, Neringa Jurkute¹⁰, Nancy Newman¹¹, Jette Lautrup-Battistini¹², Mitchell Lawlor⁸, Petra Liskova¹³, Birgit Lorenz¹⁴, Lasse Malmqvist¹⁵, Jason Peragallo³, Patrick Sibony¹⁶, Prem Subramanian¹⁷, Robert Rejdak¹⁸, Katarzyna Nowomiejska¹⁸, Valerie Touitou¹⁹, Judith Warner²⁰, Marianne Wegener¹⁵, Sui Wong²¹, Patrick Yu-Wai-Man^{22

23}, Steffen Hamann²⁴

Affiliations

¹ Moorfields Eye Hospital NHS Foundation Trust and the National Hospital for Neurology and Neurosurgery, Queen Square, Institute of Neurology, University College London, London, UK.
² Neurology and Ophthalmology, Amsterdam UMC, Locatie VUMC, Amsterdam, Netherlands.
³ Ophthalmology, Emory University, Atlanta, Georgia, USA.
⁴ Western University, London, Ontario, Canada.
⁵ Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
⁶ Utah System of Higher Education, Salt Lake City, Utah, USA.
⁷ Department of Neurology-Ophthalmology and Visual Science, John Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
⁸ Save Sight Institute, The University of Sydney, Sydney, North South Wales, Australia.
⁹ Department of Clinical Neurological Sciences and Department of Ophthalmology, Western University, London, Ontario, Canada.
¹⁰ Institute of Ophthalmology, UCL, London, UK.
¹¹ Department of Neuro-Ophthalmology, Emory University, School of Medicine, Atlanta, Georgia, USA.
¹² Copenhagen University Hospital Glostrup, Denmark.
¹³ Ophthalmology, Charles University, Prague, Czech Republic.
¹⁴ Ophthalmology, Justus Liebig University, Giessen, Germany.
¹⁵ Ophthalmology, Rigshospitalet Glostrup, Denmark.
¹⁶ Stony Brook University, Stony Brook, New York, USA.
¹⁷ Sue Anschutz-Rodgers UC Health Eye Center, University of Colorado School of Medicine, Aurora, Colorado, USA.
¹⁸ Department of General Opthalmology, Medical University, Lublin, Poland.
¹⁹ Groupe Hospitalier La Pitié Salpêtrière-Charles Foix, DHU Vision Et Handicaps, Paris, France.
²⁰ Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
²¹ Moorfields Eye Hospital City Road Campus, London, UK.
²² Cambridge University, Cambridge, UK.
²³ Moorfields Eye Hospital NHS, Foundation Trust, Medical Retina, London, UK.
²⁴ Ophthalmology, ODDS Consortium and ERN-EYE Rigshospitalet Glostrup, Denmark.

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: OCT; ODD; PHOMS.

Abstract

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