{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:38:06Z","timestamp":1788446286732,"version":"build-2803163510"},"reference-count":55,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003000","name":"Stichting MS Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003000","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Peripapillary hyper\u2010reflective ovoid masslike structures (PHOMS) are a new spectral domain optical coherence tomography (OCT) finding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective, longitudinal study included patients (n = 212) with multiple sclerosis (MS; n = 418 eyes), 59 healthy controls (HCs; n = 117 eyes), and 267 non\u2010MS disease controls (534 eyes). OCT and diffusion tensor imaging were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no PHOMS in HC eyes (0\/117, 0%). The prevalence of PHOMS was significantly higher in patients with MS (34\/212, <jats:italic>p<\/jats:italic> =\u20090.001) and MS eyes (45\/418, <jats:italic>p<\/jats:italic> =\u20090.0002) when compared to HCs (0\/59, 0\/117). The inter\u2010rater agreement for PHOMS was 97.9% (kappa = 0.951). PHOMS were present in 16% of patients with relapsing\u2013remitting, 16% of patients with progressive, and 12% of patients with secondary progressive disease course (2% of eyes). There was no relationship of PHOMS with age, disease duration, disease course, disability, or disease\u2010modifying treatments. The fractional anisotropy of the optic radiations was lower in patients without PHOMS (0.814) when compared to patients with PHOMS (0.845, <jats:italic>p<\/jats:italic> =\u20090.03). The majority of PHOMS remained stable, but increase in size and de novo development of PHOMS were also observed. In non\u2010MS disease controls, PHOMS were observed in intracranial hypertension (62%), optic disc drusen (47%), anomalous optic discs (44%), isolated optic neuritis (19%), and optic atrophy (12%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>These data suggest that PHOMS are a novel finding in MS pathology. Future research is needed to determine whether development of PHOMS in MS is due to intermittently raised intracranial pressure or an otherwise impaired \u201cglymphatic\u201d outflow from eye to brain. <jats:bold>ANN NEUROL 2020;88:309\u2013319.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.25782","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T09:30:03Z","timestamp":1589880603000},"page":"309-319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Longitudinal Development of Peripapillary Hyper\u2010Reflective Ovoid Masslike Structures Suggests a Novel Pathological Pathway in <scp>Multiple Sclerosis<\/scp>"],"prefix":"10.1002","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0344-9749","authenticated-orcid":false,"given":"Axel","family":"Petzold","sequence":"first","affiliation":[{"name":"Dutch Expertise Center for Neuro\u2010Ophthalmology and Multiple Sclerosis Center, Departments of Neurology and Ophthalmology Amsterdam University Medical Center  Amsterdam The Netherlands"},{"name":"Moorfields Eye Hospital and National Hospital for Neurology and Neurosurgery  London United Kingdom"},{"name":"University College London Queen Square Institute of Neurology  London United Kingdom"},{"name":"National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital and University College London Institute of Ophthalmology  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danko","family":"Coric","sequence":"additional","affiliation":[{"name":"Dutch Expertise Center for Neuro\u2010Ophthalmology and Multiple Sclerosis Center, Departments of Neurology and Ophthalmology Amsterdam University Medical Center  Amsterdam The Netherlands"},{"name":"Multiple Sclerosis Center and Department of Neurology Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisanne J.","family":"Balk","sequence":"additional","affiliation":[{"name":"Dutch Expertise Center for Neuro\u2010Ophthalmology and Multiple Sclerosis Center, Departments of Neurology and Ophthalmology Amsterdam University Medical Center  Amsterdam The Netherlands"},{"name":"Multiple Sclerosis Center and Department of Neurology Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Hamann","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rigshospitalet University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard M. 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