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 RejdakKatarzyna Nowomiejska, Valerie Touitou, Judith Warner, Marianne Wegener, Sui Wong, Patrick Yu-Wai-Man, Steffen Hamann

*Corresponding author for this work

Research output: Contribution to journalLetterpeer-review

15 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)413-414
Number of pages2
Issue number6
Early online date16 Jul 2020
Publication statusPublished - 1 Nov 2020
Externally publishedYes


  • OCT
  • ODD


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