Peripapillary hyper-reflective ovoid mass-like structure and dome-shaped maculopathy A case report

Rationale: Peripapillary hyperreflective ovoid mass-like structures (PHOMS) and dome-shaped macula (DSM) are 2 optical coherence tomography findings reported in 2018 and 2008, respectively. To date, there have been no ophthalmic case reports of concomitant PHOMS and DSM. Patient concerns: A 19-year-old woman presented to our clinic with complaints of decreased vision in both eyes. Diagnosis: The patient was diagnosed with PHOMS and a dome-shaped macula complicated by subretinal fluid in both eyes. Interventions: A micropulse laser under the guidance of Indocyanine green angiography was applied to the hyperfluorescent areas and drugs to improve retinal microcirculation. Outcomes: No response to any intervention over the 41 months of follow-up, her visual acuity remained the same, and the subretinal fluid often recurred. Lessons: PHOMS and DSM are associated with myopia; myopia may be a mediator between PHOMS and DSM. Dome-like structural changes may occur in different parts of the retina (optic disc and macula), caused by asymmetric myopic posterior scleral growth.