PHOMS: ovoid structures which are usually not egg-shaped

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The choroidal thinning (white arrow) at nasal level could be physiological and attributable to the patient’s myopia. Subfoveal hyperreflectivity resolved at two weeks (B) leaving a minimal sequel of subfoveal RPE thickening at 1.5 months (C). The outer nasal layers progressively recovered (B and C). In A-OCT 8×8 en-face, at ellipsoid layer level, hyperreflective points were observed surrounding the papilla (green arrow) at debut (D). After two weeks (E), these peripapillary hyperreflective points decreased but hyporeflective spots were observed (white arrow), which correlate with the disruption of the outer retina in autofluorescence. After 1.5 months (F), hyporeflective spots decreased and white peripapillary spots disappeared. The A-OCT 3×3 showed at choriocapillary level two apparent hypoperfusion spots in the debut of the disease (G), which correlate with the shadow of the subfoveal column hyperreflectivity." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. 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"apellidos" => "Adán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120303105" "doi" => "10.1016/j.oftal.2020.07.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120303105?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357942030219X?idApp=UINPBA00004N" "url" => "/21735794/unassign/S217357942030219X/v1_202011150602/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "PHOMS: ovoid structures which are usually not egg-shaped" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. González Martín-Moro" "autores" => array:1 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "González Martín-Moro" "email" => array:2 [ 0 => "juliogmm@yahoo.es" 1 => "juliogazpeitia@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Ophthalmology, University Hospital of Henares, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "University Francisco de Vitoria, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "PHOMS: estructuras ovoides que habitualmente no tienen forma de huevo" ] ] "textoCompleto" => "I greatly appreciate the comments from Fraser et al.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> regarding the recently published editorial that discussed the appropriateness of the term peripapillary hyperreflective ovoid mass-like structures (PHOMS).<a class="elsevierStyleCrossRef" href="#bib0010">2</a> I would like to clarify some aspects mentioned by the authors of the letter.Encyclopedia Britannica defines structure as "the way in which something is constructed or organized," providing examples of a series of everyday objects.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> It explains how a house, a tower, or a bridge is structured by joining a series of parts to form a whole.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> The ideas of complexity, wholeness, and three-dimensionality are intrinsic to the term structure, and the term ovoid was likely included in the acronym PHOMS because those rounded images seen in two-dimensional optical coherence tomography (OCT) made one think that the structures generating them were corpuscles that, in 3 dimensions, had an egg shape. This is probably why the plural form was used, as it was thought that there were multiple structures generating those images rather than just one. This assumption was likely made by analogy with optic nerve drusen, which, when they are extruded, they certainly have a more or less spherical in shape.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>Although an extraocular muscle is a fusiform structure that generates more or less circular images when viewed in a coronal section of a computed tomography (CT), it would be inaccurate to state that it is egg-shaped or that ovoid structures appear on the CT image. Ovoid simply means it has an egg shape, and we all know that the circular image we see is merely the cross-section of a more or less fusiform structure.In the case of PHOMS, it is quite clear that the shape is toroidal or annular and that in many cases, a single structure (singular) appears as more or less circular images on the OCT scans. Therefore, being strict, the adjective that should accompany the noun structure is annular or toroidal. The term circular could be useful to describe the images seen in the 2D OCT views, and the term ovoid does not make much sense because there is usually nothing with an egg shape inside the retina.In this author’s opinion, the term PHOMS contributes to the confusion among those who do not know the historical reasons behind the creation of this acronym, as I witness every time I try to explain to young residents what these structures are.The ideal term, at least in those common cases, should refer to axonal stasis, as this is the underlying pathophysiological fact. To illustrate this aspect, one need only ask which title is preferable for an article: "Central Retinal Vein Occlusion with Cystoid Macular Edema" or "Central Retinal Vein Occlusion with TCRIHRS (Thickening of the Central Retina with Intraretinal Hyper-Reflective Structures"). I believe that almost everyone would prefer the first title for being simpler and better reflecting the underlying clinical reality.In this author’s opinion, at most, the term PHOMS should be reserved for those specific cases where it is not suspected that these images are due to increased axonal volume, and even in those cases, the term peripapillary hyperreflective ovoid mass-like images (PHOMI) would be preferable to clarify that we are referring to a clinical sign in 2D and not to a structure that we now know usually does not have an egg shape and which, by definition, is 3D.Declaration of Generative AI and AI-assisted technologies in the writing processNo generative artificial intelligence has been used in the creation of this article.FundingNone declared." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Declaration of Generative AI and AI-assisted technologies in the writing process" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PHOMS: an apt and accurate acronym" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Corsorcio Optic Disc Drusen Studies (ODDS)" "etal" => false "autores" => array:3 [ 0 => "J.A. Fraser" 1 => "F. Costello" 2 => "S. Hamann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftale.2024.06.012" "Revista" => array:4 [ "tituloSerie" => "Arch Soc Esp Oftalmol (Engl Ed)" "fecha" => "2024" "volumen" => "S2173-5794" "numero" => "24" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PHOMS: time to change the acronym?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. González Martín-Moro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftale.2023.10.008" "Revista" => array:7 [ "tituloSerie" => "Arch Soc Esp Oftalmol (Engl Ed)" "fecha" => "2024" "volumen" => "99" "numero" => "3" "paginaInicial" => "89" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37951352" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Structure Definition & Meaning. Britannica Dictionary [Internet]. [accesssed 26 Jun 2024]. Available from: <a target="_blank" href="https://www.britannica.com/dictionary/structure">https://www.britannica.com/dictionary/structure</a>." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/unassign/S2173579424001713/v1_202410291641/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/21735794/unassign/S2173579424001713/v1_202410291641/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579424001713?idApp=UINPBA00004N"]

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Archivos de la Sociedad Española de Oftalmología is the official journal of the Ophthalmology Society of Spain, that has over 4,000 members. It gives priority to the publication of basic, translational and clinic research including reviews, original articles, short communications, editorials, letters to the editor and clinic practice guides related to Ophthalmology and its subspecialties. A small section of the journal is reserved for the most relevant papers presented at the annual Congress of the Society. All manuscripts considered for publication are reviewed by expert examiner peers (double blind). The journal is published monthly and even though its official language is Spanish all articles are translated into English to increase the dissemination of scientific information. At present, Archivos is the only Spanish language Ophthalmology journal indexed in PubMed/MEDLINE in addition to other prestigious international databases such as Scopus.

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