Peripheral Exudative Hemorrhagic Chorioretinopathy Research Articles

Understanding the relationship between pachychoroid spectrum disorders and retinitis pigmentosa: A review of the evidence.

This study aims to investigate the relationship between pachychoroid spectrum disorders and retinitis pigmentosa (RP) or rod-cone dystrophy through a comprehensive literature review. The purpose is to explore the association between these disorders, understand their underlying mechanisms, and summarize the existing hypotheses and opinions. A thorough review of the literature was conducted using PubMed, focusing on articles related to central serous chorioretinopathy (CSC), RP, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, focal choroidal excavation, peripapillary pachychoroid neovasculopathy, and peripheral exudative hemorrhagic chorioretinopathy. Relevant studies were selected for a detailed narrative review and analysis. Several studies have reported the coexistence of CSC and RP, indicating a potential association between the two conditions. The dysfunction of the retinal pigment epithelium is proposed as a common factor. Choroidal thinning is observed in RP, but conflicting results exist regarding choroidal thickness (CT). While some studies support choroidal thinning in RP, others suggest preserved or increased thickness. Additionally, cases of pachychoroid neovasculopathy and polypoidal choroidal vasculopathy in RP have been reported, suggesting an overlap between these conditions. The literature suggests conflicting reports on CT changes in RP. Future research should focus on large-scale studies using comprehensive imaging techniques, genetic analysis, and long-term follow-up to uncover the underlying mechanisms and determine the prevalence of pachychoroid spectrum disorders in RP patients.

Acute spontaneous vortex vein occlusion: clinical features, multimodal imaging and natural course

AimsTo describe the clinical features, multimodal imaging, treatments and natural course of acute spontaneous vortex vein occlusion.MethodsClinical data were collected on nine patients with acute vortex vein occlusion. The symptoms...

Pseudomelanoma diagnosis in a tertiary ophthalmologic centre in Spain

ObjectiveTo determine the types and frequency of lesions that can be misdiagnosed as choroidal or ciliary body melanomas (posterior uveal tract melanoma [PUM]). MethodsThis is a retrospective, descriptive study examining data from patients referred to Hospital La Paz in Madrid with the diagnosis of possible PUM between January 2005 and March 2020. All patients referred for PUM were studied. In collaboration with an oncology-specialized ophthalmologic centre, each patient underwent a full ophthalmic examination, ultrasonography, and optical coherence tomography, with agreed clinical criteria used to differentiate melanomas from pseudomelanomas. ResultsIn our cohort of 715 patients, 48.9% had pseudomelanomas. Thirty-five different conditions were misdiagnosed as melanomas. The 5 most common conditions were choroidal nevus (40.5%), peripheral exudative hemorrhagic chorioretinopathy (12%), choroidal hemangioma (10.5%), choroidal metastasis (8%), and age-related macular degeneration (4%). ConclusionsAltering the diagnosis and changing the treatment and prognosis for patients can be difficult for a referral centre. Herein we present the largest European cohort investigated and highlight the importance of identifying the correct diagnosis to prevent mistreatment and possible overtreatment. These misdiagnoses can have an emotional effect on patients and their families, which could be avoided with a correct diagnosis. We analyze the most common pseudomelanoma diagnoses to help physicians better diagnose patients in their care.

Less Frequent Vascular Disorders of the Retina - Part 1

This review provides an overview of retinal vascular disorders that are less frequent in Germany and Europe compared to diabetic retinopathy and retinal venous or arterial occlusive disorders. The knowledge of these disorders is important for the differential diagnosis of retinal vascular disorders as well as potentially associated systemic disorders. In the current part one epidemiology, pathophysiology, clinical presentation, and therapy are discussed for hypertensive retinochoroidopathy, ocular ischemic syndrome, retinal alterations in sickle cell disease, Eales disease, radiation retinopathy, peripheral exudative hemorrhagic chorioretinopathy, and retinal disorders associated with pregnancy.

PERIPHERAL EXUDATIVE HEMORRHAGIC CHORIORETINOPATHY IN ASIAN POPULATIONS.

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a rare degenerative disease that affects the peripheral retina. Reports of PEHCR in Asian patients are rare. Thus, the aim of this study was to investigate the clinical characteristics and outcomes of PEHCR in Asian patients. A retrospective chart review of 33 eyes of 29 Asian patients with PEHCR. The mean age of the patients was 70 years, and 75.9% of them were women. Vitreous hemorrhage occurred in 51.5% of eyes during a mean follow-up of 43.1 months. The occurrence of vitreous hemorrhage was associated with a thicker baseline subfoveal choroid ( P = 0.001) and the male sex ( P = 0.005). Final visual acuity was less than 20/200 in 29.2% of eyes. The predictive factors for a final visual acuity worse than 20/200 included poor initial visual acuity ( P = 0.002), initial lesion involvement of more than 180° of the peripheral retina ( P = 0.03), an extension of subretinal hemorrhage to the macula ( P = 0.040), and absence of complete tumor regression ( P = 0.02). Asian PEHCR patients seem to be more frequently associated with vitreous hemorrhages, especially in male patients with thicker choroids. Although PEHCR was largely self-limiting, approximately one-third of the eyes ended up with a visual acuity of less than 20/200 with extensive lesion involvement.

Pachychoroid Spectrum Disorders: An Updated Review.

Pachychoroid disease spectrum is a recent term that has been associated with an increasing number of phenotypes. This review discusses updated findings for each of the typical pachychoroid entities (central serous chorioretinopathy, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, peripapillary pachychoroid syndrome, and focal choroidal excavation), as well as two relatively new additions (peripapillary pachychoroid neovasculopathy and peripheral exudative hemorrhagic chorioretinopathy). Here, we discuss the potential pathogenic mechanisms for these diseases and relevant imaging updates. Finally, we argue for a consistent classification scheme for these entities.

Clinical analysis of peripheral exudative hemorrhagic chorioretinopathy

Objective: To evaluate the clinical features and outcomes of eyes with peripheral exudative hemorrhagic chorioretinopathy (PEHCR). Methods: It was a retrospective case series study. A total of 12 patients (12 eyes) diagnosed with PEHCR at Peking University People's Hospital from October 2016 to December 2019 were included. The clinical data of visual acuity, slit-lamp microscopy, indirect ophthalmoscopy, fundus photography, B-ultrasound, optical coherence tomography, fluorescein fundus angiography and indocyanine green angiography, surgical procedures, therapeutic effects and follow-up were analyzed. Results: Among all 12 patients included, 7 were male and 5 were female. The age was (58.0±8.8) years. All patients had unilateral disease. The right eye was involved in 6 cases and the left eye in 6 cases. All cases presented with vitreous hemorrhage, 9 of which presented with intraocular space-occupying lesions. In the patients with intraocular space-occupying lesions, the maximum basal diameter was (8.3±1.6) mm and the height was (3.5±1.2) mm measured by B-ultrasound. A-scan ultrasonography was characterized by intermediate high reflectivity or intermediate low reflectivity. Fundus fluorescence angiography revealed nonspecific alterations corresponding to the visible fundoscopic changes such as window defects, blockage, staining, but no neovascular membrane. No polyps were found on indocyanine green angiography. All patients received vitrectomy. The intraocular lesions were found to be subretinal bleeding and exudative masses intraoperatively. Two patients had combined cataract surgery; three patients received gas or silicone oil tamponade, and three patients received adjunct intravitreal anti-vascular endothelial growth factor drugs during the follow-up. The follow-up period was (30.0±12.6) months. At the last visit, the visual acuity was improved in 11 patients and remained stable in 1 patient. Conclusions: PEHCR is a peripheral hemorrhagic retinal degenerative disorder that simulates choroidal melanoma and lacks characteristic angiography changes. The overall therapeutic effect and prognosis are good.

Bilateral Macular Choroidal Abnormalities with Drusenoid Deposits in Patients with Unilateral Peripheral Exudative Hemorrhagic Chorioretinopathy.

To investigate bilateral macular features on optical coherence tomography (OCT) in patients with unilateral peripheral exudative hemorrhagic chorioretinopathy (PEHCR). In this cross-sectional study, OCT features of affected eyes (PEHCR group, n = 30) and unaffected contralateral eyes (contralateral group, n = 30) were investigated. Age- and sex-matched patients with polypoidal choroidal vasculopathy (PCV group, n = 51) and healthy controls (normal group, n = 50) were included to compare choroidal thickness, measured at six points apart from the fovea, with the PEHCR group. Subretinal drusenoid deposits were the most common feature in PEHCR (20%) and contralateral (23%) groups, followed by soft drusen. Although the macular choroid was comparably thin in both PEHCR and contralateral groups, pachyvessels were also observed. The choroids of the PEHCR group were significantly thinner than those of the normal group at the subfovea and 1 mm temporal to the fovea and considerably thinner than those of the PCV group from 3 mm nasal to 3 mm temporal to the fovea. In patients with unilateral PEHCR, bilateral choroidal thinning and drusenoid deposit accumulation were noted in the macula. The pathophysiology of PEHCR may be a rare peripheral complication of age-related macular degeneration with pathologic choroid.

Peripheral Hemorrhagic Chorioretinopathy: Differentiating Features from Choroidal Melanoma

Introduction: Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is one of the leading mimickers of choroidal melanoma because of overlapping features with choroidal melanoma that make the distinction between these two entities difficult. Methods: To identify nonoverlapping diagnostic features between PEHCR and choroidal melanoma, a retrospective study of 80 patients (80 eyes); 40 patients (40 eyes) with PEHCR; and 40 patients (40 eyes) with choroidal melanoma was conducted. Ophthalmoscopic and imaging features of PEHCR and choroidal melanoma were compared. Sensitivity and specificity for identifying PEHCR and choroidal melanoma were calculated. Youden’s J statistic was assessed for each diagnostic feature. Results: The most frequent clinical features of PEHCR were presence of druse (100%), hemorrhagic PED (93%), dome-shaped mass (B-scan) (90%), and subretinal/intraretinal hemorrhage (78%). Statistical analysis confirmed high sensitivity of hemorrhagic PED (0.93; 95% CI 0.80–0.98) and high specificity of clot retraction cleft, presence of lipid exudation, and bilaterality (1.00; 95% CI 0.91–1.00) as diagnostic features of PEHCR. Statistical analysis revealed presence of subretinal fluid 0.80 (95% CI 0.54–0.91) was most sensitive and presence of orange pigment, mushroom shape on B-scan, ciliary body extension, and choroidal excavation were most specific (1.00; 95% CI 0.91–1.00) for choroidal melanoma. Nonoverlapping diagnostic features of PEHCR were hemorrhagic PED, clot retraction cleft, presence of lipid exudation, and bilaterality. All PEHCR patients (100%) had at least one of these nonoverlapping diagnostic features. Nonoverlapping diagnostic features of choroidal melanoma were the presence of orange pigment, choroidal excavation, mushroom-shaped mass, and ciliary body extension (the latter 3 detected on B-scan). Youden’s J statistic was highest for hemorrhagic PED and lowest for dome-shape appearance on B-scan (0.075). Conclusion: PEHCR and choroidal melanoma can be differentiated by identifying diagnostic features that are exclusive to each entity. The presence of hemorrhagic PED strongly supports a diagnosis of PEHCR. B-scan ultrasonography is required to detect a mushroom-shaped mass, choroidal excavation, or ciliary body extension to exclude underlying choroidal melanoma.

Peripheral Exudative Hemorrhagic Chorioretinopathy with and without treatment-Clinical and multimodal imaging characteristics and prognosis.

PurposeTo describe clinical and imaging characteristics of patients with Peripheral Exudative Hemorrhagic Chorioretinopathy (PEHCR), prognosis and treatment response.MethodsIn this retrospective cohort study medical records of patients diagnosed with PEHCR in a tertiary medical center between 2008 and 2018 were reviewed. Collected data included demographics, medical history, ophthalmologic examination and multi-modal imaging including fundus autofluorescence, optical coherence tomography (OCT), ultrasound (US), fluorescein angiography and indocyanine green angiography when available. Bevacizumab treatment results were analyzed when applied.Results35 eyes of 32 patients were included, with a female predominance (56.25%) and an average age of 79.0±9.87 years at presentation. Most common OCT and US findings were subretinal mass (68.75%), pigment epithelial detachment (30.00%) and atrophic changes (21.86%). Median follow-up period was 18.00 months (range 0–102). Visual acuity (VA) remained stable (39.29%) or improved (25.00%) in most cases available for follow-up. Treatment with intravitreal bevacizumab induced a statistically significant clinical resolution in 88.89% of eyes available for follow-up (8/9 eyes) (p = 0.02).ConclusionsPEHCR is presented with high clinical variability and generally good prognosis. This is the first publication demonstrating a statistically significant clinical resolution of disease following intravitreal bevacizumab injections.

Clinical characteristics of peripheral exudative hemorrhagic chorioretinopathy in a referral center in Spain

ObjectiveTo publish the clinical characteristics of peripheral exudative hemorrhagic chorioretinopathy (PHEC) in the Spanish population. MethodsRetrospective study and analysis of results in patients diagnosed with PHEC. The clinical characteristics, by OCT, the treatment used and the evolution after treatment were collected. Results39 eyes of 23 patients with PHEC were evaluated. The average age at diagnosis was 79 years (66–94 years). The main ocular symptom was low vision in 26 eyes (66.6%); only 11 eyes (28.2%) were asymptomatic. The most frequent referred diagnosis was bleeding/exudation in 24 eyes (61.5%), followed by choroidal melanoma in 9 (23.1%). Intra or subretinal hemorrhages were the type of peripheral lesion most frequently found, in 24 eyes (61.5%). Twenty-five eyes (58.9%) received some type of treatment: 15 eyes (60%) underwent intravitreal injection (IIV) of antiangiogenic agents (anti-VEGF); Laser photocoagulation was performed in 2 cases (8%), Photodynamic therapy in 2 cases (8%) and 6 cases (18.2%) required pars plana vitrectomy (PPV) due to vitreous hemorrhage. There were no changes in visual acuity (VA) in patients followed with observation between baseline 0.66±0.80 (0.04–2.82) and end of follow-up 0.75±0.96 (0.00–2.82) (P=.352), nor for those who received some type of treatment between the beginning 0.78±0.79 (0.04–2.30) and the end 1.22±1.01 (0.04–2.82) (P=.157), possibly due to the large component of atrophic or exudative age-related macular degeneration (AMD) presented in both groups. (29 eyes presented atrophic or exudative AMD) ConclusionsPHEC is a rare pathology, frequently associated with AMD, which typically presents as a peripheral mass that is frequently confused with choroidal melanoma and other intraocular tumors and hence the importance of learning to identify it, making the correct differential diagnosis and avoid unnecessary treatments. Antiangiogenic therapy is effective in most patients with an active phase (exudative/hemorrhagic) into leading to fibrosis of peripheral hemorrhagic areas.

Indications and pathologic diagnoses of diagnostic chorioretinal biopsies in the province of Quebec, Canada

ObjectifExaminer l'intérêt clinique des biopsies choriorétiniennes en présence d'une inflammation intraoculaire ou de lésions choriorétiniennes peu évocatrices d'un point de vue diagnostique. NatureÉtude rétrospective d'une série de cas. ParticipantsGroupe de 7 patients ayant subi une biopsie choriorétinienne. MéthodesLa présente série de cas regroupait tous les patients consécutifs qui ont subi une biopsie choriorétinienne dans 2 hôpitaux universitaires (centres de soins tertiaires) du Québec entre 2014 et 2020. RésultatsParmi les 7 patients admis à notre étude, 5 présentaient une inflammation intraoculaire et ont dû subir une biopsie choriorétinienne visant à écarter la présence d'une infection ou d'un cancer; chez les 2 autres, la biopsie choriorétinienne a été effectuée parce que l'on soupçonnait la présence d'une tumeur choriorétinienne néoplasique. Voici les diagnostics définitifs: lymphome choriorétinien primitif (n = 2), toxoplasmose (n = 1), tumeur choroïdienne bénigne (n = 1), granulome non nécrosant (n = 1) et choriorétinopathie hémorragique exsudative périphérique (n = 1). On n'a pas pu établir de diagnostic spécifique chez 1 patient présentant une panuvéite s'accompagnant de sclérite. Aucune complication postopératoire n'a été signalée. ConclusionsLa biopsie choriorétinienne a permis d’établir le diagnostic chez 6 des 7 patients de notre série de cas, y compris un diagnostic certain de lymphome chez 2 patients. Il s'agit d'un taux élevé de diagnostic qui s'est traduit en outre par des résultats significatifs sur le plan clinique qui influeront sur la prise en charge du patient. Pour la suite des choses, il serait intéressant d'identifier les patients chez lesquels la biopsie choriorétinienne réalisée à titre adjuvant pourrait se traduire par un taux élevé de diagnostic.

PEHCR-Peripheral exudative hemorrhagic chorioretinopathy: Diagnosis and treatment

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is arare degenerative chorioretinal disease with subretinal or subepithelial hemorrhage and exudation in the fundus periphery in older patients. Even though it is the second most common entity among pseudomelanomas and its characteristic features simplify diagnosis, PEHCR is often not recognized and therefore misdiagnosed. In most cases stabilization or regression spontaneously occur. Therefore, treatment for PEHCR should be cautiously selected when function is good and surgical intervention should be preferably considered when visual loss is imminent.

Características clínicas de la coriorretinopatía exudativa hemorrágica periférica en un centro de referencia en España

ObjectiveTo publish the clinical characteristics of peripheral exudative hemorrhagic chorioretinopathy (PHEC) in the Spanish population. MethodsRetrospective study and analysis of results in patients diagnosed with PHEC. The clinical characteristics, by OCT, the treatment used and the evolution after treatment were collected. Results39 eyes of 23 patients with PHEC were evaluated. The average age at diagnosis was 79 years (66-94 years). The main ocular symptom was low vision in 26 eyes (66.6%); only 11 eyes (28.2%) were asymptomatic. The most frequent referred diagnosis was bleeding/exudation in 24 eyes (61.5%), followed by choroidal melanoma in 9 (23.1%). Intra or subretinal hemorrhages were the type of peripheral lesion most frequently found, in 24 eyes (61.5%). Twenty-five eyes (58.9%) received some type of treatment: 15 eyes (60%) underwent intravitreal injection (IIV) of antiangiogenic agents (anti-VEGF); Laser photocoagulation was performed in 2 cases (8%), Photodynamic therapy in 2 cases (8%) and 6 cases (18.2%) required pars plana vitrectomy (PPV) due to vitreous hemorrhage. There were no changes in visual acuity (VA) in patients followed with observation between baseline 0.66±0.80 (0.04-2.82) and end of follow-up 0.75±0.96 (0.00-2.82) (P=.352), nor for those who received some type of treatment between the beginning 0.78±0.79 (0.04-2.30) and the end 1.22±1.01 (0.04-2.82) (P=.157), possibly due to the large component of atrophic or exudative age-related macular degeneration (AMD) presented in both groups. (29 eyes presented atrophic or exudative AMD). ConclusionsPHEC is a rare pathology, frequently associated with AMD, which typically presents as a peripheral mass that is frequently confused with choroidal melanoma and other intraocular tumors and hence the importance of learning to identify it, making the correct differential diagnosis and avoid unnecessary treatments. Antiangiogenic therapy is effective in most patients with an active phase (exudative/hemorrhagic) into leading to fibrosis of peripheral hemorrhagic areas.

Wide-field swept source optical coherence tomography angiography for peripheral polyps in peripheral exudative hemorrhagic chorioretinopathy - A case report

<br>We depict the novel use of wide-field swept-source optical coherence tomography angiography (SSOCTA) to image and longitudinally follow peripheral polyps in peripheral exudative hemorrhagic chorioretinopathy (PEHCR). A 65-year-old man with hemorrhagic mounds in the temporal mid-periphery of his left eye underwent wide-field en face and cross-sectional SSOCTA at the baseline and 3 monthly with a total follow-up of 10 months. We were able to image the peripheral polyps and branching vascular network (BVN) on wide-field SSOCTA and document its response to treatment. The SSOCTA findings correlated well to the gold standard indocyanine green angiography (ICGA).<br>

Differential diagnosis of peripheral exudative hemorrhagic chorioretinopathy and neoplasm of the choroid (clinical case)

Peripheral exudative hemorrhagic chorioretinopathy is a relatively rare and difficult to diagnose disease. This condition is clinically similar to choroidal melanoma, which is why it is called pseudomelanoma. An erroneous diagnosis of choroidal melanoma can lead to the wrong choice of aggressive treatment tactics. The aim of this work was to present a case of differential diagnosis of suspected neoplasm of the choroid with peripheral exudative hemorrhagic chorioretinopathy. The described clinical case demonstrates characteristic clinical picture and results of ultrasound with Doppler mapping, spectral optical coherence tomography, optical coherence tomographyangiography, scanning laser ophthalmoscopy for this condition, as well as important differential diagnostic signs of choroidal melanoma. Complaints, history, clinical picture and the results of instrumental examinations were characteristic of peripheral exudative hemorrhagic chorioretinopathy and allowed to exclude the diagnosis of choroidal neoplasm. Pathogenetic treatment (intravitreal injection of anti-VEGF agents) and observation were recommended to the patient, since this disease often affects both eyes. The main differential diagnostic criterion for suspected choroidal melanoma is Doppler ultrasound imaging. In difficult clinical cases, structural optical coherence tomography, optical coherence tomographyangiography, and scanning laser ophthalmoscopy provide valuable additional information for verifying the diagnosis.

A case of bilateral pachychoroid disease: polypoidal choroidal vasculopathy in one eye and peripheral exudative hemorrhagic chorioretinopathy in contralateral eye

BackgroundWe report a case of bilateral pachychoroid disease manifesting polypoidal choroidal vasculopathy (PCV) with punctate hyperfluorescent spot (PHS) in one eye, and peripheral exudative hemorrhagic choroidal retinopathy (PEHCR) with central serous chorioretinopathy (CSC) and PHS in the contralateral eye.Case presentation: A 51-year-old healthy woman presented with complaint of blurred vision in her right eye. Corrected visual acuity was 20/20 in the right and 24/20 in the left eye. Fundus examination was normal in the left eye. In the right eye, fundus finding of an orange-red nodular lesion and optical coherence tomography (OCT) finding of polypoidal lesions led to a diagnosis of PCV. Four aflibercept intravitreal injections were performed in her right eye. After treatment, indocyanine green angiography (ICGA) confirmed residual polypoidal lesions with branching vascular networks and PHS with choroidal vascular hyperpermeability. OCT showed PHS associated with small sharp-peaked retinal pigment epithelium (RPE) elevation in peripheral fundus and small RPE elevation in posterior fundus. Based on the above findings, PCV with PHS was finally diagnosed in the right eye. Posttreatment corrected visual acuity in the right eye was 20/20. She presented again 32 months later, with complaint of vision loss in her left eye. Left corrected visual acuity was 20/20, and fundus examination showed mild vitreous hemorrhage. Vitrectomy was performed. In temporal midperipheral fundus, fluorescein angiography revealed CSC, and OCT showed pachychoroid. ICGA depicted abnormal choroidal networks and PHS in peripheral fundus. Furthermore, polypoidal lesions were confirmed by OCT. Based on the above findings, PEHCR and CSC with PHS was finally diagnosed in the left eye. Postoperative corrected visual acuity in the left eye was 20/20, and aflibercept intravitreal injection was performed for prevention of recurrence of vitreous hemorrhage.ConclusionsThis is the first case report of PCV with PHS in one eye, and PEHCR with CSC and PHS in the contralateral eye. This case suggests that PCV, PEHCR, and CSC may be linked pathologies of pachychoroid spectrum disease.

PERIPHERAL EXUDATIVE HEMORRHAGIC CHORIORETINOPATHY-A NEW ADDITION TO THE SPECTRUM OF PACHYCHOROID DISEASE?

Purpose: To demonstrate choroidal vascular changes and report a novel choroidal thickness contour in eyes with peripheral exudative hemorrhagic chorioretinopathy (PEHCR). Methods: Retrospective, observational, comparative case series. Fourteen eyes of nine patients with PEHCR and 14 eyes of 14 age-matched and sex-matched controls underwent swept-source optical coherence tomography. Choroidal thickness was measured from posterior edge of the retinal pigment epithelium–Bruch membrane to choroidoscleral interface at 11 points 1,000 µm apart. Large choroidal vessel thickness was also measured. Results: In PEHCR group, the choroid was thinnest at 3 mm nasal to fovea (mean 95.3 ± 33.5 µm) and thickest at 7 mm temporal to fovea (mean 272.7 ± 80.2 µm), with gradual increase in choroidal thickness from nasal to temporal periphery. The choroid was thickest subfoveally (259.7 ± 63.8 µm) in the control group. The choroid was significantly thicker in temporal periphery in PEHCR eyes as compared to controls (P = 0.0002). The mean large choroidal vessel thickness was 202.4 ± 50.8 µm in the PEHCR group and 160.6 ± 40.5 µm in the control group (P = 0.0235). Conclusion: Peripheral exudative hemorrhagic chorioretinopathy eyes showed progressively increasing choroidal thickness toward the temporal periphery, compared with age-matched and sex-matched controls. This gave rise to a club-shaped choroidal contour compared with the bowl-shaped contour seen in control eyes. Thicker choroid and pachyvessels favor inclusion of PEHCR in the pachychoroid disease spectrum.

A Case Report Discussing an Uncommon Peripheral Exudative Hemorrhagic Chorioretinopathy

Purpose: The purpose of this case report is to discuss an uncommon, unique hemorrhagic chorioretinopathy. Method: A 79-year-old-white female presented to clinic with complaints of difficulty reading at close distances and seeing faces at far distances in both eyes. An 85-year old white female presented with no visual complaints but stated redness in the nasal corner of her right eye. This is a case report of two patients that presented with geographic atrophy of the macula as well as midperipheral RPE alterations in both eyes, which resembled intraretinal hemorrhages. Results: The ocular findings associated with peripheral exudative hemorrhagic chorioretinopathy may include midperipheral intraretinal hemorrhages, peripheral RPE mottling, subretinal fluid or hemorrhages, subretinal exudation, pigment epithelial detachments, and/or vitreous hemorrhages. Conclusions: Although this condition is rare, primary eye care providers should be aware of this unique clinical entity, its relationship to age-related macular degeneration, and when these patients require a referral to a retinal specialist.

Intravitreal Aflibercept in peripheral exudative hemorrhagic chorioretinopathy associated with large retinal pigment epithelial tear

Intravitreal Aflibercept in peripheral exudative hemorrhagic chorioretinopathy associated with large retinal pigment epithelial tear