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S. Salas; Hemorrhagic Pseudomelanomas. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3607.
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To describe the features of peripheral exudative hemorrhagic chorioretinopathy in four patients initially diagnosed as posterior uveal melanoma.
Review of clinical charts and ancillary diagnostic tests of four patients and review of the existing literature on the subject.
There are several conditions that can be misdiagnosed as posterior uveal melanoma, such as choroidal nevi, congenital hypertrophy of the retinal pigment epithelium, circumscribed choroidal hemangioma, age related macular degeneration, and peripheral exudative hemorrhagic chorioretinopathy (PEHCR). Four patients were referred to a tertiary level with the diagnosis of choroidal melanoma and presented with a hemorrhagic subretinal mass uniform dark red to black color, and not with the brown or amelanotic appearance of uveal melanomas. The masses were totally nonfluorescent on fluorescein angiography. Ocular ultrasound was also helpful. With the clinical history and ophthalmic and ancillary testing evaluation the diagnosis of PEHCR was done.
Since patients with PEHCR are commonly diagnosed as having posterior uveal melanoma, one of the most important aspects of their ophthalmic management appears to be recognition of this entity and avoidance of unnecessary enucleation, radiotherapy or any other radical surgery.
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