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Guido R. Kuerzinger, Gabriele E. Lang; Peripheral Exudative Hemorrhagic Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5009.
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Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is an age-related retinal degeneration with choroidal neovascularization (CNV). PEHCR has much less attention in the ophthalmic literature as the age-related macular degeneration (ARMD). It is unclear whether the lack of articles about PEHCR is due to the often asymptomatic nature of the disease or the low incidence. PEHCR can also be sight-threatening and rarely lead to blindness.
Twelve patients (13 eyes) with PEHCR were examined between January 2008 and October 2010. The protocol included referral diagnosis, best corrected visual acuity before and after treatment (BCVA), age, sex, ophthalmoscopy, fundus photography, optical coherence tomography (OCT), fluorescein angiography (FAG), ultrasound findings and disease of the fellow eye. Data were analyzed descriptively.
Most common referral diagnosis of patients with PEHCR was retinal detachment. Patient age ranged from 76 to 89 years (median: 85 years). The sex distribution was female:male, 8:4. BCVA before treatment was 0.1 to 0.8 (median: 0.5), post-treatment 0.05 to 1.0 (median: 0.5). The ultrasound findings revealed a length between 4.73 mm and 10.23 mm (median: 8.0 mm), a latitude between 4.9 mm and 9.13 mm (median: 6.50 mm) and a prominence between 1.74 mm and 4.0 mm (median: 2.42 mm). 7/13 lesions were localized in the outer periphery and 6/13 in the midperiphery. 4/13 were inferotemporal, 4/13 superiotemporal, 3/13 superionasal and 2/13 inferonasal. Fluorescein angiography showed in 7/13 eyes an occult choroidal neovascularization (OCN), in 9/13 eyes hemorrhages. 3/5 eyes had a peripheral detachment of the retinal pigment epithelium in OCT, in 8 eyes the lesion was too peripheral to perform OCT. 11/13 eyes had also ARMD, all non-exudative. Size of lesions was between 5- 10 disc diameters. 11/13 eyes were treated with laser coagulation. In 10/11 eyes the lesion stabilized after laser treatment. 8/11 eyes had stable BCVA with +/- 1 line, 2/11 eyes gained > 2 lines and 1/11 eyes had BCVA deterioration with loss of > 2 lines after treatment.
Peripheral hemorrhagic exudative chorioretinopathy is rare and can lead in the advanced stages to permanent loss of vision. Retinal laser coagulation is a good treatment modality to prevent a progression of the lesion to the macula.
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