To describe two cases of peripheral exudative hemorrhagic chorioretinopathy (PEHCR).
Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
Retrospective review of multimodal imaging in two patients with PEHCR.
The patients were otherwise healthy females aged 62 and 68 years, respectively. The PEHCR was bilateral in the first patient and unilateral in the second one. On fundus examination, both patients presented with temporal peripheral hard exudates extending to the posterior pole, peripheral retinal hemorrhages and localized retinal detachment. Fluorescein angiography showed peripheral vascular leakage temporally in both cases. Indocyanine angiography demonstrated dilated choroidal vessels with polyps in the temporal area. Structural OCT showed a retinal detachment and cystoid changes in the first patient. On B-mode ultrasonography, the temporal lesion was highly hyperechogenic with surrounding retinal detachment. The diagnosis of PEHCR was retained with a delay of 15 years in the first patient (on second eye involvement and total visual loss on right eye) and of two months in the second patient. Both patients received intra-vitreal injection of anti-VEGF. On follow-up, the exudation decreased and visual acuity remained stable at 20/40 in the left eye and no light perception in the right eye for the first patient and 20/80 for the second patient.
PEHCR is a rare disorder. The diagnosis might be challenging. Multimodal imaging is helpful in diagnosing PEHCR, characterizing chorioretinal lesions, and guiding treatment.
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