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Peripheral Exudative Haemorrhagic Chorioretinopathy

  • Peter Heydon
  • Mandeep S. Sagoo
Chapter
Part of the Retina Atlas book series (RA)

Abstract

Peripheral exudative haemorrhagic chorioretinopathy (PEHCR) is a commonly bilateral process characterised by exudative and/or haemorrhagic degeneration of the peripheral retina in the elderly population. It frequently regresses spontaneously to subretinal fibrosis and/or retinal pigment epithelial atrophy. PEHCR has various synonyms, including eccentric disciform degeneration, extramacular disciform degeneration (Bardenstein et al. 1992), haemorrhagic detachment of the retinal pigment epithelium (Silva and Brockhurst 1976), haemorrhagic peripheral pigment epithelial disease (Delaney Jr. et al. 1988) and peripheral choroidal neovascularisation (Vine and Johnson 1996). Its importance in the field of ocular oncology lies in that it is a pseudotumour that can mimic a range of tumours including naevus and melanoma.

References

  1. Alforja MS, Sabater N, Giralt J, et al. Intravitreal bevacizumab injection for peripheral exudative hemorrhagic chorioretinopathy. Jpn J Ophthalmol. 2011;55:425–7.CrossRefGoogle Scholar
  2. Annesley WH Jr. Peripheral exudative hemorrhagic chorioretinopathy. Trans Am Ophthalmol Soc. 1980;78:321–64.PubMedPubMedCentralGoogle Scholar
  3. Bardenstein DS, Char DH, Irvine AR, et al. Extramacular disciform lesions simulating uveal tumors. Ophthalmology. 1992;99:944–51.CrossRefGoogle Scholar
  4. Barkmeier AJ, Kadikoy H, Holz ER, et al. Regression of serous macular detachment due to peripheral exudative hemorrhagic chorioretinopathy following intravitreal bevacizumab. Eur J Ophthalmol. 2011;21:506–8.CrossRefGoogle Scholar
  5. Bec PSP, Arnle JL, Aubry JP. La neo-vascularisation sous retinienne peripherique-une notion meconnue. Bull Soc Ophthalmol Fr. 1980;80:381–3.Google Scholar
  6. Cebeci Z, Dere Y, Bayraktar S, et al. Clinical features and course of patients with peripheral exudative hemorrhagic chorioretinopathy. Turk J Ophthalmol. 2016;46:215–20.CrossRefGoogle Scholar
  7. Delaney WV Jr, Torrisi PF, et al. Hemorrhagic peripheral pigment epithelial disease. Arch Ophthalmol. 1988;106:646–50.CrossRefGoogle Scholar
  8. Friedman E, Kuwabara T. Senile choroidal vascular patterns and drusen. Arch Ophthalmol. 1963;69:220–30.CrossRefGoogle Scholar
  9. Goldman DR, Freund KB, McCannel CA, et al. Peripheral polypoidal choroidal vasculopathy as a cause of peripheral exudative hemorrhagic chorioretinopathy: a report of 10 eyes. Retina. 2013;33:48–55.CrossRefGoogle Scholar
  10. Gonzales JA, Kapoor KG, Gibran SK. Peripheral exudative hemorrhagic chorioretinopathy: a clinical, angiographic, and histologic study. Am J Ophthalmol. 2010;149:1013–4.CrossRefGoogle Scholar
  11. Kim YT, Kang SW, Lee JH, et al. Peripheral exudative hemorrhagic chorioretinopathy in Korean patients. Jpn J Ophthalmol. 2010;54:227–31.CrossRefGoogle Scholar
  12. Mantel I, Uffer S, Zografos L. Peripheral exudative hemorrhagic chorioretinopathy: a clinical, angiographic, and histologic study. Am J Ophthalmol. 2009;148:932–8.CrossRefGoogle Scholar
  13. Mantel I, Schalenbourg A, Zografos L. Peripheral exudative hemorrhagic chorioretinopathy: polypoidal choroidal vasculopathy and hemodynamic modifications. Am J Ophthalmol. 2012;153:910–22.CrossRefGoogle Scholar
  14. Mashayekhi A, Shields CL, Shields JA. Peripheral exudative hemorrhagic chorioretinopathy: a variant of polypoidal choroidal vasculopathy? J Ophthalmic Vis Res. 2013;8:264–7.PubMedPubMedCentralGoogle Scholar
  15. Mirshahi A, Hohn F, Baatz H, et al. Peripheral exudative haemorrhagic chorioretinopathy: clinical and angiographic findings. Klin Monatsbl Augenheilkd. 2009;226:659–63.CrossRefGoogle Scholar
  16. Pinarci EY, Kilic I, Bayar SA, et al. Clinical characteristics of peripheral exudative hemorrhagic chorioretinopathy and its response to bevacizumab therapy. Eye (Lond). 2013;27:111–2.CrossRefGoogle Scholar
  17. Rishi P, Das A, Sarate P, et al. Management of peripheral polypoidal choroidal vasculopathy with intravitreal bevacizumab and indocyanine green angiography-guided laser photocoagulation. Indian J Ophthalmol. 2012;60:60–3.CrossRefGoogle Scholar
  18. Sarks SH. New vessel formation beneath the retinal pigment epithelium in senile eyes. Br J Ophthalmol. 1973;57:951–65.CrossRefGoogle Scholar
  19. Seibel I, Hager A, Duncker T, et al. Anti-VEGF therapy in symptomatic peripheral exudative hemorrhagic chorioretinopathy (PEHCR) involving the macula. Graefes Arch Clin Exp Ophthalmol. 2016;254:653–9.CrossRefGoogle Scholar
  20. Shields JA, Mashayekhi A, Ra S, et al. Pseudomelanomas of the posterior uveal tract: the 2006 Taylor R. smith lecture. Retina. 2005;25:767–71.CrossRefGoogle Scholar
  21. Shields CL, Salazar PF, Mashayekhi A, et al. Peripheral exudative hemorrhagic chorioretinopathy simulating choroidal melanoma in 173 eyes. Ophthalmology. 2009;116:529–35.CrossRefGoogle Scholar
  22. Shields CL, Manalac J, Das C, et al. Choroidal melanoma: clinical features, classification, and top 10 pseudomelanomas. Curr Opin Ophthalmol. 2014;25:177–85.CrossRefGoogle Scholar
  23. Silva VB, Brockhurst RJ. Hemorrhagic detachment of the peripheral retinal pigment epithelium. Arch Ophthalmol. 1976;94:1295–300.CrossRefGoogle Scholar
  24. Takayama K, Enoki T, Kojima T, et al. Treatment of peripheral exudative hemorrhagic chorioretinopathy by intravitreal injections of ranibizumab. Clin Ophthalmol. 2012;6:865–9.PubMedPubMedCentralGoogle Scholar
  25. Takkar B, Roy S, Sodhi PK, et al. Peripheral choroidal neovascular membrane in a case of peripheral exudative hemorrhagic chorioretinopathy managed with combination therapy. Int Ophthalmol. 2017;37:429–31.CrossRefGoogle Scholar
  26. Tsui I, Jain A, Shah S, et al. Ultra widefield imaging of peripheral exudative hemorrhagic chorioretinopathy. Semin Ophthalmol. 2009;24:25–8.CrossRefGoogle Scholar
  27. Vine AK, Johnson MW. Peripheral choroidal neovascularization. Eur J Ophthalmol. 1996;6:44–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Peter Heydon
    • 1
  • Mandeep S. Sagoo
    • 2
    • 3
    • 4
  1. 1.Medical Retina ServiceMoorfields Eye HospitalLondonUK
  2. 2.Ocular Oncology ServiceMoorfields Eye HospitalLondonUK
  3. 3.Retinoblastoma ServiceRoyal London HospitalLondonUK
  4. 4.UCL Institute of OphthalmologyLondonUK

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