Title

PERIPHERAL HEMORRHAGIC EXUDATIVE CHORIORETINOPATHY.

Introduction

Peripheral Hemorrhagic Exudative Chorioretinopathy(PEHCR)is an uncommon degenerative process, usually bilateral and symmetric in older patients and most common in caucasians.Some authors consider it to be a version of age-related macular degeneration and others believe that it is a specific variant of polypoidal choroidal vasculopathy. It is characterized by the deposition or atrophy of the retinal pigment epithelium(RPE),exudation or sub-retinal bleeding and rarely by vitreous hemorrhage.PEHCR can simulate an inflammatory process, a macroaneurysm and a choroidal melanoma.It usually presents itself as an elevated mass, usually temporal, between the equator and ora serrata involving1or2quadrants.

Methods

Medical record review.

Results

Woman, 80 years old, hypertensive, with a history of ocular trauma in the right eye (RE) in childhood and vitrectomy in the left eye (LE) 6 years ago because of vitreous hemorrhage. Reports low visual acuity (VA) in the LE since 1 week.THE EXAM:VA RE:Hand Movements,LE:20/80.Biomicroscopy: RE:Paracentral corneal leucoma and total cataract.LE:pseudophakia.Fundoscopy:RE:Impossible; LE:clear vitreous, pigment deposition; yellowish lesion at 15h, associated with sub-retinal bleeding at the edges. Ultrasound: RE:Raised lesion in the temporal periphery with irregular surface and irregular echoes; slightly elevated papilla.LE:Abundant mobile vitreous cortex in the cavity, raised lesion in the temporal periphery, very irregular and acoustically heterogeneous interior.

Discussion

In melanoma the mass is usually located between the macula and equator, affects less than1quadrant and it is an unilateral lesion commonly.Many eyes with PEHCR have macular or peripheral degenerative characteristics and resolve spontaneously, with atrophy and hyperplasia of the RPE remaining.The present case involved a white woman with fundoscopic and ultrasound findings simulating a choroid melanoma, but she presented clinical and epidemiological characteristics corroborating a PEHCR diagnosis

Keywords

PeripheralHemorrhagicExudativeChorioretinopathy, case report, choroidal melanoma

File

Area

CLINICAL CASE

Authors

Isabela Feltrin Romano, Paulo Henrique Horizonte, André Vieira Gomes, Amanda Venturini Arantes, Carolina Davoglio de Mello, Carolina Maria Barbosa Lemos, Walther de Oliveira Campos Neto

Rate