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Peripheral exudative haemorrhagic chorioretinopathy: a widefield imaging study
  1. Federico Zicarelli,
  2. Chiara Preziosa,
  3. Giovanni Staurenghi,
  4. Marco Pellegrini
  1. University of Milan Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
  1. Correspondence to Federico Zicarelli, Eye Clinic – Luigi Sacco Hospital – University of Milan, Via G.B. Grassi 74, 20157 Milano, Italy; federicozicarelli{at}


Aims To study widefield imaging features, analyse risk factors for progression and compare treatment modalities of peripheral exudative haemorrhagic chorioretinopathy (PEHCR).

Methods Clinical and imaging data from each visit were collected, including near-infrared reflectance, fluorescein angiography, indocyanine green angiography, optical coherence tomography using the Spectralis platform (Heidelberg Engineering). Clinical features and treatment performed were recorded. Lesions were classified according to treatments used and according to the prognostic index of macular involvement (MI) and intravitreal bleeding (IVB).

Results 50 eyes of 35 patients were retrospectively enrolled. Using widefield imaging, peripheral subretinal fluid (SRF) was detected in 31 (62%) eyes and peripheral neovascular networks were detected in 42 (84%) eyes and graded as focal, diffuse and subtotal in 22 (44%), 17 (34%) and 11 (22%) eyes, respectively. MI secondary to PEHCR during the follow-up was documented in 17 (34%) eyes, while IVB occurred in 7 (14%) eyes. Both MI and IVB correlated with peripheral SRF and lesion grade. Active treatment included anti-vascular endothelial growth factor (anti-VEGF) injections, photodynamic therapy (PDT) and combined anti-VEGF and PDT for 13 (26%), 1 (2%) and 18 (36%) eyes, respectively. In eyes with risk factors, anti-VEGF and combined treatment inversely correlated with MI incidence.

Conclusions In our series, peripheral subretinal exudation and the extension of peripheral involvement represented risk factors for MI in eyes with PEHCR. In those high-risk eyes, active treatment is warranted.

  • Choroid
  • Retina
  • Imaging
  • Macula
  • Neovascularisation

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  • Contributors FZ, GS and MP contributed to conception of the work, critical revision of the article and final approval of the version to be published. FZ and CP contributed to data collection and data analysis and interpretation. FZ contributed to drafting the article. The study was approved by the Luigi Sacco Hospital Review Board as a retrospective non-interventional study; therefore, no approval ID was provided.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplemental information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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