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Diagnosis and treatment of peripheral exudative haemorrhagic chorioretinopathy
  1. Sarah Vandefonteyne1,
  2. Jean-Pierre Caujolle1,
  3. Laurence Rosier2,
  4. John Conrath3,
  5. Gabriel Quentel4,
  6. Ramin Tadayoni5,
  7. Celia Maschi1,
  8. Yannick Le Mer6,
  9. Corinne Dot7,
  10. Isabelle Aknin8,
  11. Juliette Thariat9,
  12. Stephanie Baillif1
  1. 1Department of Ophthalmology, Pasteur 2 University Hospital, Nice, France
  2. 2Department of Ophthalmology, Galien Eye Clinic, Centre d’Exploration et de Traitement de la Retine et de la Macula, Bordeaux, France
  3. 3Department of ophthalmology, Centre d’Ophtalmologie Monticelli-Paradis, Marseille, France
  4. 4Department of Ophthalmology, Centre d'imagerie et de Laser, Paris, France
  5. 5Department of ophthalmology, Lariboisière University Hospital, Paris, France
  6. 6Department of ophthalmology, A. de Rothschild Ophthalmologic Foundation, Paris, France
  7. 7Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
  8. 8Department of ophthalmology, Oxford Clinic, Cannes-Juan-les-pins, France
  9. 9Department of radiotherapy, Centre François Baclesse / ARCHADE, Caen, France
  1. Correspondence to Dr Celia Maschi, Centre Francois Baclesse/ARCHADE, Mathieu 14000, France; maschi.c{at}chu-nice.fr

Abstract

Purpose Peripheral exudative haemorrhagic chorioretinopathy (PEHCR) is a rare disorder that is often misdiagnosed. The aim of this study was to better characterise PEHCR and to assess treatment options.

Material and methods Retrospective multicentric chart review.

Results Of 84 eyes (69 patients) with PEHCR referred between 2005 and 2017, the most common referral diagnosis was choroidal melanoma (41.3%). Bilateral involvement was found in 21.7% of cases. Haemorrhagic retinal pigment epithelium detachment was the most common peripheral lesion (53.6%). Maculopathy was associated with peripheral lesions in 65.8% of cases. PEHCR lesions were mostly heterogeneous (58.8%) on B-scan ultrasonography. Choroidal neovascularisation was found in 10 eyes (26.3%) out of 38 eyes that underwent fluorescein angiography. Polyps were observed in 14 eyes (58.3%) out of 24 eyes that underwent indocyanine green angiography. Fifty-one eyes were treated (62.2%). Intravitreal injections (IVTI) of antivascular endothelial growth factor (VEGF) were the most used treatment (36.6%) before laser photocoagulation, photodynamic therapy, vitrectomy and cryotherapy. Only vitrectomy improved visual acuity. Most lesions (65.6%) regressed at the last follow-up visit.

Conclusion In case of PEHCR, multimodal imaging is useful to avoid misdiagnosis, to characterise PEHCR lesions and to guide treatment strategies. Regression of PEHCR lesions was observed in two-thirds of the patients. Vitrectomy improved visual acuity. More than a third of patients underwent anti-VEGF IVTI. Further studies are needed to assess IVTI’s efficacy.

  • peripheral exudative hemorrhagic chorioretinopathy
  • imaging
  • angiography
  • ultrasonography
  • treatment
  • visual acuity
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Footnotes

  • Twitter @CAUJOLLE JP, @Dr Laurence ROSIER, @jthariat

  • Contributors SV, JT and SB contributed to the concept, collection of data analysis of data writing editing review. J-PC, LR, JC, GQ, RT, CM, YLM, CD and IA contributed to the collection of data writing review.

  • 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.

  • Patient consent for publication Not required.

  • Ethics approval This retrospective study was approved by the institutional review boards of the nine participating institutions (five public/private hospitals and four private practices).

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

  • Data availability statement Data may be obtained from a third party and are not publicly available.

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