PT  - JOURNAL ARTICLE
AU  - Sarah Vandefonteyne
AU  - Jean-Pierre Caujolle
AU  - Laurence Rosier
AU  - John Conrath
AU  - Gabriel Quentel
AU  - Ramin Tadayoni
AU  - Celia Maschi
AU  - Yannick Le Mer
AU  - Corinne Dot
AU  - Isabelle Aknin
AU  - Juliette Thariat
AU  - Stephanie Baillif
TI  - Diagnosis and treatment of peripheral exudative haemorrhagic chorioretinopathy
AID  - 10.1136/bjophthalmol-2018-313307
DP  - 2019 Oct 23
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2018-313307
4099  - http://bjo.bmj.com/content/early/2019/10/23/bjophthalmol-2018-313307.short
4100  - http://bjo.bmj.com/content/early/2019/10/23/bjophthalmol-2018-313307.full
AB  - 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.