Peripheral exudative hemorrhagic chorioretinopathy: a variant of polypoidal choroidal vasculopathy?

To report a case of peripheral exudative hemorrhagic chorioretinopathy (PEHCR) in an elderly patient.

A 74-year-old Caucasian woman, with a 20-year history of a stable choroidal nevus in her right eye, was referred for evaluation of two small hemorrhagic pigment epithelial detachments (PEDs) affecting the temporal peripheral fundus of the same eye. Nine months later, the lesions became larger and indocyanine green angiography revealed polypoidal choroidal vascular changes corresponding to the location of the ophthalmoscopically visible PEDs. Despite one session of verteporfin photodynamic therapy, the lesions continued to enlarge eventually resulting in the development of a large hemorrhagic PED, which failed to respond to two subsequent injections of intravitreal bevacizumab. The final ophthalmoscopic appearance of the large hemorrhagic PED was typical of PEHCR.

This case suggests that polypoidal choroidal vascular changes similar to that seen in our patient may underlie the development of PEHCR in some cases.