Transvitreal endoresection of peripheral exudative hemorrhagic chorioretinopathy: a clinicopathological study

To report a rare case of presumed early-stage peripheral exudative hemorrhagic chorioretinopathy (PEHCR), which was removed by transvitreal approach, and analyze the histological findings.

A 76-year-old Japanese woman presented with a fundus lesion in her left eye, and was referred to our university hospital. Her best-corrected visual acuity was 1.0 with normal intraocular pressure in both eyes. The color fundus revealed a whitish elevated lesion, measuring about 2 disc diameters, in the inferior fundus. Fluorescein angiography depicted hyperfluorescence and fluorescein leakages in the lesion in the early and late phases, respectively. Indocyanine green angiography demonstrated the hypofluorescence in the lesion without any hyperfluorescent spots. Swept-source optical coherence tomography of the lesion demonstrated a subretinal solid mass with subretinal fluid and pigment epithelial detachments. Since clinical diagnosis of the fundus lesion could not be made, transvitreal endoresection of the lesion was conducted by pars plana vitrectomy. Her visual acuity remained good with no any complications 1 year after vitrectomy. Histopathologically, the lesion was made up of AE1/AE3 (an epithelial marker)-positive retinal pigment epithelial cells, with CD34 and alpha-smooth muscle actin-positive vessel walls, which were consistent with choroidal neovascularization (CNV). These clinicopathological findings led to the diagnosis of PEHCR.

This is the first reported case of transvitreal endoresection of PEHCR, and the histopathology indicated that the origin was peripheral CNV.