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Br J Ophthalmol ; 104(6): 874-878, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31645320

RESUMO

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.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Doenças da Coroide/diagnóstico , Crioterapia/métodos , Angiofluoresceinografia/métodos , Fotocoagulação a Laser/métodos , Hemorragia Retiniana/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças da Coroide/complicações , Doenças da Coroide/terapia , Feminino , Fundo de Olho , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/terapia , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia/métodos
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