Peripheral exudative hemorrhagic chorioretinopathy: polypoidal choroidal vasculopathy and hemodynamic modifications.
OBJECTIVE
To investigate choroidal vascular abnormalities in peripheral exudative hemorrhagic chorioretinopathy, using dynamic ultrawide-field fluorescein angiography (FA) and indocyanine green angiography (ICGA).


METHODS
Prospective observational case series.


METHODS
This institutional study comprised a consecutive series of 40 patients (48 eyes) with peripheral exudative hemorrhagic chorioretinopathy. Choroidal vascular abnormalities were assessed with dynamic ultrawide-field (150-degree) FA and ICGA, using the Staurenghi 230 SLO Retina Lens and the Heidelberg scanning laser ophthalmoscope. The main outcome measures were morphologic descriptions of structural vascular abnormalities and choroidal hemodynamics (comparison with 30 normal eyes).


RESULTS
The peripheral mass lesions were highly exudative and hemorrhagic, and usually associated with a pigment epithelium detachment. FA revealed nonspecific alterations corresponding to the visible fundoscopic changes (window defects, blockage, staining), but no neovascular membrane. However, despite frequent masking, ICGA showed hyperfluorescent polyp-like structures in the choroid of the lesion area in 33 eyes (69%) and an abnormal choroidal vascular network in 24 eyes (50%). The abnormal choroidal vascular network filled in the arterial or early venous phase, while the polyp-like structures filled some seconds later. Optical coherence tomography revealed the typical dome-shaped elevation of the pigment epithelium over the vascular polyps. Peripheral choriocapillaris closure was observed as well as dilated shunting vessels.


CONCLUSIONS
Peripheral exudative hemorrhagic chorioretinopathy shares many characteristics (polyp-like choroidal telangiectases, abnormal choroidal vascular networks, exudative and hemorrhagic presentation) with polypoidal choroidal vasculopathy. Clarification of the precise role of these abnormalities requires further studies.
Ophthalmology Department of the University of Lausanne, Jules-Gonin Eye Hospital, Switzerland. irmela.mantel@fa2.ch
Irmela
I
Mantel
Ann
A
Schalenbourg
Leonidas
L
Zografos
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000175:diagnosis*; D004396:Coloring Agents; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D011127:Polyps / Q000175:diagnosis*; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000175:diagnosis*; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green