Peripheral Exudative Hemorrhagic Chorioretinopathy Simulating Choroidal Melanoma in 173 Eyes

Purpose: To evaluate the clinical features and outcomes of eyes with peripheral exudative hemorrhagic chorioretinopathy (PEHCR) simulating choroidal melanoma. Design: Noncomparative case series. Participants: A total of 173 eyes in 146 patients. Methods: Retrospective chart review. Main Outcome Measures: Clinical features and outcome. Results: All cases were referred for possible choroidal melanoma. The mean patient age was 80 years, 145 (99%) were Caucasian, and 98 (67%) were female. The main lesion had a mean diameter of 10 mm and mean thickness of 3 mm. The lesion was located temporally in 103 eyes (77%), involved 1 or 2 quadrants in 123 eyes (92%), and was located between the equator and the ora serrata in 119 eyes (89%). Features included subretinal hemorrhage in 134 eyes (78%), retinal exudation in 37 eyes (21%), retinal pigment epithelial (RPE) detachment in 48 eyes (28%), and sub-RPE hemorrhage in 45 eyes (26%). Peripheral RPE alterations or drusen were found in 120 ipsilateral eyes (69%) and 73 contralateral eyes (42%). Macular RPE alterations, drusen, or choroidal neovascularization was found in 83 ipsilateral eyes (48%) and 97 contralateral eyes (56%). After observation (mean 15 months), lesion regression or stability was found in 80 eyes (89%) and progression was found in 10 eyes (11%). Conclusions: PEHCR is a hemorrhagic retinal degenerative process that simulates choroidal melanoma. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2009; 116:529-535 (C) 2009 by the American Academy of Ophthalmology.