http://www.evrs.eu/medias/2010/congress/Non-Age-Related-Macular-Degeneration-Nor-Diabetes-Neovascularization.flv

Alexandra Brix, Klaus Lucke (Bremen, Germany)

Advantages:

To describe PEHCR, a not so rare condition in the elderly. It is often only an accidental finding without functional or therapeutic consequences. There is surprisingly little literature on the condition which has been given a variety of names such as for instance „peripheral form of AMD“. Not infrequently PEHCR is misdiagnosed as a malignant melanoma.
Occasionally patients present with sudden visual loss due to a vitreous hemorrhage or an exudative macular detachment. The fellow eye frequently is helpful in making the diagnosis. In most cases of PEHCR it is not necessary to intervene, but for patients with persistent vitreous hemorrhage or macular detachment a surgical approach could be an option.

Methods:

We report on two patients with exudative macular detachment due to PEHCR that were treated with vitrectomy, peripheral retinotomy, subretinal membrane and hemorrhage removal and silicone oil tamponade.

Effectiveness / Safety:

Intra- and postoperative courses were uncomplicated. Both patients regained 2 to 3 lines in visual acuity. PEHCR is probably one of the most underrecognized diseases in ophthalmology and frequently misdiagnosed.  90% of the lesions are stable or regressive and it is not necessary to treat them. An Injection of VEGF-Inhibitors seems to be ineffective and the question remains open whether there are choroidal neovascular membranes underlying this condition. In cases of persistent vitreous hemorrhage or macular detachment surgical removal is indicated particularly since there is no other therapy available.

Take home message:

In Peripheral Exudative Hemorrhagic Chorioretinopathy with Macular Detachment surgical removal is useful for the preservation and restoration of visual function.