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<article article-type="research-article" dtd-version="1.3" xml:lang="en">
  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Czech and Slovak Ophthalmology</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">114</article-id>
      <article-id pub-id-type="doi">10.31348/2019/2/4</article-id>
      <article-categories>
        <subj-group>
          <subject>Case report</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Peripheral Exudative Heamorrhagic Chorioretinopathy</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Mazal</surname>
            <given-names>Zdeněk</given-names>
          </name>
        </contrib>
      </contrib-group>
      <pub-date date-type="pub" publication-format="electronic">
        <day>20</day>
        <month>7</month>
        <year>2019</year>
      </pub-date>
      <issue>2</issue>
      <elocation-id>4</elocation-id>
      <abstract>
        <p>Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is relatively rare and especially less known and therefore less often diagnosed condition of the retina periphery predominantly in patients of higher age. Usually temporal periphery is affected. The finding is bilateral in approximately 30 %. Clinically it manifests by multibulbar prominences in periphery, which can sometimes resemble choroidal melanoma. It concerns exudations and hemorrhages under retina (sub-retinal) or under retinal pigment epithelium (sub-RPE). Within weeks or months hemorrhagy is resorbed and flattened and chorioretinal atrophy of various grade remains in affected area, sometimes combined with retinal fibrosis. If the affected area remains limited to the periphery, the central visual acuity does not have to be reduced. Affection is considered to be peripheral form of wet age-related macular degeneration or peripheral form of idiopathic polypoidal choroidal vasculopathy. By differential diagnosis is necessary to exclude especially malignant choroidal melanoma and choroidal detachment. Case report: Own case of 83 years old patient with bilateral PEHCR is described and photo documented. Creation of new prominence - fresh bleeding under retina and RPE in superior periphery – had been captured. Photo documentation of lesion in early stage and in stage of resorbtion after several weeks. Affected areas remained limited to periphery and did not have influence on central vision. That was influenced by degeneration of macula and vitreomacular traction syndrome with distinct epiretinal membrane. Conclusion: PEHCR is less frequent or less diagnosed condition of the retina periphery in old patients. Ongoing exudation and sub-retinal or sub-RPE bleeding. Within weeks heals with chorioretinal scars and subretinal fibrosis. Central vision does not have to be damaged, if lesions do not spread to macula.</p>
      </abstract>
      <kwd-group>
        <kwd>peripheral exudative hemorrhagic chorioretinopathy</kwd>
        <kwd>chorioretinal atrophy</kwd>
        <kwd>subretinal fibrosis</kwd>
        <kwd>choroidal melanoma</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <back>
    <ref-list>
      <title>References</title>
      <ref id="R6670">
        <mixed-citation>Annesley, WH Jr.: Peripheral exudative hemorrhagic chorio - retinopathy. Trans Am Ophthalmol Soc, 78; 1980: 321-364.</mixed-citation>
      </ref>
      <ref id="R6671">
        <mixed-citation>Collaer, N., James, C.: Peripheral exudative and hemorrhagic chorio-retinopathy…the peripheral form of age-related macular degeneration? Report on 2 cases. Bull Soc Belge Ophtamol, 305; 2007: 23-26.</mixed-citation>
      </ref>
      <ref id="R6672">
        <mixed-citation>Goldman, DR., Freund, KB., McCannel, CA.: Peripheral poly - poidal chorioideal vasculopathy as a cause of peripheral exudative hemorrhagic chorioretinopathy: A report of 10 eyes. Retina, 33(1); 2013: 48-55.</mixed-citation>
      </ref>
      <ref id="R6673">
        <mixed-citation>Mantel, I., Schalenbourg, A., Zografos, I.: Peripheral exudative hemorrhagic chorioretinopathy: polypoidal chorioideal vasculopathy and hemodynamic modifications. Am J Ophthalmol, 153(5); 2012 :910-922.e2.</mixed-citation>
      </ref>
      <ref id="R6674">
        <mixed-citation>Mantel, I., Uffer, S., Zografos, I.: Peripheral exudative hemorrhagic chorioretinopathy: a clinical, angiografic and histologic study. Am J Ophthalmol, 148(6); 2009: 932-938.</mixed-citation>
      </ref>
      <ref id="R6675">
        <mixed-citation>Mashayekhi, A., Shields, CL., Shields, JA.: Peripheral exuda - tive hemorrhagic chorioretinopathy: a variant of polypoidal chorioideal vasculopathy? J Ophthalmic Vis Res, 33(1); 2013: 264-267.</mixed-citation>
      </ref>
      <ref id="R6676">
        <mixed-citation>Sabherwal, NS., Chris, JL., Shields, CL.: Peripheral exudative hemorrhagic chorioretinopathy simulating chorioideal melanoma. Retina Today, 4; 2014: 47-49.</mixed-citation>
      </ref>
      <ref id="R6677">
        <mixed-citation>Seibel, I., Hager, A., Duncker, T., et al.: Anti-VEGF therapy in symptomatic peripheral exudative hemorrhagic choriore- tinopathy(PEHCR) involving the macula. Graefes Arch Clin Exp Ophthalmo, 254(4); 2016: 653-659.</mixed-citation>
      </ref>
      <ref id="R6678">
        <mixed-citation>Shields, CL., Furuta, M., Thangappan, A., et al.: Metastasis of uveal melanoma millimeter-by-millimeter in 8033 consecutive eyes. Arch Ophthalmol, 127; 2009: 989-998.</mixed-citation>
      </ref>
      <ref id="R6679">
        <mixed-citation>Shields, JA., Mashayekhi, A., Ra, S.: Pseudomelanomas of the posterior uveal tract: the 2006 Taylor R.Smith Lecture. Retina, 25(6); 2005: 767-771.</mixed-citation>
      </ref>
      <ref id="R6680">
        <mixed-citation>Shields, CL., Sakazar, PF., Mashayekhi, A.: Peripheral exudative hemorrhagic chorioretinopathy simulating chorioideal melanoma in 173 eyes. Ophthalmology, 116(3); 2009: 529-535.</mixed-citation>
      </ref>
      <ref id="R6681">
        <mixed-citation>Studnička, J.: Periferní exudatívní hemoragická chorioretinopatie. In Studnička, J. et al.: Onemocnění sítnice a cévnatky v praxi. Praha, Mladá fronta, 2018, s. 142-144.</mixed-citation>
      </ref>
      <ref id="R6682">
        <mixed-citation>Warren, A., Welch, J., Shields, CL.: Peripheral exudative hemorrhagic chorioretinopathy with polyps. Retina Today, 12(2); 2017: 38-40.</mixed-citation>
      </ref>
    </ref-list>
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</article>
