Abstract

FR.21.09

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) or intraocular tumor?

Stefanie Thomas, Norbert Bornfeld

Zentrum für Augenheilkunde, Universitätsklinikum Essen

Objective
Peripheral exudative hemorrhagic chorioretinopathy can be mistaken for an uveal melanoma or vice versa in clinical practice. What about very expressive clinical alterations?
The uveal melanoma is the most common primary intraocular malignancy in adults. Initial symptoms of this relatively rare tumor depend on the location of the tumor, especially tumors on the posterior pole show early symptoms.
The PEHCR is a regularly bilateral disease of the peripheral retina and choroidea and supposed to be caused by choroidal neovascularisation with loss of visual acuity in case of central progressive exudation. Especially subretinal bleeding can simulate choroidal melanoma.
Methods
Comparison of typical clinical features of patients with PEHCR and choroidal melanoma of 39 patients with fluorescein angiography and clinical aspects.
Results
Ophthalmoscopic characteristics of choroidal melanomas are pigmentation, tumorspecific vascular system, orange pigment at the surface of the tumor and exudative retinal detachment, in contrast to amelanotic tumors, which caused differential diagnostic problems.
In comparison to choroidal melanoma PEHCR is a hemorrhagic retinal degenerative process that can simulate such a tumor. It is characterized by retinal pigment epithelial (RPE) detachment, subretinal and sub-RPE hemorrhage and retinal exudation with various expression.
Conclusions
The PEHCR which appears with multiple, large-scale variances already differs clinically from the circumscribed less variable manifestation of choroidal melanoma.

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