Peripheral Exudative Hemorrhagic Chorioretinopathy Simulating Choroidal Melanoma in 173 Eyes

PurposeTo evaluate the clinical features and outcomes of eyes with peripheral exudative hemorrhagic chorioretinopathy (PEHCR) simulating choroidal melanoma.DesignNoncomparative case series.ParticipantsA total of 173 eyes in 146 patients.MethodsRetrospective chart review.Main Outcome MeasuresClinical features and outcome.ResultsAll 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%).ConclusionsPEHCR 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.