Zhu X M, Cheng Y, Deng X, Linghu D D, Liu K L, Liang J H
Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing 100044, China.
Zhonghua Yan Ke Za Zhi. 2023 Mar 11;59(3):187-195. doi: 10.3760/cma.j.cn112142-20221024-00527.
To evaluate the clinical features and outcomes of eyes with peripheral exudative hemorrhagic chorioretinopathy (PEHCR). It was a retrospective case series study. A total of 12 patients (12 eyes) diagnosed with PEHCR at Peking University People's Hospital from October 2016 to December 2019 were included. The clinical data of visual acuity, slit-lamp microscopy, indirect ophthalmoscopy, fundus photography, B-ultrasound, optical coherence tomography, fluorescein fundus angiography and indocyanine green angiography, surgical procedures, therapeutic effects and follow-up were analyzed. Among all 12 patients included, 7 were male and 5 were female. The age was (58.0±8.8) years. All patients had unilateral disease. The right eye was involved in 6 cases and the left eye in 6 cases. All cases presented with vitreous hemorrhage, 9 of which presented with intraocular space-occupying lesions. In the patients with intraocular space-occupying lesions, the maximum basal diameter was (8.3±1.6) mm and the height was (3.5±1.2) mm measured by B-ultrasound. A-scan ultrasonography was characterized by intermediate high reflectivity or intermediate low reflectivity. Fundus fluorescence angiography revealed nonspecific alterations corresponding to the visible fundoscopic changes such as window defects, blockage, staining, but no neovascular membrane. No polyps were found on indocyanine green angiography. All patients received vitrectomy. The intraocular lesions were found to be subretinal bleeding and exudative masses intraoperatively. Two patients had combined cataract surgery; three patients received gas or silicone oil tamponade, and three patients received adjunct intravitreal anti-vascular endothelial growth factor drugs during the follow-up. The follow-up period was (30.0±12.6) months. At the last visit, the visual acuity was improved in 11 patients and remained stable in 1 patient. PEHCR is a peripheral hemorrhagic retinal degenerative disorder that simulates choroidal melanoma and lacks characteristic angiography changes. The overall therapeutic effect and prognosis are good.
评估周边渗出性出血性脉络膜视网膜病变(PEHCR)患眼的临床特征及预后。这是一项回顾性病例系列研究。纳入了2016年10月至2019年12月期间在北京大学人民医院诊断为PEHCR的12例患者(12只眼)。分析了视力、裂隙灯显微镜检查、间接检眼镜检查、眼底照相、B超、光学相干断层扫描、荧光素眼底血管造影和吲哚菁绿血管造影的临床资料、手术操作、治疗效果及随访情况。纳入的12例患者中,男性7例,女性5例。年龄为(58.0±8.8)岁。所有患者均为单眼患病。右眼受累6例,左眼受累6例。所有病例均有玻璃体积血,其中9例伴有眼内占位性病变。在有眼内占位性病变的患者中,B超测量最大基底直径为(8.3±1.6)mm,高度为(3.5±1.2)mm。A超超声检查表现为中等高反射率或中等低反射率。眼底荧光血管造影显示与可见眼底改变相对应的非特异性改变,如窗样缺损、遮挡、染色,但无新生血管膜。吲哚菁绿血管造影未发现息肉。所有患者均接受了玻璃体切除术。术中发现眼内病变为视网膜下出血和渗出性肿块。2例患者联合白内障手术;3例患者接受了气体或硅油填充,3例患者在随访期间接受了玻璃体内抗血管内皮生长因子药物辅助治疗。随访时间为(30.0±12.6)个月。末次随访时,11例患者视力提高,1例患者视力稳定。PEHCR是一种周边出血性视网膜退行性疾病,类似脉络膜黑色素瘤,缺乏特征性血管造影改变。总体治疗效果及预后良好。