Clinical characteristics of peripheral exudative hemorrhagic chorioretinopathy easily misdiagnosed at initial presentation in Korean patients

Few studies have comprehensively examined the clinical features of peripheral exudative hemorrhagic chorioretinopathy (PEHCR) due to its low prevalence. This study analyzed the clinical characteristics of patients diagnosed with PEHCR at a single center in Korea. We conducted a retrospective review of patient records from November 2005 to December 2020. The cohort included 36 patients (43 eyes), with a mean age of 70 years, and 67% were female. The mean initial best-corrected visual acuity was 0.95 logMAR (Snellen equivalent, 0.11). The most common initial symptom was decreased visual acuity, followed by floaters and visual field defects, while 26% of patients reported no ocular symptoms. Lesions were predominantly located in the inferotemporal (58%) and superotemporal quadrants (51%), with exudations being the most prevalent finding (65%). More than half of the patients (56%) were initially misdiagnosed with choroidal melanoma, while only 8% received the correct diagnosis of PEHCR. Of the 37 eyes (86%) that received treatment, 57% received anti-vascular endothelial growth factor injections, and 19% underwent vitrectomy. PEHCR is a rare degenerative condition with varied presentations in the peripheral retina, often leading to misdiagnosis and delayed treatment. Thus, careful monitoring and appropriate management are essential to minimize the risk of vision-threatening complications.