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Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.
On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.
A dilated fundus examination was performed demonstrating the following:
Patient Presentation: An 88-year-old female was referred to the ocular oncology service to “rule out neoplasm.” The patient symptomatically noted decreased vision in her right eye for 1 month. Her past ocular history included retinal detachment repair OD 15 years ago, primary open angle glaucoma controlled with topical agents, and dry age-related macular degeneration changes for the past 2 years. Vision was 20/50 OD and 20/25 OS with normal IOP and pupillary examination. Optos widefield fundus photos are shown below. Notably, a laser scar was appreciated in the far temporal periphery OD, along with a suspicious, well-demarcated, dark, circular lesion in the mid-far periphery at 10 o’clock.
Fundus autofluorescence OD and bilateral OCTs of the macula were conducted and shown below:
Question: What finding is not appreciated in this OCT macula above?
A B-scan ultrasound with corresponding A-scan was completed over the lesion in the periphery and shown below, which demonstrated a lesion with a hyperechoic surface and hypoechoic core. This hypoechogenicity, if looking at the corresponding A-scan, produces a low signal similar to the level of the vitreous.
An OCT over the lesion was performed and showed below:
Question: What finding is not seen in the above OCT of the lesion?
Question: Based on fundus photo, FAF, ultrasound and OCT of the lesion, what is the most likely diagnosis?
Question: Which of the following diseases have been postulated to be a variant or causative entity of PEHCR?
Question: What treatment is typically indicated for asymptomatic PEHCR?
To understand the OCT features, fundus findings and ultrasound characteristics of peripheral exudative hemorrhagic chorioretinopathy.
To differentiate PEHCR from choroidal melanoma.
Associations and treatments of PEHCR.
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