Treatment of peripheral exudative hemorrhagic chorioretinopathy by intravitreal injections of ranibizumab

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a rare disorder that sometimes causes sudden subretinal and/or vitreous hemorrhage. Choroidal neovascularization is involved in the pathogenesis, but the etiology is unknown. Treatments with photocoagulation, cryopexy, and intravitreal bevacizumab injection have been reported. However, the therapeutic effect of intravitreal injection with ranibizumab for PEHCR is unclear. A 70-year-old woman visited our department because of sudden loss of superior visual field in her left eye. She had a history of surgical removal of hematoma due to subretinal hemorrhage associated with age-related macular degeneration 5 years ago. Peripheral subretinal hemorrhage was observed in the left eye, and fluorescein and indocyanine green angiography revealed choroidal neovascularization in the subretinal hemorrhagic region. PEHCR was diagnosed. Considering her past history, intravitreal ranibizumab injection was used for treatment. After three injections in the left eye, subretinal hemorrhage and choroidal neovascularization resolved completely. No recurrence was observed during 1 year of follow-up. This case demonstrates that intravitreal injection of ranibizumab is an effective treatment for PEHCR with subretinal hemorrhage.