Hidden in the Periphery: A Case Report on Peripheral Exudative Hemorrhagic Chorioretinopathy

Introduction: Peripheral exudative hemorrhagic chorioretinopathy is an uncommon degenerative peripheral retinal condition characterized by multilayered hemorrhaging, exudation, or both that is beneath the retinal pigment epithelium or sensory retina. Its exact etiology is not well understood. Case Report: A 91-year-old Caucasian male presented for a routine eye exam without visual complaints. His medical history included prediabetes, anemia, arrhythmia, atrial fibrillation, chronic kidney disease, hypertension, hyperlipidemia, and a history of bladder cancer. His ocular history included pseudophakia, dry eye syndrome, hypertension without ocular complications, and refractive error with presbyopia. His dilated fundus exam revealed extensive multilayered temporal peripheral hemorrhaging in the left eye. Over time, the hemorrhaging gradually resolved with residual peripheral fibrosis in the left eye. Conclusion: Peripheral exudative hemorrhagic chorioretinopathy should be considered in elderly patients presenting with peripheral multilayered hemorrhaging. Multimodal imaging helps in distinguishing peripheral exudative hemorrhagic chorioretinopathy from malignant and vascular mimickers. Most cases resolve with observation, although continued monitoring is warranted.