CHRPE ( congenital hypertrophic RPE)

✍ Typical form

☝unilateral (solitary or grouped (bear tracks)

☝unrelated to systemic disease.

☝ Solitary
• black,well-defined, round lesion
• often with depigmented lacunae deep to the neurosensory retina
• usually 2–5mm with slow progressive enlargement.

☝ Grouped

• smaller lesions

• grouped to form bear tracks

• usually <2mm.

✍ Atypical form

☝bilateral

☝multifocal

☝widely separated

☝black oval lesions with irregular depigmentation

☝usually <2mm

☝ associated with familial adenomatous polyposis and its variants(Gardner, turcot)

✅CHRPE ( congenital hypertrophic RPE) histologically

☝RPE cells are of increased height

☝ increased hyperpigmentation

✅CHRPE ( congenital hypertrophic RPE) Investigation and treatment:

✍ typical

☝ not required

✍ atypical

☝exclude familial adenomatous polyposis if so , prophylactic colectomy is recommended

☝untreated familial adenomatous polyposis, the development of colonic carcinoma is almost universal) .

☝ CNVM is reported with reasonable improvement with PDT or antiVEGF intravitreally