CHRPE ( congenital hypertrophic RPE) common benign 1% of population (typical form)
✅CHRPE ( congenital hypertrophic RPE) 2 types:
✍ Typical form
☝unilateral (solitary or grouped (bear tracks)
☝unrelated to systemic disease.
• black,well-defined, round lesion
• often with depigmented lacunae deep to the neurosensory retina
• usually 2–5mm with slow progressive enlargement.
• smaller lesions
• grouped to form bear tracks
• usually <2mm.
✍ Atypical form
☝black oval lesions with irregular depigmentation
☝ 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:
☝ not required
☝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