Good Hope Eye Clinic

Congenital hypertrophy of the retinal pigment epithelium

David Kinshuck

Congenital hypertrophy of the retinal pigment epithelium (CHRPE)

photo of CHRPE (thanks to LIverpool colleagues)

this is a darker CHRPE lesion. More typical lesions are lighter with a halo

Familial polyposis coli patients have about a 50% risk of having CHRPE. Whilst this bowel condition can lead to bowel cancers, the eye changes are harmless...they are just patches of pigment in the retina, similar to a freckle. They are darker and more pigmented than naevi.  CHRPEs are important findings in the relations of familial adenomatous polyposis patients (Gardner' syndrome). On the other hand very few patients with CHRPE have bowel cancer problems (see)  

If you are an ophthalmologist, or an optometrist familiar with CHRPE, what should you do?

At a recent discussion (2008) with a retinal professor

  • ask if there is a personal or family history of bowel cancer
  • if there is no family history, no action is needed
  • the CHRPE retinal marks are harmless
  • if there is a family history of bowel cancer, referral to a lower bowel gastroenterologist is advisable
  • advise patients how to lower the risk of bowel cancer...avoid smoking, avoid lots of red med, avoid saturated and transfats, do eat 7-9 portions of vegetables/fruit day  (the same diet for healthy hearts and maculae), and have plenty of exercise, keep thin
  • lesions with haloes are more suspicious