Good Hope, Heartlands, and Solihull Eye Clinics

Congenital hypertrophy of the retinal pigment epithelium

David Kinshuck



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?



  • Very dark, isolated, grouped, much more common peripherally,
  • if posterior pole think again,
  • deep pigment, grow, not malignant
  • Lacunae with age
  • Grouped...termed bear track