Incidental CHRPE of the left eye identified during evaluation of acute flashes
Location
Moultrie, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Background: Congenital hypertrophy of the retinal pigment epithelium (CHRPE) is a benign, congenital lesion of the RPE most often discovered incidentally on dilated fundus examination or widefield imaging. Typical solitary CHRPE is unilateral, flat, sharply demarcated, and densely pigmented, sometimes with depigmented lacunae. While solitary CHRPE is generally not associated with systemic disease, multiple, bilateral CHRPE-like lesions particularly when numerous and irregular can be associated with familial adenomatous polyposis (FAP). Recognition of characteristic features helps distinguish CHRPE from melanocytic lesions and guides appropriate counseling.
Case Presentation: A 75-year-old woman presented for acute flashes in the right eye for one day, worsened by eye movement and darkness, without vision loss. Ocular history included recent cataract surgery in both eyes. Examination showed visual acuity approximately 20/25 OD, and intraocular pressures measured 16 mmHg OU. Dilated fundus examination and Optos imaging were performed. The right eye was consistent with posterior vitreous detachment/vitreous degeneration without holes, breaks, or retinal tears on 360-degree evaluation. During imaging review, an incidental lesion in the left eye (OS) was identified consistent with CHRPE: a flat, well-circumscribed, densely pigmented geographic lesion without features concerning malignancy (no elevation, hemorrhage, or exudation apparent). The patient reported no known family history of colorectal polyps or colorectal cancer.
Management and Outcome: The patient was counseled on retinal detachment warning signs for the symptomatic right eye and advised routine monitoring of the CHRPE lesion with baseline photography and periodic follow-up to document stability. Given the unilateral, solitary appearance and absence of suggestive family history, systemic evaluation for FAP was not prioritized.
Conclusion: This case highlights classic CHRPE imaging features and the value of recognizing benign versus high-risk lesion patterns during routine retinal imaging.
Embargo Period
5-26-2026
Incidental CHRPE of the left eye identified during evaluation of acute flashes
Moultrie, GA
Background: Congenital hypertrophy of the retinal pigment epithelium (CHRPE) is a benign, congenital lesion of the RPE most often discovered incidentally on dilated fundus examination or widefield imaging. Typical solitary CHRPE is unilateral, flat, sharply demarcated, and densely pigmented, sometimes with depigmented lacunae. While solitary CHRPE is generally not associated with systemic disease, multiple, bilateral CHRPE-like lesions particularly when numerous and irregular can be associated with familial adenomatous polyposis (FAP). Recognition of characteristic features helps distinguish CHRPE from melanocytic lesions and guides appropriate counseling.
Case Presentation: A 75-year-old woman presented for acute flashes in the right eye for one day, worsened by eye movement and darkness, without vision loss. Ocular history included recent cataract surgery in both eyes. Examination showed visual acuity approximately 20/25 OD, and intraocular pressures measured 16 mmHg OU. Dilated fundus examination and Optos imaging were performed. The right eye was consistent with posterior vitreous detachment/vitreous degeneration without holes, breaks, or retinal tears on 360-degree evaluation. During imaging review, an incidental lesion in the left eye (OS) was identified consistent with CHRPE: a flat, well-circumscribed, densely pigmented geographic lesion without features concerning malignancy (no elevation, hemorrhage, or exudation apparent). The patient reported no known family history of colorectal polyps or colorectal cancer.
Management and Outcome: The patient was counseled on retinal detachment warning signs for the symptomatic right eye and advised routine monitoring of the CHRPE lesion with baseline photography and periodic follow-up to document stability. Given the unilateral, solitary appearance and absence of suggestive family history, systemic evaluation for FAP was not prioritized.
Conclusion: This case highlights classic CHRPE imaging features and the value of recognizing benign versus high-risk lesion patterns during routine retinal imaging.