- The differential diagnosis of dark fundus lesions include choroidal nevi, CHRPE, reactive hyperplasia of the RPE, melanoma and inflammatory lesions.
- In most cases, knowledge of the various clinical presentations of each allow for the differential diagnosis.
- CHRPE lesions can present as solitary lesions or as multifocal pigmented lesions termed group pigmentation or “bear tracks”.
- This week’s presentation includes several cases of “bear tracks” and large CHRPE lesions in the same eye.
- CHRPE lesions often enlarge slowly over time, can be associated with familial adenomatous polyposis (FAP) and rarely convert to an adenocarcinoma.
- Periodic follow-up of CHRPE lesions is recommended.