• 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.