Unusual Case of Congenital Hypertrophy of the Retinal Pigment Epithelium

These images come from a 35 year old Caucasian female. She did not have any visual complaints and had visual acuity of 20/20 in both eyes. Her left eye is normal, but her right eye has a lesion adjacent to the optic disc. This is an unusual example of congenital hypertrophy of the retinal pigment epithelium (CHRPE). Lesions with this condition are usually solitary and not in a peripapillary location. They are typically dark with depigmented spots known as lacunae. In her fundus image, the depigmented lesion extends from the optic disc out towards her macula but not far enough to impair her vision (black arrow). They do not cause thickening of the retina in which her optical coherence tomography photo concludes this. These lesions are benign and do not develop into cancer.