A CHRPE, or congenital hypertrophy of the retinal pigmented epithelium, is a common finding in the retina on dilated eye exams. This finding is often a benign finding that does not have any additional concerns or implications. However, if there are several CHRPEs or the CHRPE has an atypical appearance it can be a risk factor for systemic conditions or other eye conditions. A CHRPE does not require any additional treatment but should be monitored regularly.

What is the Retinal Pigmented Epithelium?

The retinal pigmented epithelium, or RPE, is a layer of cells in the back of the eye which are attached to the retina.

These cells are responsible for transporting nutrients and removing waste from the retina.

The retinal pigmented epithelium is typically pigmented and will appear dark brown or black if it is visible through the retina.

How is a CHRPE Diagnosed?

A CHRPE is not usually symptomatic and will most often be found in a dilated eye exam or on a photograph of the back of the eye.

This finding will appear to be a large area that is darker and may have light areas within the CHRPE.

Most eye doctors can make a diagnosis based solely on the appearance of the CHRPE but if it is atypical, there are many different areas of CHRPE, or there is a cause for concern, additional testing may be ordered and performed.

These tests can include a retinal photograph, a laser scan of the layers of the retina, or a B scan ultrasound of the eye.

Prognosis for CHRPE

A CHRPE is much like a freckle or mole on the skin, it is almost always a benign, stable condition that will not progress at all throughout the lifetime.

Most CHRPE will not cause any symptoms, have any impact on vision or eye health, and will not change over time.

There are conditions associated with atypical CHRPE which may present an increased risk in other health aspects, but the CHRPE itself is not a concern.

Gardner’s Syndrome and CHRPE

Multiple atypical CHRPEs in the eyes can be associated with a condition called Gardner’s Syndrome or Familial Adenomatous Polyposis (FAP).

The two main findings of Gardner’s Syndrome are atypical CHRPE in the eyes and polyps which may transform into cancerous lesions in the colon.

It is not uncommon for an eye exam to reveal the presence of these atypical CHRPE, and the eye doctor makes a referral for further work possibly including a screening colonoscopy.

There is a much higher risk of early colon cancer in an individual with Gardner’s Syndrome than in the general population and the screening and monitoring of these individuals are much more intense.

Treatment and Management for CHRPE

If the CHRPE is not atypical in appearance and there are no multiple lesions, the most common treatment is to monitor the CHRPE each year with a comprehensive eye examination.

Since there are rarely any complications from CHRPE, it should not be a concern beyond that which is standard across all individuals.

Our eye doctor at Local Eyes Optometry in New Braunfels, TX excels in prescription of glasses, contact lenses and the diagnosis of a variety of eye diseases. Call our optometrist at (830) 627-9272 or schedule an eye exam appointment online if you would are experiencing or would like to learn more about eye floaters. Our eye doctor, Dr. Marcus Page, provides the highest quality optometry services and eye exams in New Braunfels, Texas.