Vitreous & Retina



















Tumor / Others
Multiple areas of grouped congenital hypertrophy of the retinal pigment epithelium (CHRPE) which are commonly called "bear tracks".

  • Benign pigmented fundus lesions that commonly discovered during routine eye examination.
  • Clinical features:
    • Usually asymptomatic.
    • Signs:
      • Well-demarcated, round, solitary or multiple gray-brown or black lesions which have flat or scalloped margins.
      • May be encircled by hyper- or hypo-pigmented halo.
      • Depigmented or hypopigmented punched-out lacunae or fenestration lesions may be evident within larger lesions.
      • Multiple areas of grouped CHRPE simulating the animal foot-print are also called "bear tracks".
      • Generally located in the peripheral but may occasionally in the peripapillary region.
  • Fluorescein angiography demonstrates blocked choroidal fluorescence by the hypertrophied RPE and no leakage of dye.
  • Differential diagnosis include: choroidal melanomas, choroidal nevi, melanocytomas of the choroids, hyperplasia of the RPE, post-hemorrhage hemosiderin deposits.
  • Known to be associated with other systemic findings such as familial adenomatous polyposis and Gardner's syndrome (intestinal polyposis, hamartoma of the skeleton, and multiple soft tissue tumors).

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