The retinal pigment epithelium (RPE) is a layer of specialized cells directly beneath the retina. We can be born with”hypertrophic” spots of RPE cells called CHRPE. These spots in the back of the eye are a black color (not brown) and are benign.
The risk of these spots ever becoming a cancer is extremely low (1, 2, 3, 4). Many people have these spots. If a patient has a CHRPE, he or she should have a regular dilated eye exam every 1 to 2 years.
Here is a picture of a CHRPE in a 15 year old:
Here is a picture of a CHRPE in a person in his late 30s; the CHRPE has lost some of its pigmentation and appears slightly faded:
The vast majority of patients that we see have a single CHRPE lesion. A syndrome exists called Familial Adenomatous Polyposis. These patients are at increased risk of colon cancer. Patients with this syndrome may (but not necessarily) have multiple, variably sized CHRPEs in both eyes (1, 2, 3). If we see that you have multiple CHRPEs, we will recommend appropriate followup with a gastrointestinal specialist.