The retina is the thin multi-layered inner lining of the back of the eye responsible for capturing light and chemically transforming light into an electronic form so that it can be passed to the brain instantly. The bottom normally pigmented layer of the retina is called the retinal pigment epithelium (RPE). When the RPE layer of the retina is thicker than normal it presents during routine examination as a darker mole-like area. Any atypical area of our body always requires extra caution and monitoring. This condition has two forms, one being thicker than normal at birth and another form that presents itself later in life. Both types are usually without symptoms.

Congenital retinal pigment epithelial hypertrophy (CHRPE) is generally documented in patients before they reach 30 years of age. It is possible for this form of congenital hypertrophy to enlarge slightly over time however it is not associated with life-threatening malignant conditions. Literature has identified some association of this congenital form of CHRPE with certain familial colon disorders. As a result, despite its benign status in the eye it should be shared information with a physician or gastroenterologist.

The acquired type of retinal pigment epithelial hypertrophy is always found later in life. They are typically jet-black to dark grey, they are always flat without elevation and are commonly observed with halos around the edges. In addition they may be found with lightly colored areas within, called lacunae, and are most often in the peripheral retina.

These hypertrophy conditions have no observed symptoms but need to be watched carefully. Digital retinal photographs are usually taken to document any changes. Routine eye examinations are recommended to make sure these benign lesions don’t change into melanomas.