8/28/2023 0 Comments Bear tracks retina![]() Any nevus can undergo transformation to a melanoma but it is very rare. They require closer observation and sometimes further testing to make sure they are benign spots. A choroidal nevus is usually flat, but does appear more similar to melanomas in the choroid due to being located at the same level below the retina. The retina does not have melanocytes, it has pigmented epithelium cells instead. They are found in our skin and in parts of the eye. Melanocytes are the cells that hold pigment. They are due to an increase of melanocytes in the choroid. They are also referred to as benign choroidal melanomas, though they are not true melanomas. These appear as round, grey, usually flat spots and are very common occurring in up to 30% of the population. If it is an infection in one of the layers of the eye it could recur at a later date.Ī choroidal nevus is indeed like a nevus (freckle) but it is occurring in the choroid, the level below the retina which supplies circulation to the retinal tissue. The primary concern in this case is to monitor the condition that caused it. They are due to an actual increase in the number of retinal pigment epithelial cells which is called hyperplasia. Trauma to the retina whether from injury or infections in the eye can cause dark spots similar to CHRPE but they are irregular in shape. Isolated single CHRPE spots are not associated with Familial adenomatous polyposis or an increased risk of colon cancer. Not every patient with Bear Tracks will get colon cancer, but it is more likely if they are large, present in both eyes, and there are more than 3 or 4 spots in each eye. Bear tracks may require a referral to a Gastroenterologist Doctor for further evaluation. Bear Tracks may be seen years before the cancer occurs so they may be a valuable preventative sign to your optometrist. This can be due to a dominant gene that is often seen to run in families as an predisposition to colon cancer. They frequently occur in conjunction with a condition called familial adenomatous polyposis and require further testing for colon and rectal cancer. Usually no further tests are required other than eye exams with your eyes dilated in 3-6 months after first observation, then annually there after.ĬHRPE also occurs in a form called “Bear Tracks.” Bear tracks are multiple dark spots in the back of the eye that look like little bear footprints. The formation of these adenoma tumors are very rare but something eye doctors do check for on an annual basis. On rare occasions a halo nevus can change from a normally flat surface and develop elevated nodules. The difference is you can’t observe it for any changes like you can a spot on your hand, so serious conditions can advance past the treatable stages. While there are often changes over time it is mostly a stable, inconsequential change and CHRPE can be thought of like a freckle on your skin. The blood vessels underneath it atrophy also which results in a small blind spot which you are not capable of perceiving. This is hypertrophy, or an increase in the size but not the number of cells. It is an accumulation of increases in pigment in the cells of the retinal pigment epithelium cell layer. Though size varies, it is convenient to think of it as about equivalent to the top of an eraser on a pencil. They both need to be monitored to make sure they are not malignant melanomas.Ĭongenital hypertrophy of the retinal pigmented epithelium (also known as halo nevus) is a pigmented, well demarcated dark spot inside the back of your eye on your retina. Both conditions are usually benign and not a serious problem. Should you be worried? It could be a number of things but the most likely are choroidal nevus (benign choroidal melanoma) or CHRPE (congenital hypertrophy of the retinal pigmented epithelium). Optical coherence tomography (OCT) demonstrates a disruption of the highly-reflective signal from the ellipsoid zone in the region of the lesions, as indicated by the orange line on the scan.So you have been told by your eye doctor there is a freckle in your eye. The lesions are flat, sharply circumscribed, placoid, chalky white, and lie at the level of the RPE. ![]() It is believed that these spots may develop secondary to deposition of an abnormal white material in retinal pigmented epithelial (RPE) cells rather than the usual darkly pigmented melanin. Groups of the spots, as seen here, are commonly referred to as "polar bear tracks" due to their color and resemblance of animal footprints. Grouped congenital albinotic spots of the retinal pigmented epithelium (polar bear tracks) Grouped congenital albinotic spots of the retinal pigmented epithelium (polar bear tracks) Category(ies): Retina, Vitreous Contributor: Jesse Vislisel, MD Photographer: Brice Critser, CRAĬongenital albinotic spots of the retinal pigmented epithelium (CASRPE) can be configured in solitary or grouped configurations. ![]()
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