Case 33
History: A 48 year-old man was referred by his optician because of multiple pigmented lesions in the left retina. The vision was normal in both eyes and fundoscopy revealed multiple rounded black lesions in the left superotemporal area. His father suffered from bowel cancer. He underwent a colonoscopy which was unremarkable. 
The pigmented lesions are congenital hypertrophy of retinal pigment epithelium (CHRPE). They have no visual significance. However, in a minority of patients these lesions may be associated with familial polyposis coli which can lead to colorectal carcinoma. The association occurs in the autosomal dominant condition called the Gardner's syndrome. 
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