White and dark without pressure with congenital hypertrophy of retinal pigment epithelium

A 12-year-old boy was referred for congenital hypertrophy of the retinal pigment epithelium (CHRPE) in the right eye. Funduscopy revealed concomitant white without pressure (WWOP) and dark without pressure (DWOP) [Fig. 1a and b]. Optical coherence tomography (OCT) through the lesion showed slight retinal pigment epithelium (RPE) hypertrophy with overlying outer retinal loss. WWOP demonstrated hyperreflective ellipsoid layer [Fig. 1c].Figure 1: (a) Funduscopically, there was CHRPE in the temporal periphery, measuring 3 mm in diameter and surrounded by WWOP (white arrows). (b) There was DWOP superiorly (black arrows). (c) OCT (vertical cut, part A) through the lesion showed slight RPE hypertrophy with overlying outer retinal loss (yellow arrows). WWOP demonstrated hyperreflective ellipsoid layer (blue arrows). CHRPE = congenital hypertrophy of the retinal pigment epithelium, DWOP = dark without pressure, OCT = optical coherence tomography, RPE = retinal pigment epithelium, WWOP = white without pressureShields et al.[1] found WWOP in 1% of patients with CHRPE. WWOP and DWOP are asymptomatic and have no known functional defects.[2] This case is notable, given the infrequent coexisting presence due to the tendency of WWOP to expand[3] and DWOP to regress with age.[4] Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.