Foveal congenital hypertrophy of the retinal pigment epithelium in the etting of geographic atrophy from age-related macular degeneration

Purpoe To report a cae of preumed congenital hypertrophy of the retinal pigment epithelium in the fovea of an 88-year-old woman in the etting of geographic atrophy from age-related macular degeneration. Deign Obervational cae report. Method An 88-year-old woman wa examined. Reult Bet-corrected viual acuity wa 20/63 in the right eye and 20/50 in the left eye. Multifocal area of geographic atrophy and large-ized druen were een in the maculae of both eye. Biomicrocopic examination of the right eye howed hyperpigmentation conitent with congenital hypertrophy of the retinal pigment epithelium through the center of the macula. No prior photographic documentation of the retina wa available. Concluion Thi cae ugget that foveal congenital hypertrophy of the retinal pigment epithelium may be een in the etting of macular geographic atrophy. Although it i theoretically poible that the hyperpigmentation i reactive rather than congenital, the pigmentation i typical for congenital hypertrophy and i unlike any reactive pigmentation in our experience or decribed in a MEDLINE earch of feature of age-related macular degeneration. The cae ugget that a hypertrophic proce of the retinal pigment epithelium may coexit within or immediately adjacent to the anatomic boundarie of an atrophic proce uch a geographic atrophy from age-related macular degeneration.