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  • Courtesy of Anthony B. Daniels, MD, MSc.
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    Bilateral, extensive bear tracks in congenital hypertrophy of the retinal pigment epithelium (CHRPE). Inset shows a magnified cluster, highlighting the sharp borders and location deep to the retina (under the retinal vessels), consistent with localization at the level of the RPE. In contrast, pigmented lesions in familial adenomatous polyposis are more widely spaced, larger, and typically ovoid compared to the bear track lesions in this fundus photograph.