Clinically, what appears as large areas of bare choroid adjacent to hyperpigmentation?

The appearance of large areas of bare choroid adjacent to hyperpigmentation is characteristic of retinal pigment epithelium (RPE) tears. These tears can occur in conditions such as age-related macular degeneration (AMD) or after a significant change in the underlying retinal structures. When an RPE tear happens, the protective layer of cells that nourishes the retina is disrupted, revealing the choroidal tissue underneath, which can lead to the appearance of bare choroid.

The presence of hyperpigmentation nearby is often related to the atrophic changes or compensatory responses of the surrounding RPE cells, which can become more pigmented as they react to the pathological processes occurring in AMD and other retinal diseases. This distinct visual presentation helps clinicians in identifying RPE tears during examination.

Other conditions listed do not typically present with a combination of bare choroid and adjacent hyperpigmentation in the same way, as each condition has its own unique morphological features that do not overlap with that of RPE tears.