A deeper look at torpedo maculopathy

Abstract

Background

Torpedo maculopathy is a rare, congenital maculopathy classically diagnosed funduscopically as a ‘torpedo‐shaped’ lesion located temporal to the fovea. This case describes a torpedo maculopathy with non‐classic optical coherence tomographic (OCT) findings and collaborative OCT angiographic (OCTA) findings.

Case report

A 60‐year‐old Caucasian woman presented with a history of longstanding distortion and paracentral scotoma of the right eye. She had a positive family history of age‐related macular degeneration. Visual acuity was 6/6 in each eye. Dilated fundus examination revealed a torpedo‐shaped lesion in the right eye with a hypo‐pigmented head pointing toward the fovea and a hyper‐pigmented tail end. OCT imaging of the macula of the right eye revealed a subretinal cleft space with underlying thinning of the retinal pigment epithelium, increased choroidal reflectivity, as well as retinal pigment epithelial and choroidal excavation. OCTA choriocapillaris segmentation showed a hypo‐reflective area associated with the lesion, adjacent to hyper‐reflectivity. The patient was diagnosed with torpedo maculopathy of the right eye.

Conclusions

OCT and OCTA imaging have been instrumental in developing a deeper understanding of many maculopathies, allowing for accurate diagnosis of macular conditions. Although the aetiology remains unclear, these imaging devices may provide further insight into the lesion in torpedo maculopathy.

Key words:

• OCTA
• optical coherence tomography
• torpedo maculopathy

ACKNOWLEDGEMENTS

This work was presented as a poster, entitled ‘Torpedo maculopathy and focal choroidal excavation: two rare entities presenting concomitantly’, at Optometry's Meeting in Boston, Massachusetts on 2 July 2016.