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Owlya N, Barbosa M, Nascimbeni AC, Pannatier-Schuetz Y, Castro DG, Ambresin A. Torpedo Maculopathy: Case Series of an Underdiagnosed and Rare Condition Using Multimodal Imaging. Klin Monbl Augenheilkd 2024. [PMID: 38176433 DOI: 10.1055/a-2238-7245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Affiliation(s)
- Nicolas Owlya
- Medical Retina, Swiss Visio Montchoisi, Lausanne, Switzerland
- Medical Retina, Swiss Visio Retina Research Center, Lausanne, Switzerland
| | - Mickael Barbosa
- Medical Retina, Swiss Visio Montchoisi, Lausanne, Switzerland
- Medical Retina, Swiss Visio Retina Research Center, Lausanne, Switzerland
| | - Anna Chiara Nascimbeni
- Medical Retina, Swiss Visio Montchoisi, Lausanne, Switzerland
- Medical Retina, Swiss Visio Retina Research Center, Lausanne, Switzerland
| | - Yannic Pannatier-Schuetz
- Medical Retina, Swiss Visio Montchoisi, Lausanne, Switzerland
- Medical Retina, Swiss Visio Retina Research Center, Lausanne, Switzerland
| | - Daniela Gallo Castro
- Medical Retina, Swiss Visio Montchoisi, Lausanne, Switzerland
- Medical Retina, Swiss Visio Retina Research Center, Lausanne, Switzerland
| | - Aude Ambresin
- Medical Retina, Swiss Visio Montchoisi, Lausanne, Switzerland
- Medical Retina, Swiss Visio Retina Research Center, Lausanne, Switzerland
- Ophthalmology, RétinElysée, Lausanne, Switzerland
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Wang DJ, Mendel TA. A unique presentation of subretinal fluid in a type III torpedo maculopathy phenotype. Am J Ophthalmol Case Rep 2024; 33:101971. [PMID: 38131064 PMCID: PMC10733669 DOI: 10.1016/j.ajoc.2023.101971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/28/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose To report a rare type III torpedo maculopathy lesion with a unique manifestation of subretinal fluid. Observations A nine-year-old patient was referred to retina for an evaluation of a hypopigmented oval-shaped lesion in the temporal macula with an area of inferior subretinal fluid in the right eye. The lesion demonstrated inner and outer retinal and retinal pigment epithelial attenuation, intraretinal and subretinal fluid, a serous neurosensory retinal detachment, and inner choroidal excavation on optical coherence tomography. Fundus autofluorescence showed a lane of downward-tracking fluid. Intravenously administered fluorescein angiography revealed a window defect in the area of the torpedo lesion suggesting choroidal flush. Conclusions and Importance The case is the third documented case of torpedo maculopathy with subretinal fluid in the literature with a unique combination of intraretinal cystic changes and dependent descending subretinal fluid, somewhat akin to a Best disease outside of the fovea with choroidal excavation. The morphology of torpedo maculopathy continues to expand as more cases are revealed.
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Affiliation(s)
- Derrick J. Wang
- Havener Eye Institute, Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Thomas A. Mendel
- Havener Eye Institute, Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Cozzupoli GM, Fasciani R, Fedeli R, Rizzo S. Association of torpedo maculopathy and keratoconus in a young patient: A multimodal imaging study. Eur J Ophthalmol 2024; 34:52-58. [PMID: 37844612 DOI: 10.1177/11206721231207663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
PURPOSE To report and document a case of torpedo maculopathy found in a patient affected by keratoconus.Case report: An healthy 16-year-old male patient, affected by keratoconus in both eyes, was referred to the cornea service of our hospital for a follow-up visit.During the dilated fundus examination of the left eye, an oval, well-demarcated, hypopigmented lesion was observed in the juxtafoveal temporal region, pointing towards the center of the macula. Multimodal imaging of the lesion was performed, and the diagnosis of Torpedo Maculopathy was established based on the clinical picture. CONCLUSION This is the first case of torpedo maculopathy described in a patient affected by keratoconus. This association may be merely fortuitous or the result of developmental abnormalities affecting both corneal and retinal structures.
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Affiliation(s)
| | - Romina Fasciani
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italia
- Università Cattolica del Sacro Cuore, Rome, Italia
| | - Romolo Fedeli
- Ophthalmology Unit, Azienda Ospedaliera, Cardinale G. Panico, Tricase (Le), Italia
| | - Stanislao Rizzo
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italia
- Università Cattolica del Sacro Cuore, Rome, Italia
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italia
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Šulavíková Z, Krásnik V. Torpedo Maculopathy. A Case Report. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2023; 79:268-272. [PMID: 37993275 DOI: 10.31348/2023/31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
AIM Torpedo maculopathy is an incidental, congenital retinal lesion. The typical clinical finding is a unilateral, symmetric, oval, hypopigmented lesion in the inferotemporal macula. In most cases, the lesion is along the horizontal raphe, is torpedo-shaped, and the nasal edge is directed into the foveola. The diagnosis is determined on the basis of its characteristic shape, localization and findings on optical coherence tomography (OCT). The etiology and pathogenesis of torpedo maculopathy is unclear, but it is believed to be a congenital defect of the retinal pigment epithelium (RPE). The aim of this publication is highlight this diagnosis and to present an incidental finding of torpedo maculopathy in an adult patient. CASE REPORT A 30-year-old female patient reported for a routine eye examination. Fundus examination of the right eye revealed an oval hypopigmented lesion with a size of 1 disk diameter inferotemporally from the fovea, which was followed by a satellite lesion in the same axis directed into the foveola. Based on OCT, OCT angiography, fundus autofluorescence, and the typical shape and location of the lesion, the patient was diagnosed with torpedo maculopathy in the right eye. CONCLUSION In general, torpedo maculopathy is an asymptomatic, congenital, benign retinal lesion, which is mostly diagnosed accidentally during a routine fundus examination. TM is non-progressive retinal finding with a minimal risk of deterioration of visual functions, which does not require any treatment. Nevertheless, due to the rare risk of a choroidal neovascular membrane, it is recommended to examine patients once a year. It is necessary to consider this diagnosis when a unilateral hypopigmented lesion is found inferotemporally from the fovea, and to distinguish it from chorioretinal atrophy, scar, vitelliform dystrophy, or other RPE lesions as part of the differential diagnosis.
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Vienola KV, Dansingani KK, Eller AW, Martel JN, Snyder VC, Rossi EA. Multimodal Imaging of Torpedo Maculopathy With Fluorescence Adaptive Optics Imaging of Individual Retinal Pigmented Epithelial Cells. Front Med (Lausanne) 2021; 8:769308. [PMID: 34957148 PMCID: PMC8698897 DOI: 10.3389/fmed.2021.769308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
Torpedo maculopathy (TM) is a rare congenital defect of the retinal pigment epithelium (RPE). The RPE is often evaluated clinically using fundus autofluorescence (AF), a technique that visualizes RPE structure at the tissue level from the intrinsic AF of RPE fluorophores. TM lesions typically emit little or no AF, but this macroscopic assessment is unable to resolve the RPE cells, leaving the organization of the RPE cell mosaic in TM unknown. We used fluorescence adaptive optics scanning laser ophthalmoscopy (AOSLO) to show here for the first time the microscopic cellular-level structural alterations to the RPE cell mosaic in TM that underlie the tissue-level changes seen in conventional clinical imaging. We evaluated two patients with TM using conventional clinical imaging techniques and adaptive optics (AO) infrared autofluorescence (IRAF) in AOSLO. Confocal AOSLO revealed relatively normal cones outside the TM lesion but altered cone appearance within it and along its margins in both patients. We quantified cone topography and RPE cell morphometry from the fovea to the margin of the lesion in case 1 and found cone density to be within the normal range across the locations imaged. However, RPE morphometric analysis revealed disrupted RPE cells outside the margin of the lesion; the mean RPE cell area was greater than two standard deviations above the normative range up to approximately 1.5 mm from the lesion margin. Similar morphometric changes were seen to individual RPE cells in case 2. Multi-modal imaging with AOSLO reveals that RPE cells are abnormal in TM well beyond the margins of the characteristic TM lesion boundary defined with conventional clinical imaging. Since the TM fovea appears to be fully formed, with normal cone packing, it is possible that the congenital RPE defect in TM occurs relatively late in retinal development. This work demonstrates how cellular level imaging of the RPE can provide new insight into RPE pathologies, particularly for rare conditions such as TM.
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Affiliation(s)
- Kari V Vienola
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kunal K Dansingani
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrew W Eller
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joseph N Martel
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ethan A Rossi
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, United States.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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Case Report: Use of Multimodal Imaging to Document a Rare Complication of Torpedo Maculopathy. Optom Vis Sci 2021; 98:870-875. [PMID: 34460448 DOI: 10.1097/opx.0000000000001748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE This study demonstrates the importance of routine multimodal imaging for the diagnosis of choroidal neovascular membrane secondary to torpedo maculopathy. CASE REPORT A 63-year-old woman with a history of torpedo maculopathy presented with recent-onset symptoms of visual distortion in the right eye. Multimodal imaging modalities revealed the presence of a choroidal neovascular membrane. The choroidal neovascular membrane was treated, and the patient was subsequently followed up to monitor the retinal appearance over time. Significant structural restoration of the macular anatomy with overall functional improvement was seen. CONCLUSIONS Although torpedo maculopathy is often a benign diagnosis, complications such as choroidal neovascular membrane can occur. Choroidal neovascular membrane formation is well documented in younger patients with torpedo maculopathy; however, we present a rare case of choroidal neovascular membrane in an elderly individual. Multimodal imaging proved instrumental in the early detection and management of this infrequently reported complication.
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Clinical evaluation of torpedo maculopathy in an infant population with additional genetic testing for NEXMIF mutation. Eye (Lond) 2021; 36:1639-1644. [PMID: 34326501 PMCID: PMC9307558 DOI: 10.1038/s41433-021-01714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To assess clinical characteristics of torpedo maculopathy (TM) lesions in an infant population with age ≤1.5 years and to investigate the role of NEXMIF mutation in the development of TM. METHODS Retrospective analysis of medical records of 17 consecutive infants with the diagnosis of TM between 2016 January and 2019 December were done. Fundus images and a hand-held spectral-domain optical coherence tomography (Envisu 2300, Bioptigen, Morrisville, NC, USA) were used to identify clinical characteristics of TM lesions. Additional molecular testing for mutation screening for NEXMIF gene was also carried out. RESULTS Totally 55334 infants were screened during the study period and 17 (0.03%) were identified as having TM. The mean age at the time of diagnosis was 3.94±5.08 months. All TM lesions showed variable degrees of hypopigmentation. Satellite lesion in one infant was nasally located to the main TM lesion. Absence, disruption, loss, degeneration and/or irregularity of the ellipsoid zone were common findings on OCT examination. No pathogenic or likely pathogenic variant of NEXMIF gene was detected. CONCLUSION Fundoscopic appearance and OCT findings of lesions show similarities to those already reported previously. Contrary to popular belief, a nasally located satellite lesion was observed in one of our case.
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Hamm C, Shechtman D, Reynolds S. A deeper look at torpedo maculopathy. Clin Exp Optom 2021; 100:563-568. [DOI: 10.1111/cxo.12540] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/08/2017] [Accepted: 01/17/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Casey Hamm
- College of Optometry, University of Missouri‐St. Louis, Saint Louis, Missouri, USA,
| | - Diana Shechtman
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA,
| | - Sherrol Reynolds
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA,
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Menezes K, Mancera N, Patel H, Kattih Z, Mhaskar R. Torpedo Maculopathy: A Systematic Review of Case Reports. Ophthalmic Surg Lasers Imaging Retina 2021; 52:78-83. [DOI: 10.3928/23258160-20210201-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/05/2021] [Indexed: 11/20/2022]
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Light JG, Alvin Liu T. A novel phenotype of torpedo maculopathy on spectral-domain optical coherence tomography. Am J Ophthalmol Case Rep 2020; 20:100956. [PMID: 33089012 PMCID: PMC7557970 DOI: 10.1016/j.ajoc.2020.100956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 11/06/2022] Open
Abstract
Purpose To present a new phenotype of torpedo maculopathy on spectral domain optical coherence tomography imaging (SD-OCT). Observations A 31-year-old female presented with a multi-partite yellowish lesion in the macula of her left eye, with a central fovea-involving component and a temporal tail-like component. The lesion showed mixed hyper- and hypoautofluorescence on fundus autofluorescence imaging. The fovea-involving component exhibited disruption of ellipsoid zone without outer-retinal cavitation on SD-OCT, consistent with the prior-described type 1 OCT morphology. The temporal tail showed subtle inner choroidal excavation with preservation of the ellipsoid zone and outer-retinal structures. Conclusions Inner choroidal excavation with preservation of the overlying outer-retinal structures represents a novel morphological phenotype on SD-OCT in torpedo maculopathy. This case demonstrates that distinct morphological subtypes may co-exist in different regions of the same torpedo maculopathy lesion.
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Liu Y, Moore AT. Congenital focal abnormalities of the retina and retinal pigment epithelium. Eye (Lond) 2020; 34:1973-1988. [PMID: 32367006 PMCID: PMC7784997 DOI: 10.1038/s41433-020-0902-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/12/2020] [Accepted: 03/17/2020] [Indexed: 11/09/2022] Open
Abstract
This paper reviews the published literature on a group of developmental disorders of the retina and retinal pigment epithelium which result in focal abnormalities in one or both eyes. They are often asymptomatic, found on routine examination and are generally non-progressive. Some are associated with other systemic abnormalities.
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Affiliation(s)
- Yingna Liu
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Anthony T Moore
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA.
- University College London Institute of Ophthalmology, London, UK.
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Nassar S, Tarbett AK, Browning DJ. Choroidal Cavitary Disorders. Clin Ophthalmol 2020; 14:2609-2623. [PMID: 32982154 PMCID: PMC7490088 DOI: 10.2147/opth.s264731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022] Open
Abstract
The structure and functions of the choroid have been long acknowledged but the pathophysiology behind various anomalies has been difficult to understand until the advent of optical coherence tomography (OCT). With OCT imaging, choroidal cavitations appear as optically empty spaces between the outer retinal and choroidal layers with attenuation or loss of outer retinal layers. Choroidal cavitations are found in the posterior pole and seen in conditions such as pathologic myopia, north carolina macular dystrophy (NCMD), focal choroidal excavation (FCE), and torpedo maculopathy (TM). To date, these disorders have not been linked. A commonality they all share is malformation of the RPE-photoreceptor-choroid complex. The following report describes the differences and similarities of choroidal cavitation amongst the different retinal disorders and emphasizes the importance of multimodal imaging in the detection and management of potential complications.
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Affiliation(s)
- Sandra Nassar
- Eye Department, Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, NC 28210, USA
| | - Aaron K Tarbett
- Eye Department, WG Hefner VA Medical System, Salisbury, NC 28144, USA
| | - David J Browning
- Eye Department, Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, NC 28210, USA
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Distribution patterns of torpedo maculopathy: Further evidence of a congenital retinal nerve fiber layer-driven etiology. Saudi J Ophthalmol 2019; 33:260-267. [PMID: 31686968 PMCID: PMC6819754 DOI: 10.1016/j.sjopt.2019.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/13/2019] [Accepted: 07/25/2019] [Indexed: 11/24/2022] Open
Abstract
With fewer than 100 peer-reviewed cases reported in the world to date, the underlying etiology of torpedo maculopathy has remained elusive. In this literature review, we provide new evidence to better support, reject and unify claims regarding cause, diagnosis, and proper clinical management of this disease. We reviewed 44 case reports and case series, which included 77 patients (after exclusions). We additionally introduced 3 new cases from our clinical practice for a total of 80 cases. Ages at presentation ranged from 6 months old to 73 years old (mean: 24.2 years old). The nasal aspects of torpedo maculopathy lesions pointed toward the optic disc and localized to a kite-shaped region of the temporal macula, correlating with the anatomic junction of the superior arcuate, inferior arcuate, and papillomacular bundles of retinal nerve fiber layer distribution. No patterns were observed among the temporal aspects of the lesions. These findings support a congenital etiology of torpedo maculopathy and a possible influence of the retinal nerve fiber layer in the development of mature retinal pigment epithelium.
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Ding Y, Yao B, Ye H, Yu Y. Multimodal imaging of torpedo maculopathy in a Chinese woman: a case report. BMC Ophthalmol 2019; 19:154. [PMID: 31324167 PMCID: PMC6642497 DOI: 10.1186/s12886-019-1161-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/05/2019] [Indexed: 11/17/2022] Open
Abstract
Background Torpedo maculopathy is a rare, benign, and congenital macular lesion that typically appears in a ‘torpedo-shape’ and is located at the temporal macula region. This study aimed to describe in detail regarding torpedo maculopathy in a Chinese woman using multimodal imaging. Case presentation A 30-year-old Chinese woman with occasional yellowish-white macular lesions in her right eye during a routine examination was presented to our hospital. She had no other symptoms, and the best-corrected visual acuity of both eyes was 6/6. Funduscopic examination revealed a torpedo-shaped and mild hypopigmented lesion in the temporal macular area of her right eye. Infrared fundal (IR) images showed visible lesion contour, transverse elliptical, and with a tip pointing towards the central fovea of the macula. Microperimetry visual field appeared normal. The spectral-domain optical coherence tomography (SD-OCT) showed a normal inner retina, with mild thinner outer retina and retinal pigment epithelium in the temporal macular area, and correspondingly increased choroidal reflectivity. Other OCT findings included outer retinal loss/attenuation with significant atrophy of an intact ellipsoid zone. OCT angiography (OCTA) of choroid capillary layer revealed increased density of choroidal vasculature in corresponding to the area of the lesion, while the superficial and deep layers revealed normal vasculature. Fundus autofluorescence (FAF) revealed normal signal with slight hyperautofluorescence at the nasal lesion margin. Fundus fluorescence angiography (FFA) of the lesion showed variegated fluorescence and no leakage and change in the morphology during the whole imaging process. Conclusions This is the first report to include a thorough and detailed description of torpedo maculopathy by using fundal photograph, IR, microperimetry visual field, OCT, OCTA, FAF, and FFA. Multimodal imaging provides precious and detailed information to further clarify the characteristics and development of this rare disease.
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Affiliation(s)
- Yuhua Ding
- Department of Ophthalmology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Bangtao Yao
- Department of Ophthalmology, Lishui District People's Hospital, Nanjing, Jiangsu Province, China
| | - Hui Ye
- Department of Ophthalmology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
| | - Yan Yu
- Department of Ophthalmology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
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Abstract
We describe the multicolor imaging findings in two cases of Torpedo maculopathy (TM). Multicolor imaging can be a useful tool in identifying the level of retinal and choroidal layer involvement in TM. This imaging modality further confirms the hypothesis that TM is a localized congenital abnormality of retinal pigment epithelium pigmentation which leads to outer retinal and inner choroidal degeneration.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, Karnataka, India
| | - Bharathi Bavaharan
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, Karnataka, India
| | - Naresh K Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, Karnataka, India
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Parodi MB, Romano F, Montagna M, Albertini GC, Pierro L, Arrigo A, Bandello F. Choroidal Neovascularization in Torpedo Maculopathy Assessed on Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina 2019; 49:e210-e213. [PMID: 30457658 DOI: 10.3928/23258160-20181101-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 04/25/2018] [Indexed: 11/20/2022]
Abstract
Torpedo maculopathy is characterized by a congenital, unilateral, and torpedo-shaped chorioretinal lesion with unclear pathogenesis and evolution. Although the optical coherence tomography angiography (OCTA) characteristics have already been defined in literature, the authors describe for the first time the presence of choroidal neovascularization (CNV) on the temporal edge of this lesion in a 36-year-old woman with a history of altered visual field in her left eye. The authors' investigation supports the hypothesis of an aberrant choroidal circulation underlying the pathogenesis of this condition, and proves the advantage conferred by OCTA in CNV detection over the other angiographic techniques. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e210-e213.].
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Tripathy K, Sarma B, Mazumdar S. Commentary: Inner retinal excavation in torpedo maculopathy and proposed type 3 lesions in optical coherence tomography. Indian J Ophthalmol 2018; 66:1213-1214. [PMID: 30038187 PMCID: PMC6080473 DOI: 10.4103/ijo.ijo_656_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Koushik Tripathy
- Department of Vitreoretina and Uvea, ICARE Eye Hospital and Postgraduate Institute, Noida, Uttar Pradesh, India
| | - Barsha Sarma
- Department of Vitreoretina and Uvea, ICARE Eye Hospital and Postgraduate Institute, Noida, Uttar Pradesh, India
| | - Shahana Mazumdar
- Department of Vitreoretina and Uvea, ICARE Eye Hospital and Postgraduate Institute, Noida, Uttar Pradesh, India
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Chawla R, Pujari A, Rakheja V, Kumar A. Torpedo maculopathy: A primary choroidal capillary abnormality? Indian J Ophthalmol 2018; 66:328-329. [PMID: 29380796 PMCID: PMC5819133 DOI: 10.4103/ijo.ijo_784_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A 26-year-old healthy male patient's fundus revealed findings consistent with torpedo maculopathy. Swept-source optical coherence tomography (OCT) showed a dome-shaped elevation of the retina at the level of ellipsoid zone. On OCT angiography segmented at the level of the choriocapillaris, a cluster of convoluted fine vessels was seen, and further, deeper scans of the larger choroidal vessels showed a slower flow. From these observations along with the embryological correlation of choriocapillaris development, a possibility of an abnormality preventing proper fenestration of the choriocapillaris along the horizontal raphe being responsible for this anomaly is suggested.
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Affiliation(s)
- Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Rakheja
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Morpho-functional evaluation of torpedo maculopathy with optical coherence tomography angiography and microperimetry. Am J Ophthalmol Case Rep 2018; 10:165-168. [PMID: 29780930 PMCID: PMC5956676 DOI: 10.1016/j.ajoc.2018.02.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 02/13/2018] [Accepted: 02/26/2018] [Indexed: 11/22/2022] Open
Abstract
Purpose To report the case of a 13-year-old girl with torpedo maculopathy, evaluated with multimodal morpho-functional retinal imaging, including fundus photography, infra-red and blue fundus autofluorescence, swept-source optical coherence tomography (OCT), en face OCT, OCT angiography and microperimetry (MP). Observations On fundus examination, a torpedo-like hypopigmented lesion was observed temporal to the fovea in the left eye. OCT showed disruption of outer retinal layers and the presence of a subretinal cleft. On OCTA, a diffuse attenuation of signal from choriocapillaris was observed along the lesion. Functional analysis with MP revealed a reduction of retinal sensitivity over the lesion. Conclusions and importance: On OCTA, torpedo maculopathy is characterized by vascular alterations of the choriocapillaris along the lesion.
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