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Rickmann A, Bodenbender JP, Gelisken F, Kühlewein L. Type 1 and type 2 torpedo maculopathy. Graefes Arch Clin Exp Ophthalmol 2024; 262:1805-1810. [PMID: 38289371 PMCID: PMC11106192 DOI: 10.1007/s00417-024-06386-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/05/2023] [Accepted: 01/22/2024] [Indexed: 05/22/2024] Open
Abstract
PURPOSE To analyze torpedo maculopathy (TM) and to report the characteristics of the disease. METHODS Retrospective study. The review of a database for clinical diagnosis identified eight patients with TM lesions in the retina between 2016 and 2022. Multimodal imaging was used to analyze the cases. RESULTS All cases were unilateral, asymptomatic, and hypopigmented. They were associated by surrounding hyperpigmented retinal pigment epithelium changes to varying degrees. All lesions were located in the temporal retina on the horizontal axis, pointing towards the fovea, except for one patient with a lesion inferior to the fovea. Optical coherence tomography imaging revealed a normal inner retina in all eyes. In the area of the TM lesion, attenuation of the interdigitation zone was seen in mild cases (three cases). All other five patients had thinning of the outer nuclear layer and loss of ellipsoid zone and interdigitation zone of the TM lesion. Four of these cases had a subretinal cavitation/cleft, and two of them additionally an inner choroidal excavation. No patient had any sign of choroidal neovascularization. The average age for patients with type 1 TM was 18 years and for type 2 TM 16.5 years. CONCLUSION In this large case series, we could not detect an age difference between the different types of the TM. Contrary to previous discussions, type 2 TM can also occur in young patients.
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Affiliation(s)
| | - Jan-Philipp Bodenbender
- University Eye Hospital, Department for Ophthalmology, Eberhard Karls University, Tübingen, Germany
| | - Faik Gelisken
- University Eye Hospital, Department for Ophthalmology, Eberhard Karls University, Tübingen, Germany
| | - Laura Kühlewein
- University Eye Hospital, Department for Ophthalmology, Eberhard Karls University, Tübingen, Germany.
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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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3
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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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Lopez JM, Miere A, Rabinovic M, Mehanna CJ, Crincoli E, Colantuono D, Souied EH. Torpedo maculopathy: multimodal and retromodal imaging. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:e96-e99. [PMID: 37956970 DOI: 10.1016/j.jcjo.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/18/2023] [Accepted: 10/04/2023] [Indexed: 11/21/2023]
Affiliation(s)
- Juan Manuel Lopez
- Centre Hospitalier Intercommunal de Créteil, University Paris Est Créteil, Créteil, France; Institut Català de Retina, Barcelona, Spain.
| | - Alexandra Miere
- Centre Hospitalier Intercommunal de Créteil, University Paris Est Créteil, Créteil, France
| | - Mark Rabinovic
- Centre Hospitalier Intercommunal de Créteil, University Paris Est Créteil, Créteil, France
| | - Carl-Joe Mehanna
- Centre Hospitalier Intercommunal de Créteil, University Paris Est Créteil, Créteil, France
| | - Emanuele Crincoli
- Centre Hospitalier Intercommunal de Créteil, University Paris Est Créteil, Créteil, France
| | - Donato Colantuono
- Centre Hospitalier Intercommunal de Créteil, University Paris Est Créteil, Créteil, France
| | - Eric H Souied
- Centre Hospitalier Intercommunal de Créteil, University Paris Est Créteil, Créteil, France
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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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Knani L, Werda S, Ghachem M, Mahjoub A. Multimodal imaging of torpedo maculopathy with optical coherence tomography angiography. Saudi J Ophthalmol 2023; 37:63-65. [PMID: 36968781 PMCID: PMC10032280 DOI: 10.4103/sjopt.sjopt_9_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/12/2021] [Accepted: 10/25/2021] [Indexed: 03/12/2023] Open
Abstract
A 24-year-old woman presented for routine clinical evaluation. Her best-corrected visual acuity was 20/20 and slit-lamp examination of the anterior segment was normal in both eyes. Fundus examination of the left eye revealed a hypopigmented lesion, one disc diameter temporal to the fovea, with a hyperpigmented tail extending temporally from the main lesion, consistent with a torpedo maculopathy. Fundus autofluorescence showed an hypoautofluorescence with hyperautofluorescent border. Swept-source optical coherence tomography (OCT) showed a normal inner retina and a degeneration of the outer retina without retinal cavitation. OCT angiography (OCT-A) of the choriocapillaris layer revealed reverse shadowing caused by the increased transmission from the atrophied outer retina and RPE within the torpedo lesion and attenuation of signal in the area of the temporal hyperpigmentation. The superficial capillary plexus was normal. This case includes a multimodal imaging with OCT-A of torpedo maculopathy in a Tunisian woman. Further reports are required to provide a better understanding of this rare condition.
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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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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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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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Stoyukhina AS. [Tumor-like diseases and retinal hamartomas in ophthalmological practice]. Vestn Oftalmol 2020; 136:367-372. [PMID: 32880163 DOI: 10.17116/oftalma2020136042367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The article provides a detailed review of the ophthalmoscopic picture, optical coherence tomography (OCT) of the retina and fundus autofluorescence in patients with such rare pathological processes in the fundus as torpedo maculopathy, retinal myelin fibers, retinal astrocytic hamartoma and cavernous hematoma.
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Venkatesh R, Jain K, Pereira A, Thirumalesh, Yadav NK. Torpedo Retinopathy. J Ophthalmic Vis Res 2020; 15:187-194. [PMID: 32308953 PMCID: PMC7151502 DOI: 10.18502/jovr.v15i2.6736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 11/24/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose Torpedo lesions in the retina are rare. This study aimed to investigate torpedo-shaped lesions in the retina in an adult population and to determine the spectrum and features of the disease. Methods The review of a database for clinical diagnosis identified nine patients who were diagnosed with torpedo-shaped lesions in the retina between June 2017 and February 2019. Fundus photography and optical coherence tomography (OCT) imaging were used to analyze the cases. Multicolor imaging was also performed. Results Nine patients with torpedo-shaped lesions in the fundus were identified. Fundus images revealed that the lesion involved the macula in six eyes; in the remaining three eyes, the lesion was present outside the macula. OCT identified six patients with type 1 torpedo lesions, one with type 2, and two with type 3. On multicolor imaging, the lesion was visualized as a region of increased reflectance in blue, green, and infrared light in all eyes, with notably increased infrared reflectance in eyes with focal choroidal excavation. Choroidal neovascular membrane was evident in one patient on OCT angiography. Conclusion Torpedo lesions in the retina can occur away from the macula and exhibit features similar to those of torpedo maculopathy. As such, the authors propose a change in the nomenclature for torpedo lesions in the retina from "torpedo maculopathy" to "torpedo retinopathy."
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Kushagra Jain
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Arpitha Pereira
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Thirumalesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
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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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