The expanding clinical spectrum of torpedo maculopathy

Torpedo maculopathy is an idiopathic, congenital, oval-shaped region of chorioretinal hypopigmentation located temporal to the macula. Torpedo lesions are typically unilateral, occasionally harbor an intraretinal cleft, and may be associated with varying degrees of hyperpigmentation. Visual acuity is usually normal, but the lesion may produce a scotoma in the visual field. There are no known associated systemic or ocular abnormalities. Diagnosis is based upon recognition of its characteristic shape and location. Because of its nonprogressive and generally benign nature, no treatment is required.

Two cases of torpedo maculopathy associated with fundus excavation are presented. To the best of our knowledge, this is the first reported association of torpedo maculopathy with fundus excavation. In one case, the visual acuity remained unaffected and in the other case the visual acuity was reduced to 20/50. In both cases, optical coherence tomography clearly demonstrates the excavated nature of the torpedo lesions. In case 1, where the visual acuity was normal, the excavation is remote from the fovea but in case 2, where the visual acuity was 20/50, the excavation encroaches upon the fovea. In both cases, a scotoma corresponding to the excavated region could be demonstrated.

Torpedo maculopathy is a usually benign condition associated with normal visual acuity and normal visual fields. Our cases demonstrate that torpedo maculopathy may be associated with excavation of the fundus and a corresponding scotoma in the visual field. Visual acuity may be compromised should the excavation encroach upon the central fovea. Knowledge of this previously unreported clinical manifestation of torpedo maculopathy may aid in advancing the understanding of this condition and the care of patients with the disorder.