A deeper look at torpedo maculopathy

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.

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.

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.