CHOROIDAL NEOVASCULARIZATION IN TORPEDO MACULOPATHY TREATED BY AFLIBERCEPT: LONG-TERM FOLLOW-UP USING OPTICAL...

To report a case of torpedo maculopathy (TM) in an elderly patient complicated by choroidal neovascularization (CNV) and that was treated by intravitreal aflibercept injections and monitored during 30 months using optical coherence tomography (OCT) and OCT angiography.

A 74-year-old woman complained of a metamorphopsia in the left eye. Visual acuity was 20/25 while fundus examination showed a hypopigmented torpedo-shaped chorioretinal lesion in the temporal macula associated with a retinal exudation.

Multimodal imaging showed a severe chorioretinal excavation confirming the diagnosis of TM associated with an exudative Type 1 CNV. Intravitreal aflibercept injections allowed an initial good anatomical and functional improvement, but multiple recurrences occurred. At the last visit, 30 months after the start of 14 intravitreal aflibercept injections, a persistent subretinal fluid was present with a decreased visual acuity to 20/32 while the CNV surface grew in OCT angiography.

This first case of long-term follow-up of CNV secondary to TM showed an anti-VEGF dependency or even a resistance with extension of CNV. Thus, a deep retinochoroidal atrophy could be the late evolution of TM that may result on severe CNV in advanced stages. A regular TM monitoring including OCT and OCT angiography would be necessary to detect any potential CNV for an early and aggressive treatment.