Type 1 and type 2 torpedo maculopathy

Graefes Arch Clin Exp Ophthalmol. 2024 Jan 30. doi: 10.1007/s00417-024-06386-0. Online ahead of print.

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.

Keywords: Choroidal excavation; Fundus autofluorescence; Optical coherence tomography; Torpedo maculopathy; Torpedo retinopathy.