Torpedo Retinopathy

Abstract

Purpose: Torpedo lesions in the retina are rare. This study aimed to investigate torpedoshaped 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.”

Keywords:

Imaging, Maculopathy, Retinopathy, Torpedo

References
1. Villegas VM, Schwartz SG, Flynn HW Jr, Capó H, Berrocal AM, Murray TG, et al. Distinguishing torpedo maculopathy from similar lesions of the posterior segment. Ophthalmic Surg Lasers Imaging Retina 2014;45:222–226.

2. Roseman RL, Gass JDM. Solitary hypo-pigmented nevus of the retinal pigment epithelium in the macula. Arch Ophthalmol 1992;110:1358–1359.

3. Golchet PR, Jampol LM, Mathura JR Jr, Daily MJ. Torpedo maculopathy. Br J Ophthalmol 2010;94:302–306.

4. Traboulsi EI. Pigmented and depigmented lesions of the ocular fundus. Curr Opin Ophthalmol 2012;23:337–343.

5. Traboulsi EI. Ocular manifestations of familial adenomatous polyposis (Gardner syndrome). Ophthalmol Clin North Am 2005;18:163–166.

6. Shields CL, Mashayekhi A, Ho T, Cater J, Shields JA. Solitary congenital hypertrophy of the retinal pigment epithelium: clinical features and frequency of enlargement in 330 patients. Ophthalmology 2003;110:1968–1976.

7. Shields JA, Shields CL. Tumors and related lesions of the pigment epithelium. In: Shields JA, Shields CL, editors. Intraocular tumors: an atlas and textbook. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008:431–480.

8. Wong EN, Fraser-Bell S, Hunyor AP, Chen FK. Novel optical coherence tomography classification of torpedo maculopathy. Clin Exp Ophthalmol 2015;43:342–348.

9. Tripathy K, Sarma B, Mazumdar S. Commentary: inner retinal excavation in torpedo maculopathy and proposed type 3 lesions in optical coherence tomography. Indian J Ophthalmol 2018;66:1213–1214.

10. Venkatesh R, Bavaharan B, Yadav NK. Multicolor imaging findings in torpedo maculopathy. Indian J Ophthalmol 2019;67:295–297.

11. Shields CL, Guzman JM, Shapiro MJ, Fogel LE, Shields JA. Torpedo maculopathy at the site of the fetal ”bulge”. Arch Ophthalmol 2010;128:499–501.

12. Hamm C, Shechtman D, Reynolds S. A deeper look at torpedo maculopathy. Clin Exp Optom 2017;100:563–568.

13. Chawla R, Pujari A, Rakheja V, Kumar A. Torpedo maculopathy: a primary choroidal capillary abnormality? Indian J Ophthalmol 2018;66:328–329.

14. Parodi MB, Romano F, Montagna M, Albertini GC, Pierro L, Arrigo A, et al. Choroidal neovascularization in torpedo maculopathy assessed on optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retina 2018;49:e210–e213.

15. Shirley K, O’Neill M, Gamble R, Ramsey A, McLoone E. Torpedo maculopathy: disease spectrum and associated choroidal neovascularisation in a paediatric population. Eye 2018;32:1315–1320.