Indian Journal of Ophthalmology

PHOTO ESSAY
Year
: 2019  |  Volume : 67  |  Issue : 2  |  Page : 270--271

Hyperpigmented torpedo maculopathy


PC Ranjith, Anantharaman Giridhar 
 Vitreo-retinal Services, Giridhar Eye Institute, Ponneth Temple Road, Kadavanthra, Kochi, Kerala, India

Correspondence Address:
Dr. P C Ranjith
Vitreo-retinal Services, Giridhar Eye Institute, Ponneth Temple Road, Kadavanthra, Kochi - 682 020, Kerala
India

Abstract




How to cite this article:
Ranjith P C, Giridhar A. Hyperpigmented torpedo maculopathy.Indian J Ophthalmol 2019;67:270-271


How to cite this URL:
Ranjith P C, Giridhar A. Hyperpigmented torpedo maculopathy. Indian J Ophthalmol [serial online] 2019 [cited 2020 Apr 2 ];67:270-271
Available from: http://www.ijo.in/text.asp?2019/67/2/270/250689


Full Text



 Case



A 21-year-old male was referred after an incidental finding of a chorioretinal scar in his right fundus during a routine clinical examination. He had no ocular complaints and his clinical examination revealed a best-corrected visual acuity of 6/6 both eyes (−0.5D @ 150°right eye). Patient had no significant past medical or ocular history including infectious diseases or long-term exposure to retinotoxic drugs. Anterior segment was quiet and unremarkable. Goldman applanation tonometry was 14 mmHg both eyes. A 78D slit-lamp biomicroscopy revealed a flat globally hyperpigmented fusiform lesion with sharp margins. It was temporal to the fovea with its tip directed toward it [Figure 1]a, [Figure 1]b, [Figure 1]c. Binocular indirect ophthalmoscopy revealed no peripheral chorioretinal lesions in both eyes. Examination of the left eye was unremarkable. Optical coherence tomography revealed gross loss of outer retinal layers with thickening of the retinal pigment epithelium involving the lesion. The fundus autofluorescence images showed a globally hypopigmented torpedo like lesion with surrounding patchy hyper autofluorescent areas [Figure 2]a and [Figure 2]b. Normal fundus auto fluorescence [Figure 2]c.{Figure 1}{Figure 2}

 Discussion



Torpedo maculopathy is a rare congenital condition which mostly present as a hypopigmented oval-shaped lesion. Most of the reported cases are asymptomatic but rarely can present with scotomas.[1] This condition was first identified by Roseman and Gass [2] and term torpedo maculopathy was introduced by Daily.[3] Torpedo lesions can vary significantly in their presentation.[4] While features like location, temporal to the fovea, horizontal oval shape, and hypopigmentation remain constant, it can even present with certain variable features like intraretinal cleft, hyperpigmentation, fundus excavation, and visual field defects. Golchet et al.[5] demonstrated pigmentation to be variable. Globally, hyperpigmented torpedo maculopathy are rarely documented with a long follow up.[6] The differential diagnosis includes congenital retinal pigment epithelial hypertrophy (CHRPE), choroidal nevus, hamartoma of the retinal pigment epithelium, trauma, and inflammatory conditions (toxoplasmosis).

This unique case represents a variable presentation of torpedo maculopathy and multimodal imaging supports the findings.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Pian D, Ferrucci S, Anderson SF, Wu C. Paramacularcoloboma. Optom Vis Sci 2003;80:556-63.
2Roseman RL, Gass JD. Solitary hypopigmented nevus of the retinal pigment epithelium in the macula. Arch Ophthalmol 1992;110:1358-9.
3Daily MJ. Torpedo maculopathy or paramacular spot syndrome. In: New Dimensions in Retina. Chicago; 10-13 November, 1993.
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5Golchet PR, Jampol LM, Mathura JR, Daily MJ. Torpedo maculopathy. Br J Ophthalmol 2010;94:302-6.
6Rohl A, Vance S. Hyperpigmented torpedo maculopathy with pseudo-lacuna: A 5-year follow-up. Case Rep Ophthalmol 2016;7:184-90.