PMC10032280_01
Fundus imaging of the left eye showing an oval hypopigmented lesion, temporal to the fovea, with a hyperpigmented tail extending temporally from the main lesion, consistent with a torpedo maculopathy (a). The lesion shows hypoautofluorescence with hyperautofluorescent border (b). The contours are highlighted on the red-free photograph (c)
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F1
Fundus examination was unremarkable in the right eye but revealed in the left eye an oval hypopigmented lesion, one disc diameter temporal to the fovea, with a hyperpigmented tail extending temporally from the main lesion, consistent with a torpedo maculopathy [Figure 1a]. Fundus autofluorescence imaging of the left eye showed a hypoautofluorescence, with a hyperautofluorescent border surrounding the main lesion and hypoautofluoresence in the satellite temporal lesion [Figure 1b]. The infrared photograph showed the lesion contour and was consistent with the color fundus photograph [Figure 1c].
Swept-source optical coherence tomography of the left macula showing significant thinning of the outer nuclear layer and the retinal pigment epithelium-Bruch Membrane complex as well and irregular disruptions of the ellipsoid and interdigitation zones in the temporal foveal area. The Swept-source optical coherence tomography also shows choroidal thinning beneath the torpedo lesion and a forward movement of the larger choroidal vessels (both Sattler and Haller layers) towards the retinal pigment epithelium (a). On optical coherence tomography angiography, normal superficial capillary plexus (b). Decrease signal in the deep capillary plexus was noted in the lesion area (c, yellow arrow). Optical coherence tomography angiography of the choriocapillaris layer revealed reverse shadowing caused by the increased transmission form the atrophied outer retina and retinal pigment epithelium within the torpedo lesion, and attenuation of signal in the area of the temporal hyperpigmentation (e). En face optical coherence tomography angiography of the left macula shows decreased reflectivity (d-i)
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F2
The swept-source OCT (SS-OCT) showed significant thinning of the outer nuclear layer and the RPE-Bruch Membrane complex as well and irregular disruptions of the ellipsoid and interdigitation zones temporal to the foveal area [Figure 2a]. On OCT-A, superficial capillary plexus was normal [Figure 2b]. A decrease signal in the deep capillary plexus was noted in the lesion area [Figure 2c]. OCT-A of the choriocapillaris layer revealed reverse shadowing caused by the increased transmission from the atrophied outer retina and RPE within the torpedo lesion, and attenuation of signal in the area of the temporal hyperpigmentation [Figure 2e]. OCT-A of the left macula showed decreased reflectivity [Figure 2d-i]. OCT and OCT-A of the contralateral eye were normal.