Morpho-functional evaluation of torpedo maculopathy with optical coherence tomography angiography and microperimetry

Grimaldi, Gabriela; Scupola, Andrea; Sammarco, Maria Grazia; Marullo, Michele; Blasi, Maria Antonietta

doi:10.1016/j.ajoc.2018.02.019

Cited by 14 publications

(21 citation statements)

References 9 publications

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“…multifocal electroretinogram [mfERG] and adaptive optics ophthalmoscopy [AOO]) provide insight into retinal and vascular anatomy and function, and have just recently been used to describe torpedo lesions. 4 OCTA, mfERG and AOO have been used to investigate choroidal structure 5 retinal function, 6 and cone anatomy and density 6 , 7 in torpedo lesions. However, we report the first case of AOO, multifocal ERG, and OCTA in a torpedo lesion with vitelliform material.…”

Section: Introductionmentioning

confidence: 99%

Adaptive optics ophthalmoscopy, multifocal ERG and OCTA in unique case of suspected torpedo maculopathy presenting with vitelliform lesion

Lambert

Grigorian

Vasconcelos

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose To report the case of a ten-year old girl with torpedo maculopathy with a complete vitelliform lesion and describe associated optical coherence tomography (OCT), OCT angiography (OCTA), multifocal electroretinogram (ERG) and adaptive optics ophthalmoscopy (AOO) imaging of the lesion. Observations An asymptomatic ten-year old girl with visual acuity of 20/15 OU was referred for evaluation of possible Best's disease of her left eye. The unilaterality, location, and shape of the lesion was consistent with torpedo maculopathy. OCT and autofluorescence (AF) revealed that the entire lesion was composed of subretinal hyperreflective material that was hyperautofluorescent, consistent with vitelliform material. Within the boundary of the lesion, OCTA showed reduced choriocapillaris density while adjacent to the lesion, the choriocapillaris density was slightly increased. Microperimetry demonstrated normal sensitivity in both eyes, electrooculograms (EOG) were normal and multifocal ERG showed symmetrical mildly supernormal amplitudes. Additionally, AOO demonstrated that nasal to the lesion there were clusters of hyper-reflective areas, and immediately adjacent to the lesion cones were poorly resolved. However, there was a return to more normal photoreceptor architecture outside of the lesion. Conclusions and Importance Torpedo maculopathy lesions typically present with outer retinal attenuation and retinal pigmented epithelium (RPE) atrophy. Vitelliform material was recently observed for the first time in association with Torpedo maculopathy in a case report that described small vitelliform material at the periphery of the lesion. We report the second case of torpedo maculopathy associated with a vitelliform lesion and the first description of a torpedo lesion composed fully of presumed vitelliform material. We also describe findings of OCTA, multifocal ERG and AOO imaging in torpedo maculopathy with vitelliform lesion.

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Section: Introductionmentioning

confidence: 99%

Adaptive optics ophthalmoscopy, multifocal ERG and OCTA in unique case of suspected torpedo maculopathy presenting with vitelliform lesion

Lambert

Grigorian

Vasconcelos

et al. 2021

American Journal of Ophthalmology Case Reports

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“… 7 , 9 , 12 , 13 , 14 OCT-A findings included preservation of superficial capillary plexus perfusion and flow loss in the deep capillary plexus and in the area of subretinal clefting. Grimaldi et al 13 further found reduced sensitivity on microperimetry corresponding to the area of a torpedo lesion, confirming an abnormal functional component in this clinical entity. A weakness of our current report is a lack of OCT-A and microperimetry findings to further deepen our characterization of this novel type 4 morphology.…”

Section: Discussionmentioning

confidence: 99%

A novel phenotype of torpedo maculopathy on spectral-domain optical coherence tomography

Light¹,

Liu²

2020

American Journal of Ophthalmology Case Reports

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Purpose To present a new phenotype of torpedo maculopathy on spectral domain optical coherence tomography imaging (SD-OCT). Observations A 31-year-old female presented with a multi-partite yellowish lesion in the macula of her left eye, with a central fovea-involving component and a temporal tail-like component. The lesion showed mixed hyper- and hypoautofluorescence on fundus autofluorescence imaging. The fovea-involving component exhibited disruption of ellipsoid zone without outer-retinal cavitation on SD-OCT, consistent with the prior-described type 1 OCT morphology. The temporal tail showed subtle inner choroidal excavation with preservation of the ellipsoid zone and outer-retinal structures. Conclusions Inner choroidal excavation with preservation of the overlying outer-retinal structures represents a novel morphological phenotype on SD-OCT in torpedo maculopathy. This case demonstrates that distinct morphological subtypes may co-exist in different regions of the same torpedo maculopathy lesion.

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“…Fundus exam shows a hypopigmented, horizontally oriented, oval-shaped lesion in the temporal macula ( Figure 7 ). 91 , 92 Although typically unilateral, bilateral cases have been reported. 93 , 94 TM is non-progressive and spares the fovea.…”

Section: Torpedo Maculopathymentioning

confidence: 99%

“…93 , 94 TM is non-progressive and spares the fovea. 91 There have been reports of growth and change in shape. 95 , 96 While usually isolated, occasionally small, round satellite lesions temporal to the main lesion have been noted.…”

Section: Torpedo Maculopathymentioning

confidence: 99%

“…115 With the advent of OCT-A, the hypothesis focuses on a malformation of the RPE-choriocapillaris complex. 91 , 108 , 114 , 117 , 118 Using OCT-A, Giannakaki-Zimmermann et al evaluated 4 patients with TM lesions. In this study, all lesions demonstrated normal superficial and deep vascular capillary beds within the TM lesion, and choriocapillaris with on average 26% less signal when compared with healthy choriocapillaris in the same region.…”

Section: Torpedo Maculopathymentioning

confidence: 99%

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<p>Choroidal Cavitary Disorders</p>

Nassar¹,

Tarbett²,

Browning³

2020

OPTH

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The structure and functions of the choroid have been long acknowledged but the pathophysiology behind various anomalies has been difficult to understand until the advent of optical coherence tomography (OCT). With OCT imaging, choroidal cavitations appear as optically empty spaces between the outer retinal and choroidal layers with attenuation or loss of outer retinal layers. Choroidal cavitations are found in the posterior pole and seen in conditions such as pathologic myopia, north carolina macular dystrophy (NCMD), focal choroidal excavation (FCE), and torpedo maculopathy (TM). To date, these disorders have not been linked. A commonality they all share is malformation of the RPE-photoreceptor-choroid complex. The following report describes the differences and similarities of choroidal cavitation amongst the different retinal disorders and emphasizes the importance of multimodal imaging in the detection and management of potential complications.

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Morpho-functional evaluation of torpedo maculopathy with optical coherence tomography angiography and microperimetry

Cited by 14 publications

References 9 publications

Adaptive optics ophthalmoscopy, multifocal ERG and OCTA in unique case of suspected torpedo maculopathy presenting with vitelliform lesion

Adaptive optics ophthalmoscopy, multifocal ERG and OCTA in unique case of suspected torpedo maculopathy presenting with vitelliform lesion

A novel phenotype of torpedo maculopathy on spectral-domain optical coherence tomography

<p>Choroidal Cavitary Disorders</p>

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