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torpedo_maculopathy [2025/07/14 00:30] – Scott Larsontorpedo_maculopathy [2025/07/14 00:46] (current) – Scott Larson
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 ====Characteristics==== ====Characteristics====
-  * Single oval shaped lesions +  * Single oval shaped lesion of the RPE
   * Located close to the fovea   * Located close to the fovea
     * usually temporal and unilateral     * usually temporal and unilateral
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   * Causes a scotoma   * Causes a scotoma
     * Not associated with other vision loss     * Not associated with other vision loss
 +  * OCT
 +    * cleft of missing RPE or thin abnormal RPE
 +    * degeneration of photoreceptors and loss of outer segments
 +  * Fundus autofluorescence
 +    * dark in the area of the lesion
 +    * no leakage
 +  * Fluorescein angiogram
 +    * hyper-fluorescence 
   * In isolation not associated with other disease   * In isolation not associated with other disease
   * Can occur with other pigmented lesions typically seen in Familial Adenomatous Polyposis   * Can occur with other pigmented lesions typically seen in Familial Adenomatous Polyposis
  
-<WRAP round box 525px> +<WRAP round box> 
-{{:torpedo_maculopathy.jpg?500|}} +{{::torpedo_maculopathy_variation.jpg|}} 
-From reference [1]+Figure 3 from reference [2] \\ 
 +Variations in lesion pigmentation in torpedo maculopathy. 
 +(A) Lesion in patient 6, entirely hypopigmented. This allows visualisation of the deeper choroidal vessels and the sclera. (B) In patient 7, there is variable degree of hypopigmentation and a temporal region of hyperpigmentation within the lesion. (C) In patient 9, the lesion consists of only mild hypopigmentation with a hyperpigmented area within it. (D) The hypopigmented lesion in patient 4 consists of a hyperpigmented temporal crescent.
 </WRAP> </WRAP>
  
 <WRAP round box> <WRAP round box>
 {{::torpedo_maculopathy_montage.jpg|}} {{::torpedo_maculopathy_montage.jpg|}}
-Figure 1 from reference [2] Torpedo maculopathy in patient 1. (A) Hypopigmented lesion along the horizontal raphe with a tip towards the centre of the macula and a slightly pigmented tail. (B) Lesion hyperfluorescence on fluorescein angiography, secondary to the window defect. (C) Horizontal optical coherence tomography (OCT) (Stratus OCT; Carl Zeiss Meditec, Dublin, California) image taken of the superior aspect of the lesion revealing a large cleft and a seemingly absent retinal pigment epithelium signal. (D) Humphrey visual field (10-2) testing showing a corresponding scotoma. (E) Fundus autofluorescence shows hypoautofluorescence of the lesion. (F) Same OCT (Stratus OCT; Carl Zeiss Meditec, Dublin, California) cut of the lesion 2 years later showing no change in the cleft. There is increased irregularity in the photoreceptor layer of the retina. (G) Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) taken 4 years later showing the large cleft, the abnormal outer retinal layer, and the increased signal transmission in the choroid more clearly. (H) Three-dimensional view of the lesion using Spectralis OCT.+Figure 1 from reference [2] \\ 
 +Torpedo maculopathy in patient 1. (A) Hypopigmented lesion along the horizontal raphe with a tip towards the centre of the macula and a slightly pigmented tail. (B) Lesion hyperfluorescence on fluorescein angiography, secondary to the window defect. (C) Horizontal optical coherence tomography (OCT) (Stratus OCT; Carl Zeiss Meditec, Dublin, California) image taken of the superior aspect of the lesion revealing a large cleft and a seemingly absent retinal pigment epithelium signal. (D) Humphrey visual field (10-2) testing showing a corresponding scotoma. (E) Fundus autofluorescence shows hypoautofluorescence of the lesion. (F) Same OCT (Stratus OCT; Carl Zeiss Meditec, Dublin, California) cut of the lesion 2 years later showing no change in the cleft. There is increased irregularity in the photoreceptor layer of the retina. (G) Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) taken 4 years later showing the large cleft, the abnormal outer retinal layer, and the increased signal transmission in the choroid more clearly. (H) Three-dimensional view of the lesion using Spectralis OCT.
 </WRAP> </WRAP>