Torpedo maculopathy was first described by Roseman and Gass as a benign congenital solitary, sharply circumscribed, pinkish-white, placoid, hypopigmented naevus of the RPE not associated with a significant visual loss which can be detected on routine clinical evaluation. It resembles a torpedo with a characteristic leading edge pointing toward the fovea. Torpedo maculopathy by itself is an uncommon entity and is a benign condition though very rarely it can be associated with complications. We report a fourth such case of torpedo maculopathy associated with choroidal neovascular membrane (CNVM) treated with anti-VEGF therapy.
A young 14-year-old male presented with right eye diminution of vision, 6 months in duration with a history of two intravitreal ranibizumab injections over the last 2 months and an unremarkable systemic history. The right eye had a corrected distance visual acuity of 6/9 and a relative afferent pupillary defect, and an otherwise normal anterior segment exam. The left eye exam was normal. [Figs 1-3] document and describe the color fundus photo, angiography, and optical coherence tomography findings (SD-OCT [Spectral Domain Optical Coherence Tomography], Spectralis, Heidelberg, Germany). As the CNVM was active, he was advised further intravitreal anti-VEGF injections.
This case of torpedo maculopathy with CNVM is the youngest report yet; additionally it also details the neovascular elements with OCT Angiography (OCTA) making it unique. The CNVM was a mixed type with a poor response to two prior anti-VEGF injections unlike the previous report where the exact nature of CNVM is not mentioned and a good anatomical response was recorded with a single injection. In conclusion, we highlight the fact that torpedo maculopathy lesions are susceptible to the development of CNVM possibly because the outer retina and RPE are primarily affected by this entity, thereby emphasizing the need for periodic follow-up of these young patients.
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2.3 Conflicts of interest
There are no conflicts of interest.
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