Case report: Torpedo maculopathy in a pediatric patient

Objective: Torpedo maculopathy (TM) is an atypical congenital retinal lesion and, as the name suggests, with an oval shape like a torpedo, usually situated in the temporal sector of the macula. The objective of this paper was to show an accidental finding of torpedo maculopathy in a pediatric patient. Case presentation: A 7-year-old dizygotic twins Caucasian girl, born at 38 weeks, came to our clinic for a routine ophthalmological examination. She had no ocular history, other symptoms, pain, or decreased visual acuity in her left eye. The best-corrected visual acuity (BCVA) was 6/ 6 for both eyes. The posterior pole at OD (oculus dexter) was normal, without any pathological changes. OS (oculus sinister) fundus had an oval well defined hypopigmented lesion in the temporal sector of the macula, with the tip oriented towards the central fovea and the tail extending to the temporal retina, elongated in the horizontal axis, with normal underlying choroidal details, approximately 2-disc diameters (DD) in width and 1 DD in height, and with 2 smalls areas of hyperpigmentation at the level of temporal margin. The optical coherence tomography (OCT) realized on OS exposed an absent retinal pigment epithelium (RPE) combined with hyper-reflectivity of the adjacent choroid, a decreased thickness of ellipsoid zone (EZ), interdigitation zone (IZ), and the outer nuclear layer (ONL), with no focal choroidal cavitation. The inner retina was normal. OCT performed on OD was normal, without any pathological change. Conclusion: Generally, torpedo maculopathy is an asymptomatic benign congenital retinal lesion that is most often diagnosed at a routine eye examination, but with an increased risk of choroidal neovascular membrane appearance, which is why the patients must have a long-term follow-up. Abbreviations: TM = torpedo maculopathy, BCVA = best-corrected visual acuity, OD = oculus dexter, OS = oculus sinister, DD = disc diameters, OCT = optical coherence tomography, RPE = retinal pigment epithelium, EZ = ellipsoid zone, IZ = interdigitation zone, ONL = outer nuclear layer