Distribution patterns of torpedo maculopathy: Further evidence of a congenital retinal nerve fiber layer-driven etiology

• Authors: Parker J. Williams, Emory University; Sherveen Salek, Emory University; Robert A. Prinzi, Coastal Eye Group; Chris Bergstrom, Retina Consultants of Carolina; G Baker Hubbard, Emory University
• Journal Title: Saudi Journal of Ophthalmology
• Volume: Volume 33, Number 3
• Publisher: (publisher) | 2019-07-01, Pages 260-267
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.sjopt.2019.07.010
• Subjects: Health Sciences, Opthamology
• Keywords: BCVA, best corrected visual acuity; CHRPE, congenital hypertrophy of the retinal pigment epithelium; Congenital; Distribution; Embryology; Hypopigmentation; IOP, intraocular pressure; Nerve fiber layer; OCT, optical coherence tomography; RPE, retinal pigment epithelium; Torpedo

Abstract

With fewer than 100 peer-reviewed cases reported in the world to date, the underlying etiology of torpedo maculopathy has remained elusive. In this literature review, we provide new evidence to better support, reject and unify claims regarding cause, diagnosis, and proper clinical management of this disease. We reviewed 44 case reports and case series, which included 77 patients (after exclusions). We additionally introduced 3 new cases from our clinical practice for a total of 80 cases. Ages at presentation ranged from 6 months old to 73 years old (mean: 24.2 years old). The nasal aspects of torpedo maculopathy lesions pointed toward the optic disc and localized to a kite-shaped region of the temporal macula, correlating with the anatomic junction of the superior arcuate, inferior arcuate, and papillomacular bundles of retinal nerve fiber layer distribution. No patterns were observed among the temporal aspects of the lesions. These findings support a congenital etiology of torpedo maculopathy and a possible influence of the retinal nerve fiber layer in the development of mature retinal pigment epithelium.