1. Adaptive optics ophthalmoscopy, multifocal ERG and OCTA in unique case of suspected torpedo maculopathy presenting with vitelliform lesion
- Author
-
Nathan G. Lambert, Mark E. Pennesi, Huber Martins Vasconcelos, Robert C. Watzke, and Florin Grigorian
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,Case Report ,Ophthalmoscopy ,Lesion ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,lcsh:Ophthalmology ,Optical coherence tomography ,Ophthalmology ,Multimodal imaging ,medicine ,Torpedo maculopathy ,medicine.diagnostic_test ,business.industry ,Vitelliform ,Retinal ,medicine.disease ,Adaptive optics ophthalmoscopy ,eye diseases ,Optical coherence tomography angiography ,chemistry ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,Maculopathy ,sense organs ,medicine.symptom ,Multifocal electroretinogram ,business ,Erg ,Microperimetry ,030217 neurology & neurosurgery - Abstract
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.
- Published
- 2020