A novel phenotype of torpedo maculopathy on spectral-domain optical coherence tomography

Purpose: To present a new phenotype of torpedo maculopathy on spectral domain optical coherence tomography imaging (SD-OCT). Observations: A 31-year-old female presented with a multi-partite yellowish lesion in the macula of her left eye, with a central fovea-involving component and a temporal tail-like component. The lesion showed mixed hyper- and hypoautofluorescence on fundus autofluorescence imaging. The fovea-involving component exhibited disruption of ellipsoid zone without outer-retinal cavitation on SD-OCT, consistent with the prior-described type 1 OCT morphology. The temporal tail showed subtle inner choroidal excavation with preservation of the ellipsoid zone and outer-retinal structures. Conclusions: Inner choroidal excavation with preservation of the overlying outer-retinal structures represents a novel morphological phenotype on SD-OCT in torpedo maculopathy. This case demonstrates that distinct morphological subtypes may co-exist in different regions of the same torpedo maculopathy lesion.