Asian Journal of Medical Research and Case Reports

Background: Torpedo maculopathy (TM) is an uncommon congenital abnormality of the retinal pigment epithelium (RPE), characterised by a distinctive torpedo-shaped lesion that is typically situated temporal to the fovea. The condition is most frequently identified incidentally in asymptomatic individuals and may be categorised into various subtypes according to optical coherence tomography (OCT) characteristics.

Case Presentation: A 45-year-old asymptomatic male underwent routine ophthalmic evaluation. Best-corrected visual acuity was 20/20 in both eyes. Fundus examination of the right eye revealed a well-defined torpedo-shaped hypopigmented lesion located approximately two disc diameters temporal to the fovea. Multimodal imaging demonstrated characteristic features of Type 2 torpedo maculopathy. Fundus autofluorescence showed predominantly hypoautofluorescence with a focal hyperautofluorescent temporal tip. OCT revealed preservation of the inner retinal layers, thinning of the outer nuclear layer, outer retinal cavitation, and increased choroidal transmission. OCT angiography showed no evidence of choroidal neovascularisation and demonstrated preserved choriocapillaris architecture surrounding the lesion. The left eye was normal.

Conclusion: This case highlights the diagnostic value of multimodal imaging in the identification and characterisation of Type 2 torpedo maculopathy. The presence of a hyperautofluorescent lesion tip, preserved inner retina with outer retinal cavitation, and intact surrounding choriocapillaris on OCTA provides additional imaging insights that may facilitate differentiation from other hypopigmented macular lesions. Although generally benign, periodic follow-up remains advisable to monitor for rare complications such as choroidal neovascularisation.