Commentary: Inner retinal excavation in torpedo maculopathy and proposed type 3 lesions in optical coherence tomography
Abstract
While many OCT features of TM in this case series (ONL thinning, disruption of EZ and IZ, and increased backscatter) are similar to those reported in the literature,[6‐8] SS‐OCT was able to pick up additional findings. First, thinning of inner retinal layers and overlying localized PVD has never been reported in the literature previously. Second, the subretinal cleft noted in case 3 was too deep to be secondary to outer retinal atrophy alone. We believe inner choroidal atrophy and fluid accumulation secondary to localized RPE defect may have also contributed to it. Third, increased RPE hyper reflectivity was noted in case 1 and 2 in the area of the lesion without any thinning or thickening of RPE. We believe it occurred due to decreased backscatter from overlying attenuated retinal layers. Altered melanin and lipofuscin levels in RPE would also have contributed to this finding. Fourth the outer retinal cavitation was seen in a young child. On the contrary, Wong et al. had previously reported type 2 lesions to occur in older age.[4] Thus, the current understanding about this disorder is far near the requisite, and it would be too early to classify them based on the limited published data.
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