This is a case of a middle-aged man presenting with a decrease in vision in his left eye for a period of 2 months. On fundus examination the patient presented with a pigmented macular asymptomatic lesion in the right eye and vascular telangiectasias with exudates in the perifoveal area and in the temporal periphery. Further imaging including macular optical coherence tomography and fluorescein angiography confirmed the diagnosis of macular telangiectasia type 1 (Mac Tel 1) with intraretinal fluid in his left eye and torpedo maculopathy in the right eye. Decision was made to observe the right eye and to treat the left eye with an intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection. In conclusion, Mac Tel 1 and Torpedo maculopathy are developmental anomalies of retina/choroid. Torpedo maculopathy does not lead to any complication and should only be observed while Mac Tel 1 can lead to intraretinal exudation and fluid accumulation that would warrant laser photocoagulation or intravitreal injections with anti-VEGF or anti-inflammatory agents.
Presentation Date: 10/26/2023
Issue Date: 12/08/2023