It also typically features blocking, although the lacunae may show small window defects. Choroidal cavitation has also been reported on OCT.įundus autofluorescence images feature hypoautofluorescence, but the lacunae may show mild hyperautofluorescence. OCT images of CHRPE show retinal thinning, photoreceptor loss, disorganized retinal anatomy, increased RPE thickness and decreased reflectivity of the choroid. “You can have multiple CHRPE lesions in an eye, sometimes referred to as ‘bear tracks.’ Every once in a while they have a white color, and it may be referred to as ‘polar bear tracks.’ They’re essentially the same finding,” Schwartz said. Visual fields often show corresponding scotomas.ĬHRPE is usually unilateral and asymptomatic, featuring a flat, variably pigmented lesion at the level of the RPE, often with depigmented lacunae and/or a depigmented halo.

OCT images of torpedo maculopathy show outer retinal structural abnormalities such as thinning of the retina and RPE, photoreceptor loss, outer retinal clefts and increased reflectivity of the choroid.įundus autofluorescence images show hypoautofluorescence of the lesion, and a window defect is frequently seen with fluorescein angiography. Lesions involving the fovea or systemic associations have not been reported. Lesions are typically longer in the horizontal axis than in the vertical axis. Most lesions are hypopigmented, but some are hyperpigmented, particularly at the tail. “They tend to have that head and that tail, with the head pointing toward the fovea and the tail pointing away.” “The torpedo lesions tend to be just temporal to the center of the macula,” Schwartz said. Torpedo maculopathy is a congenital solitary flat oval-shaped lesion with well-defined margins. The report was published in Ophthalmic Surgery, Lasers and Imaging Retina. “I think the important entity to try to distinguish from all the other ones because of the potential systemic implications is the RPE lesions of Gardner syndrome,” he said.

However, differentiating RPE lesions of Gardner syndrome from the other lesions is important, Schwartz said. … None of them tend to grow, and none of them typically turn malignant.” “The clinical characteristics are often enough to tell them apart pretty accurately. “I think OCT is helpful in distinguishing the lesions apart from each other, but it may not be necessary,” he said. Optical coherence tomography and fundus autofluorescence can be used to distinguish torpedo maculopathy from CHRPE or RPE lesions of Gardner syndrome, but imaging may not be necessary, Schwartz said. Schwartz, MD, MBA, the corresponding author, said in an interview with Ocular Surgery News. “These are somewhat common lesions that are found usually asymptomatically in children and adults, and they superficially look similar to each other,” Stephen G. Congenital hypertrophy of the retinal pigment epithelium (CHRPE) and retinal pigment epithelial (RPE) lesions of Gardner syndrome may resemble torpedo maculopathy in clinical examination.

Bear tracks retina garners syndrome