Fig. 2

Case 2. A Color fundus photography demonstrate a horizontally oval, hyperpigmented, torpedo-shaped lesion containing a central pseudolacuna in the right eye. A small satellite lesion is noted adjacent to the temporal margin of the lesion. Serial photography documents apparent stability of the lesion over the 10 year observation period. B Fundus autofluorescence demonstrates typical features of TM, including hypoautoflurescence of the lesion interior and hyperautofluorescence of the lesion margins. The lesion is interrupted near the temporal margin by a tongue of tissue with normal autofluorescence signal that splits the lesion into two parts. This corresponds to the observed satellite lesion at the temporal edge of the torpedo lesion. There is no apparent change in the signal pattern over the observation period. C Scanning laser ophthalmoscopy images with location of corresponding B-scan highlighted in the baseline and 10-year follow-up exam. D Spectral domain optical coherence tomography (OCT). Each image represents a horizontal B-scan through approximately the same location in the middle of the torpedo lesion. Because the examinations were performed on different instruments at each time period, the scans are not of the identical fundus location. Nonetheless, they are as close to the same fundus location as possible. At the 10-year follow-up visit some progression of the inner retinal degeneration is seen. A few small cystic spaces are seen under the inner limiting membrane at baseline, and they appear larger and more numerous at the 10-year visit. While some retinal layers can be identified thoughout most of the lesion in the baseline scan, the 10-year scan reveals an almost complete loss of retinal organization within the torpedo lesion (E)Standard automated perimetry reveals a dense scotoma nasal to fixation that corresponds to the torpedo lesion in the temporal macula