Relationship between the foveal avascular zone and foveal pit morphology.

PURPOSE To assess the relationship between foveal pit morphology and size of the foveal avascular zone (FAZ). METHODS Forty-two subjects were recruited. Volumetric images of the macula were obtained using spectral domain optical coherence tomography. Images of the FAZ were obtained using either a modified fundus camera or an adaptive optics scanning light ophthalmoscope. Foveal pit metrics (depth, diameter, slope, volume, and area) were automatically extracted from retinal thickness data, whereas the FAZ was manually segmented by two observers to extract estimates of FAZ diameter and area. RESULTS Consistent with previous reports, the authors observed significant variation in foveal pit morphology. The average foveal pit volume was 0.081 mm(3) (range, 0.022 to 0.190 mm(3)). The size of the FAZ was also highly variable between persons, with FAZ area ranging from 0.05 to 1.05 mm(2) and FAZ diameter ranging from 0.20 to 1.08 mm. FAZ area was significantly correlated with foveal pit area, depth, and volume; deeper and broader foveal pits were associated with larger FAZs. CONCLUSIONS Although these results are consistent with predictions from existing models of foveal development, more work is needed to confirm the developmental link between the size of the FAZ and the degree of foveal pit excavation. In addition, more work is needed to understand the relationship between these and other anatomic features of the human foveal region, including peak cone density, rod-free zone diameter, and Henle fiber layer.

[1]  R. Williams,et al.  Structure of the cone photoreceptor mosaic in the retinal periphery of adult humans: analysis as a function of age, sex, and hemifield , 2000, Anatomy and Embryology.

[2]  D. M. Tait,et al.  Arrested development: High-resolution imaging of foveal morphology in albinism , 2010, Vision Research.

[3]  J. Carroll,et al.  Reconstructing foveal pit morphology from optical coherence tomography imaging , 2009, British Journal of Ophthalmology.

[4]  L. Laatikainen,et al.  Capillary-free area of the fovea with advancing age. , 1977, Investigative ophthalmology & visual science.

[5]  William Fischer,et al.  Race- and sex-related differences in retinal thickness and foveal pit morphology. , 2011, Investigative ophthalmology & visual science.

[6]  F. Proudlock,et al.  Erratum: Structural grading of foveal hypoplasia using spectral-domain optical coherence tomography: A predictor of visual acuity? (Ophthalmology (2011) 118 (1653-1160)) , 2011 .

[7]  Robert J Zawadzki,et al.  Visual insignificance of the foveal pit: reassessment of foveal hypoplasia as fovea plana. , 2008, Archives of ophthalmology.

[8]  D. Purves,et al.  Correlated Size Variations in Human Visual Cortex, Lateral Geniculate Nucleus, and Optic Tract , 1997, The Journal of Neuroscience.

[9]  Toco Y P Chui,et al.  Adaptive-optics imaging of human cone photoreceptor distribution. , 2008, Journal of the Optical Society of America. A, Optics, image science, and vision.

[10]  Z. Gregor,et al.  The perifoveal vasculature in albinism. , 1978, The British journal of ophthalmology.

[11]  Austin Roorda,et al.  Cone structure in retinal degeneration associated with mutations in the peripherin/RDS gene. , 2011, Investigative ophthalmology & visual science.

[12]  J. Provis,et al.  Differential expression of anti-angiogenic factors and guidance genes in the developing macula , 2009, Molecular vision.

[13]  C. Summers,et al.  Albinism and the associated ocular defects. , 1994, Metabolic, pediatric, and systemic ophthalmology.

[14]  Michael D. Abràmoff,et al.  Image processing with ImageJ , 2004 .

[15]  R A Applegate,et al.  Retinal fixation point location in the foveal avascular zone. , 1990, Investigative ophthalmology & visual science.

[16]  B. Fischer,et al.  Visual field representations and locations of visual areas V1/2/3 in human visual cortex. , 2003, Journal of vision.

[17]  S. Beatty,et al.  A central dip in the macular pigment spatial profile is associated with age and smoking. , 2010, Investigative ophthalmology & visual science.

[18]  Gordon L. Walls,et al.  SIGNIFICANCE OF THE FOVEAL DEPRESSION , 1937 .

[19]  David Williams,et al.  Noninvasive imaging of the human rod photoreceptor mosaic using a confocal adaptive optics scanning ophthalmoscope , 2011, Biomedical optics express.

[20]  Eric J. W. Visser,et al.  Abramoff MD, Magalhaes PJ, Ram SJ. 2004. Image Processing with ImageJ. Biophotonics , 2012 .

[21]  S. Beatty,et al.  Foveal anatomic associations with the secondary peak and the slope of the macular pigment spatial profile. , 2009, Investigative ophthalmology & visual science.

[22]  Alfredo Dubra,et al.  Registration of 2D Images from Fast Scanning Ophthalmic Instruments , 2010, WBIR.

[23]  Glen Jeffery,et al.  Retinal abnormalities in human albinism translate into a reduction of grey matter in the occipital cortex , 2005, The European journal of neuroscience.

[24]  A. Springer New role for the primate fovea: A retinal excavation determines photoreceptor deployment and shape , 1999, Visual Neuroscience.

[25]  Kaccie Y. Li,et al.  Intersubject variability of foveal cone photoreceptor density in relation to eye length. , 2010, Investigative ophthalmology & visual science.

[26]  B. Dreher,et al.  Ontogeny of the primate fovea:a central issue in retinal development , 1998, Progress in Neurobiology.

[27]  A. Hendrickson,et al.  Organization of the Adult Primate Fovea , 2005 .

[28]  A. Swaroop,et al.  High-resolution imaging with adaptive optics in patients with inherited retinal degeneration. , 2007, Investigative ophthalmology & visual science.

[29]  Daniel X Hammer,et al.  Foveal fine structure in retinopathy of prematurity: an adaptive optics Fourier domain optical coherence tomography study. , 2008, Investigative ophthalmology & visual science.

[30]  P. Mahendradas,et al.  Understanding clinically undetected macular changes in early retinopathy of prematurity on spectral domain optical coherence tomography. , 2011, Investigative ophthalmology & visual science.

[31]  Seong-Joon Kim,et al.  Correlation of visual acuity with foveal hypoplasia grading by optical coherence tomography in albinism. , 2007, Ophthalmology.

[32]  A D Springer,et al.  Development of the primate area of high acuity, 3: Temporal relationships between pit formation, retinal elongation and cone packing , 2005, Visual Neuroscience.

[33]  Stephen A Burns,et al.  Individual variations in human cone photoreceptor packing density: variations with refractive error. , 2008, Investigative ophthalmology & visual science.

[34]  M Palta,et al.  Abnormalities of the foveal avascular zone in diabetic retinopathy. , 1984, Archives of ophthalmology.

[35]  Amiram Grinvald,et al.  Functional imaging using the retinal function imager: Direct imaging of blood velocity, achieving fluorescein angiography-like images without any contrast agent, qualitative oximetry, and functional metabolic signals , 2009, Japanese Journal of Ophthalmology.

[36]  Austin Roorda,et al.  Noninvasive visualization and analysis of parafoveal capillaries in humans. , 2010, Investigative ophthalmology & visual science.

[37]  Mervyn G. Thomas,et al.  Structural grading of foveal hypoplasia using spectral-domain optical coherence tomography a predictor of visual acuity? , 2011, Ophthalmology.

[38]  Robert J Zawadzki,et al.  Noninvasive imaging of the foveal avascular zone with high-speed, phase-variance optical coherence tomography. , 2012, Investigative ophthalmology & visual science.

[39]  Comparison of development of the primate fovea centralis with peripheral retina , 2006 .

[40]  C. Curcio,et al.  Photoreceptor loss in age-related macular degeneration. , 1996, Investigative ophthalmology & visual science.

[41]  Austin Roorda,et al.  Visual performance in emmetropia and low myopia after correction of high-order aberrations. , 2007, Journal of vision.

[42]  Ann E Elsner,et al.  Imaging polarimetry in patients with neovascular age-related macular degeneration. , 2007, Journal of the Optical Society of America. A, Optics, image science, and vision.

[43]  R. Bone,et al.  Analysis of the macular pigment by HPLC: retinal distribution and age study. , 1988, Investigative ophthalmology & visual science.

[44]  P. D. de Jong,et al.  Macular pigment and melanin in age-related maculopathy in a general population. , 2002, Investigative ophthalmology & visual science.

[45]  R. Danis,et al.  Macular pigment: a review of current knowledge. , 2006, Archives of ophthalmology.

[46]  J Conrath,et al.  Foveal avascular zone in diabetic retinopathy: quantitative vs qualitative assessment , 2005, Eye.

[47]  J. Provis,et al.  The cellular expression of antiangiogenic factors in fetal primate macula. , 2010, Investigative ophthalmology & visual science.

[48]  G. Brown,et al.  Foveal avascular zone diameter and sickle cell disease. , 1991, Archives of ophthalmology.

[49]  J. Sahel,et al.  Foveal shape and structure in a normal population. , 2011, Investigative ophthalmology & visual science.

[50]  F. Proudlock,et al.  The functional significance of foveal abnormalities in albinism measured using spectral-domain optical coherence tomography. , 2011, Ophthalmology.

[51]  Richard V Abadi,et al.  The recognition and management of albinism , 1989, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[52]  W. H. Dobelle,et al.  The topography and variability of the primary visual cortex in man. , 1974, Journal of neurosurgery.

[53]  Arthur Bradley,et al.  Psychophysical measurement of the size and shape of the human foveal avascular zone , 1992, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[54]  A. Roorda,et al.  Observation of cone and rod photoreceptors in normal subjects and patients using a new generation adaptive optics scanning laser ophthalmoscope , 2011, Biomedical optics express.

[55]  E. Rossi,et al.  The relationship between visual resolution and cone spacing in the human fovea , 2009, Nature Neuroscience.

[56]  Barry Cense,et al.  Imaging retinal capillaries using ultrahigh-resolution optical coherence tomography and adaptive optics. , 2011, Investigative ophthalmology & visual science.

[57]  Mette Owner-Petersen,et al.  Noninvasive imaging of human foveal capillary network using dual-conjugate adaptive optics. , 2011, Investigative ophthalmology & visual science.

[58]  E Yamada,et al.  Some structural features of the fovea centralis in the human retina. , 1969, Archives of ophthalmology.

[59]  Brian A Wandell,et al.  Visual field map clusters in human cortex , 2005, Philosophical Transactions of the Royal Society B: Biological Sciences.

[60]  F. Delori,et al.  Reflectance and curvature of the inner limiting membrane at the foveola. , 1999, Journal of the Optical Society of America. A, Optics, image science, and vision.

[61]  A. Hendrickson,et al.  The morphological development of the human fovea. , 1984, Ophthalmology.

[62]  Sina Farsiu,et al.  Dynamics of human foveal development after premature birth. , 2011, Ophthalmology.

[63]  A. Hendrickson,et al.  The foveal avascular region of developing human retina. , 2008, Archives of ophthalmology.

[64]  A. Dubra,et al.  Reflective afocal broadband adaptive optics scanning ophthalmoscope , 2011, Biomedical optics express.

[65]  S. Isenberg Macular development in the premature infant. , 1986, American journal of ophthalmology.

[66]  J. Provis,et al.  Anatomy and development of the macula: specialisation and the vulnerability to macular degeneration , 2005, Clinical & experimental optometry.

[67]  H. Gao,et al.  Aging of the human retina. Differential loss of neurons and retinal pigment epithelial cells. , 1992, Investigative ophthalmology & visual science.

[68]  Austin Roorda,et al.  Modeling the foveal cone mosaic imaged with adaptive optics scanning laser ophthalmoscopy , 2010, Optics Express.

[69]  Deepa John,et al.  Dimensions of the foveal avascular zone using the Heidelberg retinal angiogram-2 in normal eyes , 2011, Indian journal of ophthalmology.

[70]  A. Hendrickson,et al.  Human photoreceptor topography , 1990, The Journal of comparative neurology.

[71]  Gerald McGwin,et al.  Human chorioretinal layer thicknesses measured in macula-wide, high-resolution histologic sections. , 2011, Investigative ophthalmology & visual science.

[72]  Yalin Zheng,et al.  Automated segmentation of foveal avascular zone in fundus fluorescein angiography. , 2010, Investigative ophthalmology & visual science.

[73]  B. Hammond,et al.  Macular pigment optical density in a Southwestern sample. , 2000, Investigative ophthalmology & visual science.

[74]  Toco Y P Chui,et al.  Variation of cone photoreceptor packing density with retinal eccentricity and age. , 2011, Investigative ophthalmology & visual science.

[75]  Austin Roorda,et al.  Disruption of the retinal parafoveal capillary network in type 2 diabetes before the onset of diabetic retinopathy. , 2011, Investigative ophthalmology & visual science.

[76]  F Jung,et al.  Retinal microcirculation in patients with diabetes mellitus: dynamic and morphological analysis of perifoveal capillary network. , 1991, The British journal of ophthalmology.

[77]  R. Raman,et al.  Structural and functional correlates in color vision deficiency , 2011, Eye.

[78]  H. Mintz-Hittner,et al.  A small foveal avascular zone may be an historic mark of prematurity. , 1999, Ophthalmology.

[79]  S. Klein,et al.  Positional uncertainty in peripheral and amblyopic vision , 1987, Vision Research.

[80]  D. Snodderly,et al.  Spatial profile of macular pigment and its relationship to foveal architecture. , 2008, Investigative ophthalmology & visual science.

[81]  Barrie Jay Albinism , 1983, Survey of ophthalmology.