Insights into the developing fovea revealed by imaging

Ye He; Xi Chen; Irena Tsui; Lejla Vajzovic; Srinivas R Sadda

doi:10.1016/j.preteyeres.2022.101067

Insights into the developing fovea revealed by imaging

Prog Retin Eye Res. 2022 Sep:90:101067. doi: 10.1016/j.preteyeres.2022.101067. Epub 2022 May 17.

Authors

Ye He¹, Xi Chen², Irena Tsui³, Lejla Vajzovic², Srinivas R Sadda⁴

Affiliations

¹ Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA; Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, China.
² Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA.
³ Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA.
⁴ Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA. Electronic address: ssadda@doheny.org.

PMID: 35595637
DOI: 10.1016/j.preteyeres.2022.101067

Abstract

Early development of the fovea has been documented by histological studies over the past few decades. However, structural distortion due to sample processing and the paucity of high-quality post-mortem tissue has limited the effectiveness of this approach. With the continuous progress in high-resolution non-invasive imaging technology, most notably optical coherence tomography (OCT) and OCT angiography (OCT-A), in vivo visualization of the developing retina has become possible. Combining the information from histologic studies with this novel imaging information has provided a more complete and accurate picture of retinal development, and in particular the developing fovea. Advances in neonatal care have increased the survival rate of extremely premature infants. However, with enhanced survival there has been an attendant increase in retinal developmental complications. Several key abnormalities, including a thickening of the inner retina at the foveal center, a shallower foveal pit, a smaller foveal avascular zone, and delayed development of the photoreceptors have been described in preterm infants when compared to full-term infants. Notably these abnormalities, which are consistent with a partial arrest of foveal development, appear to persist into later childhood and adulthood in these eyes of individuals born prematurely. Understanding normal foveal development is vital to interpreting these pathologic findings associated with prematurity. In this review, we first discuss the various advanced imaging technologies that have been adapted for imaging the infant eye. We then review the key events and steps in the development of the normal structure of the fovea and contrast structural features in normal and preterm retina from infancy to childhood. Finally, we discuss the development of the perifoveal retinal microvasculature and highlight future opportunities to expand our understanding of the developing fovea.

Keywords: Developing fovea; Infant imaging; Optical coherence tomography; Optical coherence tomography angiography; Prematurity.

Publication types

Review
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Child
Fovea Centralis* / anatomy & histology
Fovea Centralis* / diagnostic imaging
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature*
Tomography, Optical Coherence / methods