The Macula, the fovea and blood supply: What do we know and how does it help?

Jan Provis

Meeting:  2013 RANZCO


Date: 05 Nov 2013


Session Time: 10:50 am - 11:20 am

The fovea centralis is specialization of the central retina that is associated with high acuityvision. The word ‘fovea’ is Latin for ‘pit’ – a depression in the surface of the retina. But whatadvantages does the pit per se confer on central vision, and how does it come about? Furthermore,are the adaptations associated with the fovea in any way linked to our vulnerability to maculardegeneration? The use of new generation optical coherence tomography (OCT) has facilitatedgathering of information on the morphometry of the macula and fovea in a very large sampleof the population, revealing greater diversity in foveal morphology than was understood from arelatively small sample of histological specimens. In combination with molecular analyses, and datafrom preterm infants scanned using hand-held OCT devices, we are now beginning to understandthe diversity of appearances of the fovea, and the impact of both genes and the neonatal environ-ment on its development. We now know that during development, definition of an avascular area isa prerequisite for formation of a fovea. Furthermore, it appears that the molecular factors that definethe avascular area leave the adult macula dependent on a microvasculature that is vulnerable toinflammatory events.