Maturation of the human fovea: correlation of spectral-domain optical coherence tomography findings with histology.
OBJECTIVE
To correlate human foveal development visualized by spectral-domain optical coherence tomography (SDOCT) with histologic specimens.


METHODS
Retrospective, observational case series.


METHODS
Morphology and layer thickness of retinal SDOCT images from 1 eye each of 22 premature infants, 30 term infants, 16 children, and 1 adult without macular disease were compared to light microscopic histology from comparable ages.


RESULTS
SDOCT images correlate with major histologic findings at all time points. With both methods, preterm infants demonstrate a shallow foveal pit indenting inner retinal layers (IRL) and short, undeveloped foveal photoreceptors. At term, further IRL displacement forms the pit and peripheral photoreceptors lengthen; the elongation of inner and outer segments (IS and OS, histology) separates the IS band from retinal pigment epithelium. Foveal IS and OS are shorter than peripheral for weeks after birth (both methods). By 13 months, foveal cone cell bodies stack >6 deep, Henle fiber layer (HFL) thickens, and IS/OS length equals peripheral; on SDOCT, foveal outer nuclear layer (which includes HFL) and IS/OS thickens. At 13 to 16 years, the fovea is fully developed with a full complement of SDOCT bands; cone cell bodies >10 deep have thin, elongated, and tightly packed IS/OS.


CONCLUSIONS
We define anatomic correlates to SDOCT images from normal prenatal and postnatal human fovea. OCT bands typical of photoreceptors of the adult fovea are absent near birth because of the immaturity of foveal cones, develop by 24 months, and mature into childhood. This validates the source of SDOCT signal and provides a framework to assess foveal development and disease.
Department of Ophthalmology, Duke University Eye Center, Durham, NC 27710, USA.
Lejla
L
Vajzovic
Anita E
AE
Hendrickson
Rachelle V
RV
O'Connell
Laura A
LA
Clark
Du
D
Tran-Viet
Daniel
D
Possin
Stephanie J
SJ
Chiu
Sina
S
Farsiu
Cynthia A
CA
Toth
D000293:Adolescent; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005584:Fovea Centralis / Q000033:anatomy & histology* / Q000254:growth & development*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D009412:Nerve Fibers; D020419:Photoreceptor Cells, Vertebrate / Q000166:cytology; D047928:Premature Birth; D012165:Retinal Ganglion Cells / Q000166:cytology; D012189:Retrospective Studies; D047929:Term Birth; D041623:Tomography, Optical Coherence