title: In Vivo Foveal Development Using Optical Coherence Tomography.
abstract: OBJECTIVE
  To characterize the time course of normal foveal development in vivo in term infants and young children using handheld spectral-domain optical coherence tomography (HH-SDOCT).
  
  
  METHODS
  We obtained 534 HH-SDOCT scans from 261 infants, children, and young adults with a mean age of 4.9 years (range, 0-27 years). Each retinal layer was manually segmented in ImageJ and correlated with gestational age (GA) and visual acuity (VA). The developmental trajectories of each retinal layer at the fovea, parafovea, and perifovea were calculated using fractional polynomial modeling.
  
  
  RESULTS
  The central macular thickness (CMT) increases logarithmically between birth and 48.6 months GA. The foveal ganglion cell (GCL), inner plexiform, inner nuclear (INL), and outer plexiform layers decrease in thickness exponentially until 18 months GA. Interestingly, the parafoveal and perifoveal GCL and INL thicknesses initially decrease until 17 months GA and then increase in thickness until 65.5 GA. The foveal outer nuclear layer, inner segment, and outer segment of the photoreceptors increase in thickness logarithmically until 32.4, 26.9, and 45.3 months GA, respectively. The parafoveal and perifoveal outer retinal layers increase in thickness more gradually until 146 months GA. The thickness of the outer retinal layers and CMT were strongly correlated with VA, with r = 0.54 (P < 0.0001) and r = 0.52 (P < 0.0001), respectively.
  
  
  CONCLUSIONS
  We have modeled for the first time the complex, nonlinear developmental trajectories for each retinal layer and demonstrate that development continues until adolescence. Our description of normal development will be helpful in diagnosing, monitoring, and understanding pediatric retinal disease.
authors.forename: Helena
authors.initials: H
authors.lastname: Lee
authors.forename: Ravi
authors.initials: R
authors.lastname: Purohit
authors.forename: Aarti
authors.initials: A
authors.lastname: Patel
authors.forename: Eleni
authors.initials: E
authors.lastname: Papageorgiou
authors.forename: Viral
authors.initials: V
authors.lastname: Sheth
authors.forename: Gail
authors.initials: G
authors.lastname: Maconachie
authors.forename: Anastasia
authors.initials: A
authors.lastname: Pilat
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: McLean
authors.forename: Frank A
authors.initials: FA
authors.lastname: Proudlock
authors.forename: Irene
authors.initials: I
authors.lastname: Gottlob
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005584:Fovea Centralis / Q000033:anatomy & histology / Q000254:growth & development*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D047929:Term Birth; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult