Color Atlas of Retina & Optic Nervee Mohan Rajan, Nicey Roy Thomas
INDEX
A
ABCA4
genotype 17, 19
mutations 19
Acquired immunodeficiency syndrome 214
Adenocarcinoma 326
Adenoma 326
Age-related macular degeneration 134, 242, 244
Albinism 39
Amelanotic choroidal metastases 335
Anesthesia, peribulbar 344
Aneurysms 53, 96
Angiogram 153
Angioid streaks 172, 173, 175
Anisometropic amblyopia 53
Anterior ischemic optic neuropathy 314
Antiretroviral therapy 217
Antivascular endothelial growth factor therapy 92, 205, 339
Aorta, coarctation of 305
Arrestin gene 35
Arterial lesions 305
Arteriovenous shunts 53
Arteritic anterior ischemic optic neuropathy 314
Artery
occluded 104
posterior ciliary 101
Atrophic retina 221
Atrophic retinal hole 57, 276, 277
Atrophy 132, 134, 168, 217, 231, 247
choroidal 20, 27, 28, 325
diffuse 164
foveal 131
geographic 139, 146, 147
gyrate 28
macular 163, 166
peripapillary 303
Autofluorescence, normal-appearing 19
Autosomal dominant
pattern 6
radial drusen 25
Autosomal recessive
disorder 13
ocular albinism 39
Avascular peripheral retina 53
B
Bartonella henselae 236
Behçet's disease 236
Benign flecked retina syndrome 36
Bergmeister's papillae 256, 300
Berlin's edema 258
Best macular dystrophy 15
Bietti corneoretinal dystrophy 30
Bilateral multiple serous retinal detachments 192
Biopsy, corneal 30
Blindness 42
Blood
pressure 90
elevated 90
vessels 77
abnormal proliferation of 42
growth, abnormal 42
Blunt trauma 260, 263
Bone, Paget's disease of 172
Brachytherapy, episcleral 337
Branch retinal
artery occlusion 103, 106, 117
vein occlusion 106, 110, 111, 117
macular 108
major 107
Breast carcinoma 336
Bruch's membrane 167, 172
disease 133
rupture 172
Bull's eye 34
maculopathy 31
Butterfly-shaped pigment dystrophy 21
C
Calcospherites 320
Candle wax drippings 208
Carbohydrate, disorders of 68
Cardiac abnormalities 305
Carotid artery 103
Cataract
complicated 235
surgery 344
traumatic 344
Cavernous optic atrophy 317
Cellophane maculopathy 240
Cellular proliferation 294
Central areolar choroidal dystrophy 27
Central retinal artery 105
occlusion 97, 99
Central retinal vein 119
occlusion 114, 116, 118
Central vision 29
loss 142
Cerebrospinal fluid 314
Cerebrovascular anomalies 305
Cherry-red spot 97, 98, 117
Cholesterol 30
ester 30
Choriocapillaris 271
atrophy 29, 30
Chorioretinal atrophy
diffuse 163, 164
patches of 64
Chorioretinal degenerations 270
Chorioretinal wrinkling 346
Chorioretinitis 317
Chorioretinopathy
central serous 177, 178, 180, 190, 211
chronic central serous 185, 188
multifocal central serous 189
traumatic 257
Choroid 28, 97, 134, 302, 317
peripapillary 101
Choroidal depigmentation 192
Choroidal detachment 347
Choroidal diseases, hereditary 27
Choroidal filling 101
absence of 53
Choroidal melanoma, large 333
Choroidal neovascular membrane 129, 148, 330, 338, 339
Choroidal neovascularization 139, 200, 331
classic 150
membranes 313
secondary 185
Choroidal nevus
juxtapapillary 332
multiple 332
pigmented 331
Choroidal rupture 261, 262
Choroidal vascular disease 133
Choroidal vasculature 35, 285
Choroideremia 20, 29
Choroidopathy 89
punctate inner 202
Cilioretinal artery 101, 102
circulation 117
occlusion 117
sparing central retinal artery occlusion 101
temporal 101
Coats disease 48, 50, 51, 322
Coloboma 5861
atypical 58
ocular 58
Commotio retinae 258261
Cone-rod dystrophy 31, 32, 34
Consecutive optic atrophy 317
Corticosteroid 205
Cotton-wool spots 68, 71, 267
Crescents
congenital 302
heterotypical 302
Curiosities, ocular 256
Cyst
acquired pigmented vitreous 256
congenital 256
inferior intraretinal 289
intraretinal 13, 289, 290
Cystic cavities 320
Cysticercosis 235
ocular 235
Cystoid
macular edema 92, 114, 185
maculopathy 13
Cytomegalovirus
infection 214
retinitis 214
D
Deep capillary plexus 124
Deep-set eyes 344
Dextrocardia, familial 304
Diabetes mellitus 106, 114, 344
Diabetic retinopathy
nonproliferative 68
proliferative 81
Disk
collaterals 118
coloboma 62
lower border of 59
neovascularization of 112
superior border of 58
Diskiform scar 121, 161, 162
Distal retinal vasculature 99
Double optic pits 308
Doyne honeycomb retinal dystrophy 25
Drusen 134, 134
peripheral 142
Drusenoid pigment epithelial detachment 144
Dysplasia 52
Dysplastic optic disk 52
Dystrophy 22, 25
chorioretinal 27
corneal 30
pattern 21
E
Eales’ disease 226, 230
Ectatic capillaries 123
Edema
distribution of 107
intraretinal 129, 130
Ehlers-Danlos syndrome 172, 304, 344
Electro-oculogram 8
Enhanced S-cone syndrome 13
Enzyme ornithine-delta-aminotransferase 28
Epiretinal membrane 94, 239, 240
Epithelioma, nodule of 326
External beam radiotherapy 337
Extrafoveal retinal detachment 45
Extraretinal fibrovascular proliferation 44
Exudative retinal detachment 51, 211
Eye 10, 109
anomalies 305
hypomelanosis of 39
movements 284
F
Facial hemangiomas, small 321
Fat metabolism, disorders of 68
Fetal vasculature 52
Fibroglial nodule 50
Fibrosis 261
subretinal 11, 94
Fibrous growth, severities of 87
Fibrous proliferation 86, 88, 112
Fibrovascular membrane 169
Fibrovascular pigment epithelial detachment 148
Fibrovascular proliferation 42, 82, 86
Fibulin-3 gene 25
Flecked retinal syndromes 36
Fluid
source of 310
subretinal 190, 273
Fluorescein angiography 3, 11, 69, 71, 78, 95, 124, 180, 334
Forme fruste lesions 64
Förster-Fuchs’ spot 168
Fovea 32, 45, 129, 132
Foveal avascular zone, large 80
Foveola 3
Foveomacular vitelliform dystrophy, adult-onset 23
Fuchs’ coloboma 302
Fuchs’ spot 163, 169
Fundoscopy 249
Fundus
albipunctatus 37
autofluorescence 18, 19, 32, 37, 188, 312
coloboma 61, 63
fluorescein angiography 70, 105, 111, 113, 122, 150, 197, 207, 227, 334
normal 1
periphery of 110
pigmentary abnormalities 7
G
Ganglion cell layer 3
Giant cell arteritis 314
Glaucoma 346
filtration surgery 346
neovascular 114
secondary 235
Gliosis, subretinal 306
Gliotic bands, subretinal 290
Glutamate 28
Golden tapetal reflex 35
Goldmann-Favre syndrome 13
Granular hyperreflective deposits 140
Granular pigment, abnormal layer of 35
Granular structure, soft drusen of 136, 137
Granuloma, choroidal 222
H
Hair, hypomelanosis of 39
Hamartoma, astrocytic 320
Hard exudates 72
Hard nucleus 344
Heart disease, ischemic 97
Helicoid subretinal fibrosis 13
Hemangioma 305
choroidal 337
Hemicentral retinal
artery occlusion 105
vein occlusion 119
Hemoglobinopathy 172
Hemorrhage 69, 84, 94, 96, 262, 325
deep 70
diffusion of 265
distribution of 107
hourglass 93
intraretinal 55, 69, 90, 129, 130
nerve fiber layer 91
nondispersed vitreous 85
numerous retinal 106
premacular 264
preretinal 95, 96
splinter 314
subhyaloid 84
submacular 95
subretinal 55, 93, 95, 129, 130, 153, 155
superficial 70
Hemorrhagic choroidal detachment 347
Homocystinuria 344
Horseshoe tears 280, 281, 283
Human immunodeficiency virus infections 214
Hyaloid systems 52
Hyperautofluorescent 32, 312
flecks 37
Hypercoagulable disorders 114
Hyperemia 314
Hyperglycemia 68
Hyperlysinemia 344
Hyperpigmentation 231
Hyperplasia 127, 161, 215, 247
Hypertension 106, 114
chronic systemic 89
malignant 91
systemic 92
Hypoautofluorescence 33
Hypoplasia, foveal 39
Hypotony 235, 346
maculopathy 346
Hypoxia 77
I
Idiopathic inflammatory venous occlusive disease 226
Idiopathic peripheral vascular occlusive disease 226
Immunomodulatory therapy 205
Indocyanine green angiography 156, 198
Infections 213
Infectious disease 8
Inferotemporal retinal arcades 92
Inflammation 235, 344
Inflammatory disease 8, 191
Inkblot leak 180
International Vitreomacular Traction Study Group 242
Intracranial pressure 314
Intraluminal pressure 117
Intraocular lens 344
Intraocular pressure 346
Intraoperative floppy iris syndrome 344
Intraretinal crystalline deposits 125, 126
Intraretinal crystals 125
Intraretinal cystic spaces 241
Intraretinal degenerations 270
Intraretinal exudation 53
Intraretinal microvascular abnormalities 68, 77
Intraretinal pigment
hyperplasia 129
migration 127
Intravitreal ganciclovir injections 217
Ischemia 113
extensive superior 105
severe 83
zone of 51
Ischemic retinal whitening 106
J
Juvenile macular degeneration, causes of 11
K
Knapp striae 172
L
Lacquer cracks 167
Lamellar macular hole 241, 248
Lamina cribrosa 316
Laminar dot sign 317
Large serous neurosensory detachment 309
Laser
hyaloidotomy 265
photocoagulation 273, 279
Lattice degeneration 270, 275
Lens
posterior dislocation of 344
traumatic posterior dislocation of 345
Leukemia 342
Light bulb telangiectasias 48
Lipid exudation, extensive 109
Lipids 125
metabolism 30
Lipofuscin 36
laden macrophages 245
pigment-rich areas 22
Locus minoris resistentiae 65, 66
M
Macroaneurysm 96
Macula 3, 9, 22, 25, 35, 38
central 45
lutea 2
part of 106
schisis 310
Macula
periphery sparing 36
serosanguineous detachment of 339
serous detachment of 308
Macular capillaries 121
Macular capture 305
Macular degeneration
neovascular age-related 148
nonneovascular age-related 134
Macular dystrophies 15
Macular edema 68, 90, 106, 116, 255
diabetic 74, 242
Macular fibroglial nodule 50
Macular hole 239, 261
full-thickness 132, 244
traumatic 261
types of 132
Macular lesions 25
Macular pigmentary alterations 134
Macular pseudohole 249
Macular pucker 240
Macular retinal pigment epithelial changes 97
Macular schisis 13
Macular serpiginous choroiditis 201
Macular star 237
incomplete 236
Macular telangiectasia 121
vessels 49
Maculopathy, myopic 163
Malattia leventinese 25
Marfan syndrome 344
Melanocytoma 340
Melanoma 335
choroidal 333, 334
Metamorphopsia 25
Metaplasia, subretinal fibrous 25
Metastasis, choroidal 335
Microaneurysms 68
cluster of 73
Microangiopathy, diabetic 83, 255
Microcystoid degeneration 270, 272
Midperipheral nummular pigmentary 13
Mittendorf's dot 256
Mizuo-Nakamura phenomenon 35
Morning glory disk anomaly 305, 306
Mulberry appearance 320
Müller cell 125
footplates 125
Multiple evanescent white dot syndrome 203
Multiple neurosensory retinal detachments 196
Multiple posterior atrophic retinal holes 218
Multiple subretinal gliotic bands 296
Mycobacterium tuberculosis 222
Myopia 53
axial 344
pathologic 163
Myopic choroidal neovascularization 168
Myopic macular
degeneration 163
lesions, plus lesions of 167
staphyloma 170
N
Nasal staphyloma 171
Neovascular complex 82, 131
Neural retina 11
Neurofibromatosis 305, 320
Neuroretinitis 236
syndrome 205
tuberculous 236
Neurosensory
cellular elements, atrophy of 132
degeneration 121
detachment 178
retina 217, 252, 302
microcystoid degeneration of 272
Nevus, choroidal 331
Night blindness, congenital stationary 35
Night vision 38
impairment of 29
Nonarteritic anterior ischemic optic neuropathy 314
Nonischemic central retinal vein occlusion 117
Nonneovascular pigment epithelial detachments 134
Nuclear receptor gene 13
Nyctalopia 31
Nystagmus 39, 48
O
Occlusive disease 223
Occult choroidal neovascularization 148
Ocular albinism 39
Ocular damage, types of 89
Ocular hypotony 346
causes of 346
Ocular inflammation 346
Ocular surgery, complications of 343
Oguchi disease 35
Oncology 319
Ophthalmia, sympathetic 196s
Ophthalmic artery 105
Ophthalmic artery occlusion 97
Optic atrophy 97, 316
glaucomatous 316, 317
ophthalmoscopic 316
primary 316
secondary 316
Optic disk 2, 9, 26, 6163, 195, 308, 314
anomalies 299
coloboma 304
diseases 299
edema 91, 97, 196, 211, 311
hyperemic edematous 193
margin 252
melanocytoma 340
pit 66, 304, 307
situs inversus of 304
swelling 90
gross 236
Optic nerve 52, 87, 118, 207, 231, 301, 304
dysplasia 52
head 206, 314
drusen 311, 313
pallor 6
melanocytoma of 341
misrouting of 39
tumor 316
Optic neuritis 315
typical 315
Optic neuropathy 89
traumatic 316
Optical coherence tomography 77, 140, 145, 242, 346
angiography 124
Ora serrata 3
Orbit, pseudotumor of 211
Ornithine 28
Osteoma, choroidal 338, 339
Outer retinal
ischemia 258
layers 14, 27, 65
P
Paget's disease 172
Pain 48
Panretinal photocoagulation 205
Papilledema 314
Parafoveolar area 121
Paravenous retinochoroidal atrophy, pigmented 8
Pars plana
cyst 270
vitrectomy 264
Pars planitis 210
Patchy chorioretinal atrophy 163, 165
Paton's lines 315
Paving stone degeneration 270, 271
Peculiar foveomacular dystrophy 21
Pediatric retinal diseases 41
Pericyte loss 68
Perifoveal region 121
Peripapillary extension 81
Peripapillary retina, temporal 100
Peripheral exudative retinal detachment 51
Peripheral retinal
degeneration 269
periphlebitis-related vascular occlusions 227
vascular abnormalities 53
vasculitis 219
Peripheral serous choroidal detachment 347
Perivascular choroiditis scars 223
Perivasculitis 214
Persistent fetal vasculature syndrome 52
PHACE syndrome 305
Photodynamic therapy 337
Photoreceptors, degenerated 309
Phthisis 235
Pigment epithelial
atrophy 277
cells, intraretinal migration of 277
detachments 178
hyperplasia 139, 143
Pigmentary retinal dystrophy 317
Pisciform 17
Pituitary tumor 316
Pizza pie appearance 214
Plasma ornithine concentration 28
Plus disease 45
diagnosis of 45
Polyarteritis nodosa 236
Polypoidal choroidal vasculopathy 155
Polypoidal lesions 158
Polyps, hyperfluorescent 158
Popcorn lesions 43, 44
Posterior fossa anomalies 305
Posterior multifocal placoid pigment epitheliopathy, acute 197
Posterior vitreous
cortex 252
detachment 240, 252, 278
Precortical vitreous pocket 88
Premacular bursa 88
Preplus disease 45
Preretinal exudation 53
Previtelliform 15
Primary intraocular malignant tumor 333
Proline 28
Protein, disorders of 68
Pseudoexfoliation 344
Pseudohole 241
Pseudohypopyon 15, 16
Pseudolamellar macular holes 131
Pseudoretinitis pigmentosa 306
Purtscher flecken 267
Purtscher retinopathy 267, 268
R
Radial retinal folds 55
Red blood cells 85
Refractive errors 39
Reticular pseudodrusen 140
Retina 2, 6, 7, 28, 77, 83, 97, 101, 105, 317
avascular 43, 47, 215
creates hypoxia 42
depigmented 39
hamartoma of 325
lesions in 68
midperipheral 29
neovascularization of 229
nonedematous 72
normal 60
peripheral 2, 3, 10, 11, 57, 72, 219, 320
superficial 71
whitening of 98
Retinal arterioles 206
Retinal artery 54, 92, 106, 129, 131
macroaneurysms 92, 93
occlusions 97
pathogenesis of 105
Retinal astrocytic hamartoma 320
Retinal blood vessels 38
Retinal capillary bed 117
Retinal cell adhesion 11
Retinal circulations 118
Retinal degenerations 5, 270
Retinal detachment 235
chronic 287, 289, 296
rhegmatogenous 287
inferior serous 306
partial 45
risk of 58
subclinical 283
surgery 322
total 45
Retinal dialysis 282
Retinal dystrophy 5, 13, 42, 51, 55, 218, 285, 295, 325
Retinal folds 52
peripapillary 315
Retinal hard exudates 129, 130
Retinal hemorrhage 69, 115, 214, 235, 261
widespread 116
Retinal hole 273
Retinal ischemia 227
Retinal layers, deeper 127
Retinal lesions 342
Retinal necrosis 214
acute 219, 221
Retinal neovascularization 81, 120, 227
Retinal nerve fiber layer 69, 320
myelination of 300
Retinal phlebitis, inflammatory 209
Retinal pigment 276
epithelial
abnormalities 94
atrophy 215
hyperplasia 127
epithelium 6, 97, 244, 270, 302, 325
atrophy of 134, 217
congenital hypertrophy of 326, 329
damage 261
dysfunction 36
hyperplasia, degrees of 128
solitary congenital hypertrophy of 326
tears 159
Torpedo maculopathy of 330
Retinal racemose hemangioma 321
Retinal schisis 309
Retinal tears 278, 280
traumatic 263
Retinal telangiectasia 48
Retinal thickening 241
Retinal tissue 103
Retinal traction 48
Retinal transparency, loss of 121
Retinal vascular
abnormality 57, 89
development 53
disease 67
occlusive disease 240
response 6
staining 222
Retinal vasculitis 222, 231
tuberculous 223
Retinal vasoproliferative tumor 322
Retinal vein 8, 106
occlusion 242
tortuosity 114, 342
Retinal venules 91
Retinal vessels 6, 9, 11, 12, 54
major 75
superior 105
tortuosity of 47
Retinal whitening 104, 105
Retinitis 215, 219, 220
pigmentosa 6, 322, 344
inversa 7
sine pigmento 7
typical 6
punctata albescens 38
Retinochoroidal coloboma 58, 66, 125
classification of 58
Ida Mann classification of 58
Retinoids 125
Retinol dehydrogenase 37
Retinopathy 89
advanced 75
diabetic 68, 240
hypertensive 89
ischemic 230
leukemic 342
malignant hypertensive 90
mild hypertensive 89
moderate hypertensive 89
peripheral 46
Retinopathy of prematurity 42, 322
aggressive posterior 46
classification of 42
hybrid 46
treatment of 47
Retinoschisis
acquired 272
degenerative 270, 272
peripheral 11
X-linked juvenile 11
Rhegmatogenous retinal detachment 10, 247, 269, 284, 286
spontaneous reattachment of 291
Rhodopsin kinase gene 35
Rod and cone function, abnormalities of 31
Roth's spot 117, 342
S
Salt-and-pepper retinopathy 306
Sarcoidosis 208
Schisis 241
foveal 11
Scleral depression 270
Scleritis 211
Scleroderma 344
Sclerosis
multiple 316
tuberous 320
Sclerotic vessels 217
Scotoma
central 25
paracentral 23
Senile retinoschisis 272
Serous choroidal detachment 347
Serous pigment epithelial detachment 145
Serous retinal detachment 193, 306
Serpiginous choroiditis 200, 222
types of 200
Sickle cell
disease 172, 322
retinopathy 240
Situs inversus 304
Sjögren's reticular dystrophy 21
Skin, hypomelanosis of 39
Smokestack leak 180, 181
Snail track degeneration 270, 274
Snowflake degeneration 10, 270
Soft drusen 136, 137
Spectral domain optical coherence tomography 14, 65, 196, 241, 309
Staphyloma
inferior 171, 304
peripapillary 171
posterior 170, 303
Stargardt disease 17, 18
Stereoscopy 127
Strabismus 39, 48
Sturge-Weber syndrome 337
Subhyaloid space 92, 93
Sub-inner limiting membrane 264
Subretinal choroidal neovascularization 261
Subretinal exudation 53
Subretinal fibrous metaplasia, irregular 25
Subtle numerous white spots 203
Superficial paralimbal cornea 30
Superficial retinal capillary plexus 69, 124
Superotemporal hemorrhagic retinal venous occlusive disease 209
Superotemporal retinal
arcades 92
veins 209
Superotemporal sclerosed retinal arteriole 106
Supplemental oxygen therapy 42
Surgery 205, 346
T
T sign 211
Taenia solium 235
Tapetoretinal degeneration 30
Tapetoretinal disorder 38
Telangiectasia 50, 53
idiopathic
juxtafoveal 121
perifoveal 121
Telangiectatic vessels 51
Temporal retinal fold 57
Thermotherapy, transpupillary 337
Thrombocytopenia 342
Tissue extending 52
Torpedo maculopathy 330
Toxocariasis 322
Toxoplasma gondii 231
Toxoplasmic retinochoroiditis, acute 231
Toxoplasmosis 322
ocular 231
recurrent 234
scars, congenital 231, 232
Tractional retinal detachment 86, 112
Transscleral cryotherapy 205
Transsphenoidal encephalocele 305
Trauma 344, 346
Tubercles 222
Tuberculosis 222
Tumor
mass 341
vasoproliferative 322
Tunica vasculosa 52
Tunnel vision 6
U
Uvea, posterior 331
Uveitis 191, 322, 344
anterior 214
bilateral granulomatous 192
idiopathic chronic intermediate 210
intermediate 210
posterior 211
tuberculous posterior 224
V
Valsalva retinopathy 264, 266
Vascular endothelial growth factor 42, 148
Vascular retina 43
Vasculitis, idiopathic retinal 205
Vasculopathy, hemorrhagic 267
Vaso-occlusive vasculopathy 267
Vessel
choroidal 27, 167
occlusion, primary mechanism of 106
Vision 25
loss 48, 97, 229
mild blurring of 23
peripheral 7, 28
threatening necrotizing herpetic retinopathy 219
Visual acuity 307
loss of 17
Visual field 30
defect 301
deterioration 28
loss, peripheral 29
Visual impairment 42, 308
Visual loss
mild-to-moderate 21
severe 25, 103
Vitamin B6 28
Vitelliform 15, 23
lesion 15, 132
macular dystrophy 25
Vitelliruptive stage 15, 16
Vitreal traction 48
Vitreomacular adhesion 242
Vitreomacular traction 239, 242
Vitreoretinal degenerations 10, 270
Vitreoretinal disorder 248
Vitreoretinopathy
early proliferative 280
familial exudative 53
proliferative 235, 293
Vitreous 44, 83, 84
cavity 92, 93
cysts 256
degeneration 251, 253
hemorrhage 11, 85, 86, 112, 261263
inflammation 325
traction 45, 280
veils 11
Vitritis 210, 214
Vogt-Koyanagi-Harada
disease 192, 211, 236
acute uveitis stage of 192, 193
syndrome 192
V-shaped retinochoroidal degeneration 53
W
Waardenburg syndrome 322
Weill-Marchesani syndrome 344
Weiss ring 252
White polygonal irregular flecks 36
White retinal flecks 11
White retinitis 214
White spot syndromes 197
White-centered retinal hemorrhages 342
Wide macular staphyloma 170
Wyburn-Mason syndrome 321
X
Xanthocoria 48
X-linked ocular albinism 39
Z
Zonular-capsular complex 344
×
Chapter Notes

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Normal FundusCHAPTER 1

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2RETINA
The retina lines the inner surface of the eye and is a thin, delicate, and transparent membrane. It appears purplish red due to visual purple of the rods. There are approximately 6 million cones, most densely packed within the fovea, and 125 million rods, predominantly in the eccentric macula and peripheral retina. It extends from the optic disk to the ora serrata and can be divided into three distinct regions: (1) optic disk, (2) macula lutea, and (3) the rest of the peripheral retina.
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Optic Disk
The optic disk is a pale pink, well-defined circular area of about 1.5 mm in diameter. At the optic disk, all the retinal layers terminate except for the nerve fibers, which pass through the lamina cribrosa to run into the optic nerve. The physiological cup of the optic disk is a depression seen in it. The central retinal vessels emerge through the center of this cup. The cup varies in size, shape, position, and depth in different eyes.
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3Macula (Area Centralis)
The macula is a horizontal ellipse with an area of 5.5 mm in diameter at the posterior pole, demarcated approximately by the upper and lower arcade and temporal retinal vessels. The fovea centralis is the central depressed part of the retina of about 1.85 mm in diameter and 0.25 mm in thickness. The foveola forms the center of the fovea and is 0.35 mm in diameter. There are no rods in the foveola and the cones are so modified that they resemble rods in form. The umbo is a tiny depression in the very center of the foveola, which corresponds to the ophthalmoscopically visible foveolar reflex. There is a dense concentration of cell bodies of elongated cones here referred to as the cone bouquet of Rochon–Duvigneaud. A 0.5-mm wide annular zone surrounding the fovea is the area where the ganglion cell layer, nuclear layers, and outer plexiform layer of Henle are the thickest. This is referred to as the parafoveal area. This area is surrounded by a 1.5-mm ring zone called the perifoveal area where the ganglion cell layer is reduced from five to seven layers to a single layer of nuclei, as noted elsewhere in the peripheral retina. The foveal avascular zone (FAZ) is located inside the fovea, but outside the foveola. Its location can be determined with accuracy only by fluorescein angiography.
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Peripheral Retina
  • The peripheral retina can be divided into:
    • Near periphery—circumscribed region of 1.5 mm beyond the macula
    • Midperiphery—3 mm wide zone around the near periphery
    • Far periphery—extends beyond midperiphery up to the ora serrata
  • Ora serrata—serrated peripheral margin where the retina ends and ciliary body starts. At the ora serrata, the sensory retina is firmly attached both to the vitreous and retinal pigment epithelium
  • Structures seen in the peripheral retina include the equator, short and long ciliary nerves, and the ampullae of vortex veins4