Foveal avascular zone and foveal pit formation after preterm birth

Susan Elizabeth Yanni, Jingyun Wang, Melody Chan, Joseph Carroll, Sina Farsiu, Joel N. Leffler, Rand Spencer, Eileen E. Birch

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


Background: Vascularisation of the macula takes place between 24 and 27 weeks post-conception. Preterm birth may affect the formation of the foveal avascular zone (FAZ) and foveal depression, and displacement of inner retinal layers away from the incipient fovea. Objective: To examine whether vascular abnormalities accompany an inner retinal abnormality, and whether they are coincident. Methods High-density spectral domain optical coherence tomography volume scans were obtained from 24 preterm children and 34 full-term controls (5-16 years). Matlab programs were used to quantify total retinal thickness, thickness of individual retinal layers and metrics of foveal morphology. Summed voxel projections for the ganglion cell layer-inner nuclear layer were used to identify the FAZ. Results: Preterm children had significantly smaller FAZ diameters than controls (p<0.0001). The foveal pits of preterm children were significantly shallower and less steep (p<0.0001) and total retinal thickness at the fovea was significantly increased (p<0.0001) compared to controls. The ganglion cell layer-inner plexiform layer and outer nuclear layer were significantly (p≤0.0001) thicker in preterm children than in controls. Conclusions: Preterm birth results in abnormal foveal vascularisation, a failure of the inner retinal neurons to migrate away from the fovea, and an elevated outer nuclear layer ratio. The spatial coincidence of inner retinal and vascular abnormalities in preterm children supports the hypothesis that aspects of foveal development are interdependent.

Original languageEnglish (US)
Pages (from-to)961-966
Number of pages6
JournalBritish Journal of Ophthalmology
Issue number7
StatePublished - Jul 2012

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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