A qualitative and quantitative analysis of the human fovea during development

The anatomical development of the human fovea has been sampled from 22 weeks gestation to adulthood, using both qualitative and quantitative methods. The foveal depression continues to deepen after birth until 15 months, due to the migration of the cells of the inner retina toward the periphery. Before birth the rod-free zone or foveola is over 1000 microns in diameter, but it becomes progressively narrower after birth because of a centralward migration of cones. It reaches the adult diameter of 650-700 microns by 45 months of age. Postnatally, foveolar cone development is characterized by maturation, elongation, and an increase in packing density. Foveolar cone diameter changes markedly after birth, going from 7.5 microns at 5 days postnatal to 2 microns by 45 months. During this time the foveolar cone develops both its outer segment and basal axon process (fiber of Henle). This combination of elongation and centralward migration results in an increase of foveolar cone density from 18 cones/100 microns at 1 week postnatal to 42 cones/100 microns in the adult. Measures of foveola width and cone diameter reach the adult stage of development at 45 months of age, but the two important visual factors of outer segment length and cone packing density still are only half the adult values at 45 months of age.

The morphological development of the human fovea

The development of the human fovea has been traced from 22 weeks gestation to 45 months postpartum using aldehyde-fixed, plastic embedded, serially-sectioned normal retinas. Five anatomical indicators of foveal maturity were used in this study: the shape of the foveal curvatures; the presence of the transient layer of Chievitz; the width of rod-free zone in the central retina; the width and length of the individual foveal cones; and the number and thickness of layers of nuclei within the fovea. The future fovea is identifiable at 22 weeks by the presence of a thick layer of ganglion cells and a photoreceptor layer containing only cones. By 1 week after birth, there is a shallow foveal depression, but the thick cones still lack outer segments and are only 1 cell deep in the fovea. The inner nuclear layer contains a thick transient layer of Chievitz. As judged by these anatomical criteria and compared to normal adult foveas similarly processed, the human fovea reaches maturity between 15 and 45 months of age.

Maturation of the human fovea: correlation of spectral-domain optical coherence tomography findings with histology

PURPOSE

To correlate human foveal development visualized by spectral-domain optical coherence tomography (SDOCT) with histologic specimens.

DESIGN

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.

Dynamics of human foveal development after premature birth

PURPOSE

To determine the dynamic morphologic development of the human fovea in vivo using portable spectral domain-optical coherence tomography (SD-OCT).

DESIGN

Prospective, observational case series.

PARTICIPANTS

Thirty-one prematurely born neonates, 9 children, and 9 adults.

METHODS

Sixty-two neonates were enrolled in this study. After examination for retinopathy of prematurity (ROP), SD-OCT imaging was performed at the bedside in nonsedated infants aged 31 to 41 weeks postmenstrual age (PMA) (= gestational age in weeks + chronologic age) and at outpatient follow-up ophthalmic examinations. Thirty-one neonates met eligibility criteria. Nine children and nine adults without ocular pathology served as control groups. Semiautomatic retinal layer segmentation was performed. Central foveal thickness, foveal to parafoveal (FP) ratio (central foveal thickness divided by thickness 1000 μm from the foveal center), and 3-dimensional thickness maps were analyzed.

MAIN OUTCOME MEASURES

In vivo determination of foveal morphology, layer segmentation, analysis of subcellular changes, and spatiotemporal layer shifting.

RESULTS

In contrast with the adult fovea, several signs of immaturity were observed in the neonates: a shallow foveal pit, persistence of inner retinal layers (IRLs), and a thin photoreceptor layer (PRL) that was thinnest at the foveal center. Three-dimensional mapping showed displacement of retinal layers out of the foveal center as the fovea matured and the progressive formation of the inner/outer segment band in the opposite direction. The FP-IRL ratios decreased as IRL migrated before term and minimally after that, whereas FP-PRL ratios increased as PRL subcellular elements formed closer to term and into childhood. A surprising finding was the presence of cystoid macular edema in 58% of premature neonates that appeared to affect inner foveal maturation.

CONCLUSIONS

This study provides the first view into the development of living cellular layers of the human retina and of subcellular specialization at the fovea in premature infant eyes using portable SD-OCT. Our work establishes a framework of the timeline of human foveal development, allowing us to identify unexpected retinal abnormalities that may provide new keys to disease activity and a method for mapping foveal structures from infancy to adulthood that may be integral in future studies of vision and visual cortex development.

FINANCIAL DISCLOSURE(S)

Proprietary or commercial disclosure may be found after the references.

Ontogeny of the primate fovea: a central issue in retinal development

The formation of the primate fovea has fascinated a substantial number of histologists, pathologists, ophthalmologists and physiologists for more than a century. In this article, using data from the literature as well as our own observations, we identify events which we believe are crucial in this process and present a developmental neurobiologist's view of the formation of the primate fovea. The fovea is a region of the retina specialized for diurnal, high acuity functions which require a high spatial density of cone photoreceptors as well as a large number of inner retinal cells in order to establish the distinct retinofugal pathways (ganglion cell axons) receiving from individual cones in the foveal cone mosaic. A unique feature of the fovea is the displacement of cells connected to the foveal cones onto the rim of the fovea. It is generally believed that this displacement counteracts the problems caused by the scattering of the incoming light by cells and blood vessels of the inner retina. We believe that one of the crucial events in the formation of the primate fovea is the early centripetal migration of photoreceptors towards the central area (centripetal displacement). This process, initiated early in development, continues throughout intrauterine life until some months or years postnatal. We propose that the displacement of cells from the inner layers is related to the earlier developmental accumulation of photoreceptors and inner retinal cells centrally. This, we propose, leads to metabolic "starvation" of the inner retina, resulting from the complete absence of retinal vessels from the vicinity of the incipient fovea. It is suggested that these factors in turn trigger centrifugal displacement of inner retinal cells towards the encroaching perifoveal capillary network and lead to the formation of the foveal depression.

A morphological comparison of foveal development in man and monkey

The fovea can first be identified in both monkey and human retina at 26-30% gestation as a region containing all adult retinal layers and only cone photoreceptors. A shallow foveal pit and cone outer segments appear by 63-65% gestation in both species. Prenatal development continues rapidly in the monkey, so that by birth a single layer of inner retinal neurons are present in the fovea, cones are three cells deep, inner segments are elongated, and outer segments are up to 50% of inner segment length. In contrast, human fovea does not reach a similar stage until several months after birth. The fovea is adult-like in monkey at 12 weeks and in human at 11-15 months, although human will mature further up to four to five years. This study shows that human fovea is less mature at birth than monkey but develops rapidly in infancy, suggesting that it may be even more susceptible to postnatal environmental influences than the commonly-used monkey model.

Development of the primate area of high acuity. 1. Use of finite element analysis models to identify mechanical variables affecting pit formation

Most primate retinas have an area dedicated for high visual acuity called the fovea centralis. Little is known about specific mechanisms that drive development of this complex central retinal specialization. The primate area of high acuity (AHA) is characterized by the presence of a pit that displaces the inner retinal layers. Virtual engineering models were analyzed with finite element analysis (FEA) to identify mechanical mechanisms potentially critical for pit formation. Our hypothesis is that the pit emerges within the AHA because it contains an avascular zone (AZ). The absence of blood vessels makes the tissue within the AZ more elastic and malleable than the surrounding vascularized retina. Models evaluated the contribution to pit formation of varying elasticity ratios between the AZ and surrounding retina, AZ shape, and width. The separate and interactive effects of two mechanical variables, intraocular pressure (IOP) and ocular growth-induced retinal stretch, on pit formation were also evaluated. Either stretch or IOP alone produced a pit when applied to a FEA model having a highly elastic AZ surrounded by a less elastic region. Pit depth and width increased when the elasticity ratio increased, but a pit could not be generated in models lacking differential elasticity. IOP alone produced a deeper pit than did stretch alone and the deepest pit resulted from the combined effects of IOP and stretch. These models predict that the pit in the AHA is formed because an absence of vasculature makes the inner retinal tissue of the AZ very deformable. Once a differential elasticity gradient is established, pit formation can be driven by either IOP or ocular growth-induced retinal stretch.

Development of the primate area of high acuity, 3: Temporal relationships between pit formation, retinal elongation and cone packing

By establishing an avascular, highly elastic, region within the fetal area of high acuity (AHA), the developing primate eye has created a unique substrate on which the mechanical forces of intraocular pressure (IOP) and growth-induced retinal stretch (stretch) can act. We proposed (Springer & Hendrickson, 2004b) that these forces generate both the pit and high cone density found in the adult AHA. In this paper, we use quantitative measures to determine the temporal relationships between nasal and temporal retinal elongation, changes in pit depth, cone packing, and cone morphology overM. nemestrinaretinal development. Retinal length increased rapidly to about 105 days postconception (dpc; Phase 1) and then elongation virtually ceased (Phase 2) until just after birth (180 dpc). Retinal elongation due to stretch resumed during Phase 3 until approximately 315 dpc (4–5 months), after which time the retina appeared mature (Phase 4). The pit appeared during the quiescent Phase 2, suggesting that IOP acts, in conjunction with molecular changes in the inner retina, on the highly elastic, avascular, AHA to generate a deep, narrow pit and causes inner retinal cellular displacements. Subsequently (Phase 3), the pit widened, became 50% shallower and central inner retinal lamina thinned slightly due to a small amount of retinal stretch occurring in the AHA. Centripetal movement of cones was minimal until just after birth when the pit reached 88% of its maximal depth. Accelerated cone packing during Phase 3 was temporally correlated with increased stretch. A slight stretching of the central inner retina generates “lift” forces that cause the pit to become shallower and wider. In turn, these “lift” forces draw cones toward the center of the AHA (Springer, 1999). Localized changes in cone morphology associated with packing, included smaller cell body size, a change from a monolayer to a multilayered mound of cell bodies, elongation of inner segments and tilting of the apical portion toward the AHA. These changes began in cones overlying the edges of the pit, not its center. Henle cone axons formed initially in association with centrifugal displacement of the inner retina during pit formation, with an additional subsequent elongation due to cones moving centripetally. An integrated, two-factor model of AHA formation is presented. Initially, during the second half of gestation (Phase 2), IOP acts on the hyperelastic avascular zone of the AHA to generate a deep pit in the inner retina. In the first 4 months after birth (Phase 3), central retinal stretch generates tensile “lift” forces that remodel the pit and pack cones by drawing them toward the AHA center.

Gradients of cone differentiation and FGF expression during development of the foveal depression in macaque retina

Cones in the foveola of adult primate retina are narrower and more elongated than cones on the foveal rim, which in turn, are narrower and more elongated than those located more eccentric. This gradient of cone morphology is directly correlated with cone density and acuity. Here we investigate the hypothesis that fibroblast growth factor (FGF) signaling mediates the morphological differentiation of foveal cones--in particular, the mechanism regulating the elongation of foveal cones. We used immunoreactivity to FGF receptor (R) 4, and quantitative analysis to study cone elongation on the horizontal meridian of macaque retinae, aged between foetal day (Fd) 95 and 2.5 years postnatal (P 2.5 y). We also used in situ hybridization and immunohistochemistry to investigate the expression patterns of FGF2 and FGFR1-4 at the developing fovea, and three other sample locations on the horizontal meridian. Labeled RNA was detected using the fluorescent marker "Fast Red" (Roche) and levels of expression in cone inner segments and in the ganglion cell layer (GCL) were compared using confocal microscopy, optical densitometry, and tested for statistical significance. Our results show that morphological differentiation of cones begins near the optic disc around Fd 95, progressing toward the developing fovea up until birth, approximately. Levels of FGF2 and FGFR4 mRNAs expression are low in foveal cones, compared with cones closer to the optic disc, during this period. There is no similar gradient of FGF2 mRNA expression in the ganglion cell layer of the same sections. Maturation of foveal cones is delayed until the postnatal period. The results suggest that a wave of cone differentiation spreads from the disc region toward the developing fovea during the second half of gestation in the macaque. A gradient of expression of FGFR4 and FGF2 associated with the wave of differentiation suggests that FGF signalling mediates cone narrowing and elongation.

VEGF expression by ganglion cells in central retina before formation of the foveal depression in monkey retina: evidence of developmental hypoxia

In macaque monkeys the foveal depression forms between fetal day (Fd) 105 and birth (Fd 172 of gestation). Before this, the incipient fovea is identified by a photoreceptor layer comprising cones almost exclusively, a multilayered ganglion cell layer (GCL), and a "domed" profile. Vessels are absent from the central retina until late in development, leading to the suggestion that the GCL in the incipient fovea may be transitorily hypoxic. Vascular endothelial growth factor (VEGF), expressed by both glial and neuronal cells and mediated by the hypoxia-inducible transcription factor (HIF)-1, is the principal factor involved in blood vessel growth in the retina. We examined VEGF expression in macaque retinas between Fd 85 and 4 months postnatal. Digoxygenin-labeled riboprobes were generated from a partial-length human cDNA polymerase chain reaction fragment, detected using fluorescence confocal microscopy, and quantified using Scion Image. High levels of VEGF mRNA were detected in astrocytes associated with developing vessels. We also detected strong expression of VEGF mRNA in the GCL at the incipient fovea prior to Fd 105, with peak labeling in the incipient fovea that declined with distance in nasal and temporal directions. By Fd 152 peak labeling was in two bands associated with development of the inner nuclear layer (INL) capillary plexus: in the inner INL where Müller and amacrine cell somas are located, and in the outer INL where horizontal cells are found. The findings suggest that at the incipient fovea the GCL is hypoxic, supporting the hypothesis that the adaptive significance of the fovea centralis is in ensuring adequate oxygen supply to neuronal elements initially located within the avascular region.

The developing and evolving retina: using time to organize form

Evolutionary and other functional accounts of the retina and its normal development highlight different aspects of control of its growth and form than genomic and mechanistic accounts. Discussing examples from opsin expression, developmental regulation of the eye's size and optical quality, regulation of eye size with respect to brain and body size, and the development of the fovea, these different aspects of control are contrasted. Contributions of mouse models, particularly with regard to relative timing of events in different species are reviewed, introducing a Web-based utility for exploration of timing issues (www.translatingtime.net). Variation at the individual level, in early experience, and also across species is an essential source of information to understand normal development and its pathologies.

Peripheral defocus does not necessarily affect central refractive development

PURPOSE

Recent experiments in monkeys suggest that deprivation, imposed only in the periphery of the visual field, can induce foveal myopia. This raises the hypothesis that peripheral refractive errors imposed by the spectacle lens correction could influence foveal refractive development also in humans. We have tested this hypothesis in chicks.

METHODS

Chicks wore either full field spectacle lenses (+6.9 D/-7 D), or lenses with central holes of 4, 6, or 8mm diameter, for 4 days (n=6 for each group). Refractions were measured in the central visual field, and at -45 degrees (temporal) and +45 degrees (nasal), and axial lengths were measured by A-scan ultrasonography.

RESULTS

As previously described, full field lenses were largely compensated within 4 days (refraction changes with positive lenses: +4.69+/-1.73 D, negative lenses: -5.98+/-1.78 D, both p<0.001, Dunnett's test, to untreated controls). With holes in the center of the lenses, the central refraction remained emmetropic and there was not even a trend of a shift in refraction (all groups: p>0.5, Dunnetts test). At +/-45 degrees , the lenses were partially compensated despite the 4/6/8mm central holes; positive lenses: +2.63 / +1.44 / +0.43 D, negative lenses: -2.57 / -1.06 / +0.06 D.

CONCLUSIONS

There is extensive local compensation of imposed refractive errors in chickens. For the tested hole sizes, peripherally imposed defocus did not influence central refractive development. To alter central refractive development, the unobstructed part in the central visual field may have to be quite small (hole sizes smaller than 4mm, with the lenses at a vertex distance of 2-3mm).

Maturational gradients in the retina of the ferret

In the present set of studies, we have examined the site for the initiation of retinal maturation in the ferret. A variety of maturational features across the developing inner and outer retina were examined by using standard immunohistochemical, carbocyanine dye labelling, and Nissl-staining techniques, including 1) two indices of early differentiation of the first-born retinal ganglion cells, the presence of beta-tubulin and of neuron-specific enolase; 2) the receding distribution of chondroitin sulfate proteoglycans within the inner retina; 3) the distribution of the first ganglion cells to grow axons along the optic nerve; 4) the emergence of the inner plexiform layer; 5) the emergence of the outer plexiform layer and 6) the onset of synaptophysin immunoreactivity within it; 7) the differentiation of calbindin-immunoreactive horizontal cells; and 8) the cessation of proliferative activity at the ventricular surface. Although we were able to define distinct maturational gradients that are associated with many of these features of inner and outer retinal development (each considered in detail in this report), with dorsal retina maturing before ventral retina, and with peripheral retina maturing last, none showed a clear initiation in the region of the developing area centralis. Rather, maturation began in the peripapillary retina dorsal to the optic nerve head, which is consistent with previous studies on the topography of ganglion cell genesis in the ferret. These results make clear that the order of retinal maturation and the formation of the area centralis are not linked, at least not in the ferret.

The development of visual acuity in the peripheral visual field of human infants: binocular and monocular measurements

We measured binocular and monocular grating acuity in the peripheral visual field of infants, using a modified preferential looking procedure. Both binocular and monocular peripheral acuity increased between 2 and 11 months of age, but had not reached adult levels at the end of the first year of life. Binocular acuity was always higher than monocular acuity. At all ages tested, acuity was higher in the temporal than in the nasal visual field. We conclude that, in spite of the relative morphological maturity of the peripheral retina, visual acuity develops in the peripheral visual field.

Contrast insensitivity: the critical immaturity in infant visual performance

This is a targeted review of the critical immaturities limiting psychophysical luminance contrast detection in human infants. Three-month-old infants are 50 times less sensitive to contrast than adults are. Rod experiments suggest that early-stage immaturities, like the short length of infant rod outer segments, have only a modest direct effect on infant visual performance. Infant contrast sensitivity may resemble adult extrafoveal sensitivity, because the foveal cones of the neonate are immature and may not generate strong enough responses to mediate visual performance. This use of the extrafoveal retina reduces the high-spatial frequency end of the infant contrast sensitivity function (CSF), contributing to poor infant resolution acuity. The remaining difference between infant and adult CSFs may be a simple overall reduction in infant sensitivity. The maximum of the infant CSF increases proportionately with age, and may be numerically near the infant's age in weeks. Contrast discrimination experiments indicate that the critical immaturity that limits infant contrast sensitivity is a mid-level phenomenon, occurring before the site of the contrast gain control. For example, the infant ascending visual pathway might be limited by large amounts of intrinsic noise. These results suggest that there is little effect of inattentiveness to the psychophysical task by ostensibly alert infant patients or subjects. The clinician or researcher can interpret behavioral measurements of infant visual performance with confidence.

Phenotypic Spectrum of the Foveal Configuration and Foveal Avascular Zone in Patients With Alport Syndrome

Purpose

To investigate characteristics of the foveal pit and the foveal avascular zone (FAZ) in patients with Alport syndrome (AS), a rare monogenetic disease due to mutations in genes encoding for collagen type IV.

Methods

Twenty-eight eyes of nine patients with AS, and five autosomal-recessive carriers and 15 eyes from 15 age-similar healthy control subjects were examined using optical coherence tomography (OCT) and OCT-angiography (OCT-A). Foveal configuration and FAZ measures including the FAZ area, circularity, and vessel density in the central 1° and 3° were correlated.

Results

Foveal hypoplasia was found in 10 eyes from seven patients with either genotype. In contrast, a staircase foveopathy was found in seven eyes of four X-linked AS patients. The average FAZ area did not differ significantly between AS patients and control subjects (mean ± SD 0.24 ± 0.24 mm2 vs. 0.21 ± 0.09 mm2; P = 0.64). Five eyes showed absence or severe anomalies of the FAZ with crossing macular capillaries that was linked to the degree of foveal hypoplasia on OCT images leading to a significant inverse correlation of FAZ area and foveal thickness (r = -0.88; P < 0.001). In contrary, female patients with X-linked mutations exhibited a significantly greater FAZ area (0.48 ± 0.30 mm2 vs. 0.21 ± 0.09 mm2; P = 0.007), in line with OCT findings of a staircase foveopathy.

Conclusions

The foveal phenotypic spectrum in AS ranges from foveal hypoplasia and absence of a FAZ to staircase foveopathy with an enlarged FAZ. Because the development of the FAZ and foveal pit are closely related, these findings suggest an important role for collagen type IV in foveal development and maturation.

Developmental changes in astrocyte density in the macaque perifoveal region

We studied astrocyte density both in the perifoveal region and in extrafoveal regions within the same distance of the optic disc (OD) over a time period from foveal pit formation (embryonic day E112) until 2 months after birth. The study was prompted by earlier observations that the adult macaque displays an almost astrocyte-free region around the fovea which, however, at birth is occupied by astrocytes. Thus, we wanted to determine if the perifoveal region is invaded by astrocytes during early development to the same degree as other regions in the central retina, and how the reduction in density can be explained. From the earliest age we studied (embryonic day 112), less astrocytes were found in the perifovea than in other regions equidistant from the OD. In addition, the number of astrocytes steadily declined both in the perifovea and outside until birth. During the first week after birth, there was a further dramatic decline in perifoveal astrocyte density. Double-labelling with glial fibrillary acidic protein (GFAP) immunocytochemistry and the TUNEL method showed that during the whole observation period astrocytes undergo DNA fragmentation and presumably die. However, the rate of TUNEL-positive astrocytes did not significantly differ between perifovea and other regions equidistant to the OD, and at no time did we find a significant peak of apoptosis rate. Thus, the reduction in perifoveal astrocyte density cannot be explained by missing invasion or by selectively elevated apoptosis rates in the foveal and perifoveal regions. Alternative hypotheses are discussed.

Effect of Prematurity on Foveal Development in Early School-Age Children

PURPOSE

To evaluate the foveal development in preterm children with optical coherence tomography and OCT angiography.

DESIGN

Retrospective cohort study.

METHODS

This study included children aged 6-8 years who were born prematurely and who did not receive retinopathy treatment. They were evaluated between September 2018 and July 2019, categorized according to gestational age (GA) (group I: GA ≤30 weeks; group II: GA between 31 and 34 weeks), and compared with full-term children (group III). Central foveal thickness (CFT), inner retinal thickness (IRT), outer retinal thickness (ORT), subfoveal choroidal thickness (CT), temporal and nasal CT, foveal avascular zone (FAZ) diameter, and vessel densities of superficial (SCP-VD) and deep capillary plexuses (DCP-VD) of the foveal and parafoveal areas were examined in detail.

RESULTS

The study included 126 eyes of 63 patients (group I: 40 eyes; group II: 46 eyes; and group III: 40 eyes). In group I, CFT, IRT, ORT, foveal SCP-VD, and foveal DCP-VD were significantly greater than those in the other groups, and temporal CT and FAZ diameter were significantly lower (P < .05). GA showed a significant negative correlation with CFT, IRT, ORT, foveal SCP-VD, and foveal DCP-VD and a significant positive correlation with subfoveal CT, temporal and nasal CT, and FAZ diameter (P < .05).

CONCLUSION

The morphological and vascular foveal structures in early school-age children who were born premature were different from those of full-term children. These differences were correlated with GA and more pronounced in those with GA of ≤30 weeks.

Circuit Reorganization Shapes the Developing Human Foveal Midget Connectome toward Single-Cone Resolution

The human visual pathway is specialized for the perception of fine spatial detail. The neural circuitry that determines visual acuity begins in the retinal fovea, where the resolution afforded by a dense array of cone photoreceptors is preserved in the retinal output by a remarkable non-divergent circuit: cone → midget bipolar interneuron → midget ganglion cell (the "private line"). How the private line develops is unknown; it could involve early specification of extremely precise synaptic connections or, by contrast, emerge slowly in concordance with the gradual maturation of foveal architecture and visual sensitivity. To distinguish between these hypotheses, we reconstructed the midget circuitry in the fetal human fovea by serial electron microscopy. We discovered that the midget private line is sculpted by synaptic remodeling beginning early in fetal life, with midget bipolar cells contacting a single cone by mid-gestation and bipolar cell-ganglion cell connectivity undergoing a more protracted period of refinement.

Transience of astrocytes in the newborn macaque monkey retina

We investigated the morphology and spatial distribution of retinal astrocytes in newborn and early postnatal macaque monkeys. As in adults, retinal astrocytes in neonatal animals were closely associated with ganglion cell axons and blood vessels. However, in contrast with adults, astrocytes transiently occupied the fovea and perifoveal region in newborns and, to a lesser degree, also in early postnatal animals. The density of the perifoveal astrocytes rapidly declined during the first 2-3 months of life. The results are discussed in relationship to foveal development.

Astrocyte invasion and vasculogenesis in the developing ferret retina

We studied the time course of astrocyte invasion and blood vessel formation in the developing ferret retina using glial fibrillary acidic protein (GFAP)-immunohistochemistry for astrocytes and isolectin B4 histochemistry for blood vessels. As in other mammals, strongly GFAP positive astrocytes invade the ferret retina from the optic nerve. At birth, strongly GFAP positive astrocytes have reached about 22% of the distance between optic disc and outer retinal edge whereas weakly GFAP positive processes already extend to the edge of the retina. At postnatal days P30-P37 about 82% of the distance between optic disc and outer retinal edge and in the adult 88% of this distance is covered with strongly labelled astrocytes. Superficial blood vessels form from the optic disc. They reach up to about 24% of the retinal radius at birth and grow radially across the retina during further development. At P30-P37, the whole retina is covered with superficial blood vessels. The deep vascular layer forms later (around P30) through sprouting from superficial vessels. The radial pattern of astrocyte and vessel growth from the optic disc is not affected by the formation of the area centralis and visual streak.

Foveal Development After Use of Bevacizumab for Aggressive Posterior Retinopathy of Prematurity

Foveal development can occur after intravitreal bevacizumab (IVB) treatment for aggressive posterior retinopathy of prematurity (APROP). A 1,310 g male twin, born at 31 weeks, was diagnosed with APROP and undeveloped fovea at 33 weeks. IVB was injected in both eyes. Unfortunately, multiple surgical interventions were required to treat retinal detachment in the left eye, at which time, foveal development was studied in the right eye. Imaging revealed development of foveal capillary ring, avascular zone, and shallow pit. Although bevacizumab is an inhibitor of angiogenesis and delays vascular advancement, development of foveal capillary vascular network with foveal avascular zone and pit can proceed despite multiple treatments. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e185-e187.].

Histological analysis of retinal development and remodeling in the brown anole lizard (Anolis sagrei)

The fovea, a pit in the retina, is crucial for high-acuity vision in humans and is found in the eyes of other vertebrates, including certain primates, birds, lizards, and fish. Despite its importance for vision, our understanding of the mechanisms involved in fovea development remains limited. Widely used ocular research models lack a foveated retina, and studies on fovea development are mostly limited to histological and molecular studies in primates. As a first step toward elucidating fovea development in nonprimate vertebrates, we present a detailed histological atlas of retina and fovea development in the bifoveated Anolis sagrei lizard, a novel reptile model for fovea research. We test the hypothesis that retinal remodeling, leading to fovea formation and photoreceptor cell packing, is related to asymmetric changes in eye shape. Our findings show that anole retina development follows the typical spatiotemporal patterning observed in most vertebrates: retinal neurogenesis starts in the central retina, progresses through the temporal retina, and finishes in the nasal retina. However, the areas destined to become the central or temporal fovea differentiate earlier than the rest of the retina. We observe dynamic changes in retinal thickness during ocular elongation and retraction-thinning during elongation and thickening during retraction. Additionally, a transient localized thickening of the ganglion cell layer occurs in the temporal fovea region just before pit formation. Our data indicate that anole retina development is similar to that of humans, including the onset and progression of retinal neurogenesis, followed by changes in ocular shape and retinal remodeling leading to pit formation. We propose that anoles are an excellent model system for fovea development research.