Relationship between the Foveal Avascular Zone and Foveal Pit Morphology

PURPOSE. To assess the relationship between foveal pit morphology and size of the foveal avascular zone (FAZ). METHODS. Forty-two subjects were recruited. Volumetric images of the macula were obtained using spectral domain optical coherence tomography. Images of the FAZ were obtained using either a modified fundus camera or an adaptive optics scanning light ophthalmoscope. Foveal pit metrics (depth, diameter, slope, volume, and area) were automatically extracted from retinal thickness data, whereas the FAZ was manually segmented by two observers to extract estimates of FAZ diameter and area. RESULTS. Consistent with previous reports, the authors observed significant variation in foveal pit morphology. The average foveal pit volume was 0.081 mm(3) (range, 0.022 to 0.190 mm(3)). The size of the FAZ was also highly variable between persons, with FAZ area ranging from 0.05 to 1.05 mm(2) and FAZ diameter ranging from 0.20 to 1.08 mm. FAZ area was significantly correlated with foveal pit area, depth, and volume; deeper and broader foveal pits were associated with larger FAZs. CONCLUSIONS. Although these results are consistent with predictions from existing models of foveal development, more work is needed to confirm the developmental link between the size of the FAZ and the degree of foveal pit excavation. In addition, more work is needed to understand the relationship between these and other anatomic features of the human foveal region, including peak cone density, rod-free zone diameter, and Henle fiber layer. (Invest Ophthalmol Vis Sci. 2012;53:1628-1636) DOI:10.1167/iovs.11-8488