The Foveal Avascular Region of Developing Human Retina

OBJECTIVE: To study the development of the perifoveal retinal vasculature. METHODS: We studied 7 retinas aged between 26 weeks' gestation and 1 week postnatal (41 weeks' gestation). Sections were imaged using high-resolution digital photography and blood vessel profiles identified at 200% to 300% magnification. Flat mounts were immunolabeled using antibodies to CD31 and factor VIII to identify blood vessels and antibodies to rhodopsin to identify the rod-free zone. RESULTS: The foveal region was identified by the absence of rod photoreceptors in the outer retina and/or presence of a shallow depression in the inner retina. The whole mount at 26 weeks' gestation showed a blood vessel-free region centered on the rod-free zone that was open along the horizontal meridian on the temporal side. At 37 weeks' gestation, the foveal avascular zone formed a complete circle. In sections, the foveal avascular zone was approximately 500 microm in diameter at 35 weeks' gestation and 300 to 350 microm at 40 weeks' gestation; in whole mounts, it was 150 to 170 microm in diameter at 37 and 41 weeks' gestation. CONCLUSIONS: The foveal region is normally avascular during development, as in adult life. We found no evidence of foveal vascularization during development of the human retina. Clinical Relevance Instances of vascularization of the foveal region are not due to failed regression of a transient vasculature.