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. 2021 Feb 5;10(2):25.
doi: 10.1167/tvst.10.2.25.

Determining the Location of the Fovea Centralis Via En-Face SLO and Cross-Sectional OCT Imaging in Patients Without Retinal Pathology

Archana A Nair  1 , Rebecca Liebenthal  1 , Shefali Sood  1 , Grant L Hom  2 , Marc E Ohlhausen  3 , Thais F Conti  2 , Carolina C S Valentim  2 , Hiroshi Ishikawa  1 , Gadi Wollstein  1 , Joel S Schuman  1 , Rishi P Singh  2 , Yasha S Modi  1
Affiliations

Determining the Location of the Fovea Centralis Via En-Face SLO and Cross-Sectional OCT Imaging in Patients Without Retinal Pathology

Archana A Nair et al. Transl Vis Sci Technol. .

Abstract

Purpose: The purpose was to establish the position of the fovea centralis to the optic nerve via en-face, near-infrared spectral domain optical coherence tomography (NIR-OCT) in healthy patients. This may shed light on physiological variability and be used for studying subtle cases of foveal ectopia in macular pathology and after retinal detachment.

Methods: SD-OCT data of 890 healthy eyes were retrospectively analyzed. Exclusion criteria included axial myopia causing tilting of the optic disc, peripapillary atrophy >1/3 the width of the disc, macular images excluding greater than half of the optic disc, and patients unable to maintain vertical head positioning. Two independent reviewers measured the horizontal and vertical distance from the fovea to the optic disc center and optic disc diameter via cross-sectional and en-face scanning laser ophthalmoloscopy OCT imaging.

Results: 890 eyes were included in the study. The right and left eyes differed in the horizontal distance from the fovea to the disc center (4359 vs. 4248 µm, P < 0.001) and vertical distance from the fovea to the disc center (464 µm vs. 647, P < 0.001). This corresponded to a smaller angle between the right and left eyes (6.07° vs. 8.67°, P < 0.001). Older age was associated with a larger horizontal (P = 0.008) and vertical distance (0.025). These differences persisted after correcting for axial length in the 487 patients with axial-length data.

Conclusions: This study compares the position of the fovea centralis among individuals without macular pathology on a micron level basis. The significant variability between right and left eyes indicates that contralateral eye evaluation cannot be reliably used. Rather, true foveal ectopia requires assessments of preoperative and postoperative NIR-OCT scans. This finding is relevant to retinal detachment cases and evaluation of subtle foveal ectopia.

Translational relevance: This finding is relevant to retinal detachment cases and evaluation of subtle foveal ectopia.

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Conflict of interest statement

Disclosure: A.A. Nair, None; R. Liebenthal, None; S. Sood, None; G.L. Hom, None; M.E. Ohlhausen, None; T.F. Conti, None; C.C.S. Valentim, None; H. Ishikawa, None; G. Wollstein, None; J.S. Schuman, None; R.P. Singh, None; Y.S. Modi, None

Figures

Figure 1.
Figure 1.
En-face SLO OCT with fovea centralis and optic disc.
Figure 2.
Figure 2.
En-face SLO SD-OCT imaging. X measures the horizontal distance from the fovea centralis to the optic disc center. Y measures the vertical distance from the fovea centralis to optic disc center. Alpha represents the angle between the fovea centralis and the optic disc center.
Figure 3.
Figure 3.
(A) Average horizontal distance of the fovea to optic disc comparing right versus left eye. (B) Average optic nerve head diameter of the right versus left eye. (C) Average vertical distance of the fovea to the optic disc right versus left eye. (D) Interuser variability horizontal distance of the fovea to the optic disc comparing right versus left eye. (E) Interuser variability of the optic nerve head diameter comparing right versus left eye. (F) Interuser variability of the vertical distance of the fovea to the optic disc right versus left eye.
Figure 4.
Figure 4.
(A) Average horizontal distance of the fovea to optic disc versus the spherical equivalent. (B) Average optic disc diameter versus spherical equivalent. (C) Average vertical distance of the fovea to optic disc versus spherical equivalent. (D) Angle alpha versus spherical equivalent. The lines represent the linear regression of each dataset and highlights a correlation between hyperoptic refraction and increased horizontal distance.
Figure 5.
Figure 5.
(A) Average horizontal distance of the fovea to optic disc versus age. (B) Average optic nerve head diameter versus age. (C) Average vertical distance of the fovea to optic disc versus age. (D) Angle alpha versus age. The line represents the linear regression of the dataset and demonstrates a modest correlation between increased age and increased horizontal distance.
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