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Peter Heiduschka, Lea Oberfeld, Nicole Eter; Does foveal hypoplasia lead to functional deficiencies?. Invest. Ophthalmol. Vis. Sci. 2014;55(13):340.
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It is still disputed if the absence of the foveal pit, i.e. foveal hypoplasia, leads to a functional impairment of the retina. We analysed morphological and functional data in patients having presented to our retina clinic.
Patients with foveal hypoplasia were selected by screening the OCT database of our hospital. They were grouped according to stages 1 through 4 as introduced by Thomas et al., Ophthalmology, 2011; 118:1653-1660, with stage 1 for a shallow foveal pit and stage 4 for a completely flat retina with flat retinal layers. Best corrected visual acuity (BCVA), size of foveal avascular zone determined by fluorescein angiography and retinal thickness determined by OCT were correlated with the stages. Amplitudes of multifocal electroretinography (mfERG) were compared with age-matched control values.
Among more than 1000 patients with OCT documentation, 46 patients with foveal hypoplasia were selected. 18 patients were excluded from further consideration due to various accompanying disorders that disturb retinal structure and/or function, such as epiretinal gliosis, macular oedema or photoreceptor degeneration. In normal controls, retinal thickness in the fovea was about 244 µm. In the 25 examined patients, average retinal thickness at the site of the fovea was 284 µm, 276 µm, 311 µm and 325 µm for stages 1 through 4, which was statistically different for stages 1, 3 and 4. BCVA ranged between 0.1 and 1.0 with average values between 0.4 and 0.6 for each group. Large variations within the groups did allow not for statistically significant differences, although average BCVA in group of stage 1 was better than in the other groups. Large variations were also found in the area sizes of foveal avascular zones, although a clear tendency was visible that avascular zones were smaller in foveal regions of stage 4 eyes. In almost all patients, mfERG amplitudes obtained in the fovea were smaller than control values, and amplitudes obtained outside the fovea were closer to control values. There were only weak correlations between mfERG amplitudes and BCVA, depending on the stage of foveal hypoplasia.
Despite the limited number of patients, our results indicate that foveal hypoplasia leads to an impaired retinal function in all four groups.
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