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Klin Monbl Augenheilkd 2022; 239(04): 500-512
DOI: 10.1055/a-1766-7448
Klinische Studie

Structural, Microvascular, and Functional Findings Associated with Fovea Plana

Strukturelle, mikrovaskuläre und funktionelle Befunde im Zusammenhang mit Fovea plana
Sascha Mathias Jung
1   Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
,
Christophe Valmaggia
1   Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
,
Cengiz Türksever
2   Ophthalmology, Vista Klinik AG, Binningen, Switzerland
,
Margarita G. Todorova
1   Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
3   Department of Ophthalmology, University of Basel, Basel,Switzerland
4   University of Zürich, Zürich, Switzerland
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Abstract

Purpose To analyse structural (OCT), microvascular (OCTA), and functional changes (BCVA, mfERG) associated with fovea plana and to compare it to healthy controls.

Methods A retrospective observational study was performed on 13 patients (26 eyes; aged 34.46 y ± 20.26) with a clinical picture of fovea plana and 15 controls (30 eyes; aged: 41.47 y ± 14.03).

Results In fovea plana, BCVA ranged from 0.25 to 1.0, with a spherical error of − 5.5 to + 18.0 dpt. Posterior segment changes included elevated papillomacular retinal fold, uveal effusion syndrome, crowded optic discs, and hypopigmented fundus. OCTA imaging of the superficial (FAZ-S), intermediate (FAZ-I), and deep foveal avascular zone (FAZ-D) confirmed absence of foveal avascular zone (FAZ-S in 13 eyes, FAZ-I in 21 eyes, and FAZ-D in 10 eyes). Fovea plana patients had a significantly smaller FAZ-S, FAZ-I, and FAZ-D than controls (p < 0.001). Within the fovea plana group, a smaller FAZ-S correlated with reduced BCVA (p = 0.004) and with reduced mfERGs in zones 1 and 2 (p = 0.001 and p = 0.017). Also, a smaller FAZ-D showed positive correlations with the mfERG, with statistically significant values in zones 1 and 2 (p = 0.003 and p = 0.017).

Conclusion In conclusion, our results confirm an altered structural, microvascular, and functional pattern in patients with a clinical picture of fovea plana. As documented by the functional microvascular interactions in our study, the developmental arrest in foveation reflects the functional maturation by means of visual acuity and central retinal function.

Zusammenfassung

Ziel der Studie Die Analyse der strukturellen (OCT), mikrovaskulären (OCTA) und funktionellen Veränderungen (BCVA, mfERG) von Fovea-plana-Patienten und gesunden Kontrollprobanden.

Methoden Eine retrospektive Beobachtungsstudie wurde an 13 Patienten (26 Augen; Alter 34,46 Jahre ± 20,26) mit einem klinischen Bild einer Fovea plana und 15 Kontrollen (30 Augen; Alter: 41,47 Jahre ± 14,03 Jahre) durchgeführt.

Ergebnisse In der Fovea-plana-Gruppe lag die bestkorrigierte Sehschärfe (BCVA) im Bereich von 0,25 bis 1,0, mit einem sphärischen Fehler von − 5,5 bis + 18,0 dpt. Zu den Veränderungen des hinteren Segments gehörten: papillomakuläre Netzhautfalte, uveales Effusions-Syndrom, Crowded Papille und hypopigmentierter Fundus. Die OCTA-Bildgebung der oberflächlichen (FAZ-S), intermediären (FAZ-I) und tiefen fovealen avaskulären Zone (FAZ-D) zeigte das Fehlen (FAZ-S in 13 Augen, FAZ-I in 21 Augen und FAZ-D in 10 Augen). Fovea-plana-Patienten hatten signifikant kleinere FAZ-S, FAZ-I und FAZ-D als die Kontrollprobanden (p < 0,001). Innerhalb der Fovea-plana-Gruppe korrelierten kleinere foveoläre avaskuläre Zonen im superfiziellem Plexus (FAZ-S) mit reduziertem BCVA (p = 0,004) und mit reduzierten Antworten im mfERG in Zone 1 und 2 (p = 0.001 und p = 0.017). Auch Verminderungen in der FAZ-D zeigten statistische signifikante positive Korrelationen mit den Antworten im mfERG in den Zonen 1 und 2(p = 0,003 und p = 0,017).

Schlussfolgerung Eine Vielzahl klinischer, mikrovaskulärer und funktioneller Befunde kann bei Patienten mit Fovea plana berücksichtigt werden. In dieser Studie konnte gezeigt werden, dass eine Korrelation zwischen der Funktion und den mikrovaskulären Veränderungen bei Patienten mit Fovea plana verschiedenster Ätiologie vorliegt.

Key words

anatomy - electrophysiology - retina

Schlüsselwörter

Anatomie - Elektrophysiologie - Retina

Supplementary material



Publication History

Received: 22 October 2021

Accepted: 06 February 2022

Article published online:
26 April 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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