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    Fundus

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    Kristin Natalia
    The normal fundus contains several key structures including the macula, fovea, retinal arteries and veins, and optic disc. The macula is a 5.5mm area centered within the temporal retinal arcades. The fovea is a concavity within the macula measuring 1.5mm, serving high visual acuity. Retinal arteries appear lighter and narrower than veins. The optic disc measures 1.5mm and contains only ganglion cell axons, with the central cup appearing depressed. Normal fundus variants include the tigroid fundus with visible choroidal vessels, myelinated nerve fibers appearing as feather-like patches, and the albino fundus with visible choroidal vas

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    Fundus

    Uploaded by

    Kristin Natalia
    149 views10 pages
    The normal fundus contains several key structures including the macula, fovea, retinal arteries and veins, and optic disc. The macula is a 5.5mm area centered within the temporal retinal arcades. The fovea is a concavity within the macula measuring 1.5mm, serving high visual acuity. Retinal arteries appear lighter and narrower than veins. The optic disc measures 1.5mm and contains only ganglion cell axons, with the central cup appearing depressed. Normal fundus variants include the tigroid fundus with visible choroidal vessels, myelinated nerve fibers appearing as feather-like patches, and the albino fundus with visible choroidal vas

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    The normal fundus contains several key structures including the macula, fovea, retinal arteries and veins, and optic disc. The macula is a 5.5mm area centered within the temporal retinal arcades. The fovea is a concavity within the macula measuring 1.5mm, serving high visual acuity. Retinal arteries appear lighter and narrower than veins. The optic disc measures 1.5mm and contains only ganglion cell axons, with the central cup appearing depressed. Normal fundus variants include the tigroid fundus with visible choroidal vessels, myelinated nerve fibers appearing as feather-like patches, and the albino fundus with visible choroidal vas

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    149 views10 pages

    Fundus

    Uploaded by

    Kristin Natalia
    The normal fundus contains several key structures including the macula, fovea, retinal arteries and veins, and optic disc. The macula is a 5.5mm area centered within the temporal retinal arcades. The fovea is a concavity within the macula measuring 1.5mm, serving high visual acuity. Retinal arteries appear lighter and narrower than veins. The optic disc measures 1.5mm and contains only ganglion cell axons, with the central cup appearing depressed. Normal fundus variants include the tigroid fundus with visible choroidal vessels, myelinated nerve fibers appearing as feather-like patches, and the albino fundus with visible choroidal vas

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    Attribution Non-Commercial (BY-NC)
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    Download as pdf or txt
    of 10

    Chapter

    The Normal Fundus and Its Variants


    The normal fundus Macula Anatomically the macula is the area centred within the temporal arcades measuring about 5.5 mm (3.5 disc diameter, DD). Fovea The fovea is a concavity in the centre of the macula measuring about 1.5 mm or 1.0 DD. It is the most sensitive part of the retina, serving the function of high spatial resolution and colour vision. On fundoscopy, due to its concavity, a fovea maintaining its normal architecture shows a bright reflex known as the foveal reflex. Foveola A central 0.35 mm of the fovea is known as the foveal avascular zone (FAZ) of the retina as it is free of retinal capillaries. This area consists purely of cone photoreceptors and no overlying inner layers of the retina.

    Fundoscopy Made Easy

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    A normal fundus.

    22

    The Normal Fundus and Its Variants

    Retinal arteries The walls of the retinal blood vessels are transparent and therefore we see the column of blood flowing in them. On fundoscopy, the arteries appear lighter and narrower (arteriovenous ratio of 2:3) compared to the retinal veins. The central retinal artery emerges at the optic disc and divides into four branches (superotemporal, inferotemporal, superonasal and inferonasal). In the retina they divide dichotomously until third-order branches finally form a two-tier perivenular capillary network. The superior branches respect the horizontal raphe and nor mally do not communicate with the inferior branches. The retinal capillary wall is lined by endothelial cells and pericytes which form a tight inner retinal barrier. The retinal blood vessels are autoregulated like those of the brain. Retinal veins The perivenular capillaries ultimately form the four main branches (superotemporal, inferotemporal, superonasal and inferonasal) before forming the central retinal vein at the optic disc. The vessels cross over one another in the retina. The optic disc Measuring about 1.5 mm, the optic disc lies about 3 mm nasal to the fovea. The edge of the optic disc may be slightly elevated. The immediate peripapillary area may show hyperpigmentation or a scalloped pale area representing the sclera, seen through the transparent retina. The only neuroretinal elements at the optic disc are the axons of the ganglion cells which make up the neuroretinal rim. The central part, the optic cup, occupying around 30% of the entire optic disc area, is paler and appears depressed on binocular stereo fundoscopy. The central retinal vessels enter and leave in this depression. Spontaneous venous pulsations are often seen at the optic disc; however, they may be absent in around 20% of normal individuals. The optic disc also has small capillaries. Physiologically the optic disc represents the blind spot.
    23

    Fundoscopy Made Easy

    Normal fundus variants Tigroid In a tigroid fundus there are lesser amounts of pigment in the retinal pigment epithelium, allowing streaks of underlying normal choroidal pigmentation to become visible and give the characteristic appearance.

    Tigroid fundus: larger choroidal vessels with interspersed choroidal pigment showing through.

    24

    The Normal Fundus and Its Variants

    Myelinated nerve fibres Myelinated nerve fibres are relatively common and may follow several patterns: Isolated peripheral patch of myelination. Pericapillary myelination may be mistaken for papilloedema on examination. The myelinated nerve fibres follow the pattern of normal fibres and extend as regular, feather-like patches, which may or may not obscure the retinal blood vessel. Although myelination usually remains stationary, it may very well disappear in optic atrophy following either optic neuritis or ischaemia. It may be associated with neurofibromatosis-1.

    25

    Fundoscopy Made Easy

    Myelinated nerve fibres

    Myelinated nerve fibres. Note the pale appearance adjacent to the optic disc corresponding to arrangement or pattern of retinal nerve fibres.

    26

    The Normal Fundus and Its Variants

    Albino fundus Melanocytes normally synthesise melanin in the retinal pigment epithelium. Absence of melanin due to any defect in its synthesis allows the choroidal vasculature to be seen under the retinal vessels. Ocular albinism is a rare X-linked disorder, affecting the eyes only. Oculocutaneous albinism is an autosomal recessive condition, characterised by hypopigmentation of skin, hair, fundus and irides. It is often associated with a decrease in visual acuity, photophobia and nystagmus. Such patients may be classified as tyrosinase positive or negative, with the degree of pigmentation usually being greater in tyrosinasepositive patients.

    Albino fundus: note the lighter fundal reflex with large choroidal vessels showing through. Absence of normal macular pigmentation and loss of foveal reflex represents macular hypoplasia.

    27

    Fundoscopy Made Easy

    Artefacts in the normal fundus

    Note eye lash artefact inferior to the optic disc.

    28

    The Normal Fundus and Its Variants

    Blurred fundus image due to media opacity caused by cataract.

    29

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