Fovea Plana (Non-Albinism)

This healthy 24YO female was referred for asymptomatic OCT findings.

Color macular photography is normal, although swept-source OCT through each macular center reveals a flat foveal contour.

Learning Points:
Fovea plana is characterized by the absence of the foveal pit, which is formed embryologically by the inner retinal tissues and vasculature being displaced centrifugally.

It is most commonly associated with albinism, prematurity, or as an isolated finding. Despite the abnormal foveal architecture, vision is usually normal.

On further questioning, our patient was born 5 weeks prematurely and weighed about 5 pounds. We’re not sure if this caused her OCT findings.

This 20YO female presented with these asymptomatic macular findings. She was born prematurely at 24 weeks of gestation. Vision was 20/25 OU.

The right posterior pole was fairly normal clinically, although the left major temporal arcades were straightened and dragged temporally. The left fovea was also temporally displaced.

Triton swept-source OCT showed a flattening of the normal foveal depression bilaterally.

Learning Points:
Temporal dragging and straightening of the vascular arcades are common findings in regressed retinopathy of prematurity (ROP). This is caused by involuted peripheral temporal neovascularization displacing the posterior retina.

The macular center is usually about 2 disc diameters temporal to the edge of the optic nerve, and our patient’s is about 3 disc diameters.

Fovea plana is characterized by the absence of the foveal pit, which is formed embryologically by the inner retinal tissues and vasculature being displaced centrifugally.

It is most commonly associated with albinism, prematurity (as in our case), or as an isolated finding. Despite the abnormal foveal architecture, vision is usually normal.

This patient has normal vision and no history of albinism or prematurity. Fundus photos and OCT images demonstrate the incidental absence of the foveal pit.

Learning Points:
Fovea plana is characterized by the absence of the foveal pit, which is formed embryologically by the inner retinal tissues and vasculature being displaced centrifugally. It is most commonly associated with albinism or prematurity, or found as an isolated finding, as in this case. Despite the abnormal foveal architecture, vision is usually normal.