Subject(s)
Anti-Asthmatic Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Asthma/drug therapy , Bronchodilator Agents/therapeutic use , Acute Disease , Asthma/diagnosis , Asthma/etiology , Asthma/prevention & control , Child , Chronic Disease , Home Care Services/organization & administration , Humans , Patient Education as Topic , Severity of Illness IndexABSTRACT
We have examined two psychophysical procedures for assessing the size and shape of the human foveal avascular zone (FAZ). Both procedures used a Maxwellian view system with a rotating beam to create a high contrast entoptic view of the retinal vasculature. Most subjects readily report a clear avascular zone surrounding their fixation point. The size of this FAZ was measured by (a) reducing the circular Maxwellian view field stop until it appeared to coincide with the edge of the FAZ, and (b) by tracing the boundary of the FAZ with a point source. Consistent with earlier angiographic and anatomical studies, the first method (N = 34 eyes) showed a mean FAZ diameter of 0.736 mm (area 0.42 mm2). FAZ diameter ranged from 0.46 to 1.13 mm (area 0.166-1.00 mm2) and the FAZ from the right and left eyes of each individual subject were very similar (r2 = 0.863). The tracing technique (n = 24 eyes) showed that FAZ's were generally not spherical but well fit by ellipses with, on average, a major axis 17% longer than the minor axis. The maximum diameters of the FAZ tracings were very similar and significantly correlated with the circle diameters matched to the FAZ in experiment 1.
Subject(s)
Fovea Centralis/anatomy & histology , Psychophysics/methods , Adult , Anthropometry , Fixation, Ocular , Fovea Centralis/blood supply , Humans , MaleABSTRACT
The site of normal fixation is often assumed to be centered in the foveal avascular zone (FAZ). This assumed anatomic relationship is used during photocoagulation therapy as an objective guide to avoid damaging critical retinal structures on or near fixation. With laser therapy being directed closer and closer to the center of the FAZ, the accuracy with which the center of the FAZ locates the retinal point of fixation becomes an important therapeutic issue. Using an optimized technique for visualizing the retinal vasculature entoptically, the authors determined the location of the retinal point of fixation with respect to the foveal area vasculature in 26 eyes of 14 healthy subjects. In 23 eyes (12 subjects), a traditional FAZ was observed, the other three eyes (two subjects) had capillaries near or crossing the center of fixation. Of the 23 eyes with a traditional FAZ, 20 had centers of fixation located eccentric to the center but in the FAZ, (average deviation from the center of the FAZ, 66.5 +/- 49.5 microns) with the direction of deviation from the FAZ center appearing random. Consequently, when following protocols that advocate photocoagulation treatment with spot centers closer to the FAZ center than 300 microns, the center of the FAZ is a poor locator of a subject's retinal point of fixation. When using the FAZ as a reference, the resulting uncertainty in the location of the subject's retinal point of fixation increases the probability of significant damage to the actual point of fixation by up to 20%.
