Department of Ophthalmology, University of Washington, Seattle, WA, USA.
Am J Ophthalmol. 2012 Nov;154(5):767-778.e2. doi: 10.1016/j.ajo.2012.05.007. Epub 2012 Aug 28.
To describe the histologic development of the human central retina from fetal week (Fwk) 22 to 13 years.
Retrospective observational case series.
Retinal layers and neuronal substructures were delineated on foveal sections of fixed tissue stained in azure II-methylene blue and on frozen sections immunolabeled for cone, rod, or glial proteins. Postmortem tissue was from 11 eyes at Fwk 20-27; 8 eyes at Fwk 28-37; 6 eyes at postnatal 1 day to 6 weeks; 3 eyes at 9 to 15 months; and 5 eyes at 28 months to 13 years.
At Fwk 20-22 the fovea could be identified by the presence of a single layer of cones in the outer nuclear layer. Immunolabeling detected synaptic proteins, cone and rod opsins, and Müller glial processes separating the photoreceptors. The foveal pit appeared at Fwk 25, involving progressive peripheral displacement of ganglion cell, inner plexiform, and inner nuclear layers. The pit became wider and shallower after birth, and appeared mature by 15 months. Between Fwk 25 and Fwk 38, all photoreceptors developed more distinct inner and outer segments, but these were longer on peripheral than foveal cones. After birth the foveal outer nuclear layer became much thicker as cone packing occurred. Cone packing and neuronal migration during pit formation combined to form long central photoreceptor axons, which changed the outer plexiform layer from a thin sheet of synaptic pedicles into the thickest layer in the central retina by 15 months. Foveal inner and outer segment length matched peripheral cones by 15 months and was 4 times longer by 13 years.
These data are necessary to understand the marked changes in human retina from late gestation to early adulthood. They provide qualitative and quantitative morphologic information required to interpret the changes in hyper- and hyporeflexive bands in pediatric spectral-domain optical coherence tomography images at the same ages.
描述人眼中央视网膜从胎龄 22 周到 13 年的组织学发育过程。
回顾性观察性病例系列研究。
在经azure II-亚甲蓝染色的固定组织的中央凹切片和免疫标记了视锥、视杆或神经胶质蛋白的冷冻切片上，描绘视网膜层和神经元亚结构。死后组织来自胎龄 20-27 周的 11 只眼；胎龄 28-37 周的 8 只眼；出生后 1 天至 6 周的 6 只眼；9-15 个月的 3 只眼；28 个月至 13 岁的 5 只眼。
在胎龄 20-22 周，通过在外核层中存在单层视锥细胞可以识别中央凹。免疫标记检测到突触蛋白、视锥和视杆视蛋白以及分隔光感受器的 Müller 胶质过程。在胎龄 25 周时出现中央凹小凹，涉及神经节细胞、内丛状层和内核层的逐渐向周边移位。出生后，小凹变宽变浅，15 个月时变得成熟。在胎龄 25 周至 38 周之间，所有视锥细胞都发育出更明显的内、外节，但周边视锥细胞的内外节更长。出生后，随着视锥细胞的包裹，中央外核层变得更厚。视锥细胞的包裹和小凹形成过程中的神经元迁移相结合，形成了长的中央视锥细胞轴突，这些轴突在 15 个月时将外丛状层从最薄的突触足板变成中央视网膜最厚的一层。15 个月时，中央凹内、外节的长度与周边视锥细胞匹配，13 岁时长度是周边视锥细胞的 4 倍。
这些数据对于理解人眼从妊娠晚期到成年早期的显著变化是必要的。它们提供了在相同年龄的小儿频域光学相干断层扫描图像中解释高反射带和低反射带变化所需的定性和定量形态学信息。
