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ANATOMY OF RETINA

EMBRYOLOGY
embryology
The retina is derived from the two
layers of optic vesicle.
RPE-develops from the outer layer
&sensory retina from the inner
layer.
The potential space of the optic
vesicle b/w the 2 layers is bridged
by the processes of pigment cells.
anatomy
Rete in Latin means Net
the retina proper is a thin, delicate layer of nervous tissue
that has a surface area of about 266mm
2.
The major landmark of the retina are:
The optic disc
The retinal blood vessels
The area centralis with the fovea and foveola
The peripheral retina (which includes equator)
The ora serrata
the retina is thickest near the optic disc,measuring
0.56mm,it becomes thinner towards the
periphery,measuring 0.18mm at the equator and to
0.1mm at the ora serrata
THE OPTIC DISC
The optic disc is a circular to
slightly oval ,situated 1mm above
and 3mm nasal to the posterior pole
measures approx 1.5mm
horizontally and 1.75mm vertically.
It corresponds to the scleral
opening through which the axons of
the ganglion cells leave to form the
optic nerve.
THE AREA CENTRALIS(MACULA
LUTEA)
The area centralis or central
retina is divisible into the
fovea and foveola,with a
parafoveal and a perifoveal
ring around the fovea.
Avg diameter of about
5.5mm
This region in demarcated
approx by the upper and
lower arcuate temporal
retinal vessels and has an
ellipitical shape horizontally.
It corresponds to approx 15
degress of the visual field.
Yellow colouration is derived
from the presence of the
carotenoid
pigment,xanthophyll in the
ganglion and bipolar cells.
Contdarea centralis
The macula lutea can be best visualized in red free light and in
darkly pigmented individuals
Parafovea-this is 0.5mm wide zone around the fovea.it has the
maximum no. of nerve cells especially the ganglion cells &cells of
the inner nuclear layer.the cone:rod ratio is 1:1
Perifovea-this is the outermost ring of area centralis.1.5mm
wide,the cell density is less in this area. The cone:rod ratio is 1:2
foveal avascular zone or capillary free zone-is approx
500microm in diameter & is often taken to be the centre of the
macula and thus the point of fixation.
- is an important clinical landmark in the treatment of subretinal
neovascular membrane by laser photocoagulation.
The fovea
It marks the approximate
centre of the area
centralis,is located at the
posterior pole of the
globe,4mm temporal to the
centre of the optic disc and
about 0.8mm below the
horizontal meridian.
1.85mm in diameter and
0.25mm in thickness.
It corresponds to the central
5 degrees of the visual field.
At the fovea, the only layers
that are present are
RPE,photoreceptors( only
cones), the ext limiting
membrane, the outer
nuclear layer, the inner
fibers of the
photoreceptors(Henles fibre
layer) and the internal
limiting membrane.
The foveola
Represents the area of the
highest visual acuity in the
retina because of the sole
presence of cones and its
avascular nature.
Correspond to the central 1
degree of the visual field.
Measures 0.35mm in
diameter and 0.1mm in
thickness,thinnest part of the
retina,is devoid of ganglion
cells. Appears deeper red
than does the adjacent retina
because of the rich choroidal
circulation of the
choriocapillaries which shines
through it.
The colour of the fovea
persists and is called cherry-
red spot when the
surrounding retina becomes
cloudy which occurs after
obstruction in the central
retinal vasculature and in
certain metabolic storage
diseases.
The peripheral retina
The peripheral retina increases the field of vision
and is divided into four regions:
The near periphery
The mid-periphery
The far periphery and
The ora serrata
the near periphery is a 1.5mm around the
area centralis and the mid-periphery is a 3mm
wide zone around the near periphery.
the far periphery is a region that extends from
the optic dics,9-10mm on the temporal side and
16mm on the nasal side in the horizontal
meridian.
Ora serrata
It is the most anterior region of the
retina, which consists of a
dentate fringe and which denoted
the termination of the retina. it
terminates by becoming
continouous with the non-
pigmented epithelium of pars
plana.
Here the nervous tissues of the retina
end.
2.1mm wide temporally ,0.7-
0.8mm wide nasally
Located 6mm nasally and 7mm
temporally from the limbus
6-8mm from the equator and
25mm from the optic nerve on
the nasal side.
the external landmark of the ora
serrata is the location of the
insertions of the recti
muscles(except for the superior
rectus which inserts post to the
ora)
The vitreous base is attached to
the retina at the ora.
Varous anolamies at the ora which can
predispose to retinal tears and vitreoretinal
detachments include;1.retinal tufts
2.meridional folds
3.meridional complexes.
beginning at the young age,cystoid
degeneration occurs,usually in the outer
plexiform layer at the ora serrata.the
cystic spaces become pronounced in the
elderly and are more marked on the nasal
than on the temporal aspect.later they
extend betn the inner and outer limiting
membranes and may communicate with the
vitreous and give rise to retinal
detachment.
It is in a watershed zone betn the anterior
and posterior vascular system,which may in
part explain why peripheral retinal
degeneration is relatively common.
Contd
The ora has distinct anatomical
properties because of-
1.It is the point of peripheral retina
termination.
2.It is thin.
3.It is avascular.
4.Its intimate relationship to the
vitreous.
5.External landmark of the insertion
of the recti muscles.
Factors keeping the retina attached
1.MECHANICAL FORCES OUTSIDE THE SUB
RETINAL SPACE:
A.FLUID PRESSURE:hydrostatic &osmotic
fluid is driven from the vitreous towards the
choroid.but the posterior route is limited bcos the
retina & RPE provide substantial resistance to water
movement. hence as an effect of this outward push of
fluid the retina remains on the wall of the eye.
B.PRESSURE DIFF ACROSS THE RETINA:
C.VITREOUS ADHESIONS:
vitreous has a physical structure of a gel that may
help to keep the retina in place. even in syneresis a
thin cortical layer remains aiding fluid pressure keeping
the retina in place.
2.FORCES IN THE SUB RETINAL SPACE:
1.RPE PUMP:
the RPE can pump fluid out of the subretinal space to
the choroid at the rate of 0.3microL\hr\sqmm.this is an
active energy dependent process and keeps the
subretinal space dry.
2.MECHANICAL INTERDIGITATION:
RPE microvilli wrap closely around the tips of the outer
segments of the photoreceptors.
C.INTERPHOTORECEPTOR MATRIX:
1.Cell-cell adhesion mediated by CELL ADHESION
MOLECULES, which are intrinsic membrane
glycoproteins.
2.Cell-matrix adhesion mediated by matrix molecules
like fbronectin,laminin,collagen and proteoglycans.
On cross section,from outer to
inner retina,retinal layers are
RPE and its basal lamina
Rod and cone inner and outer
segments
External limiting membrane
Outer nuclear layer(nuclei of
photoreceptors)
Outer plexiform layer
Inner nuclear layer
Inner plexiform layer
Ganglion cell layer
Nerve fibre layer(axons of the
ganglion cells)
Internal limiting membrane
Retinal pigment epithelium
The RPE consists of a monolayer of
hexagonal cells that extends anteriorly
from the optic disc to the ora serrata,
where it merges with the pigmented
epithelium of the ciliary body.
4-6 million cells\eye
It is 10-14 microns thick at the macula
and becomes thinner towards the ora.
3 parts-
a.base(plasma membrane,mitochondria)
b.body-(nucleas,ER,lipofuscin)
c.apex-(pigment,ingested outer
segment{phagosomes})
-microvilli
-terminal bars.
The apical portion of each RPE has a
villous process that envelops the outer
segment of the photoreceptor cells
whereas the basal surface shows a rich
infolding of the plasma membrane.the
basal portion is rich in mitochondria and
annulate lamellae which are active in
protein synthesis.
The brown colour of the pigment is due
to melanin granules which are present
towards the apex.
RPE contd
The cells joined at their lateral apical margins by
terminal bars which constitute gap
junctions,ZONULA OCCLUDENS &ZONULA
ADHERENCE,which maintain the blood-retinal
barrier.the space not occupied by the terminal
bars is filled with extracellular matrix & forms
VERHOEFFS MEMBRANE.
The lipofuscin granules are present in the central
and basal parts ,probably arise from the discs of
photoreceptor outer segments.
Throughout the life,incompletely digested residual
bodies,lipofuscin pigment,phagosomes and other
materials are excreted beneath the basal lamina
and form drusen
Functions of RPE
Vitamin A metabolism
Maintenance of the outer blood-retinal
barrier
Phagocytosis of the photoreceptor outer
segments
Absorption of light (reduction of scatter)
Heat exchange
Formation of the basal lamina
Production of the mucopolysaccharide
matrix surrounding the outer segments
Active transport of materials in and out of
the RPE
NEUROSENSORY RETINA
1.PHOTORECEPTOR CELLS
a.outer segment (rods and
cones)
b.Cilium
c.Inner segments
Ellipsoid
Myloid
Outer fiber
Cell body(NUCLEUS)
Inner fiber
Synaptic vesicle
2.MODULATOR CELLS (NUCLEI
FROM INNER NUCLEAR
LAYER)
a.bipolar b.horizontal
c.amacrine
3. TRANSMITTER CELLSganglion
4.SKELETAL SUPPORT
a.muller calls(nuclei form inner
nuclear layer)
b.astroglia nerve fiber layer
The layer of rods and cones
Number of rods 110-125 million
Number of cones 6.3- 6.8
the density of rods and cones varies in diff parts of
retina.
The density of cones is maximal at the fovea ,with an
avg of 199000\sq mm the numbers decreases at the
periphery.
The rods are absent at the fovea, rising rapidly towards
the periphery and then slowly diminishing at the
extreme periphery.
Rods & cones have diff visual pigments,the rods have
rhodopsin which is sensitive to light having a wavelenth
of 493mm,cones have 3 diff types of iodopsins-
Blue cones-444mm
Green cones-540mm
Orange\red cones-577mm
OUTER SEGMENTS:
RODS: cylindrical in shape and have
stacks of flat,double lamellae in the
form of discs,which have no
atttachments to each other or to
the ensheating plasma
membrane.visual pigments are
arranged on the surface of these
lamellae.
CONES:they are short and cone like
at the periphery .there are more
discs and they are attached to the
plasma membrane.
the outer and inner segments are
joined to each other by a narrow
cilium .at the inner end the cilium
has 9 doublets of microtubules and
they become 9 singlets at the outer
segments.
INNER SEGMENTS:
THEY HAVE AN OUTER ELLIPSOID
PART AND INNER MYLOID part.
ELLIPSOID PART-is eosinophili,rich
in mitochondria and smooth
endoplasmic reticulum.
MYLOITD PART- basophilic,has
ribosomes and rough ER.It carries
out protein synthesis.
The external limiting membrane
It is not a true membrane as small
molecules pass freely through the
junctional complexes.
Main function is to provide a
selective barrier for nutrients that
pass betn the adjacent muller cells
as well as stabilization of the
position of the transducing portion
of the photoreceptors.
The outer nuclear layer
It lies internal to the ext limiting membrane and
contains the soma and nuclei of the photoreceptor
cells.
Nasal to the disc the outer nuclei layer is
45microm thick and has 8-9rows of nuclei,at the
temporal disc only 4 rows of nuclei are present
and the thickness is reduced to 22micrm and in
the fovea 10 rows of cone nuclei increases the
width of the nuclear layer by 50microm.
The diff nuclei of the two types of photoreceptors
may be distinguished because the nuclei of rods
stain orange and those of the cones red with
Malorys stain.
The outer plexiform layer
This layer marks the junction of the first and
second order neurons in the retina.
The outer 2\3
rd
of this layer is composed of the
inner fibres of the photoreceptors surrounded by
the processes of the Muller cells and the
remaining 1\3
rd
consists of the dendrites of the
bipolar and horizontal cells as well as Muller cell
processes.
The OPL in macular region is known as fibre layer
of Henle,accumulation of lipid and other blood
products within the layer of Henle accounts for
the star pattern observed ophthalmoscopicaly at
the macula in some cases of sys hypertension
The inner nuclear layer
This layer consists of 8-12 rows of clensely packed nuclei of the bipolar cells,horizontal
cells,amacrine cells,interplexiform cells and supportive Muller cells.
HORIZONTAL CELLS
the flat horizontal cells serve to modulate and transform visual information received
from the photoreceptors.
Their concentration is highest at the fovea and their number decreases towards the
periphery but their processes branch extensively as from the the central retina towards
the ora serrata.
A characteristic feature of these cells is kolmer crstalloid-stacks of parallel dense
tubules with ribosome like particles.
BIPOLAR CELLS
They are the second order neurons
oriented radially in the retina,the perikarya of these cells are located in the inner
nuclear and their processes extend to the outer and inner plexiform layers.
On the basis of morphology and synaptic relationships,there are 9 main types of bipolar
cells;
rod or mop-connect several rod cells to one to four ganglion cells.
Invaginating midget
Flat midget-connect a single cone cell with a single midget ganglion cell.
Flat diffuse or brush connect many cone cells with many ganglion cells.
Invaginating diffuse
ON-centre blue cone
OFF-centre blue cone
Giant bistratified
Giant diffuse invaginating
MULLER CELLS
Most of the inner intermediate layer of the inner nuclear layer
is occupied by the cell bodies of Muller cells, although their
perikarya can be present at any sublayers.
Embryonically,they are derived from the inner layer of the
optic vesicle.
As the principal glial cells of the retina, they conserve the
structural alignment of its neuronal elements.
They are the largest of all the cells in the retina and extend
from the ext to int limiting membrane.
Muller cells are characterized by their cytoplasmic expansions
which fill all intercellular spaces and envelop the cell bodies of
the neurons.
They form 4 types of processes-
radial in the inner plexiform layer
Fine horizontal processes in the nerve fibre & both the
plexiform layers.
Thin villous processes around the inner segments.
Honey comb mesh work enveloping ganglion cell bodies &
cells of inner nuclear layer.
AMACRINE CELLS
They were so named because it was believed that they
had no axons.
They can be recognized by their large cell bodies with
abundant cytoplasm and lobulated indented nuclei.
They are situated close to the ganglion cells and their
long processes radiate widely and synapse with one
another and with the dendrites of the ganglion cells
and axonal endings of the bipolar cells.
The neurotransmitter associated with amacrine cell
function include
ach,GABA,glycine,dopamine,serotonin,cholecystokinin,
glucagon, etc..
Most amacrine cells contain GABA and glycine which have
inhibitory action on ganglion cells.
THE INNER PLEXIFORM LAYER
This layer marks the junction of the
second order neuron ,the bipolar
cells with the third order neurons,
the ganglion cells.
THE GANGLION CELL LAYER
This layer is composed mainly of the cell bodies of
the third order ganglion cells,although processes
of Muller cells,other neuroglia and branches of
retinal vessels are also present.
These cells form a single layer in the peripheral
retina but 2 layers are formed at the temporal
side of optic disc and 6-8 layers at the edge of the
foveola.
At the foveola and optic nerve head this layer is
absent.
two major types of ganglion cells are;
M ganglion cells
P ganglion cells-p1
p2
THE NERVE FIBRE LAYER
This layer is formed
by axons of the
ganglion
cells.Normally,they
do not become
myelinated until they
pass thorugh the
lamina cribrosa ,the
myelin sheath being
formed by the
oligodendrocytes.
THE INTERNAL LIMITNG
MEMBRANE
It forms the innermost layer of the retina
and the outer boundary of the
vitreous.this is also not a true membrane
Both the retina and vitreous contribute to
the formn of this membrane,which
consists of following elements;
Collagen fibril and
Proteoglycans (mostly hyaluronic acid)of
the vitreous
The basement membrane
The plasma membrane of the Muller cells.
Overall,cells & their processes in the
retina are oriented perpendicular to the
plane of the RPE in the middle & outer
layers but parallel to the retinal surface in
the inner layers.
For this reason,deposits of blood or
exudates tend to form round blots in the
outer layers (whr small capillaries are
found) and linear or flame shaped
patterns in the nerve fibre layer.
At the fovea,the outer layers tend to be
parallel to the surface(Henles layer).as a
result,radial or star-shaped patterns may
arise when these extracellular spaces are
filled with serum and exudate.
Retinal blood supply
Arterial supply of retina is from 2 systems:
1.The choroidal circulation supplies the
outer1\3
rd
of the retina.
2.The retinal circulation supplies the inner
2\3
rd
of the retina.
the retina is most exclusively supplied by
the central retinal artery, a branch of the
ophthalmic artery.
The retinal arteries are anatomic end
arteries and there are no arteriovenous
anastomoses.
Contdblood supply
CAPILLARY NETWORK-2 capillaries plexus are given off which in
turn anastomose with one another.
1.superficial or inner capillary network- this is present in
the superficial part of the nerve ,are arranged in 2-dimensional
pattern.
2.deep network- this is more complex and lies betn the inner
nuclear &outer plexiform layer.
the capillary network is more dense around the veins.
The 2 layered pattern is marked at the equator & is modified
near the disc, periphery &around macula.
Peripapillary the area. around the macula, the superficial radial
network becomes thicker & 3 dimensional, it forms 3 separate
layers around the disc excluding the macula.
1.superficial radial network
2.superficial plexus proper.
3.reduplication of the above layer at inner nuclear
layer.
Contd
PERIPHERAL RETINA-here the deep
network becomes intermittent being represented
only around the veins. at the periphery it
disappears totally. the capillaries of superficial
network also loop around in arches to become
continuous with veins 1 mm behind the ora,thus
making the extreme end of retina avascular.
the terminal venules bend around to form an
incomplete ring near the ora.they run
independently for some distance and then in close
connection with the arteries, the retina is
eventually drained by the central retinal vein which
joins the superior ophthalmic vein.