The retina is the delicate neuroepithelium that lines the posterior aspect of

the eye, adhering firmly to the optic nerve head posteriorly and to the ora
serrata anteriorly. Divided into central and extra-areal periphery, this layer
of modified sensory cilia serves important aspects of visual function:
 detail discrimination
 color perception
 vision in dim illumination
 peripheral vision

The central area, or macula, measures 5.5 mm in diameter and is centered between
the disc and the temporal vascular arcades.
The central 1.5 mm of the macula is called the fovea (or fovea centralis), which
is specialized for high spatial acuity and for color vision. The fovea has a margin,
declivity, and floor known as the foveola, a 0.35-mm-diameter region where cones
are slender, elongated, and densely packed. The very center of the foveola is a
small depression, 150–200 μm in diameter, known as the umbo. Within the fovea is
a region devoid of retinal vessels known as the foveal avascular zone (FAZ). The
geometric center of the FAZ is often taken to be the center of the macula and thus
the point of fixation; it is an important landmark in fluorescein angiography.
Surrounding the fovea is a ring 0.5 mm in width called the parafovea, where the
ganglion cell layer, inner nuclear layer, and outer plexiform layer (also known as Henle layer)
are thickest. Surrounding this zone is a ring approximately 1.5 mm
wide termed the perifovea (Table 1-1). Thus, the umbo forms the center, and the
periphery of the perifovea forms the margin, of the area centralis, or macula.

The retina outside the macula, the extra-areal periphery, is commonly divided
into a few concentric regions, starting with a 1.5-mm ring peripheral to the temporal
major vascular arcades called the near periphery. The retina around the equator is
called the equatorial retina, and the region anterior to it is called the peripheral
retina. In the far periphery, the border between the retina and the pars plana is
called the ora serrata. The posterior border of the vitreous base is located between
the ora serrata and the equator of the eye. This region is where most retinal tears
occur. Jetties of retinal tissue, called dentate processes, extend anteriorly into the
pars plana. These processes are more prominent nasally. Ora bays are posterior
extensions of the pars plana toward the retinal side. On occasion, dentate processes
may wrap around a portion of ora bay to form an enclosed ora bay. A meridional
fold is a radially oriented, prominent thickening of retinal tissue extending into the
pars plana. When aligned with a ciliary process, such folds are known as a
meridional complex

lapisan retina
1. internal limiting membrane (ILM)
2. nerve fiber layer (NFL; the axons of the ganglion cell layer)
3. ganglion cell layer (GCL)
4. inner plexiform layer (IPL)
5. inner nuclear layer (INL)
6. middle limiting membrane (MLM)
7. outer plexiform layer (OPL)
8. Henle fiber layer (HFL)
9. outer nuclear layer (ONL; the nuclei of the photoreceptors)
10. external limiting membrane (XLM)
11. rod and cone inner and outer segments (IS/OS)

Light must travel through the full thickness of the retina to reach the
photoreceptors. The density and distribution of photoreceptors vary with topographic
location.

The RPE is a monolayer of pigmented cells derived from the outer layer of the
optic cup and thus maintains the apex-to-apex arrangement with müllerian glia (Fig
1-8). This layer is continuous with the pigment epithelium of the ciliary body and
iris. The RPE contributes to retinal function in several ways; it
 absorbs light
 phagocytoses rod and cone outer segments
 participates in retinal and polyunsaturated fatty acid metabolism
  forms the outer blood–ocular barrier
 maintains the subretinal space
 heals and forms scar tissue

fisiologi

● Sebuah foton cahaya berinteraksi dengan retinal di dalam sel fotoreseptor. Retinal
mengalami isomerisasi, mengubah dari bentuk 11-cis ke all- trans.Retinal mudah
lepas dari sisi pengikatan opsin.Opsin selanjutnya mengalami perubahan bentuk
menjadi metarhodopsin II.Metarhodopsin II adalah bentuk yang tidak stabil dan
terbelah, membentuk opsin dan all-trans retinal.Opsin mengaktifasi protein
regulator transducin. Hal ini menyebabkan transducin terpecah dari ikatannya
dengan GDP dan mengikat GTP, kemudian subunit α dari transducin lepas dari
subunit β dan γ, dengan GTP tetap terikat pada subunit α.
● α-subunit teraktivasi-GTP akan berbalik mengaktivasi suatu phosphodiesterase yang
terkait; sebuah enzim yang menghidrolisis cyclic-GMP (cGMP) menjadi GMP.Cyclic
GMP diperlukan untuk menjaga kanal Na+ dari sel batang dalam keadaan terbuka.
Phosphodiesterase memecah cGMP menjadi 5'-GMP. Hal ini menyebabkan
penurunan kadar cGMP dan oleh karenanya akan menutup kanal sodium . Di sini
berlangsung pengeluaran potassium melalui kanal nongate K+-selective.
Pengeluaran langsung ini cenderung menyebabkan hiperpolarisasi photoreceptor
sekitar -70 mV (potential equilibrium untuk K+).
● Hiperpolarisasi sel menyebabkan penutupan kanal voltage-gated calcium.Bila kadar
kalsium di sel photoreceptor turun, sejumlah neurotransmitter glutamate yang
dikeluarkan sel juga ikut turun. Hal ini terjadi karena kalsium diperlukan vesikel yang
berisi glutamat untuk berfusi dengan membrane sel dan melepas isinya.Penurunan
sejumlah pelepasan glutamat oleh photoreceptor menyebabkan depolarisasi On
center sel- sel bipolar (sel On bipolar batang dan kerucut) dan hiperpolarisasi dari
sekeliling sel bipolar Off kerucut. Sehingga impuls diteruskan melalui ganglion
kemudian serabut saraf diteruskan hingga ke otak dan dipersepsikan sebagai terang
● DEAKTIVASI : GTPase Activating Protein (GAP) berinteraksi dengan subunit alpha
transducin, dan menyebabkan hidrolisis ikatan GTPnya menjadi GDP, dan akhirnya
 menghentikan aksi phosphodiesterase, menghentikan transformasi cGMP menjadi
GMP.
 Pada Keadaan Gelap, Sel Photoreceptor mengalami depolarisasi dalam gelap. Kadar cGMP
tinggi dan menjaga kanal sodium cGMP-gated terbuka sehingga ada aliran langsung, yang
disebut dark current. Dark current ini menyebabkan sel dalam keadaan depolarisasi sekitar-
40 mV.Depolarisasi membran sel akan membuka kanal kalsium voltage-gated. Peningkatan
kadar Ca2+ intraseluler menyebabkan isi vesikel (neurotransmitter) menyatu dengan
membran sel, kemudian melepaskan neurotransmitter ke celah sinaps.Neurotransmitter
yang dikeluarkan adalah glutamat. Peningkatan Penurunan sejumlah pelepasan glutamat
oleh photoreceptor menyebabkan hiperpolarisasi On center sel- sel bipolar (sel On bipolar
batang dan kerucut) dan menghambat kerja ganglion dalam hantarkan impuls ke serabut
saraf, tidak adanya impuls sampai ke otak dipersepsikan sebagai kondisi gelap.