ANATOMY AND HISTO PATHOLOGY OF THE MACULAR REGION
ANATOMY AND HISTO PATHOLOGY OF THE MACULAR REGION
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DOI：
10.1097/00004397-198102130-00003
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发表时间：
1981-01-01
影响因子：
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通讯作者：
APPLE D J
中科院分区：
文献类型：
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作者：
APPLE D J
黄斑是视网膜的一个特殊分化区域，位于视神经乳头颞侧2个椎间盘直径处（图1）[1]。Spitznas [2]将黄斑区描述为直径约5.5 mm，鼻缘位于视神经的颞缘。黄斑区的大体检查显示一个环绕中央凹的橙黄色圆形病灶。这种黄色在眼球摘除后出现轻微混浊的死后视网膜中最明显。在刚摘除的眼睛中，死后自溶尚未进展，着色更难察觉。这种黄色物质可能是叶黄素，一种脂溶性色素，是导致术语黄斑（希腊lutca，意思是黄色）的来源。除黄色外，黄斑的颜色通常比其余的眼底更深，这是因为其下的色素上皮细胞着色更深。黄斑又分为四个区：小凹区、中央凹区、旁凹区和中央凹周围区（见图1）。直径为1.5 mm的中央凹包含小凹和中央凹（图2），该位置负责中央视觉和色觉。中央小凹覆盖0.2 mm的面积。此处视网膜最薄，其整个厚度完全由光感受器及其核组成。内界膜沿着视网膜表面的轮廓，在组织学切片（内凹）中中心凹陷明显。此外，外部lim-c
The macula lutea is a specially differentiated region of retina tluat lics 2 disc diametcrs temporal to the optic nerve head (Fig. 1)[1]. Spitznas [2] dcscribes the macular region as approximately 5.5 mm. in diameter, thc nasal margin being at thc temporal border of the optic nerve. Gross examination of the macular region reveals a circular focus of orange-yellow discoloration that encircles the fovea centralis. This yellow color is best seen in postmortem retinas in which slight opacification following enucleation has occurred. In freshly enucleated eyes in which postmortem autolysis is not yet advanced, coloration is more difficult to perceive. This yellow sub-stance is presumably xanthophyll, a lipid-soluble pigment that is responsible for the derivation of the term macula lutea (Greek lutca, meaning yellow). In addition to the yellow coloration the macula often appears to have deeper color than the remaining fundus bccause the underlying pigment epithelium is more hcavily pigmented. The macula is subdivided into four zones: foveola, fovea, parafovea, and perifovea (see Fig. I). The central depression of 1.5 mm. in diameter contains the foveola and the fovea centralis (Fig. 2), the sitc subserving central vision and color vision. The central foveola covers an area of 0.2 mm. Here the retina is maximally thinned, and its entire thickness consists completely of photoreceptors and their nuclei. The internal limiting membrane follows the contour of the surface of the retina, and the depression at the center is obvious in histological sections (fovea interna). Additionally, the external lim-c