dr. ayesha abdullah 14.12.2012. learning outcomes by the end of this lecture the students would be...

Review of anatomy & physiology of the

Retina

Dr. Ayesha Abdullah14.12.2012

Learning outcomes

By the end of this lecture the students would be able to;

• Correlate the structural organization of the retina with its functions and development.

• Identify structural landmarks on retinal photographs.

• Name the investigations commonly employed for the assessment of retinal disorders.

Some questions • How do we see?• What are the similarities and differences between a camera and

the eye?• Name part of the nervous system that can be visualized without

any invasive procedure? • Why is the optic disc referred to as the blind spot?• Have you noticed tiny bright moving dots when looking into the

blue sky?• If the photoreceptor had been anteriorly placed, what would have

happened?• How do we know its day/ night?• How does the brain regulate circadian rhythms?

Camera and the eye

• Unlike the image from a camera the resolution of the retinal image is not uniform.

• Why?• What is the result?• There are about 100 times more photoreceptors than the Ganglion cells.• Retina compresses images as unlike the camera.

Anatomical landmarks of the retina

Normal dimensionsAnatomical characteristics Clinically Observable

characteristics Optic disc Place where the optic nerve fibers leave

the retina. It is devoid of rods and cones hence the blind spot. Contains the central retinal artery and vein

It’s a pale disc like structure with vessels emerging out of its center called the cup. Its about 1.5 mm in size.

Macula It is the area where the ganglion cells are two layered. Contains the xanthophyl pigment giving it the pigmented look.

It is about 5.5 mm in diameter (3.5 disc diameter/ 180 of visual angle). Roughly the area between the arterial arcades.

Fovea

Foveola

A depression in the inner retinal surface. It contains cones only.The inner nuclear layer and the ganglion cell layer is absent.

A concave central retinal depression about the same size as the disc (1.5mm)

Parafovea The thickest part of the retina Area surrounding the fovea

Histological structure of the retina

Development of the retina

Functions of the retina

• Light perception• Brightness appreciation• Contrast sensitivity • Two point discrimination and appreciation of

details• Colour perception• Light and dark adaptation • Circadian rhythms & hormonal balance

Some important facts• There are about 150 million receptors and only 1 million optic nerve fibers,

there must be convergence and thus mixing of signals• The horizontal action of the horizontal and amacrine cells can allow one

area of the retina to control another (e.g., one stimulus inhibiting another). This inhibition is key to the sum of messages sent to the higher centers of the brain.

• The response of cones to various wavelengths of light is called their spectral sensitivity

• There are blue, green, and red cones but more accurately short, medium, and long wavelength sensitive cone subgroups- trichromatic vision

• The receptive field of a sensory neuron is a region of space in which the presence of a stimulus will alter the firing of that neuron

• The receptive field of a Ganglion cell in the retina of the eye is composed of input from all of the photoreceptors which synapse with it, and a group of ganglion cells in turn forms the receptive field for a cell in the brain. This process is called convergence.

vitreous

RPE

Rods & Cones

• Rod System– Achromatic– High convergence– High light sensitivity– Low visual acuity

• Cone System– Chromatic– Low convergence– Low light sensitivity– High visual acuity

Direction of visual impulse

Direction of light

Investigations for retinal structural and functional assessment

• Clinical assessment- Ophthalmoscopy

Ophthalmic investigations

• Ultrasound –B & A scans• Ocular coherence tomography (OCT)• Angiography • Elctroretinogram • Elctro-oculogram

OCT

Angiography

Electroretinogram

Homework

• What is the blood supply of the inner and outer retinal layers?

• What makes the inner and outer retinal blood barriers and what is their significance?

• E mail me at, the answer should not more than 04 lines.

msqheartline@hotmail.com