The macula (/ˈmakjʊlə/) or macula lutea is an oval-shaped pigmented area in the center of the
retina
The retina (; or retinas) is the innermost, photosensitivity, light-sensitive layer of tissue (biology), tissue of the eye of most vertebrates and some Mollusca, molluscs. The optics of the eye create a focus (optics), focused two-dimensional ...
of the
human eye
The human eye is a sensory organ in the visual system that reacts to light, visible light allowing eyesight. Other functions include maintaining the circadian rhythm, and Balance (ability), keeping balance.
The eye can be considered as a living ...
and in other animals. The macula in humans has a diameter of around and is subdivided into the umbo,
foveola
The foveola is located within a region called the macula, a yellowish, cone photoreceptor filled portion of the human retina. Approximately 0.35 mm in diameter, the foveola lies in the center of the fovea and contains only cone cell
C ...
,
foveal avascular zone
The foveal avascular zone (FAZ) is a region within the fovea centralis at the centre of the retina of the human eye that is devoid of retinal blood vessels. The geometric centre of the FAZ is often taken to be the centre of the macula and thus the ...
, fovea, parafovea, and perifovea areas.
The anatomical macula at a size of is much larger than the clinical macula which, at a size of , corresponds to the anatomical fovea.
The macula is responsible for the central, high-resolution, color vision that is possible in good light. This kind of vision is impaired if the macula is damaged, as in
macular degeneration
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred vision, blurred or vision loss, no vision in the center of the visual field. Early on there are often no sym ...
. The clinical macula is seen when viewed from the pupil, as in ophthalmoscopy or retinal photography.
The term macula lutea comes from
Latin
Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...
''macula'', "spot", and ''lutea'', "yellow".
Structure
The macula is an oval-shaped pigmented area in the center of the
retina
The retina (; or retinas) is the innermost, photosensitivity, light-sensitive layer of tissue (biology), tissue of the eye of most vertebrates and some Mollusca, molluscs. The optics of the eye create a focus (optics), focused two-dimensional ...
of the
human eye
The human eye is a sensory organ in the visual system that reacts to light, visible light allowing eyesight. Other functions include maintaining the circadian rhythm, and Balance (ability), keeping balance.
The eye can be considered as a living ...
and other animal
eye
An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system.
In higher organisms, the ey ...
s. Its center is shifted slightly away from the
optical axis
An optical axis is an imaginary line that passes through the geometrical center of an optical system such as a camera lens, microscope or telescopic sight. Lens elements often have rotational symmetry about the axis.
The optical axis defines ...
(laterally, by 5°=1.5 mm).
The macula in humans has a diameter of around and is subdivided into the umbo,
foveola
The foveola is located within a region called the macula, a yellowish, cone photoreceptor filled portion of the human retina. Approximately 0.35 mm in diameter, the foveola lies in the center of the fovea and contains only cone cell
C ...
,
foveal avascular zone
The foveal avascular zone (FAZ) is a region within the fovea centralis at the centre of the retina of the human eye that is devoid of retinal blood vessels. The geometric centre of the FAZ is often taken to be the centre of the macula and thus the ...
, fovea, parafovea, and perifovea areas.
An even smaller central region of highest receptor density (40–80 μm) is sometimes referred to as the ''foveal bouquet''.
The anatomical macula at is much larger than the clinical macula which, at , corresponds to the anatomical fovea.
The clinical macula is seen when viewed from the pupil, as in
ophthalmoscopy
Ophthalmoscopy, also called funduscopy, is a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope (or funduscope). It is done as part of an eye examination and may be done as part ...
or
retinal photography
Fundus photography involves photographing the rear of an eye, also known as the fundus. Specialized fundus cameras consisting of an intricate microscope attached to a flash enabled camera are used in fundus photography. The main structures tha ...
. The anatomical macula is defined
histologically
Histology,
also known as microscopic anatomy or microanatomy, is the branch of biology that studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at large ...
in terms of having two or more layers of ganglion cells. The umbo is the center of the foveola which in turn is located at the center of the fovea.
The fovea is located near the center of the macula. It is a small pit that contains the largest concentration of
cone cell
Cone cells or cones are photoreceptor cells in the retina of the vertebrate eye. Cones are active in daylight conditions and enable photopic vision, as opposed to rod cells, which are active in dim light and enable scotopic vision. Most v ...
s. The retina's receptor layer contains two types of photosensitive cells, the
rod cell
Rod cells are photoreceptor cells in the retina of the eye that can function in lower light better than the other type of visual photoreceptor, cone cells. Rods are usually found concentrated at the outer edges of the retina and are used in ...
s and the cone cells.
Color
Because the macula is yellow in color, it absorbs excess blue and ultraviolet light that enter the eye and acts as a natural sunblock (analogous to sunglasses) for this area of the retina. The yellow color comes from its content of
zeaxanthin
Zeaxanthin is one of the most common carotenoids in nature, and is used in the xanthophyll cycle. Synthesized in plants and some micro-organisms, it is the pigment that gives paprika (made from bell peppers), corn, saffron, goji ( wolfberries) ...
, which are yellow
xanthophyll
Xanthophylls (originally phylloxanthins) are yellow pigments that occur widely in nature and form one of two major divisions of the carotenoid group; the other division is formed by the carotenes. The name is from Greek: (), meaning "yellow", an ...
carotenoid
Carotenoids () are yellow, orange, and red organic pigments that are produced by plants and algae, as well as several bacteria, archaea, and fungi. Carotenoids give the characteristic color to pumpkins, carrots, parsnips, corn, tomatoes, cana ...
s, derived from the diet. Zeaxanthin predominates at the macula, while lutein predominates elsewhere in the retina. There is some evidence that these carotenoids protect the pigmented region from some types of
macular degeneration
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred vision, blurred or vision loss, no vision in the center of the visual field. Early on there are often no sym ...
. A formulation of 10 mg lutein and 2 mg zeaxanthin has been shown to reduce the risk of age-related macular degeneration progressing to advanced stages, although these carotenoids have not been shown to prevent the disease.
After death or enucleation (removal of the eye), the macula appears yellow, a color that is not visible in the living eye except when viewed with light from which red has been filtered.
Foveal avascular zone
The foveal avascular zone (FAZ) is a region within the fovea centralis at the centre of the retina of the human eye that is devoid of retinal blood vessels. The geometric centre of the FAZ is often taken to be the centre of the macula and thus the ...
(FAZ) –
*
Foveola
The foveola is located within a region called the macula, a yellowish, cone photoreceptor filled portion of the human retina. Approximately 0.35 mm in diameter, the foveola lies in the center of the fovea and contains only cone cell
C ...
Structures in the macula are specialized for high- acuity vision. Within the macula are the fovea and foveola that both contain a high density of cones, which are nerve cells that are photoreceptors with high acuity.
In detail, the normal human eye contains three different types of cones, with different ranges of spectral sensitivity. The brain combines the signals from neighboring cones to distinguish different colors. There is only one type of rod, but the rods are more sensitive than the cones, so in dim light, they are the dominant photoreceptors active, and without information provided by the separate spectral sensitivity of the cones it is impossible to discriminate colors. In the fovea ''centralis'', cones predominate and are present at high density. The macula is thus responsible for the central, high-resolution, color vision that is possible in good light; and this kind of vision is impaired if the macula is damaged, for example in
macular degeneration
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred vision, blurred or vision loss, no vision in the center of the visual field. Early on there are often no sym ...
.
Clinical significance
The clinical macula is seen when viewed from the pupil, as in ophthalmoscopy or retinal photography.
Whereas loss of
peripheral vision
Peripheral vision, or ''indirect vision'', is vision as it occurs outside the point of fixation, i.e. away from the center of gaze or, when viewed at large angles, in (or out of) the "corner of one's eye". The vast majority of the area in the ...
may go unnoticed for some time, damage to the macula will result in loss of central vision, which is usually immediately obvious.
The progressive destruction of the macula is a
disease
A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
known as
macular degeneration
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred vision, blurred or vision loss, no vision in the center of the visual field. Early on there are often no sym ...
and can sometimes lead to the creation of a macular hole. Macular holes are rarely caused by trauma, but if a severe blow is delivered it can burst the blood vessels going to the macula, destroying it.
Visual input from the macula occupies a substantial portion of the brain's visual capacity. As a result, some forms of visual field loss that occur without involving the macula are termed macular sparing. (For example, visual field testing might demonstrate ''
homonymous hemianopsia
Hemianopsia, or hemianopia, is a visual field loss on the left or right side of the vertical midline. It can affect one eye but usually affects both eyes.
Homonymous hemianopsia (or homonymous hemianopia) is hemianopic visual field loss on the s ...
with macular sparing''.)
In the case of occipitoparietal ischemia owing to occlusion of elements of either
posterior cerebral artery
The posterior cerebral artery (PCA) is one of a pair of cerebral arteries that supply oxygenated blood to the occipital lobe, as well as the medial and inferior aspects of the temporal lobe of the human brain. The two arteries originate from the d ...
, patients may display cortical
blindness
Visual or vision impairment (VI or VIP) is the partial or total inability of visual perception. In the absence of treatment such as corrective eyewear, assistive devices, and medical treatment, visual impairment may cause the individual difficul ...
(which, rarely, can involve blindness that the patient denies having, as seen in Anton's Syndrome), yet display sparing of the macula. This selective sparing is due to the collateral circulation offered to macular tracts by the
middle cerebral artery
The middle cerebral artery (MCA) is one of the three major paired cerebral artery, cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches an ...
. Neurological examination that confirms macular sparing can go far in representing the type of damage mediated by an infarct, in this case, indicating that the caudal visual cortex (which is the principal recipient of macular projections of the optic nerve) has been spared. Further, it indicates that cortical damage rostral to, and including,
lateral geniculate nucleus
In neuroanatomy, the lateral geniculate nucleus (LGN; also called the lateral geniculate body or lateral geniculate complex) is a structure in the thalamus and a key component of the mammalian visual pathway. It is a small, ovoid, Anatomical ter ...
is an unlikely outcome of the infarction, as too much of the lateral geniculate nucleus is, proportionally, devoted to macular-stream processing.
Additional images
File:Retinography.jpg, A fundus photograph showing the macula as a spot to the left. The optic disc is the area on the right where blood vessels converge. The grey, more diffuse spot in the centre is a shadow artifact.
File:Retina-OCT800.png, Time-Domain OCT of the macular area of a retina at 800 nm, axial resolution 3 μm
File:SD-OCT Macula Cross-Section.png, Spectral-Domain OCT macula cross-section scan.
File:Macula Histology OCT.jpg, alt=macula histology (OCT), macula histology (OCT)
See also
*
Macular degeneration
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred vision, blurred or vision loss, no vision in the center of the visual field. Early on there are often no sym ...
Macular pucker
Epiretinal membrane or macular pucker is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes. Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as t ...
Cherry-red spot
A cherry-red spot is a finding in the macula of the eye in a variety of lipid storage disorders and in central retinal artery occlusion.
It describes the appearance of a small circular choroid shape as seen through the fovea centralis.
Its appea ...
*
Macular hypoplasia
Macular hypoplasia (or foveal hypoplasia) is a rare medical condition involving the underdevelopment of the macula, a small area on the retina (the eye's internal surface) responsible for seeing in detail and sensing light. Macular hypoplasia is of ...