Age-related Changes in the Foveal Bulge in Healthy Eyes

BACKGROUND Intact foveal bulge has been associated with good visual outcome in retinal diseases. The aim of this study was to study the variation in foveal bulge with age. METHODS It was an observational cross-sectional study conducted between October 2014 and December 2015. Totally, 101 eyes of 101 healthy volunteers were studied in a tertiary care center. All individuals had best corrected visual acuity of 20/20 or better. High myopia (>6 D), high hyperopia (>4 D), unstable fixation, media opacities and retinal disorder like diabetic retinopathy, retinal vein occlusion were the exclusion criteria. Spectral domain optical coherence tomography was used to identify foveal bulge. The height of foveal bulge was measured as the distance between inner border of retinal pigment epithelium and outer border of inner segment - outer segment line (ellipsoid zone) at fovea. Main outcome measures were a correlation between the height of the foveal bulge and age of the participants. RESULTS Foveal bulge was present in 61 (60.4%) and absent in 40 (39.6%) eyes. Mean age of patients with and without foveal bulge was 33.3 ± 16.2 years and 44.1 ± 20.5 years respectively (P = 0.02). Mean height of foveal bulge was 41.1 ± 6.4 μ (range: 23-51 μ). The height of the foveal bulge showed a negative correlation with the age of the participants (r = -0.15). CONCLUSION Foveal bulge was more commonly seen in younger individuals and its height decreased with age. Age matching across groups should be undertaken in studies using foveal bulge as prognostic tool.