[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Macula [Sense organs](https://durgical.com/en/anatomy/system/sense-organs/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Macula The macula is a small yellowish spot in the centre of the retina, with a central pit (the fovea); it gives the sharp central vision used to read and see faces. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=macula&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A 5 mm yellowish spot in the centre of the retina, with a central pit (the fovea). ## What it does Gives sharp central and colour vision for reading and faces. ## Key points - Cherry-red spot: when the inner retina turns pale ([central retinal artery](https://durgical.com/en/anatomy/central-retinal-artery/) occlusion, Tay–Sachs, Niemann–Pick), the thin fovea lets the red [choroid](https://durgical.com/en/anatomy/choroid/) show through - Age-related macular degeneration: dry form with drusen and slow atrophy; wet form with new choroidal vessels that grow through Bruch membrane and leak or bleed, treated with anti-VEGF injections into the vitreous - Its yellow colour comes from the pigments lutein and zeaxanthin, which filter blue light - Macular sparing in occipital stroke is often explained by the dual blood supply and the large cortical area given to the macula ## Key facts **Where** Posterior pole, ~4 mm temporal to the optic disc; fovea at its centre **Blood supply** Choroid (fovea has no retinal vessels) **Function** Sharp central and colour vision (cones only at the fovea) ## Relations **Superficial** Retinal pigment epithelium, Bruch membrane and the choriocapillaris, which supplies the fovea **Deep** [Vitreous body](https://durgical.com/en/anatomy/vitreous-body/); abnormal adhesion of the posterior hyaloid can pull on it (vitreomacular traction, macular hole) **Medial** [Optic disc](https://durgical.com/en/anatomy/optic-disc/), on the nasal side, joined to it by the papillomacular bundle of nerve fibres **Lateral** Temporal [retina](https://durgical.com/en/anatomy/retina/), whose nerve fibres arch above and below the macula and meet at the horizontal raphe ## How to find it On fundoscopy it is the darker zone temporal to the disc, free of large vessels, with a bright foveal reflex at its centre in young eyes. Asking the patient to look straight at the ophthalmoscope light brings it into view. ## Examination - Amsler grid: wavy or missing lines (metamorphopsia, scotoma) suggest macular disease - Visual acuity and colour vision: both drop early in macular disease - Photostress recovery: slow return of acuity after a bright light points to the macula rather than the [optic nerve](https://durgical.com/en/anatomy/optic-nerve/) ## On imaging OCT shows the foveal pit, fluid, drusen, holes and membranes in cross-section; fluorescein angiography shows leaking new vessels; fundus autofluorescence maps atrophy of the pigment epithelium. ## Common problems - Age-related macular degeneration: central vision blurs or distorts (straight lines look wavy); the wet form can worsen fast. - Diabetic macular oedema: fluid swells the macula and blurs reading vision. - Macular hole or pucker: a gap or wrinkle in the central retina. ## How it is diagnosed A grid test (Amsler) at home, dilated eye exam and OCT scans. ## Treatment - Regular injections into the eye (anti-VEGF) for wet macular degeneration and macular oedema. - Vitamin supplements in some dry macular degeneration. - Vitrectomy surgery for holes and puckers. ## Clinical notes - Hydroxychloroquine and chloroquine can damage it (bull's-eye maculopathy), so long-term users are screened - Macular star: exudates radiating around the fovea in severe hypertensive retinopathy and in neuroretinitis - Central serous chorioretinopathy: fluid under the macula, typically in young men and linked to steroid use - Cystoid macular oedema can follow cataract surgery or uveitis ## Anatomical variants - A cilioretinal artery, from the ciliary (choroidal) circulation and entering at the disc edge, supplies part of the macula in a sizeable minority of eyes (figures vary by method); it can save central vision in a central retinal artery occlusion ## Development The fovea is immature at birth; its cones pack closer and the pit deepens over the first years of life. ## Related conditions - [Tay–Sachs disease](https://durgical.com/en/conditions/tay-sachs-disease/) - [Sandhoff disease](https://durgical.com/en/conditions/sandhoff-disease/) - [GM2 activator deficiency (GM2 gangliosidosis, AB variant)](https://durgical.com/en/conditions/gm2-activator-deficiency/) - [GM1 gangliosidosis](https://durgical.com/en/conditions/gm1-gangliosidosis/) - [Diabetic retinopathy](https://durgical.com/en/conditions/diabetic-retinopathy/) - [Age-related macular degeneration](https://durgical.com/en/conditions/age-related-macular-degeneration/) ## Test yourself Think of the answer, then tap the question to see it. ## Why does a cherry-red spot appear at the macula in central retinal artery occlusion? The inner retina turns pale, and the thin fovea lets the red choroid show through. ## How do the dry and wet forms of age-related macular degeneration differ? Dry: drusen and slow atrophy; wet: new choroidal vessels grow through Bruch membrane and leak or bleed, treated with anti-VEGF injections. ## Which simple test detects distortion from macular disease? The Amsler grid: wavy or missing lines (metamorphopsia, scotoma) suggest macular disease. ## Why are long-term users of hydroxychloroquine screened at the macula? The drug can damage the macula, giving a bull's-eye maculopathy. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/macula/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** macula lutea TA2 6784 **Official Spanish (DeCS)** Mácula Lútea DeCS D008266 **English (TA2)** Macula **Also called** macula lutea · yellow spot ## Related - [Retina](https://durgical.com/en/anatomy/retina/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=8438&filter=ths_termall&q=Macula%20Lutea); [Anatomy, Head and Neck, Eye Fovea](https://www.ncbi.nlm.nih.gov/books/NBK482301/); [Macular Degeneration](https://www.ncbi.nlm.nih.gov/books/NBK560778/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/macula/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/macula/