Early development of the fovea has been documented by histological studies over the past few decades. However, structural distortion due to sample processing and the paucity of high-quality post-mortem tissue has limited the effectiveness of this approach. With the continuous progress in high-resolution non-invasive imaging technology, most notably optical coherence tomography (OCT) and OCT angiography (OCT-A), in vivo visualization of the developing retina has become possible. Combining the information from histologic studies with this novel imaging information has provided a more complete and accurate picture of retinal development, and in particular the developing fovea.

Advances in neonatal care have increased the survival rate of extremely premature infants. However, with enhanced survival there has been an attendant increase in retinal developmental complications. Several key abnormalities, including a thickening of the inner retina at the foveal center, a shallower foveal pit, a smaller foveal avascular zone, and delayed development of the photoreceptors have been described in preterm infants when compared to full-term infants. Notably these abnormalities, which are consistent with a partial arrest of foveal development, appear to persist into later childhood and adulthood in these eyes of individuals born prematurely. Understanding normal foveal development is vital to interpreting these pathologic findings associated with prematurity.

In this review, we first discuss the various advanced imaging technologies that have been adapted for imaging the infant eye. We then review the key events and steps in the development of the normal structure of the fovea and contrast structural features in normal and preterm retina from infancy to childhood. Finally, we discuss the development of the perifoveal retinal microvasculature and highlight future opportunities to expand our understanding of the developing fovea.

过去几十年的组织学研究记录了中央凹的早期发育。然而，由于样本处理和高质量尸检组织的缺乏导致的结构变形限制了这种方法的有效性。随着高分辨率无创成像技术的不断进步，尤其是光学相干断层扫描 (OCT) 和 OCT 血管造影 (OCT-A)，发育中的视网膜的体内可视化已成为可能。将来自组织学研究的信息与这种新颖的成像信息相结合，提供了更完整和更准确的视网膜发育图像，尤其是发育中的中央凹。

新生儿护理的进步提高了极早产儿的存活率。然而，随着生存率的提高，视网膜发育并发症也随之增加。与足月儿相比，早产儿已经描述了几个关键异常，包括中央凹中心的内部视网膜增厚、中央凹坑变浅、中央凹无血管区变小以及光感受器发育迟缓。值得注意的是，这些异常与中心凹发育的部分停滞一致，在这些早产个体的眼睛中似乎持续到儿童后期和成年期。了解正常的中心凹发育对于解释这些与早产相关的病理结果至关重要。

在这篇综述中，我们首先讨论了适用于婴儿眼睛成像的各种先进成像技术。然后，我们回顾了中心凹正常结构发育的关键事件和步骤，并对比了从婴儿期到儿童期正常和早产视网膜的结构特征。最后，我们讨论了中央凹周围视网膜微血管系统的发展，并强调了未来扩大我们对发育中的中央凹理解的机会。