Absence of foveal avascular zone demonstrated by laser scanning fluorescein angiography

We present laser scanning fluorescein angiograms of abnormal foveal capillary patterns in a healthy subject and an insulin-dependent diabetic patient with mild diabetic retinopathy. In both subjects capillaries were seen to cross the central foveal area where capillaries are usually absent. The flow pattern of the foveal capillaries, which were visualised with the use of a laser scanning ophthalmoscope, was indistinguishable from that of the more peripheral capillaries, indicating that foveal vessels are functionally normal retinal capillaries. The two cases demonstrate that identification of abnormal capillary patterns induced by retinal disease such as diabetic retinopathy is made difficult by the marked interindividual variation in capillary anatomy. In prospective studies, however, the method may be capable of detecting subtle changes in early diabetic retinopathy with a high degree of sensitivity.