A–C: Images from a 10-year-old boy who was referred for evaluation because visual acuity was correctable only to 20/40. Pertinent medical history was his birth at 28 weeks’ gestation. Color photograph (A) shows macular dragging and a blood vessel entering the foveal area. Optical coherence tomography (OCT) (B) through the anatomical center of the macula shows absence of a foveal depression and persistence of all retinal layers. OCT angiography (OCTA) (C) shows absence of a foveal avascular zone. D, OCTA from a 10-year-old child born at full term is shown for comparison. The finding of a blunted or absent foveal depression (also termed fovea plana) is a biomarker of premature birth. Normally, the foveal depression forms embryologically by a patterned centrifugal regression of inner retinal layers by the 30th week of gestation. Although the finding of foveal dysplasia or fovea plana, as seen here, indicates a premature birth, it is still compatible with good vision.