Abstract: Background　Macular-foveal capillarization (MFC), characterized by abnormal vascularization within the foveal avascular zone (FAZ), arises from congenital or acquired factors and may occur in healthy individuals with normal vision. Objective　To report a case of MFC identified during air force cadets' medical selection in an adolescent with normal vision and review relevant literature, so as to provide reference for air force medical selection.Methods　The candidate underwent routine fundus examination. Retinal structure was assessed using ultra-wide-angle fundus photography, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Visual function was evaluated with multifocal electroretinogram (mfERG), Rabin cone contrast testing and visual field testing.Results　This 18-year-old male cadet exhibited diminished foveal reflex and reduced area of the FAZ upon fundus examination. OCT/OCTA demonstrated foveal hypoplasia, with capillaries traversing the foveal center connecting to the surrounding retinal capillary network. mfERG showed a reduced central peak response. Conclusion　Employing fundus examination alongside novel technologies like OCT and OCTA during air force pilot medical selection enhances detection of subtle retinal microstructural abnormalities that may affect future high-performance flight visual function, enabling more scientific and precise selection.