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Clinical Cases
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Idiopathic Macular Hole

Idiopathic Macular Hole - Start  
Idiopathic Macular Hole - End  

A macular hole is a full-thickness defect of retinal tissue involving the anatomic fovea of the eye.

There are various causes of macular hole: it can be idiopathic or due to trauma, accidental foveal burns with laser, long-standing cystoid macular edema and myopia.

The underlying pathophysiology for the formation of these holes is not well understood, although epiretinal membrane formation, vitreous traction and hydraulic forces may play a role in a few cases. The anteroposterior and “tangential” vitreous traction on the fovea may be a primary cause off macular holes in the majority of cases.

Differential Diagnosis

  • Central serous retinopathy
  • AMD
  • Cystoid macular edema
  • Epiretinal membrane with pseudo-hole
  • Lamellar hole
  • Solar retinopathy
  • Solitary drusen
  • Vitreomacular traction syndrome


Johnson RN, Gass JD. Idiopathic macular holes. Observations, stages of formation, and

implications for surgical intervention. Ophthalmology. Jul 1988;95(7):917-24. [Medline].

Clinical Cases 377 2