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Macular hole
Retina & Vitreous
Key Points
- •FTMH is classified by OCT-based minimum linear diameter: small ≤250 µm, medium 250–400 µm, large >400 µm. Smaller holes have better closure rates and visual outcomes
- •Vitreomacular traction (VMT) during PVD is the primary mechanism - stage 1 VMT resolves spontaneously in ~50%; full-thickness holes require surgery
- •Standard surgery is PPV + ILM peeling + gas tamponade with face-down positioning; closure rates >90% for small-medium holes
- •The inverted ILM flap technique achieves >90% closure even for large holes - it has transformed outcomes for previously difficult cases
- •Watzke-Allen sign (broken beam) is positive in FTMH and negative in pseudohole/lamellar hole - a key clinical exam distinction
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Keep reading Macular hole
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations