Pathogenesis of idiopathic macular holes

An improvement in our understanding of the pathogenesis and natural history of idiopathic macular holes over the last 10 years has led to a more optimistic and interventionist approach to the surgical management of this vitreoretinal disorder. This article reviews the theories postulated for the pathogenesis of this condition and looks at recent work that has investigated the role of the vitreous, internal limiting membrane, and posterior vitreous detachment in the natural history of macular holes.