[Formation of idiopathic macular holes]

Sixty-eight patients (136 eyes) with idiopathic macular hole (IMH) were examined, using optic coherent tomography. 91% of these patients were women, mean age 66.6 years. Preholes were detected in 14 eyes, lamellar ruptures in 11, and perforating ruptures in 78 eyes. Specific functional and morphological changes in the retina, vitreous, and vascular membrane were detected. Three main mechanisms of IMH formation were distinguished. Conceptual scheme of the pathogenesis of this condition was developed and a new more complete pathogenetically justified classification of IMH is offered, which helps more objectively diagnose, predict the functional outcome, determine the treatment strategy, and evaluate the efficiency of surgery.