Macular Microhole of the Outer Retinal Defect with a Perifoveal Posterior Vitreous Detachment

To report a case of a macular microhole of an outer retinal defect that resolved spontaneously during visualization of the sequential anatomic changes on optical coherence tomography (OCT) before and after detachment of the posterior hyaloid from the fovea. The patient was a 47-year-old woman with a central scotoma and metamorphopsia. OCT 3 detected a small outer retinal defect, a so-called macular microhole. The OCT ophthalmoscope showed an elevated foveal photoreceptor layer with a perifoveal posterior vitreous detachment (PVD) at the initial visit. Six months later, both OCTs showed resolution of the photoreceptor layer abnormality and detachment of the posterior hyaloid from the fovea. The photoreceptor layer abnormality and visual symptoms resolved almost simultaneously. These findings may explain that the elevated foveal photoreceptor layer associated with the perifoveal PVD could be the anatomic mechanism responsible for macular microhole formation.