[Observing idiopathic macular break by scanning laser ophthalmoscope vitreous videography]

We used vitreous videography in conjunction with the scanning laser ophthalmoscope (SLO) to evaluate the pathogenesis of idiopathic macular breaks. The fundamental aspect of this method is videographic documentation of the mobile posterior vitreous and an operculum. The high reflectivity from the vitreous gel using the SLO clearly showed the mobility of the operculum and the posterior vitreous in the idiopathic macular breaks. In some cases without posterior vitreous detachment, the operculum initially was suspended superior to the macular break and anterior to the retinal surface. Upon ocular movement, the operculum moved down smoothly in front of the macular break. The findings of these vitreous videographs using the SLO suggest that anteriorly oriented vitreous traction is one cause of idiopathic macular breaks.