Idiopathic macular hole

Macular hole is a common cause of vision loss in older persons. Macular hole is formed by an actual hole through the neurosensory retina in the foveola area. The neurosensory retina adjacent to the hole is typically detached, which results in decreased central vision. Macular hole can be bilateral. Vitreous interactions with the posterior retinal surface are thought to be the essential cause of idiopathic macular hole formation. Until recently, no treatment was available for macular hole. Various surgical procedures are now being performed to repair macular hole and restore the neurosensory retina to its normal anatomical position. This paper presents the clinical characteristics of macular hole, reviews its incidence and its pathogenesis, and discusses the benefits and risks of surgical intervention in idiopathic macular hole formation.