Contraction of a perifoveal epiretinal membrane simulating a macular hole

Four patients observed for a three- to four-year period had a hole in an epiretinal membrane overlying the macula that mimicked a macular hole. In two patients the clinical appearance remained essentially constant. In one, the epiretinal membrane contracted further, reducing the apparent macular hole to a slit and causing the typical appearance of a macular pucker. In the fourth patient, the epiretinal membrane peeled spontaneously causing the apparent hole to disappear. None of the patients had static perimetric findings that suggested a true macular hole. All of the patients had normal or nearly normal visual acuity when first seen. This was maintained except in the patient who suffered further membrane contraction. Fluorescein angiography demonstrated a slight fluorescence in the base of the hole in three of the four patients; however, it was not as pronounced as one sees in true macular holes. Lamellar macular holes characteristically show no fluorescence in the area of the hole.