What is macular hole retinal detachment?

Macular hole retinal detachment is a special type of retinal detachment, clinically manifested as an atrophic hole or a tear hole, and the hole is irregular in shape. In the early stage, it may appear thin or crescent-shaped. As the disease progresses, the detachment develops downward or causes complete detachment.

1. Macular hole morphology

The diameter of the hole is generally less than 0.5PD, and the smallest one is as small as a pinpoint. Its existence can be confirmed by OCT examination or funduscopy. According to their nature, fissures are divided into atrophic holes and tearing holes. Atrophic holes often occur in high myopia accompanied by posterior scleral staphyloma or on the basis of cystoid macular degeneration. They are generally round or oval in shape and often have no operculum. The tear hole is the result of trauma or posterior vitreous detachment and traction. The shape of the tear hole is irregular and may be crack-shaped, crescent-shaped or horseshoe-shaped in the early stage.

2. Extent of retinal detachment

Retinal detachment caused by macular hole is initially limited to the posterior pole. As the disease progresses, the detachment develops downward and temporally, eventually leading to complete detachment. The extent of detachment is related to many factors, including the duration of the disease, the size of the tear, the degree of vitreous liquefaction, and whether vitreoretinal traction exists.

3. Vitreous changes

Most non-traumatic macular hole retinal detachments are complicated by varying degrees of posterior vitreous detachment. Sometimes a rift cover may be seen attached to it. Incomplete posterior detachment often involves vitreoretinal traction.