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BOOK TITLE: Retina: Medical and Surgical Management
This chapter gives an overview on macular hole. Macular holes are characterized by the absence of neurosensory retinal tissue at the fovea. The peak incidence of Idiopathic macular hole occurs in 6–8 decades of life, affecting women more frequently than men. It occurs earlier in myopic eyes. Vitreomacular traction has been said to be the factor behind idiopathic macular holes. Idiopathic macular hole results from the earliest stage of PVD. The age and sex prevalence of this disease are similar to those of PVD. Macular hole is a full thickness retinal defect at the fovea. Patients with macular hole who are symptomatic present with a variable degree of central visual loss depending on the size of the hole, the location of the hole relative to the foveola, and the size of any associated neurosensory retinal detachment. Optical coherence tomography, fundus autofluorescence, fluorescein angiography, b-scan ultrasonography, microperimetry, and multifocal electroretinography are different investigations and diagnosis options for macular hole. A detailed discussion on surgical management and techniques has been also provided in this chapter.