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macular holeAn ocular change caused by ageing, diabetes and degeneration resulting in shrinkage of the vitreous over the fovea, creating traction on the fovea and eventually a macular defect. In early stages, an epiretinal membrane compromises visual acuity, leading over time to metamorphopsia (lines on an Amsler grid appear wavy or crooked) and increasingly severe loss of vision.
Patients see anything from a fine, glistening membrane overlying the macula (cellophane maculopathy), to a thickened, whitish tissue that obscures underlying blood vessels. As it progresses, traction by the vitreous causes a puckering that appears as retinal folds radiating from the macula when viewed by fundoscopy.
A tear or discontinuity in the central portion of the retina, resulting in central visual loss.
A condition in which there is a partial or full thickness absence of the retina in the macular area. It may occur as a result of trauma, degeneration, old age, preretinal macular fibrosis or pathological myopia. It appears ophthalmoscopically as a round or oval, well defined, reddish spot at the macula. There is metamorphopsia, loss of visual acuity and a central scotoma. An operculum of retinal tissue may overlie the hole. The vitreous in front of the hole eventually condenses and separates from the retina. In partial macular hole a layer of photoreceptors may still be attached to the retinal pigment epithelium (lamellar hole), as in cystoid macular oedema. Treatment usually consists of reattaching the retina, if detached, and possibly vitrectomy. See preretinal macular fibrosis; confocal scanning laser ophthalmoscope; retinal break; solar retinopathy; optical coherence tomography.