Macular holes. Pathogenesis, natural history and surgical outcomes.

Idiopathic full-thickness macular holes (FTMH) are a common cause of usually uniocular reduced visual acuity. The accepted pathogenesis has macular hole formation proceeding in stages from an impending hole to a FTMH, with visual acuity deteriorating to less than 6/60 in 85% of cases. Recent surgical advances in the treatment of FTMH, with excellent anatomic and visual results, have changed the surgical indications for both impending and established full-thickness macular holes.