Microholes of the macula

Objective: To describe the clinical syndrome of microholes of the macula. Patients: Fourteen patients with acute symptoms caused by full-thickness microholes of the macula. Results: Patients with macular microholes had the acute onset of a central scotoma with mild to moderate visual acuity loss. Examination revealed a detachment of the vitreous over the fovea, often with an operculum or a total posterior vitreous detachment, and a sharply demarcated, 50- to 133-mu m round hole in the center of the macula. On follow-up, all patients had a stable or improved scotoma and visual acuity. Conclusions: Macular microholes appear to be caused by an acute detachment of the vitreous from the fovea and can be distinguished from Gass stage 2 idiopathic macular holes.