An elderly woman presents with retinal thinning. Why?

Tip #217


Here there is absence of retinal tissue centrally. The normal foveal depression is lost and there is intraretinal fluid noted. The RPE is thickened centrally. There are also some areas of reverse shadowing. The patient’s other eye showed SHRM on OCT and a hyperreflective lesion on OCTA (video).

The patient was treated for diopathic macular hole in this eye and a CNV in the other.

In this tip's accompanying 12 min. video, we'll review:

  • The different stages of a macular hole
  • The pathogenesis of a macular hole
  • How macular hole is treated
Tip #217 Analysis


In a person with absence of retinal tissue in the fovea, consider the diagnosis of an idiopathic macular hole.

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