title: Traction-induced foveal damage predisposes eyes with pre-existing posterior vitreous detachment to idiopathic macular hole formation.
abstract: OBJECTIVE
  To propose a new mechanism for the development of idiopathic macular hole in the setting of pre-existing posterior vitreous detachment (PVD).
  
  
  METHODS
  Patients were examined clinically with fundus contact lens biomicroscopy and high-definition optical coherence tomography (OCT) was used to characterize the structural changes in the fovea following PVD.
  
  
  RESULTS
  Two patients presented with vitreofoveal separation and were found by high-definition OCT to have subtle foveal disruption and irregularity of the foveal contour with no evidence of a full thickness macular hole. Sequential examination of these patients demonstrated delayed formation of idiopathic macular hole.
  
  
  CONCLUSIONS
  Traction-induced inner foveal damage occurring before or coincident with spontaneous vitreofoveal separation destabilizes the fovea and predisposes some eyes to delayed macular hole formation.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Besirli
authors.forename: M W
authors.initials: MW
authors.lastname: Johnson
mesh_terms: D000368:Aged; D005584:Fovea Centralis / Q000293:injuries*; D006801:Humans; D008297:Male; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology*; D020255:Vitreous Detachment / Q000150:complications* / Q000175:diagnosis