Materiały źródłowe

• #1 Macular Hole: Symptoms, Causes, & Treatment

  https://my.clevelandclinic.org/health/diseases/14208-macular-hole

  A macular hole is a gap in the macula, which is the center of the retina of your eye. […] What causes a macular hole? In most people, macular holes are due to vitreous traction that’s more likely to happen with aging. Sometimes a macular hole is the result of an injury or a medical condition that affects the eye, including being very nearsighted. […] You may be more likely to develop a macular hole if you have: A very high degree of myopia (nearsightedness). Inflammation within your eye (uveitis). Eye trauma (injury). […] Risk factors for macular holes include: Aging. Female sex. History of eye trauma. Being very nearsighted. Previous eye surgeries or eye inflammation.

• #2 Macular hole – Wikipedia

  https://en.wikipedia.org/wiki/Macular_hole

  A macular hole is a small break in the macula, located in the center of the eye’s light-sensitive tissue called the retina. […] If the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole. Also, once the vitreous has pulled away from the surface of the retina, some of the fibers can remain on the retinal surface and can contract. This increases tension on the retina and can lead to a macular hole. In either case, the fluid that has replaced the shrunken vitreous can then seep through the hole onto the macula, blurring and distorting central vision. […] The eye contains a jelly-like substance called the vitreous. Shrinking of the vitreous usually causes the hole. As a person ages, the vitreous becomes watery and begins to pull away from the retina. If the vitreous is firmly attached to the retina when it pulls away, a hole can result.

• #3 Revisiting Macular Holes

  https://www.reviewofophthalmology.com/article/revisiting-macular-holes

  The exact cause of macular hole remains unknown. The first reported macular holes in the late 19th century were believed to result from trauma that caused cystoid changes in the macula. Concurrent with the discovery around 1970 that the majority of macular holes were not associated with trauma, the predominant thought was that macular hole etiology was related to the presence of cystoid macular edema (CME), including any condition that may lead to CME. The vitreomacular traction theory of macular hole pathogenesis gained in popularity with the recognition that peripheral retinal breaks occur secondary to vitreoretinal traction and that strong adhesion exists between the vitreous and fovea. There is evidence that A-P traction may not be the only factor in macular hole formation. Researchers have documented macular hole formation after complete PVD/vitrectomy as well as spontaneous closure of macular hole in eyes without PVD (documented by OCT). Such observations led to the development of other theories of macular hole pathogenesis such as the hydrodynamic model, in which the macular hole is formed or maintained by fluid flow caused by the macular retinal pigment epithelium pump. Macular hole has long been recognized as a female-predominant disease, yet despite extensive research, the reason for such a gender predilection is unclear, and there is no strong evidence to support an association between estrogen replacement and macular hole. In reality, the etiology of macular hole is probably multifactorial, and determining which is the primary event is less important than the recognition that vitreomacular traction, foveolar dehiscence and other factors likely play a role.

• #4 Hole In The Macula — What Is It & How Is It Possible To Get?

  https://www.morningtoneye.com.au/hole-in-the-macula/

  Macular holes are literally that a break or hole in the macula region of the retina. Most macular holes involve the fovea, resulting in a significant impact on your central sight. […] The vast majority of macular holes are known as idiopathic, meaning the condition occurred spontaneously without any known cause. There is often an association with a natural age-related change to the vitreous gel inside the eyeball, known as a posterior vitreous detachment. A posterior vitreous detachment occurs when the vitreous gel liquefies and loses its solid molecular arrangement. As it liquefies and slowly collapses, it can pull on points of attachment to the retina, including at the macula. This tugging, commonly called traction, is thought to create a hole in the macula. However, while everyone experiences a posterior vitreous detachment, not everyone will develop a macular hole.

• #5 Macular Holes: How They Are Caused and Treated | Retina Associates Kansas City

  https://www.kcretina.com/blog/macular-holes-how-they-are-caused-and-treated

  Like macular degeneration, macular holes interfere with a persons central vision and are most common among those over the age of 60, though they can affect people at any age. […] Unfortunately, the most common cause of macular holes is one that cannot be prevented: aging. Over time, the vitreous – the gel-like substance that fills the eye and allows it to maintain its shape – gradually shrinks and pulls away from the surface of the retina. […] Although age is the primary culprit behind macular holes, it is not the only one. Other potential causes include: Severe myopia, Retinal detachment, Diabetic retinopathy, Injury or trauma to the eye, In rare cases, macular pucker.

• #6

  https://www.aao.org/eye-health/diseases/what-is-macular-hole

  Age is the most common cause of macular hole. As you get older, the vitreous begins to shrink and pull away from the retina. Usually the vitreous pulls away with no problems. But sometimes the vitreous can stick to the retina. This causes the macula to stretch and a hole to form. […] Sometimes a macular hole can form when the macula swells from other eye disease. Or it can be caused by an eye injury.

• #7 Macular hole

  https://www.nhs.uk/conditions/macular-hole/

  We don’t know why macular holes develop. The vast majority of cases have no obvious cause. They most often affect people aged 60 to 80 and are more common in women than men. […] One possible risk factor is a condition called vitreomacular traction. As you get older, the vitreous jelly in the middle of your eye starts to pull away from the retina and macula at the back of the eye. If some of the vitreous jelly remains attached to the retina as it shrinks, it can pull a section of the retina away with it, leading to a macular hole. […] A few cases may be associated with: retinal detachment when the retina begins to pull away from the blood vessels that supply it with oxygen and nutrients, severe injury to the eye, being slightly long-sighted (hyperopic), being very short-sighted (myopic), persistent swelling of the central retina (cystoid macular oedema).

• #8 Macular hole: Symptoms, causes, and prognosis

  https://www.medicalnewstoday.com/articles/macular-hole

  A macular hole is when an opening forms in the middle of the light-sensitive tissue at the back of the eye. […] It is unclear what causes most macular holes. A hole can develop when the macula, which is the central area of the back of the eye, becomes stretched or something pulls at it. […] One condition that can affect the macula in this way is called vitreomacular traction, or vitreous traction. In this condition, the gel that fills the center of the eye begins to pull away from the tissue at the back of the eye. This pulling apart is called vitreous detachment. […] Macular holes can occur at any age, although they are most common in females in their 50s and 60s. General risk factors for the condition include: being 60 years old or older, having had a macular hole in one eye already, having had an eye injury or eye surgery, being very nearsighted. […] Macular holes in children are rare. When they do develop, it is most likely due to a blow to the eye.

• #9 Macular Hole

  https://www.asrs.org/patients/retinal-diseases/4/macular-hole

  Macular hole commonly affects people over the age of 55 and most often occurs in women. The vast majority of cases develop spontaneously without an obvious cause. For this reason, there is currently no effective way to prevent their formation and development. […] Several conditions can increase the risk of macular hole formation, including: Vitreous traction: the vitreous is the gel that fills up the inside of the eye. With normal aging, the vitreous can shrink and pull away from the retina, sometimes creating a macular hole in the process. […] Genetics, environmental factors, and systemic causes dont seem play a role in macular hole formation.

• #10 Macular Hole | Eye Disorders | Ophthalmology | Area of Care | SUNY Downstate

  https://www.downstate.edu/patient-care/find-treatment/areas-of-care/ophthalmology/eye-disorders/macular-hole.html

  A macular hole can cause blurred and distorted central vision. Macular holes are related to aging and usually occur in people over age 60. […] What causes a macular hole? Most of the eye’s interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape. […] However, if the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole. […] Macular holes can also occur from eye disorders, such as high myopia (nearsightedness), macular pucker, and retinal detachment; eye disease, such diabetic retinopathy and Best’s disease; and injury to the eye.

• #11 Macular hole | Macular Disease Foundation Australia Macular Disease Foundation Australia

  https://www.mdfoundation.com.au/about-macular-disease/other-macular-conditions/macular-hole/

  A macular hole is a small break in the macula, the part of your eye responsible for detailed, central vision. […] Its not clear why some people develop a macular hole and others dont. […] In some people the vitreous jelly is firmly attached to the retina at the macula. As the vitreous shrinks, it can pull on the macula, causing a small tear. This is the start of a macular hole. […] Theres nothing you can do to prevent a macular hole. Diet or exercise are not thought to contribute to the problem. […] Theres no evidence that taking any kind of medicine or vitamins can help fix a macular hole.

• #12 Macular Hole: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1224320-overview

  Trauma-related macular holes are suspected to be related to the transmission of concussive force in a contrecoup manner, which results in the immediate rupture of the macula at its thinnest point. […] While the vitreous was suspected to be involved in the causation of idiopathic macular holes by Lister in 1924, Johnson and Gass, in 1988, first described a classification system that focused on anteroposterior and tangential vitreous traction on the fovea as a primary underlying cause for idiopathic macular holes. […] Shrinkage of prefoveal cortical vitreous with persistent adherence of vitreous to the foveal region results in the causative traction.

• #13 Differential Diagnosis of Macular Holes and Pseudoholes | Retinal Physician

  https://retinalphysician.com/issues/2011/julyaug/differential-diagnosis-of-macular-holes-and-pseudoholes/

  Vitreomacular interface pathology is a term used to describe a group of conditions involving the macula, consisting of full-thickness macular holes (FTMH), lamellar macular holes (LMH), macular pseudoholes (MPH), vitreomacular traction (VMT) and myopic macular schisis. […] It has been postulated that the various lesions that manifest as macular interface pathology are the result of tractional forces working on the foveal and perifoveal retina. These forces are classically divided into anteroposterior vitreoretinal traction forces, as well as tangential traction forces. These latter tangential forces may result from ERMs or eccentric perifoveal vitreoretinal attachment and partial posterior vitreous detachment. […] Haouchine et al. suggested that the tractional forces on the fovea resulted in the formation of intraretinal spaces (termed pseudocysts) or foveal detachment, and that these were the first steps in LMH or FTMH formation.

• #14 Macular Hole – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559200/

  A macular hole is mostly idiopathic or related to vitreomacular traction syndrome. The macular hole may be associated with various forms of macular pathology including: […] Apart from this, ocular pathology, which may predispose the eye to develop a macular hole, is myopia with or without posterior staphyloma. […] Trauma is another important cause, specifically in the young age group. […] If it is not associated with any other predisposing condition, it is called a primary macular hole. Those associated with predisposing conditions designated as secondary macular holes.

• #15 Macular Hole: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1224320-overview

  A macular hole first was described by Knapp in 1869 in a patient who sustained blunt trauma to the eye. Subsequent case reports and series pointed to antecedent episodes of ocular trauma such that the two were customarily linked to each other. However, throughout this century, ophthalmologists increasingly have recognized that this condition more commonly occurs in atraumatic settings and have differentiated these macular holes from trauma-induced holes by describing them as idiopathic full-thickness macular holes. In fact, case series as far back as the 1970s reported that more than 80% of macular holes are idiopathic and that only less than 10% have associated history of trauma to the eye. […] The causes underlying trauma-related macular holes and idiopathic macular holes are understandably divergent.

• #16 Our Offices

  https://associatedretinaconsultants.com/what-causes-a-macular-hole/

  A macular hole is a small break in the macula, located in the center of the eyes light-sensitive tissue called the retina. […] The cause of a macular hole is usually associated with aging and usually occurs in people over the age of 60. Several conditions can increase the risk of macular hole formation, including: […] Injury or trauma: some young people develop macular holes after blunt trauma […] Diabetic eye disease […] High degree of myopia (nearsightedness) […] Macular pucker: formation of scar tissue over the macula that can warp and contract, causing wrinkling of the retina […] Retinal detachment.

• #17 Macular Hole | Types | Surgery and Repair

  https://www.allaboutvision.com/conditions/macular-holes/

  Because macular holes often are related to aging processes, they are more likely to develop if you are over age 60. Also, women have a slightly higher risk for macular holes than men. […] Macular holes can occur due to: […] Vitreous shrinkage and/or separation […] Diabetic eye disease […] High amounts of nearsightedness (myopia) […] Macular pucker […] A detached retina […] Best’s disease (inherited condition causing macular damage) […] Eye injury […] Another direct cause of macular holes due to vitreous shrinkage is when the strands stay attached to the retina and break away from the vitreous. These strands can contract around the macula, causing the macula to develop a hole from the traction.

• #18 Macular Hole: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1224320-overview

  Trauma-related macular holes are suspected to be related to the transmission of concussive force in a contrecoup manner, which results in the immediate rupture of the macula at its thinnest point. […] While the vitreous was suspected to be involved in the causation of idiopathic macular holes by Lister in 1924, Johnson and Gass, in 1988, first described a classification system that focused on anteroposterior and tangential vitreous traction on the fovea as a primary underlying cause for idiopathic macular holes. […] Shrinkage of prefoveal cortical vitreous with persistent adherence of vitreous to the foveal region results in the causative traction.

• #19 Common Causes of Macular Holes in Young Adults | Austin Retina Blog

  https://www.austinretina.com/blog/common-causes-of-macular-holes-in-young-adults

  A macular hole is a small break in the macula of the eye, which is the central part of the retina that gives people the ability to see details. […] These are the three most common causes of macular holes in young adults: […] Injury or trauma Young adults who participate in high-contact activities are at an increased risk of developing a macular hole following blunt trauma to the eye. Dr. James Dooner notes that this is by far the most common cause of all macular holes in young people. […] High myopia Young adults with high myopia – nearsightedness requiring a corrective lens prescription of at least -6.00 diopeters (D) are at an increased risk of developing macular holes. […] Ocular inflammation Ocular inflammation is inflammation of the uvea, or middle layer of the eye, and is often caused by autoimmune disorders, inflammatory disorders or other diseases that weaken the immune system. Ocular inflammation may also result from a normal immune response of the body fighting an eye infection.

• #20 AAO 2023: Pediatric macular holes: Causes, characteristics, and care

  https://www.modernretina.com/view/aao-2023-pediatric-macular-holes-causes-characteristics-and-care

  Pediatric macular holes are rare and generally result from blunt trauma. […] In most cases, the macular holes developed as the result of blunt trauma.

• #21 Macular Hole in the Eye: Definition, Causes, Symptoms, Diagnosis, and Treatment

  https://www.oscarwylee.com.au/glasses/eye/macular-hole?srsltid=AfmBOopJQoraWbp77cgi-wGH6D1Buli5a0rXCpCOwXwYAjtdPrbDn3_X

  A macular hole is commonly caused by vitreous detachment, in which the vitreous fluid does not cleanly separate from the macula, leaving a hole or tear, and is often caused by ageing. […] Other causes of a macular hole can include retinal detachment, eye injuries and refraction errors such as myopia. […] One of the most common causes of a macular hole in the eye is vitreous separation due to the ageing of the eye. […] Eye injuries and refraction errors such as myopia may also contribute to the development of a macular hole, however, this is not as common. […] The exact answer to what causes a hole in the retina or a macular hole, is most often a vitreous detachment, as a consequence of the eye ageing. […] The main risk factor for macular holes is generally getting older. […] As people get older, the eye also ages and can lead to issues with the vitreous, such as vitreous detachment, which is one of the top causes of a macular hole in the eye.

• #22 Common Causes of Macular Holes in Young Adults | Austin Retina Blog

  https://www.austinretina.com/blog/common-causes-of-macular-holes-in-young-adults

  A macular hole is a small break in the macula of the eye, which is the central part of the retina that gives people the ability to see details. […] These are the three most common causes of macular holes in young adults: […] Injury or trauma Young adults who participate in high-contact activities are at an increased risk of developing a macular hole following blunt trauma to the eye. Dr. James Dooner notes that this is by far the most common cause of all macular holes in young people. […] High myopia Young adults with high myopia – nearsightedness requiring a corrective lens prescription of at least -6.00 diopeters (D) are at an increased risk of developing macular holes. […] Ocular inflammation Ocular inflammation is inflammation of the uvea, or middle layer of the eye, and is often caused by autoimmune disorders, inflammatory disorders or other diseases that weaken the immune system. Ocular inflammation may also result from a normal immune response of the body fighting an eye infection.

• #23 Macular Hole: Symptoms, Causes, & Treatment

  https://my.clevelandclinic.org/health/diseases/14208-macular-hole

  A macular hole is a gap in the macula, which is the center of the retina of your eye. […] What causes a macular hole? In most people, macular holes are due to vitreous traction that’s more likely to happen with aging. Sometimes a macular hole is the result of an injury or a medical condition that affects the eye, including being very nearsighted. […] You may be more likely to develop a macular hole if you have: A very high degree of myopia (nearsightedness). Inflammation within your eye (uveitis). Eye trauma (injury). […] Risk factors for macular holes include: Aging. Female sex. History of eye trauma. Being very nearsighted. Previous eye surgeries or eye inflammation.

• #24 Common Causes of Macular Holes in Young Adults | Austin Retina Blog

  https://www.austinretina.com/blog/common-causes-of-macular-holes-in-young-adults

  A macular hole is a small break in the macula of the eye, which is the central part of the retina that gives people the ability to see details. […] These are the three most common causes of macular holes in young adults: […] Injury or trauma Young adults who participate in high-contact activities are at an increased risk of developing a macular hole following blunt trauma to the eye. Dr. James Dooner notes that this is by far the most common cause of all macular holes in young people. […] High myopia Young adults with high myopia – nearsightedness requiring a corrective lens prescription of at least -6.00 diopeters (D) are at an increased risk of developing macular holes. […] Ocular inflammation Ocular inflammation is inflammation of the uvea, or middle layer of the eye, and is often caused by autoimmune disorders, inflammatory disorders or other diseases that weaken the immune system. Ocular inflammation may also result from a normal immune response of the body fighting an eye infection.

• #25 Our Offices

  https://associatedretinaconsultants.com/what-causes-a-macular-hole/

  A macular hole is a small break in the macula, located in the center of the eyes light-sensitive tissue called the retina. […] The cause of a macular hole is usually associated with aging and usually occurs in people over the age of 60. Several conditions can increase the risk of macular hole formation, including: […] Injury or trauma: some young people develop macular holes after blunt trauma […] Diabetic eye disease […] High degree of myopia (nearsightedness) […] Macular pucker: formation of scar tissue over the macula that can warp and contract, causing wrinkling of the retina […] Retinal detachment.

• #26 Macular Hole: Symptoms, Causes, Types & Treatments

  https://www.dragarwal.com/diseases-conditions/macular-hole/

  A macular hole is a small break or defect in the macula, the central part of the retina responsible for sharp, detailed vision. […] The condition primarily affects older adults, typically over the age of 60, and is often associated with changes in the vitreous, the gel-like substance inside the eye. As people age, the vitreous shrinks and pulls away from the retina, sometimes creating tension on the macula and leading to the development of a hole. […] Several factors can contribute to its development: […] The most common cause. As we age, the vitreous gel inside the eye shrinks and pulls away from the retina. If it adheres to the macula too strongly, it can create a hole. […] People with high myopia have thinner retinas, making them more susceptible to macular holes. […] Direct trauma to the eye, such as a blow or accident, can cause a macular hole. […] Conditions that cause traction or pulling on the retina may lead to a macular hole. […] Severe diabetic retinopathy can weaken the macula, increasing the risk of holes forming. […] Fluid buildup can weaken the macular tissue, leading to hole formation.

• #27 Macular hole

  https://www.nhs.uk/conditions/macular-hole/

  We don’t know why macular holes develop. The vast majority of cases have no obvious cause. They most often affect people aged 60 to 80 and are more common in women than men. […] One possible risk factor is a condition called vitreomacular traction. As you get older, the vitreous jelly in the middle of your eye starts to pull away from the retina and macula at the back of the eye. If some of the vitreous jelly remains attached to the retina as it shrinks, it can pull a section of the retina away with it, leading to a macular hole. […] A few cases may be associated with: retinal detachment when the retina begins to pull away from the blood vessels that supply it with oxygen and nutrients, severe injury to the eye, being slightly long-sighted (hyperopic), being very short-sighted (myopic), persistent swelling of the central retina (cystoid macular oedema).

• #28 Macular Holes: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/macular-holes

  Most patients with impending macular holes have a perifoveal vitreous detachment with focal attachment of the vitreous to the foveal umbo as well as a cystoid cleavage in the inner part of the umbo. […] Risk factors include cystoid macular oedema, retinal detachment, retinal surgery, laser injury, hypertension, very high myopia and diabetic retinopathy.

• #29 Our Offices

  https://associatedretinaconsultants.com/what-causes-a-macular-hole/

  A macular hole is a small break in the macula, located in the center of the eyes light-sensitive tissue called the retina. […] The cause of a macular hole is usually associated with aging and usually occurs in people over the age of 60. Several conditions can increase the risk of macular hole formation, including: […] Injury or trauma: some young people develop macular holes after blunt trauma […] Diabetic eye disease […] High degree of myopia (nearsightedness) […] Macular pucker: formation of scar tissue over the macula that can warp and contract, causing wrinkling of the retina […] Retinal detachment.

• #30 Macular Conditions – North Carolina Retina Associates

  https://www.ncretina.com/retinal-care/macular-conditions

  A macular hole is a type of macular condition that is common in older adults. It is characterized by tissue defects in the macular layers. […] There are several factors that can cause a macular hole, including: […] Vitreomacular traction: a condition in which the vitreous jelly tugs at the macula […] Foveal schisis: a condition associated with high myopia (i.e. extreme nearsightedness) in which the layers of the retina separate […] Traumatic injury: approximately 6% of macular holes are caused by contusion injuries […] Prior retinal detachment: in a small number of cases, retinal detachments that impact the macula can sometimes lead to the formation of a macular hole after undergoing a scleral buckle procedure. […] Aside from age, VMT is more likely to occur in patients with certain eye conditions, including diabetic retinopathy and age-related macular degeneration (AMD). It is also sometimes associated with retinal vascular occlusive diseases.

• #31 Our Offices

  https://associatedretinaconsultants.com/what-causes-a-macular-hole/

  A macular hole is a small break in the macula, located in the center of the eyes light-sensitive tissue called the retina. […] The cause of a macular hole is usually associated with aging and usually occurs in people over the age of 60. Several conditions can increase the risk of macular hole formation, including: […] Injury or trauma: some young people develop macular holes after blunt trauma […] Diabetic eye disease […] High degree of myopia (nearsightedness) […] Macular pucker: formation of scar tissue over the macula that can warp and contract, causing wrinkling of the retina […] Retinal detachment.

• #32 Hole In The Macula — What Is It & How Is It Possible To Get?

  https://www.morningtoneye.com.au/hole-in-the-macula/

  Other causes of macular holes can include as a result of fluid swelling from other conditions, such as diabetic retinopathy or severe trauma to the eye. […] Several risk factors have been associated with the development of macular holes. One study reported that: Female gender has been found to be at a 64% increased risk compared to males. Asian patients have a 117% increased risk compared to Caucasians. The mean age of study participants who developed a macular hole was 62 years old. […] In addition to gender and age, other risk factors include: Myopia condition (short-sightedness), Trauma, Ocular inflammation, Diabetes, Epiretinal membrane (a membrane that forms over the surface of the macula, which can contract and cause traction on the tissues beneath).

• #33 Macular Hole | Eye Disorders | Ophthalmology | Area of Care | SUNY Downstate

  https://www.downstate.edu/patient-care/find-treatment/areas-of-care/ophthalmology/eye-disorders/macular-hole.html

  A macular hole can cause blurred and distorted central vision. Macular holes are related to aging and usually occur in people over age 60. […] What causes a macular hole? Most of the eye’s interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape. […] However, if the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole. […] Macular holes can also occur from eye disorders, such as high myopia (nearsightedness), macular pucker, and retinal detachment; eye disease, such diabetic retinopathy and Best’s disease; and injury to the eye.

• #34 Macular Hole | Types | Surgery and Repair

  https://www.allaboutvision.com/conditions/macular-holes/

  Because macular holes often are related to aging processes, they are more likely to develop if you are over age 60. Also, women have a slightly higher risk for macular holes than men. […] Macular holes can occur due to: […] Vitreous shrinkage and/or separation […] Diabetic eye disease […] High amounts of nearsightedness (myopia) […] Macular pucker […] A detached retina […] Best’s disease (inherited condition causing macular damage) […] Eye injury […] Another direct cause of macular holes due to vitreous shrinkage is when the strands stay attached to the retina and break away from the vitreous. These strands can contract around the macula, causing the macula to develop a hole from the traction.

• #35 Macular Hole: Symptoms, Causes, & Treatment

  https://my.clevelandclinic.org/health/diseases/14208-macular-hole

  A macular hole is a gap in the macula, which is the center of the retina of your eye. […] What causes a macular hole? In most people, macular holes are due to vitreous traction that’s more likely to happen with aging. Sometimes a macular hole is the result of an injury or a medical condition that affects the eye, including being very nearsighted. […] You may be more likely to develop a macular hole if you have: A very high degree of myopia (nearsightedness). Inflammation within your eye (uveitis). Eye trauma (injury). […] Risk factors for macular holes include: Aging. Female sex. History of eye trauma. Being very nearsighted. Previous eye surgeries or eye inflammation.

• #36 Macular Hole, Macular Hole Surgery, Macular Hole Causes

  https://midatlanticretina.com/disease/macular-hole/

  Most macular holes develop as a result of the vitreous gel pulling on the delicate macular tissue. […] The vitreous gel separating from the retina with age is the most common cause, and is more common in those aged 55 years and older. […] Other potential macular hole causes include: ocular injury or trauma, retinal detachment, diabetic eye disease, risk factors such as myopia and uveitis. […] The condition is also more common for women than men.

• #37 Macular Hole: Diagnosing and Treating This Tricky Eye Problem

  https://www.healthline.com/health/eye-health/macular-hole

  Macular holes develop when the layers of the macula within the retina separate, which leads to progressive loss of central vision. […] A macular hole occurs when layers of the macula separate or tear. A macular hole can be partial or complete. […] The most common cause of macular holes is age. The vitreous naturally begins to pull away from the retina as someone ages. Normally this happens with no problems, but sometimes the vitreous can stick to the retina. This can cause the macula to stretch and a hole to form. […] Macular holes can also sometimes occur when there’s an injury to the eye, or the macula swells from an eye disease. […] Although age is a common cause, macular holes are different from age-related macular degeneration even though the symptoms may be similar. […] You’re also more likely to have a macular hole if you’ve had one in the other eye. About 1 in 10 people who get a macular hole in one eye will also get one in their other eye.

• #38 Hole In The Macula — What Is It & How Is It Possible To Get?

  https://www.morningtoneye.com.au/hole-in-the-macula/

  Other causes of macular holes can include as a result of fluid swelling from other conditions, such as diabetic retinopathy or severe trauma to the eye. […] Several risk factors have been associated with the development of macular holes. One study reported that: Female gender has been found to be at a 64% increased risk compared to males. Asian patients have a 117% increased risk compared to Caucasians. The mean age of study participants who developed a macular hole was 62 years old. […] In addition to gender and age, other risk factors include: Myopia condition (short-sightedness), Trauma, Ocular inflammation, Diabetes, Epiretinal membrane (a membrane that forms over the surface of the macula, which can contract and cause traction on the tissues beneath).

• #39 Macular Hole – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559200/

  A macular hole is mostly idiopathic or related to vitreomacular traction syndrome. The macular hole may be associated with various forms of macular pathology including: […] Apart from this, ocular pathology, which may predispose the eye to develop a macular hole, is myopia with or without posterior staphyloma. […] Trauma is another important cause, specifically in the young age group. […] If it is not associated with any other predisposing condition, it is called a primary macular hole. Those associated with predisposing conditions designated as secondary macular holes.

• #40 Macular Hole: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1224320-overview

  A macular hole first was described by Knapp in 1869 in a patient who sustained blunt trauma to the eye. Subsequent case reports and series pointed to antecedent episodes of ocular trauma such that the two were customarily linked to each other. However, throughout this century, ophthalmologists increasingly have recognized that this condition more commonly occurs in atraumatic settings and have differentiated these macular holes from trauma-induced holes by describing them as idiopathic full-thickness macular holes. In fact, case series as far back as the 1970s reported that more than 80% of macular holes are idiopathic and that only less than 10% have associated history of trauma to the eye. […] The causes underlying trauma-related macular holes and idiopathic macular holes are understandably divergent.

• #41 Macular Hole: Symptoms, Causes, Types & Treatments

  https://www.dragarwal.com/diseases-conditions/macular-hole/

  A macular hole is a small break or defect in the macula, the central part of the retina responsible for sharp, detailed vision. […] The condition primarily affects older adults, typically over the age of 60, and is often associated with changes in the vitreous, the gel-like substance inside the eye. As people age, the vitreous shrinks and pulls away from the retina, sometimes creating tension on the macula and leading to the development of a hole. […] Several factors can contribute to its development: […] The most common cause. As we age, the vitreous gel inside the eye shrinks and pulls away from the retina. If it adheres to the macula too strongly, it can create a hole. […] People with high myopia have thinner retinas, making them more susceptible to macular holes. […] Direct trauma to the eye, such as a blow or accident, can cause a macular hole. […] Conditions that cause traction or pulling on the retina may lead to a macular hole. […] Severe diabetic retinopathy can weaken the macula, increasing the risk of holes forming. […] Fluid buildup can weaken the macular tissue, leading to hole formation.

• #42 Differential Diagnosis of Macular Holes and Pseudoholes | Retinal Physician

  https://retinalphysician.com/issues/2011/julyaug/differential-diagnosis-of-macular-holes-and-pseudoholes/

  Vitreomacular interface pathology is a term used to describe a group of conditions involving the macula, consisting of full-thickness macular holes (FTMH), lamellar macular holes (LMH), macular pseudoholes (MPH), vitreomacular traction (VMT) and myopic macular schisis. […] It has been postulated that the various lesions that manifest as macular interface pathology are the result of tractional forces working on the foveal and perifoveal retina. These forces are classically divided into anteroposterior vitreoretinal traction forces, as well as tangential traction forces. These latter tangential forces may result from ERMs or eccentric perifoveal vitreoretinal attachment and partial posterior vitreous detachment. […] Haouchine et al. suggested that the tractional forces on the fovea resulted in the formation of intraretinal spaces (termed pseudocysts) or foveal detachment, and that these were the first steps in LMH or FTMH formation.

• #43 Revisiting Macular Holes

  https://www.reviewofophthalmology.com/article/revisiting-macular-holes

  The exact cause of macular hole remains unknown. The first reported macular holes in the late 19th century were believed to result from trauma that caused cystoid changes in the macula. Concurrent with the discovery around 1970 that the majority of macular holes were not associated with trauma, the predominant thought was that macular hole etiology was related to the presence of cystoid macular edema (CME), including any condition that may lead to CME. The vitreomacular traction theory of macular hole pathogenesis gained in popularity with the recognition that peripheral retinal breaks occur secondary to vitreoretinal traction and that strong adhesion exists between the vitreous and fovea. There is evidence that A-P traction may not be the only factor in macular hole formation. Researchers have documented macular hole formation after complete PVD/vitrectomy as well as spontaneous closure of macular hole in eyes without PVD (documented by OCT). Such observations led to the development of other theories of macular hole pathogenesis such as the hydrodynamic model, in which the macular hole is formed or maintained by fluid flow caused by the macular retinal pigment epithelium pump. Macular hole has long been recognized as a female-predominant disease, yet despite extensive research, the reason for such a gender predilection is unclear, and there is no strong evidence to support an association between estrogen replacement and macular hole. In reality, the etiology of macular hole is probably multifactorial, and determining which is the primary event is less important than the recognition that vitreomacular traction, foveolar dehiscence and other factors likely play a role.

• #44 Macular Hole | Information, Symptoms & Treatment Options

  https://www.naturaleyecare.com/eye-conditions/macular-hole/?srsltid=AfmBOopp5fRjIWTTc5eFiygLOMtEigFLGkR5yOSEu4n9RNbSaf_pOW4P

  A macular hole is a small hole in the center of the retina, the macula. […] Trauma-caused macular holes are thought to be linked to a concussive blow delivered from the opposite site of the head. […] Idiopathic macular holes are caused by pulling of the vitreous to the side (at a tangent) as the gel and vitreous sac contracts. […] There have been a few studies to determine the causes and distribution of macular holes, and a few risk factors have been suggested, such as cardiovascular disease, hypertension, and hysterectomy, but none of these risks were statistically significant. […] Trauma or injury to the eye causes a macular hole less than 10% of the time. […] Usually these holes seem to develop spontaneously. […] The medical term describing this type of development is idiopathic, which means the cause is unknown. […] Researchers have reported cases of macular hole formation after complete posterior vitreous detachment and vitrectomy. […] Other theories have been proposed such as a fluid-flow theory.

• #45 Revisiting Macular Holes

  https://www.reviewofophthalmology.com/article/revisiting-macular-holes

  The exact cause of macular hole remains unknown. The first reported macular holes in the late 19th century were believed to result from trauma that caused cystoid changes in the macula. Concurrent with the discovery around 1970 that the majority of macular holes were not associated with trauma, the predominant thought was that macular hole etiology was related to the presence of cystoid macular edema (CME), including any condition that may lead to CME. The vitreomacular traction theory of macular hole pathogenesis gained in popularity with the recognition that peripheral retinal breaks occur secondary to vitreoretinal traction and that strong adhesion exists between the vitreous and fovea. There is evidence that A-P traction may not be the only factor in macular hole formation. Researchers have documented macular hole formation after complete PVD/vitrectomy as well as spontaneous closure of macular hole in eyes without PVD (documented by OCT). Such observations led to the development of other theories of macular hole pathogenesis such as the hydrodynamic model, in which the macular hole is formed or maintained by fluid flow caused by the macular retinal pigment epithelium pump. Macular hole has long been recognized as a female-predominant disease, yet despite extensive research, the reason for such a gender predilection is unclear, and there is no strong evidence to support an association between estrogen replacement and macular hole. In reality, the etiology of macular hole is probably multifactorial, and determining which is the primary event is less important than the recognition that vitreomacular traction, foveolar dehiscence and other factors likely play a role.

• #46 Revisiting Macular Holes

  https://www.reviewofophthalmology.com/article/revisiting-macular-holes

  The exact cause of macular hole remains unknown. The first reported macular holes in the late 19th century were believed to result from trauma that caused cystoid changes in the macula. Concurrent with the discovery around 1970 that the majority of macular holes were not associated with trauma, the predominant thought was that macular hole etiology was related to the presence of cystoid macular edema (CME), including any condition that may lead to CME. The vitreomacular traction theory of macular hole pathogenesis gained in popularity with the recognition that peripheral retinal breaks occur secondary to vitreoretinal traction and that strong adhesion exists between the vitreous and fovea. There is evidence that A-P traction may not be the only factor in macular hole formation. Researchers have documented macular hole formation after complete PVD/vitrectomy as well as spontaneous closure of macular hole in eyes without PVD (documented by OCT). Such observations led to the development of other theories of macular hole pathogenesis such as the hydrodynamic model, in which the macular hole is formed or maintained by fluid flow caused by the macular retinal pigment epithelium pump. Macular hole has long been recognized as a female-predominant disease, yet despite extensive research, the reason for such a gender predilection is unclear, and there is no strong evidence to support an association between estrogen replacement and macular hole. In reality, the etiology of macular hole is probably multifactorial, and determining which is the primary event is less important than the recognition that vitreomacular traction, foveolar dehiscence and other factors likely play a role.

• #47 Etiology And Risk Factors For Macular Hole – Klarity Health Library

  https://my.klarity.health/etiology-and-risk-factors-for-macular-hole/

  Research indicates that those who have a family history of macular holes are at a higher risk of developing them. […] In contrast to idiopathic macular holes, traumatic macular holes which arise from an eye injury or trauma are more frequently discovered in younger people AMAB in their early twenties. […] Macular holes can arise as a result of systemic disorders in a number of ways. […] The structural support of the eye can be compromised by connective tissue conditions such as Ehlers-Danlos syndrome or Marfan syndrome. […] Further raising the likelihood of macular hole formation are autoimmune illnesses like systemic lupus erythematosus (SLE), which can induce inflammation and immune-mediated damage to retinal structures. […] Susceptibility is further increased by genetic predisposition, especially if there is a family history of macular holes or disorders such as excessive myopia. […] Furthermore, by influencing retinal blood flow and structural integrity, systemic illnesses including diabetes mellitus and hypertension as well as traumatic eye injuries can lead to the formation of macular holes.

• #48 Revisiting Macular Holes

  https://www.reviewofophthalmology.com/article/revisiting-macular-holes

  The exact cause of macular hole remains unknown. The first reported macular holes in the late 19th century were believed to result from trauma that caused cystoid changes in the macula. Concurrent with the discovery around 1970 that the majority of macular holes were not associated with trauma, the predominant thought was that macular hole etiology was related to the presence of cystoid macular edema (CME), including any condition that may lead to CME. The vitreomacular traction theory of macular hole pathogenesis gained in popularity with the recognition that peripheral retinal breaks occur secondary to vitreoretinal traction and that strong adhesion exists between the vitreous and fovea. There is evidence that A-P traction may not be the only factor in macular hole formation. Researchers have documented macular hole formation after complete PVD/vitrectomy as well as spontaneous closure of macular hole in eyes without PVD (documented by OCT). Such observations led to the development of other theories of macular hole pathogenesis such as the hydrodynamic model, in which the macular hole is formed or maintained by fluid flow caused by the macular retinal pigment epithelium pump. Macular hole has long been recognized as a female-predominant disease, yet despite extensive research, the reason for such a gender predilection is unclear, and there is no strong evidence to support an association between estrogen replacement and macular hole. In reality, the etiology of macular hole is probably multifactorial, and determining which is the primary event is less important than the recognition that vitreomacular traction, foveolar dehiscence and other factors likely play a role.

• #49 Macular Hole: Symptoms, Causes, & Treatment

  https://my.clevelandclinic.org/health/diseases/14208-macular-hole

  A macular hole is a gap in the macula, which is the center of the retina of your eye. […] What causes a macular hole? In most people, macular holes are due to vitreous traction that’s more likely to happen with aging. Sometimes a macular hole is the result of an injury or a medical condition that affects the eye, including being very nearsighted. […] You may be more likely to develop a macular hole if you have: A very high degree of myopia (nearsightedness). Inflammation within your eye (uveitis). Eye trauma (injury). […] Risk factors for macular holes include: Aging. Female sex. History of eye trauma. Being very nearsighted. Previous eye surgeries or eye inflammation.

• #50 Macular Hole Treatment | Retinal Consultants Medical Group

  https://www.retinalmd.com/retina-conditions/macular-hole

  The central part of the retina is called the macula and the most central part of the macula is called the fovea. The fovea is so thin it is sometimes prone to develop problems. Thin wisps of scar-like tissue can pull the edges apart and create a macular hole. […] A macular hole forms in the center of the retina in the back of the eye. […] Patients who have a macular hole in one eye are more likely than the average person to have a macular hole in the other eye. The risk of developing a macular hole in the other eye is around 10-15%. The risk is lower if a posterior vitreous detachment (PVD) is already present in the eye. Ask your retina specialist about your individual risk.

• #51 Macular Hole: Symptoms, Causes, Types & Treatments

  https://www.dragarwal.com/diseases-conditions/macular-hole/

  A macular hole is a small break or defect in the macula, the central part of the retina responsible for sharp, detailed vision. […] The condition primarily affects older adults, typically over the age of 60, and is often associated with changes in the vitreous, the gel-like substance inside the eye. As people age, the vitreous shrinks and pulls away from the retina, sometimes creating tension on the macula and leading to the development of a hole. […] Several factors can contribute to its development: […] The most common cause. As we age, the vitreous gel inside the eye shrinks and pulls away from the retina. If it adheres to the macula too strongly, it can create a hole. […] People with high myopia have thinner retinas, making them more susceptible to macular holes. […] Direct trauma to the eye, such as a blow or accident, can cause a macular hole. […] Conditions that cause traction or pulling on the retina may lead to a macular hole. […] Severe diabetic retinopathy can weaken the macula, increasing the risk of holes forming. […] Fluid buildup can weaken the macular tissue, leading to hole formation.

• #52 Common Causes of Macular Holes in Young Adults | Austin Retina Blog

  https://www.austinretina.com/blog/common-causes-of-macular-holes-in-young-adults

  A macular hole is a small break in the macula of the eye, which is the central part of the retina that gives people the ability to see details. […] These are the three most common causes of macular holes in young adults: […] Injury or trauma Young adults who participate in high-contact activities are at an increased risk of developing a macular hole following blunt trauma to the eye. Dr. James Dooner notes that this is by far the most common cause of all macular holes in young people. […] High myopia Young adults with high myopia – nearsightedness requiring a corrective lens prescription of at least -6.00 diopeters (D) are at an increased risk of developing macular holes. […] Ocular inflammation Ocular inflammation is inflammation of the uvea, or middle layer of the eye, and is often caused by autoimmune disorders, inflammatory disorders or other diseases that weaken the immune system. Ocular inflammation may also result from a normal immune response of the body fighting an eye infection.

• #53 Macular Hole

  https://www.asrs.org/patients/retinal-diseases/4/macular-hole

  Macular hole commonly affects people over the age of 55 and most often occurs in women. The vast majority of cases develop spontaneously without an obvious cause. For this reason, there is currently no effective way to prevent their formation and development. […] Several conditions can increase the risk of macular hole formation, including: Vitreous traction: the vitreous is the gel that fills up the inside of the eye. With normal aging, the vitreous can shrink and pull away from the retina, sometimes creating a macular hole in the process. […] Genetics, environmental factors, and systemic causes dont seem play a role in macular hole formation.

• #54 Macular hole – information, causes and treatment | RNIB | RNIB

  https://www.rnib.org.uk/your-eyes/eye-conditions-az/macular-hole/

  Often there is no known reason why someone develops a macular hole. They are more common between the ages of 60 and 80 and women experience them more often than men. It has been linked to: […] having a severe eye injury […] having had a retinal detachment […] having long lasting macular swelling (cystoid macular oedema) […] your vitreous gel pulling on the macula (vitreomacular traction). […] There is nothing you can do to avoid getting a macular hole and it doesn’t develop because of anything you’ve done. Diet and exercise haven’t been found to make macular hole more likely.

• #55 Revisiting Macular Holes

  https://www.reviewofophthalmology.com/article/revisiting-macular-holes

  The exact cause of macular hole remains unknown. The first reported macular holes in the late 19th century were believed to result from trauma that caused cystoid changes in the macula. Concurrent with the discovery around 1970 that the majority of macular holes were not associated with trauma, the predominant thought was that macular hole etiology was related to the presence of cystoid macular edema (CME), including any condition that may lead to CME. The vitreomacular traction theory of macular hole pathogenesis gained in popularity with the recognition that peripheral retinal breaks occur secondary to vitreoretinal traction and that strong adhesion exists between the vitreous and fovea. There is evidence that A-P traction may not be the only factor in macular hole formation. Researchers have documented macular hole formation after complete PVD/vitrectomy as well as spontaneous closure of macular hole in eyes without PVD (documented by OCT). Such observations led to the development of other theories of macular hole pathogenesis such as the hydrodynamic model, in which the macular hole is formed or maintained by fluid flow caused by the macular retinal pigment epithelium pump. Macular hole has long been recognized as a female-predominant disease, yet despite extensive research, the reason for such a gender predilection is unclear, and there is no strong evidence to support an association between estrogen replacement and macular hole. In reality, the etiology of macular hole is probably multifactorial, and determining which is the primary event is less important than the recognition that vitreomacular traction, foveolar dehiscence and other factors likely play a role.

• #56 Macular Hole in the Eye: Definition, Causes, Symptoms, Diagnosis, and Treatment

  https://www.oscarwylee.com.au/glasses/eye/macular-hole?srsltid=AfmBOopJQoraWbp77cgi-wGH6D1Buli5a0rXCpCOwXwYAjtdPrbDn3_X

  Short-sightedness (myopia) may be a risk factor for a macular hole due to tractional forces in the eye. […] Injuries to the eye may be a risk factor for developing a hole in the eye due to the trauma that an injury may cause. […] A macular hole can be a serious eye condition, as it can impact a person’s central vision and in turn their quality of life. […] If a macular hole is not treated, it can lead to a decrease in central vision and affect quality of life.

• #57 Macular Hole – What is It, Causes and Treatment Options – Asia Retina Eye Surgery Centre

  https://asiaretina.com/news-articles-blog/macular-hole-causes-and-treatment-options/

  Macular holes can be caused by a wide range of external and internal issues, including: […] Disease, most prominently diabetes. A congenital condition called Best’s Disease can also cause macular holes. […] Changes to the eye, including highly advanced myopia, or nearsightedness, puckering of the macula, and a decrease in the volume of vitreous humor. […] Injuries to the macula, including those caused by external trauma and those caused by related issues such as detached retinas. […] Most of these factors are either related to other, more pressing issues, such as diabetes or retinal detachment; in these cases, macular holes can be addressed as part of a broader treatment for the underlying condition. Others, like injury, are unforeseeable. […] Loss of vitreous humor, though, is a special case that demands a bit more explanation.

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