The accuracy of lamellar macular hole (LMH) diagnosis was strongly improved by the introduction of optical coherence tomography (OCT), although our understanding of pathogenesis, clinical progression, and therapy of this macular defect remains incomplete.
Although progress was made in visualizing retinal anatomy by OCT during the last decade, there is no generally
accepted definition of LMH. To distinguish LMHs from other similar macular lesions, such as macular pseudoholes, Witkin and colleagues
recently proposed distinct OCT criteria based on qualitative image analysis without measurement of retinal thickness. According to these four criteria, diagnosis of a lamellar macular hole is based on: (1) an irregular foveal contour; (2) a break in the inner fovea; (3) a dehiscence of the inner foveal retina from the outer retina; and (4) an absence of a full-thickness foveal defect with intact foveal photoreceptors.

By biomicroscopic and fluorescein angiographic findings, lamellar macular holes were initially described to result from cystoid macular edema.Recent findings of OCT studies indicate that LMHs may result from …