Correspondence

摘要

First, Li et al suggested that "severe vitreomacular traction had weakened the normal retinal architecture" thereby implicating the traction as the primary factor in the pathogenesis of the holes. However, we believe that preexisting traction may not be the only reason for hole formation in this case. Holes in the macula have been reported after vitreous surgery for various mac-ular conditions, such as idiopathic macular hole, mac-ular pucker, and cystoid macular edema, albeit rarely. Although most of these macular holes are eccentric, they may occur centrally.3 These iatrogenic holes have been associated with peeling of the internal limiting membrane, presence of extensive drusen, and myopic macular degeneration, but occasionally they have occurred in the absence of internal limiting membrane peeling.4-5 Internal limiting membrane peeling possibly results in decapitation of Miiller cells and subsequent degeneration of adjacent retinal neurons, predisposing to the development of macular holes.