Differences in the presentation of stage 1 macular holes illustration by optical coherence tomography.

Two different pathological mechanisms appear to underlie the formation of macular holes: The optical coherence tomography-guided classification of Gass stage 1 macular hole as an antero-posterior traction with a triangular foveolar detachment has to be distinguished from a tangential traction and a complete posterior vitreal detachment. Tangential traction is typically associated with a more dome-shaped or irregular foveolar detachment and a hyper-reflective band at the vitreoretinal interface.