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Foveolar detachment of cone outer segment tip line may be responsible for yellow spot in early macular holes

Retina. 2011;31(1):127-147.

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The yellow spot observed in stage 1A macular holes may be caused by foveolar detachment of the cone outer segment tip line, a study showed.

The prospective observational case series examined 43 fellow eyes of 43 patients with a stage 2, 3 or 4 full-thickness macular hole, five of which had a yellow spot, and two eyes with a foveolar yellow spot with metamorphopsia.

Perifoveal posterior vitreous detachment with vitreofoveal adhesion occurred in all seven eyes with a yellow spot, while spectral-domain optical coherence tomography showed no foveolar detachment for the 38 fellow eyes lacking a yellow spot, the study authors noted.

Of the seven eyes with foveolar detachment, two with foveal splits progressed to a full-thickness macular hole.

The authors suggested that the spatial relation of a foveolar detachment to the splits may play a significant role in the formation of a full-thickness macular hole.