Outer retinal changes preceding secondary macular hole formation years after vitreomacular traction release demonstrated on spectral-domain OCT

This report describes changes documented on spectral-domain optical coherence tomography (SD-OCT) in the right eye of a 58-year-old woman who eventually developed a secondary fullthickness macular hole (FTMH). She had a history of vitreomacular traction (VMT) that had resolved spontaneously with a complete posterior vitreous detachment. Despite VMT resolution, a hyperreflective band from the internal to the external limiting membrane and evidence of photoreceptor disruption persisted on SD-OCT for 2 years, at which point an FTMH developed. Despite VMT release, the unexpected FTMH coupled with the preceding outer retinal changes suggest persistent secondary damage to Müller cells as a potential factor.