Fig. 1

Schistic splitting of the foveal walls between the outer plexiform layer (OPL) and Henle fiber layer (HFL) as a characteristic of tractional lamellar holes. The images show SD-OCT scans through the fovea and parafovea of 5 eyes of 5 patients. In c, e, f the months after the first visit (0) are indicated left of the images. a The presence of an operculum (arrowhead) may suggest that traction exerted by the posterior hyaloid removed the inner Müller cell layer from the foveola. The tissue of the foveal walls splitted between the OPL and HFL. b The scans were recorded at and 85 months after the first visit. The orientations of the scans are shown at the left side. The arrowhead indicates a tissue band with medium reflectivity extending from the center of the foveola to the edge of the elevated dorsal foveal wall. c Development of a tractional lamellar hole from a macular pseudohole. The orientations of the scans are shown above. Note the presence of epiretinal membranes (ERM) which bridged deep retinal folds in the fovea and parafovea. Note also that the fovea externa was not disrupted. d Circumpapillary scans recorded in the same eye 34.5 months after the first visit. The right image shows a part of the image at higher magnification. Note the schistic splitting between the OPL and ONL at various sites of the peripapillary retina which was associated with a disappearance of the ellipsoid zone (EZ) line. e Development of a lamellar hole by tractional detachment of the foveola from the retinal pigment epithelium (RPE) and subsequent disruption of the junction between the inner layer of the foveola and the nasal foveal wall. The disruption allowed a reattachment of the central outer nuclear layer (ONL) at the RPE and was associated with a schistic splitting of the foveal walls between the OPL and HFL. An ERM was present in the nasal parafovea. f Development of a tractional lamellar hole after disruption of the Müller cell cone. Scale bars, 200 µm. ELM: external limiting membrane; GCL: ganglion cell layer; ELM: external limiting membrane; INL: inner nuclear layer; IPL: inner plexiform layer; IZ: interdigitation zone; NFL: nerve fiber layer