Full-thickness macular holes (FTMH) are an important cause of visual deterioration. However, different modes of FTMH formation are less investigated. It is also not clear whether the development of edematous cysts contributes to FTMH formation. In this retrospective case series of 30 eyes of 30 patients, we describe using spectral-domain optical coherence tomography different modes of FTMH formation. Morphological alterations of established FTMH are shown in 5 eyes of 5 patients. We found in 2 of 30 eyes investigated that anterior hyaloidal traction induced a hyperreflectivity of the inner Müller cell layer of the foveola prior to FTMH formation. In 3 eyes, FTMH were caused by anterior hyaloidal traction which produced foveal pseudocysts that developed to an outer lamellar hole (OLH) characterized by a disruption of the central outer retina. The OLH developed to a FTMH by the disruption of the inner layer of the foveola. FTMH formation from an OLH by hyaloidal traction was observed also in further 7 eyes. In 2 eyes, the OLH, which preceded FTMH formation, was generated by a serous retinal detachment. In 3 eyes, anterior hyaloidal traction caused a detachment of the fovea from the retinal pigment epithelium (RPE); the subsequent disruption of the foveola resulted in a FTMH. Six eyes showed the development of a FTMH from a degenerative lamellar hole (DLH). In 5 eyes with macular pucker, FTMH were formed by traction of epiretinal membranes (ERM) or hyaloidal traction. Two eyes showed the development of a FTMH by anterior or tangential hyaloidal traction likely without a formation of an OLH. FTMH formation from an OLH proceeded with or without an enlargement of cystic cavities in the foveal walls. The formation of FTMH from a DLH, after a detachment of the fovea, and in macular pucker eyes was associated with a formation of cystic cavities in the foveal walls. The best-corrected visual acuity (BCVA) of eyes with an OLH or FTMH was inversely correlated to the base and minimum diameters of the holes, and with the height of the foveal walls; the highest correlation coefficients were found between the BCVA and the base diameter. The data show that FTMH may be formed via different modes by hyaloidal traction and/or traction of ERM, or after a serous retinal detachment. It is suggested that, after FTMH formation, the impaired fluid clearance through the RPE after detachment of the central outer retina causes the development of edematous cysts in the foveal walls which enlarges the FTMH. The BCVA of eyes with an OLH or FTMH mainly depends on the size of the central photoreceptor-free area.

全层黄斑裂孔（FTMH）是视觉恶化的重要原因。但是，对FTMH形成的不同模式的研究较少。还不清楚水肿性囊肿的发展是否有助于FTMH的形成。在这30例患者的30眼的回顾性病例系列中，我们描述了使用光谱域光学相干断层扫描成像的FTMH形成的不同模式。在5名患者的5只眼中显示出已建立的FTMH的形态学改变。我们在30只眼睛中的2只眼睛中进行了调查，发现前透明环牵引在FTMH形成之前引起了黄斑内Müller细胞层的超反射性。在三只眼中，FTMH是由前玻璃样牵引引起的，产生的中央凹假性囊肿发展为以中央外视网膜破裂为特征的外层板孔（OLH）。OLH通过破坏小窝内层而发展成为FTMH。在另外7只眼中，也观察到由​​玻璃体牵引引起的OLH引起的FTMH形成。在2眼中，FTH形成之前的OLH是由浆液性视网膜脱离产生的。在3只眼中，前玻璃样牵引导致视网膜中央凹脱离视网膜色素上皮（RPE）。随后的中央凹破裂导致了FTMH。六只眼睛显示了退化性板状孔（DLH）形成的FTMH。在5眼黄斑皱纹眼中，FTMH是由视网膜前膜（ERM）牵引或玻璃体牵引形成的。两只眼睛显示出由前或切向玻璃状牵引产生的FTMH可能没有形成OLH。由OLH形成FTMH的过程是在中央凹壁囊性腔增大或不增大的情况下进行的。从中央凹脱离后，在黄斑褶皱眼中，DLH形成FTMH与中央凹壁囊性腔的形成有关。用OLH或FTMH进行的最佳矫正视力（BCVA）与孔的底部和最小直径以及中央凹壁的高度成反比。在BCVA和底径之间发现最高的相关系数。数据显示，FTMH可能通过玻璃体牵引和/或ERM牵引或在浆液性视网膜脱离后通过不同的方式形成。建议在FTMH形成后，视网膜中央中央视网膜脱离后，通过RPE清除液体的能力受损，导致中央凹壁出现水肿性囊肿，从而扩大了FTMH。使用OLH或FTMH的眼睛的BCVA主要取决于中央无感光区的大小。