Pathogenesis and Management of Macular Hole: Review of Current Advances

Table 1

Classifications of macular holes.

Gass stages	Description	OCT	IVTS group classification	E3-SD‐OCT-based classification	Chun et al. classification [12]
					Type A: dehiscence and centrifugal retraction	Type B: tearing or full thickness fovea
Stage 0	VMA in the fellow eye of a patient with a known/previous MH without any change in foveal architecture		VMA
Stage 1A	Impending macular hole with outer retinal elevation from RPE at foveal centre		VMT without MH: can occur with outer or inner retinal changes or both		(i) Impending hole; (ii) Occult hole	Occult hole
1B
Stage 2	≤400 µm MH with VMA		Small- or medium-sized MH with VMT	(i) Small (<250 μm); (ii) Medium (>250 to ≤400 μm)	Opercula that are still attached to the hole edge	Opercula that are still attached to the hole edge
Stage 3	>400 µm MH without VMA		Large MH without VMT	Large macular hole (>400 μm)	Small holes (i.e., <400 μm) and longer lengths from the tip of the ELM to the GCL	>400 μm
Stage 4	MH with complete posterior vitreous detachment		Small, medium, or large MH without VMT

IVTS, International Vitreomacular Traction Study Group classification; E3-SD‐OCT, European Eye Epidemiology (E3) consortium spectral‐domain optical coherence tomography-based classification; VMA, vitreomacular adhesion; RPE, retinal pigment epithelium; MH, macular hole; VMT, vitreomacular traction; ELM, external limiting membrane; GCL, ganglion cell layer.