Fig. 78. Macular hole following blunt trauma. A. A hole in the fovea is surrounded by localized retinal detachment several years after blunt ocular trauma. B. Rounded edges (arrow) indicate a true hiatus of the retina in the region of the fovea. Artifactual holes are characterized by sharp, right-angle profiles. Traumatic chorioretinal scarring is characterized by marked proliferation of retinal pigment epithelium (P), causing the retina to adhere to the underlying choroid. In most cases of retinal hole formation (pseudoretinal hole formation), there is no retinal detachment or retinal pigment epithelial fibrous metaplasia as found in this case. (Hematoxylin-eosin stain; × 40.)