Macular fissure is a defect of the whole retinal epithelium in the macula. 1869 was reported by Knapp and the name macular fissure was introduced, and it was thought to be related to trauma, and there has been no effective treatment. In 1988, Gass proposed the doctrine of posterior vitreous cortical traction, and in the 1990s, vitreous surgery plus inner boundary membrane removal and biological adjuvant were used to treat macular fissure, and advanced examination equipment such as optical coherence tomography (OCT), retinal tomography (HRT) and retinal thickness analyzer (RTA) were applied, which provided a broad prospect for the diagnosis and treatment of macular fissure. I. Anatomical characteristics of macula The macula is about 5.5L in diameter, residing at 4.0L on the temporal side of the optic disc and 0.8L below the central line of the optic disc. the macula can be divided into several areas: central (central) concave (fovea centralis) in the center of the macula, which is a place low down from the retinal surface, with a diameter of about 1.5L or 1.0DD, and a halo-like halo equivalent to the central concave can be seen under the examiner’s eye. The edge. The central foveola is in the center of the central fovea, with a diameter of about 0.35 L. The central umbo is in the center of the central fovea, and the foveola can be seen under the examiner’s eye as the central macular reflection. The parafoveal area has a 0.5L wide halo around the central concavity, and this area has retinal nodal cells, inner nuclear layer and Heale outer retinal layer so it is the thickest. The parafoveal area is a 1.5L wide ring around the periphery of the parafoveal sulcus. Clinical manifestations of Macular Hole-MH 1. Symptoms: Significant decrease in central vision, usually 0.1 or worse, visual deformation, central dark spot. The main reasons are (1) no retinal photoreceptor cells at the hole, (2) shallow detachment of retina around the hole, (3) cystic edema around the hole, and (4) different degrees of degeneration of retina around the hole. 2.Fundus: There is a round or oval retinal defect in the macula, dark red, clear border, generally less than 1PD, and there may be small yellow-white dot-like deposits at the base, and the light is interrupted by triple-sided slit lamp examination. 3, fundus fluorescence angiography (FFA): In the arterial phase, a strong fluorescence consistent with the size of the fissure can be seen in the macular area, no leakage, no diffusion, and dissipates with the background fluorescence. This phenomenon is mainly caused by retinal pigment epithelial atrophy. 4, optical coherence tomography (OCT): the use of low-coherence light in the eye to obtain a high-resolution cross-section of living tissue. Macular fissure is manifested as the absence of neuroepithelium in macular area, if the whole layer of neuroepithelium is absent, it is a full-layer fissure in macular area, if part of neuroepithelium is absent, it is a fissure in macular lamina. 5.Visual function examination: visual electrophysiology is often used to determine the visual function of macula. Including bright retinal electrogram, scintillation light retinal electrogram, local retinal electrogram, multifocal retinal electrogram, etc.. Among them, mERG has obvious changes, showing a general decrease in macular visual function and a significant decrease or disappearance of central sulcus response, as an objective and sensitive index for evaluating visual function, which is important for analyzing the progress of the disease and the effect of surgery. Differential diagnosis ① Macular pseudoholes (pseudoholes): A state in which there is actually no tissue loss in the macula, but the retina is invaginated due to lesions on the inner surface around the macula. It is mostly caused by contraction of the anterior retinal membrane resulting in a full-layer macular fissure pseudopholes. It can be distinguished by the intact retinal neuroepithelial light band under triple-lens microscopy, the absence of typical “window-like defect” changes in the macular area under FFA, and the steep shape of the central recess on OCT. If the central sulcus is not involved, the vision is mostly normal or slightly affected. Macular cystic degeneration (macular cysts): It means that the inner and outer layers of the macula are intact, but there is fluid accumulation in the retina. The fundus shows a foveal appearance, with continuous light through the cyst on slit lamp triangulation and mild forward elevation. fluorescence accumulation in the cystic cavity is seen in the late stage of FFA vein. octa-visualization shows complete actual retinal tissue and cystic cavity-like changes. Visual acuity is between 0.2-0.1. It may develop into macular fissure.