What distinguishes a lamellar macular hole from a full-thickness macular hole?

• A. It involves full thickness of retina
• B. It does not involve full thickness of the retina
• C. It is caused by trauma
• D. It involves outer retina only

Answer: (B)

The key idea is whether the defect goes through the entire thickness of the retina at the fovea. A lamellar macular hole is a partial-thickness defect that does not traverse the full retinal thickness, so some retinal layers remain intact. On OCT, you see disruption mainly in the inner layers with the outer retina preserved to a large extent. A full-thickness macular hole, by contrast, involves the entire retinal thickness from the surface to the RPE, creating a complete hole and typically showing more extensive outer retinal disruption. The distinction you’re testing is precisely that full-thickness involvement is what characterizes a full-thickness hole, while lamellar holes do not have that complete breach.