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May 1992

Subhyaloid Hemorrhage Illustrating a Mechanism of Macular Hole Formation

Author Affiliations

Los Angeles, Calif

Arch Ophthalmol. 1992;110(5):598. doi:10.1001/archopht.1992.01080170020007

To the Editor.  —The hemorrhagic lesion of the posterior pole described in the June 1991 issue1 of the Archives is extremely interesting, and several aspects of the report warrant comment.First, in discussing the pathogenesis of the lesion, the authors misinterpret and misquote the electron microscopic findings previously reported by me.2 Although my report was concerned with the vitreoretinal juncture, it dealt primarily with the inner limiting lamina (ILL) (the basal lamina that lines the inner surface of the retina), the topographical variation in its thickness, and the basis for its attachment to the retina—not, as indicated by Nork et al, the attachment of the vitreous to the retina.A fundamental physiologic basis for the adherence of the ILL to the retina is the attachment plaques (not hemidesmosomes, as indicated by the authors), which strongly anchor the lamina to the underlying retina. However, in the region of the

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