Idiopathic macular hole is a condition widely believed to result from disruption of retinal tissue due to anteroposterior vitreofoveal traction.1 Previous reports have used spectral-domain optical coherence tomography (SD-OCT) to demonstrate cross-sectional images of macular hole formation in the setting of vitreomacular traction.1-3 Herein, we present sequential en face SD-OCT analysis of an evolving macular hole to attempt to elucidate its pathogenesis.