The progression findings for macular hole formation. (A,C) One month after first aflibercept injection. The color fundus photograph shows a tear of the RPE, rolled RPE flap beneath the retina, and subretinal fibrosis. OCT shows rolled RPE flap and SRD. (B,D) One month after second aflibercept injection. The color fundus photograph shows contracted subretinal fibrosis. OCT shows thin foveal retina secondary to traction associated with the rolled RPE flap. (E, F,G, H) One month after third aflibercept injection. The color fundus photograph shows contracted subretinal fibrosis and RPE tear (E). Fluorescein angiography shows choroidal flush due to a macular hole (F). Indocyanine green angiography shows blocked fluorescence due to subretinal fibrosis (G). OCT shows full thickness macular hole with shrunken, rolled RPE flap (H). Arrows show the edge of rolled RPE flap (A, B, E).