A patient with progressive visual loss and macular hole development due to progressive myopic traction maculopathy was studied using spectral domain optical coherence tomography (SD-OCT). A characteristic, deep retinal schisis-like change was clearly demonstrable. Progression to a full-thickness macular hole was documented. Postoperatively, the macular hole was closed, and the visual acuity was restored. SD-OCT imaging allowed better resolution of macular features but requires evaluation of all scan data. The source of progressive inner retinal traction may be the posterior extension of the staphyloma.