BACKGROUND AND OBJECTIVE: To compare vessel density and the foveal avascular zone (FAZ) area among eyes with full-thickness macular hole (FTMH), lamellar macular hole (LMH), and macular pseudohole (MPH) using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Cross-sectional study involving 10 eyes with idiopathic FTMH, 10 eyes with LMH, 10 eyes with MPH, 17 unaffected fellow eyes, and 10 healthy controls. All patients underwent 3 mm × 3 mm OCTA centered on the macula. Vessel density and FAZ area were calculated. RESULTS: In the deep capillary plexus, FTMHs disclosed the highest vessel density (82.7% ± 16.8%), superior to LMHs (63.7% ± 5.9%; P = .0092), MPHs (37.8% ± 2.5%; P = .0011), and controls (53.0% ± 12.2%; P < .0001). In the superficial capillary plexus (SCP), MPHs had the lowest vascular density. Fellow eyes had reduced vascular density at SCP compared to control eyes. CONCLUSIONS: Microvascular changes are evident in different subtypes of macular holes. Unaffected fellow eyes exhibit early involvement of SCP.