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AIM: To evaluate anatomic foveal configuration changes in fellow eyes of patients with idiopathic macular hole using spectral-domain optical coherence tomography(SD-OCT). <p>METHODS: Fifty eyes of fifty patients were studied and divided in two groups: group 1=25 patients with idiopathic macular hole and group 2=25 healthy individuals(control group). SD-OCT cross line scans were obtained using RTVue 100(Optovue, Inc., Fremont, CA, USA). The widest foveal B-scan was selected on each patient. Bi-dimensional foveal configuration was measured in mm² using caliper tool.<p>RESULTS:The mean foveal configuration in group 1 was 0.159±0.03mm² and in group 2 was 0.079±0.01mm². The difference between the two groups was statistically significantly(<i>P</i><0.001). In group 1, one patient developed a macular hole in the fellow eye.<p>CONCLUSION: Fellow eyes of patients with idiopathic macular hole tend to have an enlarged foveal configuration when compared to healthy subjects. Our finding combined with other vitreomacular risk factors may play a role in idiopathic macular hole formation.