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Title: Macular hole : imaging and post operative positioning studies
Author: Pasu, Saruban
ISNI:       0000 0004 8507 6011
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Since 1991 when Kelly and Wendel published the first case series of a surgical technique to repair macular holes, both the closure rates and functional outcomes have improved. The four novel studies presented in this thesis all have the subject of macular hole as a common theme running throughout. A comprehensive review of the pathophysiology, imaging and surgical reparative techniques is described in Chapter 1 which concludes with the results of a Cochrane review undertaken to determine the value of post-operative face down positioning. Chapter 2 focuses on a previously unreported method of imaging a macular hole using the Shadowgram overlay tool on the Topcon 3D - OCT 2000 (Topcon, Tokyo, Japan). This technique while offering no significant benefit over traditional linear OCT measurements may be of interest in other causes of macula pathology. Another aspect of macula imaging is explored in Chapter 3, which concentrates on assessing the reproducibility and reliability of the caliper tool on three different OCT devices. This original piece of work is the first of its kind to look in detail at the varies aspects of macular hole geometry. Chapters 4 and 5 offer an extensive explanation of the PIMS (positioning in macular hole study) trial. This NIHR funded trial is to date the largest multi-centre randomised controlled trial to determine whether advice to position face down improves the surgical success rate of closure of large (≥400 μm) macular holes.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available