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Title: Imaging following retinal detachment
Author: Casswell, Edward Joshua
ISNI:       0000 0004 9359 2825
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2020
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Background: The last two decades have seen huge advances in retinal imaging, with the advent of a range of non-invasive cross-sectional imaging technologies. Aims: To investigate the impact of retinal imaging in three different settings of retinal detachment (RD): (1) Fundus autofluorescence imaging following rhegmatogenous RD (2) Adaptive optics (AO) and optical coherence tomography (OCT) imaging following RD complicated by proliferative vitreoretinopathy (PVR) grade C (3) Widefield OCT imaging of round hole (RH) RDs. Methods: (1) PostRD Trial: a randomised controlled trial of 262 patients to assess the effect of face down posturing on post-operative retinal displacement. (2) AO in PVR study: a prospective study of 25 patients to assess cone density using AO imaging of RDs complicated by PVR C. (3) Round Hole Retinal Detachment study: a retrospective observational feasibility study of 28 eyes with widefield OCT imaging of peripheral round holes, with or without RD. Results: PostRD study: at 6 months, retinal displacement was detected in 42% of the face down group vs 56% of the support-the-break group (OR 1.77, 95%CI 1.01–3.11, p=0.04). Groups were similar in corrected visual acuity, objective D Chart distortion scores and quality of life scores at 2 and 6 months. AO in PVR study: no clear differences in cone density were demonstrated in eyes with or without PVR, however the study was limited by the low number of analysable AO images. Round Hole RD study: Vitreous attachment was detected at the site of the retinal hole in 27/28 (96.4%) cases. Vitreous attachment in a U shape configuration was more commonly seen in holes associated with SRF or RD. Conclusions: These studies illustrate the potential impact of retinal imaging in assessing post-operative retinal displacement, investigating retinal damage caused by PVR and demonstrating the vitreoretinal interactions surrounding peripheral round holes.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available