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Imaging following Retinal Detachment

Casswell, Edward Joshua; (2020) Imaging following Retinal Detachment. Doctoral thesis (M.D(Res)), UCL (University College London).

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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.

Type: Thesis (Doctoral)
Qualification: M.D(Res)
Title: Imaging following Retinal Detachment
Event: UCL (University College London)
Language: English
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10100180
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