UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Structure function correlation in retinal ischaemia and macular oedema

Sen, Piyali; (2023) Structure function correlation in retinal ischaemia and macular oedema. Doctoral thesis (M.D(Res)), UCL (University College London). Green open access

[thumbnail of Sen_10173803_thesis.pdf]
Preview
Text
Sen_10173803_thesis.pdf

Download (2MB) | Preview

Abstract

Diabetic retinopathy (DR) and retinal vein occlusion (RVO) are the two most prevalent retinal vascular diseases which affect macular perfusion, altering visual function. Firstly, healthy eyes [eyes with no structural pathology identified on Optical coherence tomography (OCT) and OCT angiogram (OCTA)] were assessed for the foveal parameters to identify the reliability of structural markers before studying pathological changes. The white ethnic group had a smaller foveal avascular zone area and perimeter compared to the Asian and Afro-Caribbean (AFC) ethnic groups, respectively in our study. Retinal capillary loss is an irreversible complication of DR. We analysed patients with advanced DR and found higher parafoveal capillary vessel density (VD) at the level of superficial capillary plexus (SCP) was associated with better best corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) while for radial peripapillary capillary plexus (RPCP) only VD of temporal sector was the predictor of LLVA. Disorganization of the retinal inner layers (DRIL), a potential biomarker of focal ischaemia affects LLVA more than BCVA. In a final adjusted model, the SCP density of the parafoveal area was the only parameter that most accurately ascertained BCVA and LLVA. In the next section of this thesis, functional assessment of the effect of treatment (anti-vascular endothelial growth factor [VEGF] versus laser) on active proliferative diabetic retinopathy (PDR) showed BCVA and LLVA are well correlated before and after treatment. Our findings suggest ten letters difference between BCVA-LLVA; however, this difference becomes more remarkable for a lower level of BCVA, suggesting more advanced ischaemia affects LLVA aggressively. Next analysing, OCTA changes at the macula for PDR, and central retinal vein occlusion (CRVO), I found capillary loss was more pronounced in PDR than CRVO. The final chapter of the thesis looked at the baseline demographic and morphological changes in CRVO patients to predict vision outcomes. Baseline retinal central subfield thickness (CST) up to 900 microns can be expected to improve by 2 or more lines on Early Treatment Diabetic Retinopathy Study (ETDRS) chart or achieve >70 letters visual acuity (VA) at 100 weeks of follow up and treatment. Age of the patient and vision at the time of diagnosis of CRVO and intact ellipsoid zone can predict BCVA at 100 weeks following initiation of treatment in CRVO eyes.

Type: Thesis (Doctoral)
Qualification: M.D(Res)
Title: Structure function correlation in retinal ischaemia and macular oedema
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
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/10173803
Downloads since deposit
22Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item