The UK clinical eye research strategy: refreshing research priorities for clinical eye research in the UK.

Objectives: To validate and update the 2013 James Lind Alliance (JLA) Sight Loss and Vision Priority Setting Partnership (PSP)'s research priorities for Ophthalmology, as part of the UK Clinical Eye Research Strategy.

Methods: Twelve ophthalmology research themes were identified from the JLA report. They were allocated to five Clinical Study Groups of diverse stakeholders who reviewed the top 10 research priorities for each theme.

An evaluation of optometric advanced skills within a UK tertiary based setting.

Introduction: Hospital-based optometrists are undertaking extended roles across ophthalmology that may require them to perform advanced skills (AS). Moorfields Eye Hospital (MEH) is the largest UK employer of hospital-based optometrists, it was sought to investigate which AS are being performed at this centre and how they align to the four pillars of advanced clinical practice (ACP).

Methods: An online survey was sent to MEH optometrists in May 2022 that asked about professional status, sub-specialties worked, qualifications, acquisition and validation of AS, research and leadership.

Investigating the Spatiotemporal Summation of Perimetric Stimuli in Dry Age-Related Macular Degeneration.

Purpose: To measure achromatic spatial, temporal, and spatiotemporal summation in dry age-related macular degeneration (AMD) compared to healthy controls under conditions of photopic gaze-contingent perimetry.

Methods: Twenty participants with dry AMD (mean age, 74.6 years) and 20 healthy controls (mean age, 67.

Spatial Summation in the Glaucomatous Macula: A Link With Retinal Ganglion Cell Damage.

Purpose: The purpose of this study was to test whether functional loss in the glaucomatous macula is characterized by an enlargement of Ricco's area (RA) through the application of a computational model linking retinal ganglion cell (RGC) damage to perimetric sensitivity.

Methods: One eye from each of 29 visually healthy subjects <40 years old, 30 patients with glaucoma, and 20 age-similar controls was tested with a 10-2 grid with stimuli of 5 different area sizes. Structural estimates of point-wise RGC density were obtained from optical coherence tomography (OCT) scans.

Investigating the linkage between mesopic spatial summation and variations in retinal ganglion cell density across the central visual field.

Purpose: The relationship between perimetric stimulus area and Ricco's area (RA) determines measured thresholds and the sensitivity of perimetry to retinal disease. The nature of this relationship, in addition to effect of retinal ganglion cell (RGC) number on this, is currently unknown for the adaptation conditions of mesopic microperimetry. In this study, achromatic mesopic spatial summation was measured across the central visual field to estimate RA with the number of RGCs underlying RA also being established.

Spatiotemporal summation of perimetric stimuli in healthy observers.

Spatial summation of perimetric stimuli has been used to derive conclusions about the spatial extent of retinal-cortical convergence, mostly from the size of the critical area of summation (Ricco's area, RA) and critical number of retinal ganglion cells (RGCs). However, spatial summation is known to change dynamically with stimulus duration. Conversely, temporal summation and critical duration also vary with stimulus size.

Temporal summation in myopia and its implications for the investigation of glaucoma.

Purpose: We have previously demonstrated the upper limit of complete spatial summation (Ricco's area) to increase in non-pathological axial myopia compared to non-myopic controls. This study sought to investigate whether temporal summation is also altered in axial myopia to determine if this aspect of visual function, like in glaucoma, is influenced by reductions in retinal ganglion cell (RGC) density.

Methods: Achromatic contrast thresholds were measured for a GIII-equivalent stimulus (0.

Ageing changes in retinal outer nuclear layer thickness and cone photoreceptor density using adaptive optics-free imaging.

Purpose: To investigate age-related changes of the outer nuclear layer (ONL) thickness and cone density, and their associations in healthy participants using a modified, narrow scan-angle Heidelberg Retina Angiograph (HRA2).

Methods: Retinal cones were imaged outside the fovea at 8.8° eccentricity and cone density was compared to ONL thickness measurements obtained by Spectral-Domain Optical Coherence Tomography (SD-OCT) at the same locations.

Examining the concordance of retinal ganglion cell counts generated using measures of structure and function.

Purpose: There are several indirect methods used to estimate retinal ganglion cell (RGC) count in an individual eye, but there is limited information as to the agreement between these methods. In this work, RGC receptive field (RGC-RF) count underlying a spot stimulus (0.43°, Goldmann III) was calculated and compared using three different methods.

Mesopic conditions optimise the detection of visual function loss in drivers with simulated media opacity.

Drivers have different visual demands across varying contrast and luminance conditions. However, vision assessments for driving are typically conducted under photopic conditions. This study investigated the sensitivity of photopic and mesopic conditions to detect contrast sensitivity (CS) loss in drivers with simulated media opacities.

The Effect of Induced Intraocular Stray Light on Recognition Thresholds for Pseudo-High-Pass Filtered Letters.

Purpose: The Moorfields Acuity Chart (MAC)-comprising pseudo-high-pass filtered "vanishing optotype" (VO) letters-is more sensitive to functional visual loss in age-related macular degeneration (AMD) compared to conventional letter charts. It is currently unknown the degree to which MAC acuity is affected by optical factors such as cataract. This is important to know when determining whether an individual's vision loss owes more to neural or optical factors.

Preliminary clinical validation of a new picture-based visual acuity test in children with amblyopia: a comparison of The Auckland Optotypes and crowded logMAR letters.

Background/aims: Amblyopia is the most common visual deficit in children and accurate visual acuity (VA) assessment is essential for diagnosis. While ETDRS high-contrast logMAR VA is the reference standard test for adults, less agreement exists for pre-literate children. A new picture optotype acuity test (The Auckland Optotypes [TAO]) has shown favourable comparison to letter acuity charts but has not yet been evaluated in children with amblyopia.

Machine Learning Algorithms to Detect Subclinical Keratoconus: Systematic Review.

Background: Keratoconus is a disorder characterized by progressive thinning and distortion of the cornea. If detected at an early stage, corneal collagen cross-linking can prevent disease progression and further visual loss. Although advanced forms are easily detected, reliable identification of subclinical disease can be problematic.

Intravitreal injections: past trends and future projections within a UK tertiary hospital.

Aims: To describe past trends and future projections for the number of intravitreal injections being administered at a large tertiary hospital in London, United Kingdom.

Methods: Retrospective data from Moorfields Eye Hospital were collected using the electronic medical record system. Descriptive statistics were used to visualise overall trends.

Altered spatial summation optimizes visual function in axial myopia.

This study demonstrates significant differences between the area of complete spatial summation (Ricco's area, RA) in eyes with and without non-pathological, axial myopia. Contrast thresholds were measured for six stimuli (0.01-2.

In Vivo Confocal Microscopy Morphologic Features and Cyst Density in Acanthamoeba Keratitis.

Purpose: To correlate in vivo confocal microscopy morphologic features (IVCM-MF) and Acanthamoeba cyst density (ACD) with final best-corrected visual acuity (BCVA) in Acanthamoeba keratitis (AK).

Design: Retrospective cohort study.

Methods: Patient demographics, treatment outcome, and corresponding IVCM-MF performed at the acute stage of infection were analyzed.

Automated Pupillometry Using a Prototype Binocular Optical Coherence Tomography System.

Purpose: To determine the test-retest reliability and diagnostic accuracy of a binocular optical coherence tomography (OCT) prototype (Envision Diagnostics, El Segundo, California, USA) for pupillometry.

Design: Assessment of diagnostic reliability and accuracy.

Methods: Fifty participants with relative afferent pupillary defects (RAPDs) confirmed using the swinging flashlight method (mean age 49.

High-Resolution In Vivo Fundus Angiography using a Nonadaptive Optics Imaging System.

Purpose: We provide a proof of concept for the detailed characterization of retinal capillary features and surrounding photoreceptor mosaic using a customized nonadaptive optics angiography imaging system.

Methods: High-resolution fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA) images were obtained using a modified Heidelberg retina angiograph (HRA2) device with a reduced scan angle enabling 3° field of view. Colocalized images of the photoreceptor mosaic also were captured in vivo using the same instrument.

Use of a Binocular Optical Coherence Tomography System to Evaluate Strabismus in Primary Position.

Importance: Current clinical methods for assessing strabismus can be prone to error. Binocular optical coherence tomography (OCT) has the potential to assess and quantify strabismus objectively and in an automated manner.

Objective: To evaluate the use of a binocular OCT prototype to assess the presence and size of strabismus.

Optimising the glaucoma signal/noise ratio by mapping changes in spatial summation with area-modulated perimetric stimuli.

Identification of glaucomatous damage and progression by perimetry are limited by measurement and response variability. This study tested the hypothesis that the glaucoma damage signal/noise ratio is greater with stimuli varying in area, either solely, or simultaneously with contrast, than with conventional stimuli varying in contrast only (Goldmann III, GIII). Thirty glaucoma patients and 20 age-similar healthy controls were tested with the Method of Constant Stimuli (MOCS).

Human Factor and Usability Testing of a Binocular Optical Coherence Tomography System.

Purpose: To perform usability testing of a binocular optical coherence tomography (OCT) prototype to predict its function in a clinical setting, and to identify any potential user errors, especially in an elderly and visually impaired population.

Methods: Forty-five participants with chronic eye disease (mean age 62.7 years) and 15 healthy controls (mean age 53 years) underwent automated eye examination using the prototype.

Relationship between Psychophysical Measures of Retinal Ganglion Cell Density and In Vivo Measures of Cone Density in Glaucoma.

Purpose: Considerable between-individual variation in retinal ganglion cell (RGC) density exists in healthy individuals, making identification of change from normal to glaucoma difficult. In ascertaining local cone-to-RGC density ratios in healthy individuals, we wished to investigate the usefulness of objective cone density estimates as a surrogate of baseline RGC density in glaucoma patients, and thus a more efficient way of identifying early changes.

Design: Exploratory cohort study.