Continuing professional development requirements for UK health professionals: a scoping review.

Objectives: This paper sets out to establish the numbers and titles of regulated healthcare professionals in the UK and uses a review of how continuing professional development (CPD) for health professionals is described internationally to characterise the postqualification training required of UK professions by their regulators. It compares these standards across the professions and considers them against the best practice evidence and current definitions of CPD.

Design: A scoping review.

Retrospective analysis of newly recorded certifications of visual impairment due to diabetic retinopathy in Wales during 2007-2015.

Objective: The aim of this study was to analyse the changes in new certifications for both sight impairment (SI) and severe sight impairment (SSI, blindness) in Wales due to diabetic retinopathy (DR)/maculopathy between 2007 and 2015.

Research Design And Methods: This is a retrospective analysis of annual data of new certifications for visual impairment and blindness (Certificate of Vision Impairment) for England and Wales derived from the national database provided by the Certifications Office, Moorfields Eye Hospital, over a period of 8 years from 2007.

Results: In Wales there were 339 less new certifications for both SI and severe SSI from any cause combined from 2007-2008 to 2014-2015.

Automated Retinal Layer Segmentation Using Spectral Domain Optical Coherence Tomography: Evaluation of Inter-Session Repeatability and Agreement between Devices.

Retinal and intra-retinal layer thicknesses are routinely generated from optical coherence tomography (OCT) images, but on-board software capabilities and image scaling assumptions are not consistent across devices. This study evaluates the device-independent Iowa Reference Algorithms (Iowa Institute for Biomedical Imaging) for automated intra-retinal layer segmentation and image scaling for three OCT systems. Healthy participants (n = 25) underwent macular volume scans using a Cirrus HD-OCT (Zeiss), 3D-OCT 1000 (Topcon), and a non-commercial long-wavelength (1040nm) OCT on two occasions.

Diabetic Retinopathy in Newly Diagnosed Subjects With Type 2 Diabetes Mellitus: Contribution of β-Cell Function.

Purpose: The association of hyperglycemia and diabetic retinopathy (DR) in established type 2 diabetes mellitus (T2DM) subjects is well accepted. However, the association between β-cell responsiveness and insulin sensitivity leading to fasting and postprandial hyperglycemia with DR in newly diagnosed treatment-naïve T2DM subjects remain unreported.

Methods: A total of 544 newly diagnosed treatment-naïve T2DM subjects were screened for DR (digital photography) and underwent a standardized meal tolerance test.

Impact of Eye Cosmetics on the Eye, Adnexa, and Ocular Surface.

Despite the fact that cosmetic products undergo rigorous testing to ensure they are safe for human use, some users report mild discomfort following their application. The cutaneous changes, such as allergic dermatitis, are well reported, but the ocular changes associated with eye cosmetic use are less so. Some pigmented cosmetic products may accumulate within the lacrimal system and conjunctivae over many years of use, but immediate reports of eye discomfort after application are most common.

Automated Registration of Multimodal Optic Disc Images: Clinical Assessment of Alignment Accuracy.

Purpose: To determine the accuracy of automated alignment algorithms for the registration of optic disc images obtained by 2 different modalities: fundus photography and scanning laser tomography.

Materials And Methods: Images obtained with the Heidelberg Retina Tomograph II and paired photographic optic disc images of 135 eyes were analyzed. Three state-of-the-art automated registration techniques Regional Mutual Information, rigid Feature Neighbourhood Mutual Information (FNMI), and nonrigid FNMI (NRFNMI) were used to align these image pairs.

Migration of Cosmetic Products into the Tear Film.

Purpose: To examine, record, and quantify the migration of a conventional eye cosmetic pencil when applied to periocular skin in two different locations: behind the lash line (ELI) and along the periocular skin (ELO).

Methods: This was a pilot study (prospective, randomized crossover design) involving two visits on separate days. Three female subjects were randomly assigned one of two eyeliner application conditions: ELI (inside the lash line) or ELO (anterior to the lash line).

Prevalence of diabetic retinopathy within a national diabetic retinopathy screening service.

Aims: Determine the prevalence and severity of diabetic retinopathy (DR) and risk factors in a large community based screening programme, in order to accurately estimate the future burden of this specific and debilitating complication of diabetes.

Methods: A cross-sectional analysis of 91,393 persons with diabetes, 5003 type 1 diabetes and 86,390 type 2 diabetes, at their first screening by the community based National Diabetic Retinopathy Screening Service for Wales from 2005 to 2009. Image capture used 2×45° digital images per eye following mydriasis, classified by qualified retinal graders with final grading based on the worst eye.

Adaptive-weighted bilateral filtering and other pre-processing techniques for optical coherence tomography.

This paper presents novel pre-processing image enhancement algorithms for retinal optical coherence tomography (OCT). These images contain a large amount of speckle causing them to be grainy and of very low contrast. To make these images valuable for clinical interpretation, we propose a novel method to remove speckle, while preserving useful information contained in each retinal layer.

Branch retinal vein occlusion in an asymptomatic adult with cystic fibrosis.

Purpose: This article aims to describe a case of asymptomatic branch retinal vein occlusion (BRVO) in a patient with cystic fibrosis (CF) and discuss the possible link between the two.

Case Report: A young adult (aged 35 years) with CF who presented for routine ocular examination was found to have a superior temporal BRVO in the left eye. Visual acuity was unaffected, measuring -0.

The accuracy of the inferior>superior>nasal>temporal neuroretinal rim area rule for diagnosing glaucomatous optic disc damage.

Purpose: To determine the accuracy with which the optic disc can be diagnosed as normal or glaucomatous according to the ISNT rule, whereby, in the normal eye, the neuroretinal rim area follows the order inferior (I) > superior (S) > nasal (N) > temporal (T).

Design: Prospective, cross-sectional, observational, case series.

Participants: Fifty-one normal individuals and 78 individuals with open-angle glaucoma exhibiting field loss (median mean deviation, -4.

Mapping choroidal and retinal thickness variation in type 2 diabetes using three-dimensional 1060-nm optical coherence tomography.

Purpose: To map choroidal (ChT) and retinal thickness (RT) in healthy subjects and patients with diabetes with and without maculopathy using three dimensional 1060-nm optical coherence tomography (3D-1060nm-OCT).

Methods: Sixty-three eyes from 42 diabetic subjects (41-82 years of age; 11 females) grouped according to a custom scheme using Early Treatment Diabetic Retinopathy Study definitions for pathology within 1 disc-diameter of fovea (without pathology [NDR], microaneurysms [M1], exudates [M2], clinically significant macular edema [CSME]) and 16 eyes from 16 healthy age matched subjects (38-79 years of age; 11 females) were imaged by 3D-1060nm-OCT performed over a 36° × 36° field of view. Axial length, 45° fundus photographs, body mass index, plasma glucose, and blood pressure measurements were recorded.

Effect of a proparacaine 0.50%-sodium fluorescein 0.25% mix and contact ultrasound pachymetry on central and midperipheral corneal thickness measured by noncontact optical pachymetry.

Purpose: To assess the effect of a combination of proparacaine 0.50%-sodium fluorescein 0.25% and ultrasound (US) pachymetry on central and midperipheral corneal thickness.

Inter-subject, inter-ocular and inter-session repeatability of the photopic negative response of the electroretinogram recorded using DTL and skin electrodes.

The photopic negative response (PhNR) has attracted interest as a flash ERG component reflecting inner retinal activity, with investigators adopting various approaches to analysing the response. This study has two principal aims: first to determine the most reliable technique for assessing the PhNR amplitude; secondly to compare the repeatability characteristics of the PhNR recorded using DTL and skin active electrodes. Electroretinograms were recorded in 31 subjects, using both electrode types, in response to a Ganzfeld red stimulus (Lee filter "bright red"; 1.

Three-dimensional 1060-nm OCT: choroidal thickness maps in normal subjects and improved posterior segment visualization in cataract patients.

Purpose: To evaluate the performance and potential clinical role of three-dimensional (3D) 1060-nm OCT by generating choroidal thickness (ChT) maps in patients of different ages with different degrees of ametropia and axial lengths and to investigate the effect of cataract grade on OCT retinal imaging quality.

Methods: Axial lengths (ALs) and 45° fundus photographs were acquired from 64 eyes (34 healthy subjects, 19 to 80 years, ametropia +3 to -10 D). 3D 1060-nm OCT was performed over a 36° × 36° field of view with ∼7-μm axial resolution and up to 70 frames/s (512 A-scans/frame).

Screening athletes with Down syndrome for ocular disease.

Background: Persons with Down syndrome are well known to have a high prevalence of vision and eye health problems, many of which are undetected or untreated primarily because of infrequent ocular examinations. Public screening programs, directed toward the pediatric population, have become more popular and commonly use letter or symbol charts. This study compares 2 vision screening methods, the Lea Symbol chart and a newly developed interactive computer program, the Vimetrics Central Vision Analyzer (CVA), in their ability to identify ocular disease in the Down syndrome population.

Electrophysiological evidence of early functional damage in glaucoma and ocular hypertension.

Purpose: The quantification of early retinal ganglion cell damage in ocular hypertension and glaucoma.

Methods: Thirty subjects under treatment for open-angle glaucoma, 23 subjects with ocular hypertension, and 28 healthy subjects in a control group were investigated by monocular pattern electroretinogram (ERG), L&M (long and medium wavelength) cone ERG, and S (short wavelength)-cone ERG. The diagnosis of glaucoma was based on masked assessment of digital stereoscopic optic nerve head images by three glaucoma specialists.

Tear ferning in contact lens wearers.

Tear ferning (TF) has shown good sensitivity and specificity in the diagnosis of dry eye, but is a relatively uncommon test, especially in contact lens wearers. The aim of this study was to investigate the relationship between TF, ocular comfort and tear film stability amongst contact lens (CL) wearers and non-contact lens (NCL) wearers. Subjects (36 NCL, 24 CL; mean age 23.

Ganglion cell loss and dysfunction: relationship to perimetric sensitivity.

Purpose: To describe two methods of neural damage quantification from perimetric data, and to discuss their theoretical implications.

Methods: A recently published model of retinal ganglion cell (GC) receptive field density is used to obtain best estimates of the receptive fields per solid degree at each stimulus point in the 24-2 test pattern array. A method of age related change compensation is proposed and a functional relationship between perimetric sensitivity and GC survival is used for loss quantification.

Can pulsatile ocular blood flow distinguish between patients with and without diabetic retinopathy?

Purpose: Our aim was to determine if pulsatile ocular blood flow (POBF) measurements could distinguish between type 2 diabetes mellitus (DM) subjects with and without diabetic retinopathy (DR).

Methods: Ninety-eight DM subjects were recruited. POBF was measured using an Ocular Blood Flow tonometer and retinopathy was assessed using retinal digital photography.

Silent substitution S-cone electroretinogram in subjects with diabetes mellitus.

A defect in the blue sensitive mechanism has been reported in certain ocular and systemic diseases. For example, tritanopic colour vision defects and changes to the S-cone electroretinogram (ERG) have been demonstrated in glaucoma and diabetes mellitus. Electrophysiological methods of eliciting the S-cone ERG, however, often result in considerable L- and M-cone intrusion.

The effect of post prandial glucose changes on oscillatory potentials in subjects with type 2 diabetes mellitus.

Purpose: To investigate the effect of elevated plasma glucose levels on oscillatory potentials (OPs) in patients with diabetes mellitus.

Method: 15 patients with type 2 diabetes mellitus, with no ophthalmoscopically visible signs of diabetic retinopathy (NDR), were recruited, mean (SD) age 65.1 (10.

Digital stereoscopic analysis of the optic disc: evaluation of a teaching program.

Purpose: To determine if a computer-based stereoscopic teaching program could improve optic cup/disc ratio (CDR) agreement between student observers and an expert.

Design: Experimental study.

Participants: Six student observers (A-F) assessed at least 30 digital stereoscopic optic disc images using a digital stereoscopic analysis program.

S-cone, L + M-cone, and pattern, electroretinograms in ocular hypertension and glaucoma.

Silent substitution and selective adaptation techniques were used to obtain full field S-cone and L + M-cone electroretinograms from 18 patients with ocular hypertension (OHT), 9 with normotensive glaucoma (NTG), 18 with early primary open angle glaucoma (POAG) and 19 normal controls. Pattern electroretinograms were also recorded, using a reduced check size to increase the contribution of retinal ganglion cells. In the OHT and POAG groups, statistically significant reductions (P = 0.

The S-cone electroretinogram: a comparison of techniques, normative data and age-related variation.

The blue sensitive mechanism in human colour vision is highly susceptible to damage in ocular disease. There is a need for objective methods to assess this and several methods of recording the blue cone (S-cone) electroretinogram (ERG) have been described. We therefore compared a silent substitution technique (SST) and a selective adaptation technique (SAT) using a novel combination of optical filters, on 24 normal subjects.