Victorius vs Dionysius: the Irish Easter controversy of AD 689

Over the past few decades, the early medieval Easter controversy has increasingly been portrayed as a conflict between the ‘Celtic’ and the ‘Roman’ churches, limiting the geographical extent of this most vibrant debate to Britain and Ireland (with the exception of the disputes caused by Columbanus’ appearance on the Continent). Both are not the case. Before c.AD 800, there was no unanimity within the ‘Roman’ cause. Two ‘Roman’ Easter reckonings existed, which could not be reconciled, one invented by Victorius of Aquitaine in AD 457, the other being the Alexandrian system as translated into Latin by Dionysius Exiguus in AD 525. The conflict between followers of Victorius and adherents of Dionysius occurred in Visigothic Spain first, reached Ireland in the second half of the 7th century, and finally dominated the intellectual debate in Francia in the 8th century. This article will focus on the Irish dimension of this controversy. It is argued that the southern Irish clergy introduced the Victorian reckoning in the AD 630s and strictly adhered to that system until the end of the 7th century. When Adomnan, the abbot of Iona, converted to Dionysius in the late AD 680s and convinced most of the northern Irish churches to follow his example, this caused considerable tension with southern Irish followers of Victorius, as is impressively witnessed by the computistical literature of the time, especially the texts produced in AD 689. From this literature, the issues debated at the time are reconstructed. This analysis has serious consequences for how we read Irish history towards the end of the 7th century; rather than bringing the formerly ‘Celtic’ northern Irish clergy in line with southern Irish ‘Roman’ practise, Adomnan added a new dimension to the conflict.

The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease

Introduction
Standard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.

Methods
The Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.

Discussion
This trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.