Effectiveness of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES): a virtual non-inferiority trial

OBJECTIVES: To compare the ability of ophthalmologists versus optometrists to correctly classify retinal lesions due to neovascular age-related macular degeneration (nAMD).

DESIGN: Randomised balanced incomplete block trial. Optometrists in the community and ophthalmologists in the Hospital Eye Service classified lesions from vignettes comprising clinical information, colour fundus photographs and optical coherence tomographic images. Participants' classifications were validated against experts' classifications (reference standard).

SETTING: Internet-based application.

PARTICIPANTS: Ophthalmologists with experience in the age-related macular degeneration service; fully qualified optometrists not participating in nAMD shared care.

INTERVENTIONS: The trial emulated a conventional trial comparing optometrists' and ophthalmologists' decision-making, but vignettes, not patients, were assessed. Therefore, there were no interventions and the trial was virtual. Participants received training before assessing vignettes.

MAIN OUTCOME MEASURES: Primary outcome-correct classification of the activity status of a lesion based on a vignette, compared with a reference standard. Secondary outcomes-potentially sight-threatening errors, judgements about specific lesion components and participants' confidence in their decisions.

RESULTS: In total, 155 participants registered for the trial; 96 (48 in each group) completed all assessments and formed the analysis population. Optometrists and ophthalmologists achieved 1702/2016 (84.4%) and 1722/2016 (85.4%) correct classifications, respectively (OR 0.91, 95% CI 0.66 to 1.25; p=0.543). Optometrists' decision-making was non-inferior to ophthalmologists' with respect to the prespecified limit of 10% absolute difference (0.298 on the odds scale). Optometrists and ophthalmologists made similar numbers of sight-threatening errors (57/994 (5.7%) vs 62/994 (6.2%), OR 0.93, 95% CI 0.55 to 1.57; p=0.789). Ophthalmologists assessed lesion components as present less often than optometrists and were more confident about their classifications than optometrists.

CONCLUSIONS: Optometrists' ability to make nAMD retreatment decisions from vignettes is not inferior to ophthalmologists' ability. Shared care with optometrists monitoring quiescent nAMD lesions has the potential to reduce workload in hospitals.

TRIAL REGISTRATION NUMBER: ISRCTN07479761; pre-results registration.

Monday Morning Eye Opener, June 13, 2016

Weekly Newsletter from the Northwest District Office for libraries containing programs, activities, classes for the upcoming week.

Monday Morning Eye Opener, June 20, 2016

Weekly Newsletter from the Northwest District Office for libraries containing programs, activities, classes for the upcoming week.

Monday Morning Eye Opener, June 27, 2016

Weekly Newsletter from the Northwest District Office for libraries containing programs, activities, classes for the upcoming week.

Wearing Eye Tracking Technology During Batting Practice: Assessing the Experiences of Professional Baseball Athletes

Utilizing wearable technology in sport allows for the collection of motor behavior data during task engagement. This data can be assessed in real-time or retrospectively. Although enriching the scope of performance data, the consequences of wearable technology on the athlete-user, specifically the cognitive effects, has not been fully investigated, hence the purpose of this study. This qualitative study examines the cognitions of 57 professional baseball players who wore eye tracking technology whilst engaged in batting practice. Their verbal self-reports were framed by temporal context: before-during-after task. Three themes emerged during the pre-task segment: social appearance anxiety, claimed self-handicapping, and curiosity. During the task of batting, verbal behavior contained motivational and instructional overt self-talk while claimed self-handicapping was sustained. The final, post-performance segment was marked by the re-emergence of curiosity from the pre-task period as well as self-evaluation/appraisal. Given the participants were professional athletes, their performance has greater career implications than amateur competitors. Nonetheless, the verbal behavior elicited while wearing eye tracking technology indicates an awareness of the equipment by the user. This study found cognitive effects from wearable technology; more research is required to under-stand the scope and nature of those effects on cognitive and motor behaviors.

Monday Morning Eye Opener, July 11, 2016

Weekly Newsletter from the Northwest District Office for libraries containing programs, activities, classes for the upcoming week.

La valutazione della sicurezza stradale delle piste ciclabili mediante Mobile Eye Detector

Nella presente tesi viene valutata l'efficienza in termini di sicurezza del tratto nord-ovest della Tangenziale delle Biciclette, un percorso ciclabile nel comun di Bologna. Sono stati analizzati dei video (ottenuti dall'apparecchiatura Mobile Eye) che mostrano su cosa l'utente, durante la pedalata, sofferma maggiormente il suo sguardo. Da tali video, quindi, sono state estrapolate informazioni riguardanti il grado di attenzione del ciclista nel percorrere Il tratto di ciclabile. Per questo motivo sono stati analizzati in termini di frame, poi convertiti in secondi, tutti gli elementi capaci di influenzare l'attenzione dell'utente durante la guida: la segnaletica ciclabile (orizzontale e verticale) e l'eventuale presenza di altri pedoni/ciclisti. Con tali dati, inoltre, è stata effettuata un'analisi statistica descrittiva. L'ultima parte è l'analisi cinematica: valutazione dello spazio percorso, del tempo di percorrenza inclusi i tempi di attesa ai semafori rossi e stima della velocità media.

Mobil-eye detector: lo studio del comportamento visivo del ciclista in ambito urbano

In questa tesi viene studiato il comportamento visivo del ciclista durante la guida in ambiente urbano diversificato, così da esaminare quali siano le diverse strategie visive adottate dal conducente della bicicletta, in rapporto al contesto in cui si trova. L’analisi del comportamento visivo è stata effettuata mediante l’esecuzione di test su campo, utilizzando il Mobile-Eye Detector, grazie al quale si sono potuti studiare i filmati relativi alle prove compiute da 12 utenti. In seguito ad una fase primaria di elaborazione generale dei dati e di scarto di quelli non ritenuti validi ai fini dello studio, sono state rilevate le fissazioni, le saccadi e i loro relativi tempi. In particolare, studiando i video, si è creato un database in cui vengono analizzate una ad una (fotogramma per fotogramma) le fissazioni e vengono individuati gli elementi ad esse relativi, quali: goal, target, pedoni, ciclisti, veicoli, ammaloramenti della pavimentazione, edifici, segnaletica verticale e orizzontale e intersezioni. Tali elementi sono quelli che attirano maggiormente l'attenzione del ciclista sia da un punto di vista pratico, ai fini della conduzione del mezzo, sia a fini di "svago". Inoltre sono state individuate delle aree di dispersione visiva, ovvero zone su cui è maggiormente ricaduto lo sguardo dei partecipanti all’esperimento: esse sono state studiate, analizzandone le dimensioni e mettendole in relazione col tipo di tragitto e con gli elementi fissati. In questo modo si è cercato di dare un'interpretazione del comportamento visivo del ciclista, sottoposto a tragitti con caratteristiche diverse. In seguito a tale analisi, è stata verificata la compatibilità tra i risultati ottenuti mediante i filmati visionati e le risposte date dai partecipanti nei questionari, proposti al termine della prova, finalizzati ad attestare la percezione soggettiva del ciclista.

Monday Morning Eye Opener, July 18, 2016

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RETINAL ANGIOMATOUS PROLIFERATION: A Quantitative Analysis of the Fundoscopic Features of the Fellow Eye

PURPOSE: To quantitatively analyze and compare the fundoscopic features between fellow eyes of retinal angiomatous proliferation and typical exudative age-related macular degeneration and to identify possible predictors of neovascularization. METHODS: Retrospective case-control study. Seventy-nine fellow eyes of unilateral retinal angiomatous proliferation (n = 40) and typical exudative age-related macular degeneration (n = 39) were included. Fundoscopic features of the fellow eyes were assessed using digital color fundus photographs taken at the time of diagnosis of neovascularization in the first affected eye. Grading was performed by two independent graders using RetmarkerAMD, a computer-assisted grading software based on the International Classification and Grading System for age-related macular degeneration. RESULTS: Baseline total number and area (square micrometers) of drusen in the central 1,000, 3,000, and 6,000 μm were considerably inferior in the fellow eyes of retinal angiomatous proliferation, with statistically significant differences (P < 0.05) observed in virtually every location (1,000, 3,000, and 6,000 μm). A soft drusen (≥125 μm) area >510,196 μm2 in the central 6,000 μm was associated with an increased risk of neovascularization (hazard ratio, 4.35; 95% confidence interval [1.56-12.15]; P = 0.005). CONCLUSION: Baseline fundoscopic features of the fellow eye differ significantly between retinal angiomatous proliferation and typical exudative age-related macular degeneration. A large area (>510,196 μm2) of soft drusen in the central 6,000 μm confers a significantly higher risk of neovascularization and should be considered as a phenotypic risk factor.

Monday Morning Eye Opener, July 25, 2016

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Negligent Eye

This presentation was both an illustrated lecture and a published paper presented at the IMPACT 9 Conference Printmaking in the Post-Print Age, Hangzhou China 2015. It was an extension of the exhibition catalogue essay for the Bluecoat Gallery Exhibition of the same name. In 2014 I curated an exhibition The Negligent Eye at the Bluecoat Gallery in Liverpool as the result of longstanding interest in scanning and 3D printing and the role of these in changing the field of Print within Fine Art Practice. In the aftermath of curatingshow I have continued to reflect on this material with reference to the writings of Vilém Flusser and Hito Steyerl. The work in the exhibition came from a wide range of artists of all generations most of whom are not explicitly located within Printmaking. Whilst some work did not use any scanning technology at all, a shared fascination with the particular translating device of the systematizing ‘eye’ of a scanning digital video camera, flatbed or medical scanner was expressed by all the work in the show. Through writing this paper I aim to extend my own understanding of questions, which arose from the juxtapositions of work and the production of the accompanying catalogue. The show developed in dialogue with curators Bryan Biggs and Sarah-Jane Parsons of the Bluecoat Gallery who sent a series of questions about scanning to participating artists. In reflecting upon their answers I will extend the discussions begun in the process of this research. A kind of created attention deficit disorder seems to operate on us all today to make and distribute images and information at speed. What value do ways of making which require slow looking or intensive material explorations have in this accelerated system? What model of the world is being constructed by the drive to simulated realities toward ever-greater resolution, so called high definition? How are our perceptions of reality being altered by the world-view presented in the smooth colourful ever morphing simulations that surround us? The limitations of digital technology are often a starting point for artists to reflect on our relationship to real-world fragility. I will be looking at practices where tactility or dimensionality in a form of hard copy engages with these questions using examples from the exhibition. Artists included in the show were: Cory Arcangel, Christiane Baumgartner, Thomas Bewick, Jyll Bradley, Maurice Carlin, Helen Chadwick, Susan Collins, Conroy/Sanderson, Nicky Coutts, Elizabeth Gossling, Beatrice Haines, Juneau Projects, Laura Maloney, Bob Matthews, London Fieldworks (with the participation of Gustav Metzger), Marilène Oliver, Flora Parrott, South Atlantic Souvenirs, Imogen Stidworthy, Jo Stockham, Wolfgang Tillmans, Alessa Tinne, Michael Wegerer, Rachel Whiteread, Jane and Louise Wilson. Scanning, Art, Technology, Copy, Materiality.