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  •  Professional ConductOcular examinationOcular Disease                                                      

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    This edition of Advances in Eyecare has interviews with experts discussing their fields of research applicable to optometric practice, including: electrophysiology, compact electrode ERG and OCT-angiography.

    Advantages of Optical Coherence Tomography Angiography (OCTA): Mr Pearse Keane

    Benefits of Electrophysiological Testing: Dr Dorothy Thomson

    New Systems of Assessing Electrophysiology: Prof Will Ayliffe

    Last published: May 2017

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      Learning objectives

      • 2.5.3 Understand the nature of two new developments (OCT-angiography and compact electrophysiology) in eye assessment and how they may influence future eye examination
      • 3.1.3 Understand the use of OCT-angiography and how it provides a non-invasive assessment of retinal and choroidal vascular patency
      • 6.1.3 Understand the nature of electrophysiological assessments and how it provides a useful objective method of assessing visual pathway and aid diagnosis of many common eye conditions
      • 6.1.14 Understand the use of electrophysiology in assessing neural transmission through the visual pathway as a means of detecting neurological disease
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        Unit 1 - Advantages of OCTA (~20 mins)

        Pearse Keane and Reena Chopra

        Optical coherence tomography (OCT) is a routinely used non-invasive test that uses light waves to obtain cross sectional images of the retina. Optical coherence tomography angiography (OCTA) adds a new dimension to OCT; functional vascular network imaging. Pearse Keane, a Consultant Ophthalmologist at Moorfields Eye Hospital, has recently co-written a paper detailing the advantages and disadvantages of OCTA over conventionally used imaging tests. The paper explores the potential future development of this technique, and reviews the current literature on the clinical application of OCTA in common ocular diseases, including diabetic retinopathy, and retinal artery and vein occlusion. In this piece, Reena Chopra interviews Pearse on his research, and what implications it could have in primary eye care.

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        Unit 2 - Benefits of Electrophysiological Testing (~14 mins)

        Dorothy Thompson and Simranjit Gill
        Clinical visual electrophysiological testing is not currently used outside the hospital eye service. However, newer techniques are being developed which make the test more accessible and adaptable to the optometrist, without the need for multiple electrodes and complicated visual stimuli targets. Electrophysiology, measuring the electrical activity in the visual pathway, makes it possible to assess the functioning of different elements of the pathway and provides unique information leading to definitive diagnosis of ocular disease. Dorothy Thompson is Director of Education of the International Society for Clinical Electrophysiology of Vision. She works as a consultant clinical scientist in visual electrophysiology in the Ophthalmology Department at Great Ormond Street Hospital. In this piece, Dorothy discusses her work with Simranjit Gill.

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        Unit 3 - New Systems of Assessing Electrophysiology (~12 mins)

         Johann Panthakey and Will Ayliffe
        New systems of assessing electrophysiology, such as electroretinography (ERG) and visual evoked potential (VEP) assessments, have been developed in the US, and are being viewed with increasing interest by optometrists. Early results suggest they are easy to use; for example an ERG is now possible with the application of one simple strip electrode under the patient’s lower lid.  And they are able to detect early disease damage, such as ganglion cell loss in early glaucoma. They are also being trialled as a way of assessing macular health - for example while a patient is taking a potentially maculopathic drug such as hydroxychloroquine. Our interviewer, Johann Panthakey talks to consultant ophthalmologist Will Ayliffe who is involved in UK based trials looking at the technique.

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