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City University, London

UOA 12B - Allied Health Professions and Studies: Optometry and Visual Science

RA5a: Research environment and esteem

RA5: Development of Research in Optometry & Visual Science

 

1. Overview:  The Applied Vision Research Centre (AVRC) at City University has expanded its research activities during the last six years to meet new challenges and to strengthen its role as an important international centre with the objective of advancing fundamental studies of vision and optometric research; and the translation of this knowledge to clinical and industrial applications. The AVRC is housed in the Henry Wellcome Laboratories for Vision Sciences, a suite of 30 offices and 36 experimental rooms, refurbished during this period with support from the Wellcome Trust and City University. The Centre has expanded its faculty through targeted recruitment to ensure strengthening of its research in visual development, clinical applications of visual psychophysics, vascular physiology, glaucoma, assessment and genetics of eye disease and treatment, and retinal imaging through the use of adaptive optics and light scattering techniques. The translation of knowledge derived from fundamental vision studies into eye care and clinical applications has benefited greatly from the strong links established with Moorfields Eye Hospital Trust, The Institute of Ophthalmology and the National Hospital (Queens Square). Patient-based studies that exploit the latest research techniques to understand diseases of the eye, their detection and management and their effects on patients’ quality of life as well as the funding to support this work have benefited significantly from these links. The award of research contracts by RCUK, the European Community and USA agencies, the selection and nomination of AVRC members to serve on international vision committees (ARVO, CIE, ICVS, etc)  and the prestigious Royal Society Research Fellowship (awarded to Peter Neri) confirm the status of the AVRC as an important international centre in clinical and applied vision research. 

 

 2. Research students

Support for research students has been enhanced through provision of newly refurbished offices and equipment and the further development of generic research training, including short-courses, training sessions and regular research symposia. The latter include eight international symposia organised at the AVRC since the last RAE in which the research students have been involved, both in terms of organisation and attendance. Regular events include an annual two-day research methods course and specialised lecture series in photometric measurements and signal processing. Research students attend the regular AVRC lecture series which features both internal and external speakers.  These arrangements provide a vigorous and stimulating research environment, supported by formal arrangements to ensure proper monitoring of research progress. The latter include regular meetings with supervisors, progress reports every six months, a yearly interview with the senior tutor for research and formal presentations of research papers at the Annual AVRC Seminar when the students present their research findings and receive feedback on their work. During the period covered by RAE2008, 29 additional students (FTE’s) have been recruited and 12 PhD and 2 MPhil degrees have been awarded with 13 students in the writing up category. The majority of those who have completed their research studies have either been recruited as lecturers or have been given research appointments at City and other universities. The programme also involves 9 part-time students who are allowed up to 7 years to complete. 

 

3. Research Income

The research has been supported by organisations which include research councils (EPSRC, BBSRC, PPARC), industry (Qinetiq, Bausch&Lomb, Roche Vitamins, FAA, CAA, Transport for London), government organisations (Department of Health, Department for Transport, The Royal Society), charities (Wellcome Trust, Action Medical Research) and the European Community. Since the last RAE, the total research grant income, including recently awarded grants which have not yet incurred expenditure, has been approximately £6m. The largest item was a JIF infrastructure development Grant of £2.3m.  Recently awarded Research Council/Wellcome Trust Grants include £272k from the Wellcome Trust for ‘Mechanisms of Extrapolation in Human Vision’; £85k from PPARC for development of a ‘Smart Ophthalmoscope’; £85k from EPSRC for ‘Scattering properties of the Human Retina’; £75k from EPSRC for ‘Selective Attention and Signal Detection Theory’; £364k from the Foresight Initiative of Wellcome/BBSRC for ‘Orientation Coding’, £222k from BBSRC for ‘Texture Variance Encoding’ and £165k from the Wellcome Trust for ‘Amblyopia and Eye-Hand coordination’.  Other grants awarded since the last RAE include £169k from EPSRC to study “Limits of functional diffraction limited vision”, £309k from the Civil Aviation Authority to establish “Minimum vision requirements within the aviation environment”, £189k from the EU to study “Mesopic Vision”,  £249k from the Department of Health for Adaptive Technology in Retinal Imaging’, £297k from the DfT for the ‘Medical Aspects of Fitness to Drive’ project,  £464k from the NHS to develop Primary Care Eye Research, and £383k plus £83k from Pfizer to promote glaucoma research. In addition to external research income, support from the University has also been received during this period to enhance research infrastructure facilities and to introduce new researchers and new research areas that fit within the objectives of the Centre. 

 

4. Research Structure and the Environment

The AVRC is equipped with purpose-built instrumentation for electrodiagnostics, pupillometry, light scatter measurements and adaptive optics, as well as commercial state of the art clinical equipment (e.g., wavefront sensors, fundus cameras, radiometers, eye-trackers, SLOs, corneal topographers, etc). The ‘Active Vision’ laboratory has equipment for eye movement and manual reaching-grasping recording.  

 

Approval of new investigations is dealt with rapidly by the local Research & Ethical Committee within the centre and where required by the Senate Research Ethics Committee. The local committee also deals with research student matters and monitors the progress achieved in each project. The research groups and labs reflect the strengths, skills and interests of our faculty and fall naturally into four groups. The research studies are carried out in a number of specialised, but closely linked laboratories. The table below lists the researchers associated with the centre and indicates their involvement in different areas either as full (highlighted) or affiliated members. 

 

 


 

4.1 Applied Vision Research  (Group leader David Crabb)

The Applied Vision Research (AVR) Group unites a large number of researchers with interests in the optometric, wider clinical, and applied environments. This diverse research group has benefited from significant recruitment, which has allowed us to reach a critical mass of experienced researchers in the areas of amblyopia, glaucoma, measurement techniques in vision, and primary care optometry. An overarching aim of our research is to link basic visual mechanisms with clinical practice. To achieve this we use a variety of research methods and techniques, ranging from standard clinical tools to mathematical models, to enhance the detection of visual disorders and improve the quality of life for those with visual problems. Our research impacts on the full spectrum of the population, from pre-term babies to the elderly patient with glaucoma. The group is organised into four laboratories, each of which has made key contributions to clinical investigative optometry, ophthalmology or visual science during the census period. 


4.1.1 Visual Development and Amblyopia Laboratory

 

                                                Core members:                   Cocker, Fielder (leader), Finlay, Moseley, Stewart,                                                        Wilson

Associated members:       Grant, Melmoth

 

This group focuses on two main aspects of the developing visual system: the effects of preterm birth (notably retinopathy of prematurity) and Amblyopia.  Both research arms utilise clinical populations across west London and are undertaken in collaboration with clinical colleagues at St Mary’s, Hillingdon and Chelsea & Westminster Hospitals NHS Trusts.

 

Work on Amblyopia is led by Moseley and Stewart in collaboration with David Stephens, McGill University, Montreal, and has been supported by Fight for Sight, National Institute for Health Research and the Emerald Fund. This clinically-related research has focused, though a randomised trial, on the therapeutic dose response relationship of Amblyopia therapy. This work delineated in detail for the first time the response to different interventions (refractive correction and occlusion) and permitted for the first time modelling of the treatment response. Why the response characteristics to two interventions are so different is enigmatic and is being addressed by Stewart in her NIH Research Trainee Award.   She is investigating the neural basis of the therapeutic response using psychophysical and fMRI studies, the latter in collaboration with Anthony Morland, University of York.  

 

The laboratory has also been active in developing methods of analysing digital images obtained from the preterm retina in health and disease (retinopathy of prematurity). This work is funded by PPARC, in collaboration with Physics and Bioengineering at Imperial College and clinical ophthalmologists in North America. Wilson, Clinical Research Fellow funded by Action Medical Research, with  Cocker is developing clinical and semi-automated methods of quantifying the vascular changes which accompany severe ROP.  Fielder is national coordinator for ophthalmology in the MRC-funded trial BOOST II UK, a randomised controlled trial to study – “Which oxygen saturation level should we use for very premature infants?” This is a 4-year UK-wide project run from the National Perinatal Epidemiology Unit (NPEU), Oxford, with links to similar studies in other countries.

 

4.1.2 Measurement Techniques in Vision (MTV)  

 

Core Members:                   Crabb (leader), Garway-Heath, Hull, Kotecha,                                                                Viswanathan 

Associated members:       Barbur, Diaz-Santana, Gruppetta, Harlow,                                                                       Hosking, Rauscher, Rodriguez-Carmona, 

                                                Thomson  

 

The MTV laboratory aims to improve clinical measurement and analytical techniques in glaucoma and other retinopathies. The laboratory is concerned with functional measurements, such as visual fields from clinical perimetry, and the evaluation of how these relate to the activities of daily living, reading and driving. Software developed in our laboratory is already used in clinical instrumentation worldwide (Heidelberg Retina tomography). The laboratory also focuses on technologies for in-vivo imaging of the posterior segment of the eye (structural measurement of the retina and optic nerve) that are becoming standard tools in eye care. In particular, we aim to develop clinically useful information management tools for these measurements, and provide efficient clinical trial design to develop safer and more targeted treatments with respect to disease progression. For example, the UK Glaucoma Treatment study (PI Garway-Heath, 2007) is the first placebo-controlled RCT for glaucoma medical treatment: the end points and data (more than 650 subjects) from this trial will be assessed solely in our laboratory. The laboratory has also determined the effect of corneal biomechanics on the accuracy and precision of intraocular pressure (IOP) measurements particularly with respect to glaucoma and in refractive surgery. The laboratory is involved in the investigation of newer psychophysical tests for glaucoma detection, and other measurement systems such as eye movements, corneal topography and image processing for objective analysis of posterior capsular opacification. The laboratory is composed of a mixture of clinical ophthalmologists, optometrists, computer scientists, statisticians and mathematicians: a unique blend of the necessary expertise required for this research. Close clinical collaboration with Moorfields Eye Hospital is at the centre of the activity in this laboratory (Garway-Heath and Viswanathan are visiting professors at City).

 

The laboratory continues to be strongly supported by unrestricted industrial funding (around £170k since 2005) and the NHS Moorfields Special Trustees (£135k since 2005). Two new recently awarded unrestricted grants will support PDRAs to be appointed to the laboratory before the end of 2007 (£83k from Pfizer Inc and £134k from Allergan Ltd). These projects will examine how longitudinal structural and functional measurements can be integrated to improve the detection of disease progression in glaucoma: this work is a collaboration with the Rotterdam Eye Hospital (Netherlands) and Dalhousie University, Halifax (Canada). 

 

4.1.3 Clinical Practice in primary-care optometry

Core Members:                   Edgar (leader), Evans, Subramanian

Associated members:       Barbur, Crabb, Hull, Kotecha, Lawrenson                                                             

This recently established laboratory is noteworthy for its inter-disciplinary and inter-institutional research, exemplified by the ‘Medical aspects of fitness to drive’ project (£297K, Edgar PI, see Rauscher output) funded by the DfT. The team comprised researchers from five UK universities, Moorfields, and the National Hospital. This research investigated the relationship between central scotomata and driving in subjects with bilateral visual field defects, and assessed their visual performance using conventional and novel approaches. 

 

Another research focus is optometrists’ role as primary eyecare providers, and topics include: models of care delivery, standards of clinical practice, clinical decision making, evaluation of optometrists’ prescribing, visual impairment, screening for eye disease, and the links between wider health and well-being and visual health.  Current projects include the evaluation of case-finding strategies used by community optometrists for detecting primary open angle glaucoma (POAG) (£383k, Lawrenson PI) supported by Pfizer. Collaborators Kotecha and Edgar are joined by Sirwardena and Murdoch from Moorfields. 

 

Evans (PI) and Edgar are conducting the first systematic research investigating standards of clinical practice within optometry, using the “standardized patient” approach and clinical vignettes to assess the typical content of UK optometric eye examinations. Lawrenson, with colleagues in the Centre for Allied Health Research (City University), is assessing the role of Allied Health Professions in health promotion (£148k from the National Institute for Health Research). Lawrenson, with Murdoch (PI), is also developing a novel community-based model for POAG management, funded by Moorfields Special Trustees (£143k). The Central LOC fund and College of Optometrists are supporting (£72k, Lawrenson PI) an evaluation of the scope of therapeutic practice and optometrist prescribing. 

 

Recently Crabb was awarded an NHS New and Emerging technology (NEAT) grant, funding “Detecting glaucoma: PC based perimetry” (£70k). Visual impairment is the major research focus of Subramanian, who has published several papers in collaboration with colleagues in Manchester and Anglia Ruskin universities. 

 

Edgar, plus community optometrists and those from other disciplines, collaborate in EyeNET, the network supporting primary-care research in London (£552k, Edgar PI, funded by NHS). Through EyeNET, 30+ primary-care optometrists have undertaken research and dedicated research training, leading to 25+ refereed publications, with 8 MSc’s and 1 PhD awarded, and another PhD student writing-up.

 

4.1.4 Visual Assessment & Screening

Core members:                   D’Ath, Hunt, Thomson (leader)

Affiliated members:            Barbur, Crabb, Evans, Lawrenson, Subramanian

 

The focus of this laboratory has been the development of tests for vision screening and the clinical assessment of visual performance. Much of this work has involved the development of software which has exploited recent advances in computer and display technology to provide clinicians with an unprecedented array of tools for assessing visual function. For example, Test Chart 2000 is a computer programme which transforms a standard PC and flat panel display into a powerful visual assessment tool. Other programs such as Near Chart 2000, the PC Hess Screen and the Optometric Toolbox are also used by thousands of eye care professionals.

 

Drugs Database PRO provides a unique source of information about the ocular adverse reactions of all the pharmaceutical preparations currently available in the UK. The programme has recently been extended to include detailed information and guidance to support the extended role of optometrists in prescribing and the supply of therapeutic drugs. The new software, eMedInfo, will be made available by the College of Optometrists to all optometrists in the UK early in 2008.

The group has also developed a suite of software for vision screening. The Vision Screener for Schools is already used in over 500 schools worldwide and a new program for school-entry screening has already been adopted by a number of Primary Care Trusts. This approach has been extended to provide a Vision Screener for the Elderly which is currently being evaluated in a joint project with the Institute of Optometry supported by the Pocklington Trust. The group has also recently developed a general vision screener/ eye care information booth in conjunction with CIBA Vision.

 

The group has been at the forefront of the development of software for screening for Meares-Irlen syndrome. The Coloured Overlay Screener and Colour Screener PRO have provided innovative solutions for identifying individuals who are likely to benefit from the use of coloured filters or spectacles and the software is widely used in schools and optometric practice.

 

More recently the group has developed software to assist visually-impaired individuals to optimise the characteristics of their display screen in a project funded by the College of Optometrists.

 

4.2 Visual Psychophysics and Perception (Group leader Michael Morgan)

 

The research activities in this group focus on studies designed to unravel the properties of visual mechanisms and to understand changes in disease. Computer modelling of visual processes and the motor response play an important part in these studies. Several projects also employ brain imaging techniques to reveal the processing of different stimulus attributes in various areas of the cortex and the function of subcortical projections in human vision.  Many studies are multidisciplinary and can involve collaboration with research groups that specialise in the use of other experimental techniques (Retinal imaging / adaptive optics: C Dainty, National University of Ireland; Genetics of human colour vision: J & M Neitz, University of Wisconsin).  The research studies are carried out in three closely linked labs.

 

4.2.1 Perception Laboratory

Core members:                   Mareschal, Melmoth, Morgan (leader), Solomon 

Affiliated members:            Barbur, Fahle, Tibber

 

Work supported by the ‘Foresight’ Joint Research Council Initiative (BBSRC and Wellcome; £364k) is examining the processes underlying orientation interactions between hypercolumns using psychophysics and computational modelling. The project is joint with the Gatsby Institute for Computational Neuroscience at UCL, where a second postdoc is located.  The associated grant to the Gatsby was £425k. 

 

Another project supported by BBSRC (£222k) will investigate the mechanisms underlying the visual computation of texture variance. The project is joint with Charles Chubb at UC Irvine, who was awarded a BBSRC Fellowship to visit City in 2003.

 

Work on ‘crowding’ was supported by two grants from EPSRC and has resulted in 5 publications, one in ‘Nature Neuroscience’.  

 

Work on basic mechanisms of motion detection was supported by BBSRC and has resulted in published papers demonstrating a multiplying nonlinearity in the basic motion detector and a novel order effect with temporal frames of differing contrast. 

 

Work jointly with Geoffrey Arden (see Arden outputs) has investigated differential effects of light and alcohol on the electro-oculographic responses of patients with age-related macular disease, and electrical activity in visual cortex associated with combined auditory and visual stimulation in temporal sequences known to be associated with a visual illusion.  

 

Joint work with City’s Psychology Department is investigating visual illusions in adults with Asperger’s syndrome.

 

Collaborative work with Professor John Sloper at Moorfields on binocular vision in Duane’s patients and M- and P-pathways in Amblyopes has resulted in three publications in IOVS (see Sloper outputs).

 

Work supported by the Wellcome Trust, and published recently in PLosOne, has measured, for the first time, contrast sensitivity within an artificial scotoma (Morgan output).

 

4.2.2 Brain Imaging and Active Vision Laboratory 

 Core members:                   Fahle (leader), Spang, Tibber

Affiliated members:            Barbur, Hosking, Melmoth, Morgan

 

Brain imaging work at the Centre has been expanded significantly through the use of state of the art fMRI facilities in Bremen, the Wellcome Functional Imaging Laboratory in London and the University of Melbourne Medical School. Novel stimuli that provide better isolation of the stimulus attributes of interest (such as neural mechanisms involved in extrapolation of stimulus direction, colour constancy or conscious visual perception) have been developed in the Centre and used in collaborative studies. The Active Vision Laboratory has equipment for measuring eye movements and reaching/grasping. Current investigations include the following: 

 

Work supported by the Wellcome Trust (Morgan, Grant, Tibber & Melmoth) is examining the mechanisms involved in ‘Active Vision’, including the motor extrapolation of visual direction, using a combination of psychophysical, movement tracking and fMRI techniques, the latter in collaboration with Geraint Rees at the Wellcome Functional Imaging Laboratory at UCL.  

 

A current fMRI project based in Bremen has used the BOLD response to localise the mechanisms responsible for the detection of microsecond interocular delays. Another fMRI project in Bremen has demonstrated convincingly that rapid colour constancy mechanisms are associated largely with monocularly driven neurons and that the primary visual cortex plays a major part in this function. 

 

Hosking is conducting collaborative work between the departments of ophthalmology and brain imaging in the University of Melbourne medical school. The investigations have received funding from the Imaging Research Foundation of Australia to identify new applications for functional and anatomical MRI in glaucoma. The project aims to identify cortical changes associated with retinal ganglion cell death at various stages of disease and the effect of disease progression and anti glaucoma therapy. The primary objective is to develop a new software application for case-wise risk assessment of glaucoma onset and progression.

 

4.2.3 Colour Research Laboratory / Clinical Applications  

Core members:         Arden, Barbur (leader), Birch, Hammond, Harlow,                                                         Plant, Rauscher, Rodriguez-Carmona, Sharpe, Weiskrantz,                                       Wolf 

Affiliated members:  Connolly, Fahle, Morgan, Spang, Thomson 

The long tradition of research into normal and deficient colour vision at City University has been greatly enhanced since the last RAE through a series of collaborative research projects that exploit the latest techniques in genetics, visual psychophysics and fMRI. The work programme is based on fundamental studies of colour vision, but also includes clinical and industrial applications. The achievements are numerous and the work of the laboratory has received international acclaim through the establishment of the standard Colour Assessment and Diagnosis (CAD) observer with direct applications in mass screening for diabetes, aviation, the fire service and the transport environment. Barbur has been invited to chair a CIE technical committee to examine the establishment of international standards for colour vision assessment and guidelines for minimum colour vision requirements within professional environments. The loss of colour vision in optic neuritis and multiple sclerosis and the subsequent recovery of visual function have been examined using psychophysical and pupil colour responses in collaboration with Moorfields (Plant), National Hospital (Bremner) and Bascom Palmer Eye Research Institute (Miami) (Lamb). The work on genetics with Jay and Maureen Neitz (University of Wisconsin) has established the relationship between loss of chromatic sensitivity and the genetic specification of cone pigment genes. The genetic factors that cause increased variability within normal trichromats, the mysteries of the Rayleigh match that remained unsolved for over 50 years, the variation in chromatic sensitivity with light level and chromatic adaptation, the limitations of occupational colour vision tests and the interaction between luminance and chromatic contrast are now better understood and these findings have been translated into functional tests that can be used to:

         detect abnormal congenital and acquired deviations, diagnose the class of congenital deficiency and quantify the loss of chromatic sensitivity;

         detect early stages of systemic (e.g. diabetes) and ocular (e.g. ARMD) diseases and monitor disease progression and effects of treatment; 

         establish minimum colour vision requirements within certain occupational environments such as rail transport and aviation.

 

The laboratory has also promoted fundamental studies in colour constancy using visual psychophysics and fMRI techniques in collaboration with the University of Bremen (Fahle and Spang). The latter studies identified the primary visual cortex as the principal site for both the extraction of colour signals and the processing of chromatic context that leads to instantaneous colour constancy in human vision. 

 

The work has been sponsored by industry and government departments (La Roche, Transport for London, Qinetiq, Civil Aviation Authority, Department for Transport and the Federal Aviation Authority (USA)). 

 

4.3 Visual Neuroscience  (Group leader Ron Douglas) 

Group members have overlapping research interests in both the peripheral and central components of the visual pathway and associated structures. The strength of the group lies in the broad range of experimental approaches employed, extending from molecular and cellular biology, biomechanics and electrophysiology, to whole animal and human biology. Research employs anatomical, biochemical, physiological, tissue culture and behavioral techniques.

 

4.3.1 Retina and Neurophysiology Laboratory

Core Members:        Baker, Constable, Douglas (leader), Grant, Lawrenson

Affiliated:                 Arden

The broad methodological approach in a variety of species has led to a number of advances in our understanding of fundamental neural mechanisms underlying both normal and abnormal functioning of the visual system. More specifically:

The use of the pupil response as a means of assessing visual function in mice has been pioneered. This has, for instance, led to the characterisation of a novel photoreceptor in mammals (published in Nature Neuroscience). The action spectrum of pupil responses in transgenic mice lacking both rods and cones represents the spectral sensitivity of intrinsically photosensitive melanopsin-containing retinal ganglion cells, which mediate 'non-image forming' visual responses such as circadian behaviour and the pupil response. 

The mouse pupil response has, with colleagues from the Institute of Ophthalmology, also been used to investigate the efficacy of retinal transplantation. It was shown that if rod progenitor cells isolated from a developing mouse were transplanted into an adult donor animal with retinal degeneration, they formed rods which were integrated into the host retina leading to a significant increase in pupil sensitivity. 

A completely new form of vision is possessed by some deep-sea fish emitting far red bioluminescence, involving the use of chlorophyll as a photosensitizer and very long-wave sensitive visual pigments. Part of this work is funded by the NERC and the Royal Society. 

Retinal pigment epithelial (RPE) cell lines that are used to model the outer blood-retinal barrier show heterogeneity in expression of the drug transporter P-glycoprotein (this work is funded by the College of Optometrists and the British Retinitis Pigmentosa Society). 

Human studies show that oral doses of alcohol cause a rise in the ocular standing potential that mimics the light-rise of the EOG. Using cell culture models there is evidence that a Ca2+-gated basolateral chloride channel is responsible for the alcohol-EOG (this work is funded by the College of Optometrists and the British Retinitis Pigmentosa Society). 

Misrouted retinal projections at the optic chiasm characteristic of all albino mammals do not occur in non-mammalian mutants lacking ocular melanin. It is suggested that pigment-dependent interactions between the RPE and neural retina are peculiar to mammals and may depend upon their special need to simultaneously generate crossed and uncrossed inputs to the brain early in retinal development 

Several widely-accepted models of information transfer between separate areas of the cerebral cortex are based on the idea that different laminar connectivity patterns define feedforward, feedback and lateral processing 'hierarchies'. The laminar distribution of ~150,000 cortical neurons contributing to >150 projections in the cat visual cortex was quantified and their patterns analyzed using cluster analysis. This work provided the first objective evidence supporting these hierarchical schemes.

Studies have been carried out in the area of Human Visuo-Motor Control to examine the types of visual information required for skilled reaching and grasping (prehension) performance (Wellcome Trust). Adults with long-standing amblyopia or stereovision losses show selective grasping deficits. This work is continuing, with Wellcome Trust support, to investigate extrapolated movements, in collaboration with the Amblyopia & Brain Imaging and Active Vision Laboratories (see above).

 

4.3.2 Vascular Physiology & Vision Laboratory

Core Members:       Benavente-Perez, Connolly, Conway, Hosking (leader)           

Affiliated:                  Kotecha, Lawrenson

            

The vascular physiology research group is concerned with the ocular perfusion profile of the eye’s vessel beds and the relationship to visual health and disease. The group adopts a whole system approach to the investigation of perfusion, balancing systemic blood pressure responses against ocular perfusion pressure to determine flow profiles in physiological and pathological conditions. Vascular stress testing, using gas perturbations and cold pressor testing, is used to define the autoregulatory responses of the various vessel beds of the eye, which have been shown to be dysfunctional even when baseline flow rates appear normal. 

 

The principal outcome measures of damage due to systemic, neurologic or ocular disease are defects of visual function and/or structural changes to the visual pathway. The group has a strong track record in establishing functional loss predominantly using clinical psychophysics, and structural changes in the anterior optic nerve using scanning laser imaging and ultrasound technologies. Recent collaborative studies have extended to functional and anatomical changes of the posterior visual pathway. 

 

These principles of study have been applied to investigate the ocular effects of a wide range of disease categories with vascular associations and which may result in visual loss, including systemic vascular, neurological and eye diseases. Particular areas of interest are glaucomatous optic neuropathy, epilepsy, diabetes and Sturge Weber Syndrome. This work provides outcomes that can and do change the clinical approach to disease measurement and management. 

 

Major Findings

Normal Eyes

         Autoregulation is present in the retina and short posterior ciliary arteries

         Ocular blood flow is greater in the inferior retina

         Mild hypoxia impairs mesopic chromatic sensitivity

         Ocular perfusion diminishes with normal ageing

 

Glaucoma

         Patients with early disease exhibit relative vasoconstriction which is reversible

         Hypercapnia (vasodilation) results in acute loss of visual contrast in early disease

         Autoregulatory defects suggest autonomic dysfunction in glaucoma 

 

Epilepsy

         Epilepsy patients have reduced ocular perfusion

         Patients treated with Vigabatrin (VGB) exhibit central vision defects and greater compromise to ocular perfusion characteristics

 

4.4 Imaging and Instrumentation for Vision Research (Group leader Luis Diaz-Santana)

 

Core members:                   Diaz-Santana, Gruppetta

Affiliated members:            Arden, Barbur, Crabb, Edgar, Kotecha, Morgan

 

The research interests of the IIV are centred on the development of novel non-invasive instrumentation, data analysis techniques and image processing to study the visual system. Currently the group focuses on two main topics: measurement of ocular aberrations and high-resolution retinal imaging with adaptive optics, although it also pursues a number of other small instrumentation projects in scleral imaging and retinal scattering. 

 

SmartOptics Faraday Partnership (EPSRC-PPARC): this project saw the development of a novel digital hand-held ophthalmoscope in collaboration with three industrial partners and two other academic institutions. One patent has been filed with Keeler optics in this project and a product is expected to reach the market in the next two years. 

 

SHARP EYE (FP-5, Subcontractor to NUI, Galway) permitted the development of strong links with the research groups leading adaptive optics research in Europe. During this project the impact that physiological and systematic noise have in ocular wavefront sensing was investigated, and a new curvature wavefront sensor for the eye was developed with distinct advantages over conventional methods. The research has led to two publications.  

 

ATRIUM (Department of Health/Health Technology Devices Link scheme) has been central to the establishment of the group as the leading Adaptive Optics research team in the UK. Collaboration with OPTOS, plc has meant that optimisation of traditional adaptive optics techniques for the eye has been taken a long way. A novel optical architecture for adaptive optics in the eye has been developed and a patent will be filed followed by a peer reviewed publication. This set-up is being used in collaboration with Keith Martin, from the Centre for Brain Repair at the University of Cambridge, to study the development of glaucoma at a microscopic level in vivo. 

 

Ocular speckle interferometry (EPSRC-First Grant Scheme): The impact that retinal scattering has on image quality and wavefront sensing has been studied. This project benefited greatly from the SHARP-EYE grant as collaboration with leading groups in the field in Spain (CSIC, Madrid and LOUM, Murcia) provided valuable input. 

 

Academic Fellowship in Bio-photonics for Vision Health Care (RCUK): This fellowship permitted pioneering work in aberration dynamics and their statistics and the mechanisms of accommodation, in collaboration with Arden from City University, and helped consolidate a seminal collaboration with Prof Jensen from Imperial College. Thanks to this work the Centre has the only adaptive optics scanning laser ophthalmoscope for very high-resolution retinal imaging in the UK. 

 

5. Staffing Policy

Research at City is led by a Pro-Vice-Chancellor for Research and by an Associate Dean for Research in each School.  Optometry is submitting 95% of Academic Staff to RAE2008. This high participation rate is evidence of the supportive research environment, which includes light initial teaching loads for starters, a Mentoring system by the Group Heads, the appointment of University Research Fellows from the Strategic Development Fund, and the ready availability of study and sabbatical leave. The Department recognises its responsibility for succession planning, demonstrated by its recent appointments of Gruppetta (RCUK Research Fellow), Subramanian (Lecturer), Kotecha (Lecturer), Rodriguez-Carmona (University Research Fellow [URF]), Conway (URF), Benavente-Perez (URF); Rauscher (MSc Director) and Stewart (Department of Health Research Fellow). All are expected to be offered permanent Academic positions in the Department when their Fellowships/Probationary Periods end. Mid-career appointees are Hosking, Crabb and Mosely.  

 

5.1 Early Career Researchers.  These are highlighted above with details of each included in RA5b entries.

 

5.2 Category C Staff

The invaluable contribution made by Category C staff is evident in their joint publications with Category A members (see RA2) and from descriptions of individual laboratories. Notably, close collaborations involve Professors Garway-Heath (Crabb and Kotecha) and Viswanathan (Crabb); Sloper (Morgan); Plant (Barbur); and Evans (Edgar and Thomson).

 

6. Outputs

The outputs listed in RA2 are peer-reviewed Research Journal Articles and prestigious reviews, with one notable exception. In the case of Thomson (Head of Department) we have chosen to list 3 outputs consisting of testing software (http://www.thomson-software-solutions.com/), rather than papers selected from his other publications, because we consider them to be of exceptionally high profile (see 4.1.4 Visual Assessment Lab).  

 

7. Research Strategy  

The Centre sees its role as that of carrying out high-quality basic and applied research in the service of Health and UK Industry. Our links and collaboration with both hospitals and industry are a model for this process. The investment and strategic expansion that we have embarked upon are intended to meet the challenges of maintaining and advancing the Centre’s international standing in clinical and applied research. The rapid progress in technological advances in relation to visual displays, refractive surgery, retinal and brain imaging and genetics in relation to vision have created significant opportunities to expand both basic and applied vision research. Equally exciting opportunities exist in the detection and management of disease, notably glaucoma, and in the rapid expansion of clinical optometry into areas such as therapeutics, primary care research, and evidence-based evaluation of clinical activities. We wish to build upon our strengths and interests by pursuing further research in these areas. Increased support for basic science investigations will be sought from Research Councils and the Wellcome Trust. Care will be taken to ensure that industrial projects also include adequate support for some level of basic research, when this is needed. Multidisciplinary patient-based research will be enhanced by employing the latest visual psychophysics, retinal imaging and genetics research techniques in collaboration with clinical colleagues both in UK and abroad. We will continue to develop our already extensive research links with Moorfields. An effort will be made to expand the current level of international collaboration through joint projects that affect us all. A good example of this is the work the Centre has undertaken in collaboration with the CIE (Commission Internationale de L'éclairage) and ICAO (International Civil Aviation Organisation) to establish appropriate standards for assessing colour deficiency and for setting minimum vision requirements within professional environments (that are agreed internationally). 

    

 

8. Evidence of Esteem

Evidence for prestige is spread widely and ranges from impact on the optometric community (as illustrated by the work of the Visual Assessment Laboratory) and the development of world-wide standards for minimum vision requirements in aviation (see the Colour Laboratory) to significant contributions to international vision organisations such as the Child Vision Research and the International Colour Vision Societies. The following is a summary of some of these activities that provide evidence of esteem and strong international interest in the work of the Centre:

 

Contributions to Public Understanding of Science

Centre members have delivered public lectures at organisations including the Hay Book Festival, the BAAS, The Hayward Gallery, the British Society of Architects (Morgan) and the Royal Television Society (Barbur). Other activities include appearances on BBC radio, talking on diverse topics such as bull fighting, giant squid, colour vision defects, accommodation in ducks, lights in the depths off California, the BBC Radio 4 ‘Nature’ series ‘Life in the trenches’ (Douglas) and the production of documentaries on the pupil and the effects carotenoids and diet on vision (Barbur). ‘The Space Between Our Ears’ (Morgan) won the Wellcome Trust Popular Science Book Prize.

 

 

Medals and awards

The British Medical Council Silver Award; The H. Lewis Award (Barbur); The Doyne Medal and the Gold Medal of Australian for Ophthalmology award (Arden); Max Planck Prize for Basic Research and Heisenberg Award (Fahle); The 2006 City University Staff Prize Award for Excellence in Research (Solomon); “Innovation in Optics” award for optometric software from the Spectacle Makers Company (Thomson).  

 

 

Distinguished lectures / keynote presentations / invited addresses

The Royal College of Ophthalmologists Bowman Lecture for 2006 UCSF; Caygill Lecture for 2005, Department of Ophthalmology, University of California; invited lecture to British and Irish Orthoptic Society Congress, 2007; invited keynote speaker: 2nd Rotterdam Amblyopia Meeting 2007 (Fielder); invited lecture at the World Congress in Glaucoma meeting (Singapore, 2007) (Garway-Heath);  invited lecture at Oxford Ophthalmological Congress, 2006 (Crabb). The 2002 ‘Perception’ lecture to The European Conference of Visual Perception, invited lecture to the 2007 Bristol Conference on Vision and Action; The 2004 Stiles Lecture  (Morgan); invited lectures to JOSA Fall Vision meeting (2005), INOS (2006), UK displays society (2006), Aegean summer school, 2004 (Barbur); invited lectures at CLEO-Europe (2003), Aegean summer school, 2004, 2005 (Diaz-Santana).

 

 

External Appointments and Academies

Election to the Royal Society (Morgan); Member of MRC college of experts (Barbur, Fielder); Trustee of the European Ophthalmological Society, Action for Blind People, and Senior Scientific Adviser and grant awarding panel chairman for Fight for Sight (Fielder); Chair of Academic Committee of the College of Optometrists and Member of Research Committee (Lawrenson); 

Member of the international ARVO meeting committee (Garway-Heath) and of the UK Government Advisory Panel on Driving and Visual Disorders (Viswanathan); Member of grant awarding committees of the Wellcome Trust, the EPSRC and the Royal Society (Morgan); JOSA Vice-Chair for the Clinical Vision Division and JOSA member on the Tillyer Award Nomination Committee (Barbur); Advisor on a variety of government policy initiatives in primary eye care to the Department of Health, General Optical Council, and National Prescribing Centre (Lawrenson). 

 

 

Impact of research on government and national / international practice development

         Report on National Survey of Therapeutic Practice was presented as evidence to the Commission for Human Medicines, informing the decision to extend independent prescribing responsibilities to optometrists (Lawrenson).

         Report on Medical Aspects of Fitness to Drive was submitted to DfT and will inform the decision-making process in relation to the visual fields driving standards for UK (Barbur, Edgar, Crabb, Plant and Rauscher with input from Aston, Bradford, Nottingham and UCL). 

         Contribution to CIE work on “Limits of normal colour vision and methods for assessing loss of chromatic sensitivity” (Barbur).

         Work with ICAO, CAA and FAA to establish minimum, internationally agreed requirements for colour vision within the aviation environment (Barbur, Rodriguez-Carmona).

 

 

Editorial activities

Editorial board members for: Perception, Vision Research, Journal of Vision and Journal of Theoretical Biology (Morgan); Perception and Psychophysics (Solomon); Visual Neuroscience (Douglas); OPO (Barbur, Evans,Fielder); Current Eye Research, Eye (Garway-Heath); Optometry in Practice (Edgar); British Journal of Visual Impairment, British & Irish Orthoptic Journal (Fielder, Moseley).  

 

 

Tangible indicators of esteem from the user community

         Optometric software developed by Thomson is used in a number of hospitals and universities and by over 4000 optometrists worldwide. 

         The CAD test designed to detect and quantify colour vision losses is being considered by ICAO as a standard for aviation. 

         Protocols developed by the Colour Vision laboratory are currently used to assess pilots, fire fighters, train drivers and all applicants to the armed services who had corneal refractive surgery. 

 

 

Evidence of national and international collaborations

Much of the basic science knowledge acquired during the last six years and its translation into eye care and clinical applications has been achieved in collaboration with organisations in the UK and abroad. Joint research income and publications have emerged from this collaboration which included the following organisations:

Moorfields, Institute of Ophthalmology, National Hospital and Bascom Palmer Institute (USA), UCL functional Imaging Laboratory (Wellcome), Gatsby Centre for Computational Neuroscience (BBRSC), Department of Cognitive Science, UC Irvine (BBSRC), National University of Ireland (Galway), Helsinki University of Technology, University of Tübingen Eye Centre and Bremen Institute for Brain Research.