Optical coherence tomography in infants and children: A normative database and assessment of clinical use

Lead Research Organisation: University of Leicester
Department Name: Cardiovascular Sciences

Abstract

Our aim is to make optical coherence tomography (OCT) accessible for clinical use in infants and young children.
Optical coherence tomography provides scans of the back of the eye (the retina and optic nerve) in living people with the precision of a microscope. This has contributed, over the last 15 years, to significant progress in the diagnosis and treatment of retina and optic nerve diseases in adults. However, infants and young children have been deprived of the diagnostic progress as they cannot cooperate with conventional OCT.
The normal optic nerve and retina are not mature at birth and undergo significant changes until adulthood. However, to date little is known about the normal postnatal development. There are no normative OCT data for different ages and therefore OCT can currently not be used for children clinically.
The advent of a new hand-held OCT allows scanning of infants, small children and people who cannot cooperate. However, to date there is little knowledge about its clinical use.
Over the last three years, we have used the hand-held OCT successfully to characterise normal retina development and to compare retinal developmental in disease. This allows us to now use OCT for retinal diagnosis in children in Leicester ophthalmology clinics.
Our objective is to improve OCT acquisition methods for children, to visualise for the first time the development of the optic nerve from birth to 6 years of age using the hand-held OCT device and to establish normative data of the retina and optic nerve in 12 different age groups (90 children per group). OCTs will be performed in a large amount of children with normal eyes to establish normative data. We will also scan the optic nerve in various optic nerve diseases in childhood and investigate to what extent OCT can help with diagnosis. For example, we will look at children who have tumours of the optic nerve (optic nerve glioma) or childhood glaucoma (high pressure in the eye with damage to the optic nerve). We will investigate whether vision can be predicted from OCT scans of various optic nerve diseases. We will investigate to what extent the OCT can help to improve monitoring of childhood glaucoma and optic nerve tumours and reduce the number of examinations under anaesthesia. We anticipate that this study will also help us to understand mechanisms of optic nerve anomalies.
We are planning to develop automatic computer programmes to analyse the OCT images obtained during scanning. This will make the use of the OCT easy and user-friendly and enable the use in clinics.
Developmental abnormalities of the optic nerve and childhood optic nerve diseases, such as glaucoma, are leading causes of child blindness. We anticipate that our study will be an important step in validating OCT and making OCT accessible to newborns, infants and young children with optic nerve diseases. The normative database will provide the groundwork for using OCT in children and will be directly available to other OCT users (it will be shared with the OCT Company Bioptigen Inc.). The optimisation of the use of hand-held OCT opens a wide range of settings outside of the traditional ophthalmology or optometry clinics including intraoperative, primary care, developing countries and military medicine.

Technical Summary

Optical coherence tomography (OCT) provides high-resolution scans of the retina and optic nerve and has contributed to significant progress in the diagnosis and treatment of retinal and optic nerve diseases in adults. However, infants and young children have been deprived of the diagnostic progress as they cannot cooperate with conventional OCT.
The advent of a new hand-held OCT (HH-OCT) allows scanning infants and small children. Over the last three years, we have used the HH-OCT successfully to establish progression of normal human retinal development and develop a diagnostic algorithm for nystagmus. However the lack of normative data and knowledge about presentation of diseases prevents wider clinical use. The normal optic nerve is not mature at birth and is likely to undergo significant changes until adulthood. However, to date little is known about the normal postnatal development. Developmental abnormalities of the optic nerve and childhood optic nerve diseases such as glaucoma are leading causes of child blindness.
First, we plan to optimise and acquisition protocols to enable fast and reliable volumetric scans. We then aim to establish a normative database for optic nerve and retina with OCT in infants and children. We will investigate to what extent OCT can help in improving diagnosis of childhood optic nerve disease. We also will explore whether visual acuity can be predicted from OCT scans. We will investigate to what extent OCT can help improve monitoring of childhood glaucoma and optic nerve glioma and reduce the number of examinations under anaesthesia.
Software for automatic segmentation will be developed for easier and faster interpretation of OCT scans.
We anticipate that our study will be an important step in validating and providing access of OCT in young children with optic nerve diseases. The normative database will provide the groundwork for using OCT in young children.

Planned Impact

The main beneficiaries from the proposed research will be:
Parents and children through:
- enabling access to optical coherence tomography (OCT) for infants and small children who have suspected optic nerve anomalies. Currently, without normative data for different age groups OCT cannot be used clinically.
- earlier diagnosis will accelerate and facilitate appropriate care pathways for infants and small children, providing them with a more objective and targeting management plan.
- avoiding invasive and costly tests under general anaesthetic for ambiguous diagnoses.
- providing parents with an indication of possible prediction of visual acuity.
- enhanced health and quality of life.

Clinicians, such as ophthalmologists, paediatricians, neurologists, opticians and orthoptists may benefit from:
- a new and better diagnostic tool which can be used in the clinic setting.
- increased knowledge of the diagnosis and monitoring of several childhood diseases. For example in glaucoma and optic pathway glioma OCT may become the primary method by which this diseases are monitored. It is likely that OCT will help to identify specific retinal and optic nerve changes which can help to recognise genetic syndromes or inform genetic treatment.
-automatic segmentation will improve diagnosis and has a large potential also to facilitate adult OCT

Academics through:
- knowledge of normal development of ocular structures.
- study of mechanisms of disease in a novel way and identification of new therapeutic targets.
- Easier analysis of OCT scans with new segmentation software.

Paediatric ophthalmology clinics in the NHS and worldwide both in terms of time and cost through increased effectiveness and minimisation of resources.

The Royal College of Ophthalmologists, the NHS, NICE and other health policy makers by updating or developing guidelines to improve the care of infants and children.

Industry by:
- Increased use and production of hand-held OCTs due to increased applications and availability of normative data for the first time. This is likely to increase quality and reduce costs of hand-held OCTs.
- Easier and faster use of OCT analysis due to new segmentation software will also be applicable to adult OCT machines.
- Commercialisation of the hand-held OCT by Bioptigen Inc. (the company producing this device) for clinical use.
A successful outcome will also improve the likelihood of relevant medical charities to raise funds for similar research.

The optimisation of the use of hand-held OCT opens a wide range of settings outside of the traditional ophthalmology or optometry clinics including intraoperative, primary care, developing countries and military medicine.

Our proposed project is in line with priority areas 2, 4, 5 and 6 from Fight for Sight research priorities (http://fightforsight.org.uk/research-overview) as well as disease specific priorities (Childhood onset eye disorders, priorities 2, 4, 5, 6; glaucoma priorities 3, 6; neuro-ophthalmology, priority 6 and refractive errors and ocular motility, priority 2) (http://fightforsight.org.uk/tl_files/Documents/Sight-Loss-PSP/SLV-PSP_Final_Report_WEB.pdf). These priorities have been set by consultation with patients and clinicians.

Publications

10 25 50
 
Title Images of research Exhibition at University of Leicester, 2017 
Description Images of Research is a local competition for staff and students to display the breadth and quality of their research in a single photograph. Aarti's image was shortlisted for exhibition allowing her to communicate important aspects of her work to members of the university and the public 
Type Of Art Image 
Year Produced 2017 
Impact The exhibition raised interest from new audiences within the university and public to my research. The image chosen for display highlighted important aspects of the project - the difficulties examining very young children, close relationships between members of staff and the use of new technology 
URL http://www2.le.ac.uk/institution/researchimages/gallery
 
Description Live Clinical Symposium: Paediatric Optical Coherence Tomography
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
URL https://www.leica-microsystems.com/science-lab/hand-held-oct-clinical-research-applications/
 
Description iii Leicester OCT coourse
Geographic Reach Europe 
Policy Influence Type Influenced training of practitioners or researchers
Impact Several paediatric ophthalmologists have decided to acquire hand-held OCT instrument which will make changes in their clinical practice.
 
Description Early Recognition of Raised Intracranial Pressure in Craniosynostosis using Handheld Optical Coherence Tomography
Amount £345,379 (GBP)
Organisation National Institutes of Health (NIH) 
Sector Public
Country United States
Start 10/2020 
End 09/2023
 
Description • A new approach to optical coherence tomography image analysis using machine learning (PI Bai Li - University of Nottingham)
Amount £185,789 (GBP)
Funding ID BB/P027105/1 
Organisation Biotechnology and Biological Sciences Research Council (BBSRC) 
Sector Public
Country United Kingdom
Start 09/2017 
End 02/2019
 
Title FDA approved dataset for retinal and optic nerve development - ongoing 
Description A highly curated dataset has been developed by the Ulverscroft Eye Unit for clinical and research use. This is currently undergoing the process for FDA approval 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2021 
Provided To Others? No  
Impact In progress 
 
Title Premature Infant Retinal Development 
Description As part of the current award Dr Aarti Patel is collecting retinal images of infants born prematurely. To my knowledge it is the largest collection in the world and will provide very useful information for current and future clinical and research work. 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact Data generated will be published to reach a wide international clinical audience once complete. 
 
Title normative database for OCT parameters for children 
Description We have collected over 1000 OCTs of retinae and optic nerves of children for a large normative database 
Type Of Material Database/Collection of data 
Year Produced 2019 
Provided To Others? No  
Impact We have collected the database and are now in the process to analyze and publish normative data Normative data have been published partially for normal retina and optic nerve development 
 
Description Artificial Intelligence in Ophthalmology with Leica Microsystems 
Organisation Leica Microsystems GmbH
Country Germany 
Sector Private 
PI Contribution Application of Artificial Intelligence in Paediatric Ophthalmology we established a collaboration with one of the leading OCT handheld manufacturer - Leica Microsystems. We have been collecting OCT data to develop an AI software for automated classification of scans.
Collaborator Contribution Leica Microsystems have been providing an advisory/mentorship role. They have also provided technical assistance and released a prototype software for our use. This provides us access to the encrypted files used on their OCT technology
Impact Main output: Novel AI algorithm Multi-disciplinary - with the School of Informatics (University of Leicester, UK), Machine Learning Lab (IIIT, Hyderabad, India), Ophthalmology (University of Leicester, UK). Additional Outputs: Title: Using Artificial Intelligence to Distinguish Between Normal and Abnormal Development of the Fovea Conference: British Congress of Optometry and Visual Science (BCOVS) Date: 07/09/2020 Prize: Best Presentation (Miss H Kuht) Title: Using Artificial Intelligence (AI) to Differentiate between Normal and Abnormal Retinal Development Conference: Kettering Eye Meeting Date: 11/09/2020 Title: Using Artificial Intelligence (AI) to Differentiate between Normal and Abnormal Retinal Development. Conference: Midlands Ophthalmological Society Date: 02/10/2020 Prize: Best Academic Presentation Prize (Dr M Thomas) Title: Using Artificial Intelligence to Differentiate between Normal and Abnormal Retinal Development Conference: European Days in Albinism Date: 4-7/11/2020
Start Year 2018
 
Description Changes of retinal layers in Schizophrenia 
Organisation University Hospitals of Leicester NHS Trust
Country United Kingdom 
Sector Academic/University 
PI Contribution Initiate collaboration, research set up, supervision, ophthalmic examination, OCT acquisition and analysis, manuscript writing, statistics
Collaborator Contribution Patient recruitment and psychiatric examination of patients, manuscript revision
Impact Retinal Layer Abnormalities as Biomarkers of Schizophrenia. Samani NN, Proudlock FA, Siram V, Suraweera C, Hutchinson C, Nelson CP, Al-Uzri M, Gottlob I. Schizophr Bull. 2017 Dec 19. doi: 10.1093/schbul/sbx130. [Epub ahead of print]
Start Year 2016
 
Description Clinical teaching on the Use of Hand-held Optical Coherence Tomography 
Organisation Leica Microsystems GmbH
Country Germany 
Sector Private 
PI Contribution Several members of the team including Frank Proudlock, Mervyn Thomas and Zhanhan Tu have collaborated with Leica Microsystems to generate a live clinical symposium on the use of hand-held optical coherence tomography.
Collaborator Contribution The session was hosted by Leica Microsystems
Impact Attendance of this session was over 200 participants with representatives from all over the globe. The session was useful in informing clinicians on the applications of hand-held optical coherence tomography in the clinic and practical ways of using this technique.
Start Year 2020
 
Description Collaboration with Birmingham Children's Hospital 
Organisation Birmingham Children's Hospital
Country United Kingdom 
Sector Hospitals 
PI Contribution We have contacted the Birmingham team and planned to recruit patients from their clinics. We have developed specific techniques to acquire and analyse of anterior and posterior hand-held OCT from these young children with complex problems.
Collaborator Contribution The partners examine very complex patients in clinic such as paediatric glaucoma, craniosynostosis, retinoblastoma, rare retinal and optic nerve diseases and phenotypr these patients.
Impact Detection and characterisation of optic nerve and retinal changes in primary congenital glaucoma using hand-held optical coherence tomography. Pilat AV, Shah S, Sheth V, Purohit R, Proudlock FA, Abbott J, Gottlob I. BMJ Open Ophthalmol. 2019 Jun 24;4(1):e000194. doi: 10.1136/bmjophth-2018-000194. eCollection 2019. PMID: 31321308 Free PMC Article Similar articles
Start Year 2016
 
Description Collaboration with Queen Elizabeth Hospital, Blantyre, Malawi 
Organisation Queen Elizabeth Central Hospital, Malawi
Country Malawi 
Sector Hospitals 
PI Contribution We have done preliminary hand-held OCT scanning in patients with cerebral malaria and malaria retinopathy on admission in the acute stage. We have determined specific signs for malarial retinopathy. We also have obtained long-term follow-up. Comparison between OCT parameters, clinical presentation and MRI are being made.
Collaborator Contribution Characterisation of patients. Facilitating the study
Impact Hand-held Optical Coherence Tomography - A New Biomarker of Brain Swelling in Cerebral Malaria OPEN ACCESS Zhanhan Tu; Viral Sheth; Jack Gormley; Chatonda Manda; Frank A Proudlock; Karl Seydel; Terrie Taylor; Simon P Harding; Irene Gottlob Invest. Ophthalmol. Vis. Sci.. 2018; 59(9):612. doi: https://doi.org/
Start Year 2016
 
Description Collaboration with the University of Bristol 
Organisation University of Bristol
Country United Kingdom 
Sector Academic/University 
PI Contribution e established collaboration to increase the collection of normative data. We provided collaborators in Bristol with know how about the hand-held OCT
Collaborator Contribution Recruitment of normal subjects for OCT scanning
Impact in preparation
Start Year 2017
 
Description Use of hand-held OCT in children with malaria retinopathy 
Organisation Wellcome Trust
Department Malawi-Liverpool Wellcome Trust Clinical Research Programme
Country Malawi 
Sector Academic/University 
PI Contribution Expertise in hand-held OCT, equipment (hand-held OCT has been transported to Malawi and is still there), lead by our team to collect data. We have examined for the first time children with cerebral malaria using hand-held OCT in Malawi to investigate if specific retinopathy changes can predict course of disease and to what extend OCT can contribute to characterise the retinal changes at high resolution. We have characterised the retinal changes on OCT and compared them with fundus pictures, fluorescein angiography and histology. We have looked at optic nerve changes and correlated swelling to opening pressure at lumbar puncture and found correlation. Publication is in preparation
Collaborator Contribution We have examined for the first time children with cerebral malaria using hand-held OCT in Malawi to investigate if specific retinopathy changes can predict course of disease and to what extend OCT can contribute to characterise the retinal changes at high resolution. We have characterised the retinal changes on OCT and compared them with fundus pictures, fluorescein angiography and histology. We have looked at optic nerve changes and correlated swelling to opening pressure at lumbar puncture and found correlation. Publication is in preparation. Our partners have done treatment and all paediatric examinations.
Impact http://ARVO Annual Meeting Abstract June 2017 New insights into malaria retinopathy using optical coherence tomography OPEN ACCESS Jack Gormley; Zhanhan Tu; Viral Sheth; Frank A Proudlock; Karl Seydel; Terrie Taylor; Gerald Msukwa; Nicholas V Beare; Simon P Harding; Irene Gottlob Invest. Ophthalmol. Vis. Sci.. 2017; 58(8):5134. doi: Subclinical changes on hand-held optical coherence tomography in apparently malaria retinopathy-negative patients with cerebral malaria OPEN ACCESS Zhanhan Tu; Jack Gormley; Viral Sheth; Frank A Proudlock; Karl Seydel; Terrie Taylor; Gerald Msukwa; Nicholas V. Beare; Simon P Harding; Irene Gottlob Invest. Ophthalmol. Vis. Sci.. 2017; 58(8):5135. doi:
Start Year 2016
 
Title Development of an FDA Approved Normative Paediatric Clinical Dataset to Improve the Diagnosis of Eye Diseases in Children 
Description At the present the normative dataset in being developed in collaboration between the University of Leicester and Translational Imaging Innovations (https://tiinnovations.com/, USA), to gain approval for use as a clinical diagnostic device by gaining FDA approval of the dataset. To accomplish the dataset is undergoing a series of validation steps as well as clean up and sorting of the data. 
Type Diagnostic Tool - Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2021
Development Status Under active development/distribution
Impact As this normative dataset has wide applicability to many paediatric eye diseases the potential benefits of this dataset are far reaching. 
 
Description ImageJ macro to analyse manually a b-scan of optic nerve head structure. Specifically for 8x12 protocol used by Patel et al., 2016 (10.1016/j.ophtha.2016.06.057)Requires:1. ABSnake plugin2. Leica ImageJ plugin to read data3. Set of images to show location of segmented layers 
Type Of Technology Software 
Year Produced 2022 
Open Source License? Yes  
URL https://leicester.figshare.com/articles/software/Leica_ONH_analysis_program_8x12mm_protocol_/1946485...
 
Description ImageJ macro to analyse manually a b-scan of optic nerve head structure. Specifically for 8x12 protocol used by Patel et al., 2016 (10.1016/j.ophtha.2016.06.057)Requires:1. ABSnake plugin2. Leica ImageJ plugin to read data3. Set of images to show location of segmented layers 
Type Of Technology Software 
Year Produced 2022 
Open Source License? Yes  
URL https://leicester.figshare.com/articles/software/Leica_ONH_analysis_program_8x12mm_protocol_/1946485...
 
Description "Big Bang" Science and Technology fair at Leicester Grammar School 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact A visit with demonstating the Hand-hel OCT and explaining anatomy and physiology of the eye and research popportunities
Year(s) Of Engagement Activity 2019
 
Description A talk or presentation - Participation in 5th European Days of Albinism (EDA) for people with albinism and researchers 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This is the largest albinism patient and researcher meeting which was held virtually this year (2020). The research group presented a range of different talks including (related to this award):
1. Phenotypic Characteristics as a Diagnostic Tool for Albinism: Sensitivity and Specificity Analysis
2. Phenotypical characteristics in albinism carriers
3. Using artificial intelligence to distinguish between normal and abnormal retinal development
This raised interesting discussion about diagnostic criteria and the need for the development of consensus guidelines.
Year(s) Of Engagement Activity 2020
URL http://5eda.albinism.eu/
 
Description American Nystagmus Network Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact I gave a presentation on the effect of nystagmus (in Washington DC, USA) on vision for daily living mainly to people with nystagmus and their health care professionals
Year(s) Of Engagement Activity 2019
URL http://nystagmus.org/new/conferences/previous-conferences/2019-conference/
 
Description Anterior Optical Coherence Tomography in Children with Primary Congenital Glaucoma< ARVO, May 2017, Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Attendance of American Nystagmus Network patient and researcher conference, New Orleans, USA 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact The purpose of the visit was to be involved in a combined researcher and patient meeting to share with sufferers of nystagmus some of the research we have been doing and to offer expert opinions. The visit also enabled researchers to hear from patients about what really impacts upon their life as individuals with nystagmus and express their views concerning where further research needs to be carried out.
Year(s) Of Engagement Activity 2015
URL http://nystagmus.org/new/conferences/previous-conferences/2015-conference/
 
Description Attendance of European Days of Albinism (EDA) patient and researcher conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact The European Days of Albinism (EDA) are organised to bring together researchers and patients under the one roof to share information and establish links. The meeting involves research talks which are then summarised to the patients which attend from all over the world. The meeting also provides an opportunity for individuals with albinism to share their experienced and to hear about difficulties encountered from individuals across the globe. This includes those who suffer persecution as a result of having albinism. The meeting offers education to researchers and patients alike.
Year(s) Of Engagement Activity 2014,2016
URL http://www.ledha.it/allegati/LED_t2_notizie_allegati/2171/FILE_Allegato_Albinism_DEF_19022016.pdf
 
Description BIPOSA prize 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This prestigious price was won by a trainee in our team for presenting "The prediction of later visual acuity in nystagmus from OCT early in life)
Year(s) Of Engagement Activity 2009
URL https://www2.le.ac.uk/colleges/medbiopsych/research/clinical-academic-training/trainee-achievements/...
 
Description Big Bang Science air - Leicester Grammar School 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact We had a stand at the Science Day of Leicester Grammar School about our research and the connection of the eye and brain. We also offered a retinal scan with the handheld OCT to students. There was large interest with queues forming in front of our station. After the event we had many emails and phone calls to enquire study collaborations by parents in the school who are medical doctors or scientists. Families who could not be scanned on the day are keen to come in our department to help with normative data.
Year(s) Of Engagement Activity 2017
 
Description Brain Awareness Day 2019 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Involvement in demonstration of hand-held optical coherence tomography to schools and members of the public attending the Brain Awareness Day. Poster used to describe amblyopia research and engage the public.
Year(s) Of Engagement Activity 2013,2014,2015,2016,2017,2018,2019
URL https://www2.le.ac.uk/departments/npb/news-1/baw
 
Description Brain Awareness Day, University of Leicester, March 2017 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Research made lay for the general public, increase awareness in Brain/eye research
Year(s) Of Engagement Activity 2017
 
Description Brain awareness Day University of Leicester 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact The demonstration was called: "The developing eye - using light to explore the retina". It was given at the Brain awareness day and there was one session for school children and one for the general public. The hand-held OCT was used to demonstrate how the retinal layers and the optic nerve can be visualised. Thee were also short talks to explain how the OCT can be used for patients and for observing normal retinal / optic nerve development.
Year(s) Of Engagement Activity 2016
 
Description Brain awareness day 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Demonstration of the Hand-Held OCT to the public and school classes
Year(s) Of Engagement Activity 2019
 
Description British and Irish Paediatric Ophthalmology and Strabismus (BIPOSA) society meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of work at the largest paediatric ophthalmology meeting in UK (October 2-4, 2019). This raised significant interest and engagement from other healthcare practitioners from across UK and validation of the need for this research. Team member (HK), received best oral presentation prize.
Year(s) Of Engagement Activity 2019
URL https://www.biposa.org/
 
Description Can grading foveal hypoplasia in infants using handheld optical coherence tomography predict future visual acuity? A longitudinal cohort study, ARVO May 2017, Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Careers Fair at Leicester Grammar School 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Aarti was invited to participate in a local careers fair for senior school students. During the event she spoke about a career in academic medicine and has subsequently helped students organise work experience within the department and guided them through the medical school application process.
Year(s) Of Engagement Activity 2017
 
Description Co-organisation of ARVO Annual Meeting and Lecture Baltimore 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Comparison of retinal development in idiopathic infantile nystagmus and nystagmus associated with albinism, PAX6 mutations and achromatopsia, ARVO May 2017, Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Contribution of Central and Peripheral Visual Cues to Postural Control in Infantile Nystagmus, ARVO, May 2017, Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description High School Vision Program (Diversity Initiatives and Committee) event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Schools
Results and Impact School children were invited to attend a special event at The Association for Vision and Ophthalmology Annual Meeting in Baltimore May 2017. Aarti volunteered to help giving individuals a tour of the event and discussing her own and other research activities. She looks forward to taking part again in 2018.
Year(s) Of Engagement Activity 2017
 
Description International OCT course in Leicester 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a 2 day OCT course , the first day was hands on with practical teaching to enable other practitioners to acquire OCT images. Patients (children) attended to allow to develop practical skills. The second day included dissemination of the latest research results and how they can be applied in clinic.
Year(s) Of Engagement Activity 2017
URL https://www2.le.ac.uk/departments/npb/news-1/oct-course
 
Description Interview for national optometry magazine 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Approached to be interviewed for an optometry magazine (Optometry Today) to inform the profession of our proposed innovation and the potential impact. This was well received and subsequently had various practitioners requesting more information about our research
Year(s) Of Engagement Activity 2020
URL https://www.aop.org.uk/ot/in-practice/practitioner-stories/2020/05/09/we-are-beginning-to-appreciate...
 
Description Invited Keynote talk 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact Invited Keynote (by team member HK) talk for 100% Optical in ExCeL, London (January 25-27, 2020) (100% Optical is the UK's largest optical event, bringing together 9,115 professionals)
Year(s) Of Engagement Activity 2020
 
Description Invited Lecture EUNOS 2017 Budapest 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at EUNOS annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Invited Lecture SOE 2017 Barcelona 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation SOE annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Invited Presentation - Optic Nerve Changes in Children with Primary Congenital Glaucoma, BIPOSA, Hull, 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at BIPOSA meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Invited Presentation - Optic Nerve Head Drusen and IIH, Northampton Eye Meeting, Northampton, 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at Northampton eye meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Invited Presentation - Optic Neuropathy in Children with Primary Glaucoma, ARVO 2017 Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Invited lecture - European Neuro-ophthalmology Society Porto 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited lecture on normal development of retina and pathology investigated by hand-held OCT
Year(s) Of Engagement Activity 2019
 
Description Invited lecture European Society of Ophthalmology 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited lecture on normal development of retina and pathology investigated by hand-held OCT
Year(s) Of Engagement Activity 2019
 
Description Invited lecture European Strabological Association 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited lecture on normal development of retina and pathology investigated by hand-held OCT
Year(s) Of Engagement Activity 2019
 
Description Invited public lecture for Brain awareness week at the University of Leicester 2019 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Brain Awareness Week (BAW) is the global campaign to increase public awareness of the progress and benefits of brain research. I was invited to give the public lecture for this event on my research and how it impacts patients. This event was held at the prestigious George Davies Centre, Lancaster Road, on Wednesday, 13th March 2019.

This event was attended by A-level and GCSE students, members of the public, as well as University staff, students, their friends and families. The event attracted more than 200 people. Along with my talk there will was live demonstrations of the research I was involved in and the opportunity to meet current students, researchers and neuroscientists. It raised the awareness of my research and engaged with >100 schools students and members of the general public.
Year(s) Of Engagement Activity 2019
URL https://www2.le.ac.uk/departments/npb/news-1/baw/BAW
 
Description Invited talk or presentation - Scientific Committee meeting - 5th European Days of Albinism (EDA) for people with albinism and researchers 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presented development of international guidelines for the diagnosis and management of albinism to the albinism scientific committee. Other invited members included patient organisations and their respective representatives.
Year(s) Of Engagement Activity 2020
URL http://5eda.albinism.eu/
 
Description Leicester Grammar Visit 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Participation in workshop to Leicester Grammar School which sparked questions and discussions afterward. Aim was to increase awareness about research in Ophthalmology
Year(s) Of Engagement Activity 2017
 
Description Leicester OCT Course Demonstration and Case Report 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation at the Leicester OCT Course
Year(s) Of Engagement Activity 2017
 
Description New insights into malaria retinopathy using optial coherence tomography, ARVO, May 2017, Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Normative Recruitment Presentation at Tongren Eye Hospital 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation on recruitment of patients for OCT testing
Year(s) Of Engagement Activity 2018
 
Description Nursery Visit - Stanhope Nursery, Leicester 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Recruitment for OCT Testing
Year(s) Of Engagement Activity 2017
 
Description Nursery Visit, Play Days Nursery, Leicester 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Recruitment of children for OCT testing for research grant
Year(s) Of Engagement Activity 2017
 
Description Nursery Visit, Willows Pre-School, 2018 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Recruitment of children for OCT testing at Leicestershire nursery
Year(s) Of Engagement Activity 2018
 
Description Nystagmus Network (2019) - Patient and researcher two day workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact This was a workshop and patient outreach event organised by Nystagmus network. This allows researchers and patients/carers to interact and discuss research and patient priorities.
Year(s) Of Engagement Activity 2019
URL https://nystagmusnetwork.org/uk-nystagmus-research-workshop/
 
Description Nystagmus Network UK Research Workshop 2021 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Supporters
Results and Impact This activity was run to update the members of Nystagmus Network UK of the research developments that have taken place in Leicester, UK on nystagmus research. In addition, the update was also given to other university departments who are also carrying out nystagmus research.
Year(s) Of Engagement Activity 2021
 
Description Optic Nerve Head Development of Premature and Full Term infants from Term to Six Years of Age Using Hand-Held Ultra-High Resolution Spectral Domain Coherence Tomography, ARVO, May 2017, Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Organisation of BINOC Conference Rutland 2017 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at BINOC annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Organisation of Paediatric OCT Course Leicester 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at Paediatric OCT Course with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Paediatric OCT Course 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact OCT course in Leicester with international attendance
Year(s) Of Engagement Activity 2017
 
Description Paediatric and World Ophthalmology Registrars Prize 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Paediatric and World Ophthalmology Registrar's Prize
Year(s) Of Engagement Activity 2017
URL https://www2.le.ac.uk/offices/press/press-releases/2017/july/university-of-leicester-researcher-wins...
 
Description Participation in Brain Awareness Day 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Involvement in demonstration of hand-held optical coherence tomography to schools and members of the public attending the Brain Awareness Day. Poster used to describe amblyopia research and engage the public.
Year(s) Of Engagement Activity 2018
URL https://www2.le.ac.uk/departments/npb/news-1/baw
 
Description Participation in Brain Awareness Day 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact Involvement in demonstration of hand-held optical coherence tomography to schools and members of the public attending the Brain Awareness Day.
Year(s) Of Engagement Activity 2015,2016,2017
URL http://www2.le.ac.uk/departments/npb/news-1/baw
 
Description Participation in IV European Days of Albinism (EDA) in Norway (near Oslo) for people with albinism and researchers 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact The European Days of Albinism (EDA) are organised to bring together researchers and patients under the one roof to share information and establish links. The meeting involves research talks which are then summarised to the patients which attend from all over the world. The meeting also provides an opportunity for individuals with albinism to share their experienced and to hear about difficulties encountered from individuals across the globe. This includes those who suffer persecution as a result of having albinism. The meeting offers education to researchers and patients alike.
Year(s) Of Engagement Activity 2018
URL http://4eda.albinism.eu/
 
Description Participation in Wobbly Wednesday 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Wobbly Wednesday is a day run by Nystagmus Network UK to raise public awareness of nystagmus and assist with fund raising.
Year(s) Of Engagement Activity 2014,2015
URL http://nystagmusnetwork.org/fundraise/wobbly-wednesday/
 
Description Patient Public Involvement - questionnaire 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact Aarti has utilised written correspondence to communicate with participants of the study including cards, questionnaires and newsletters. Questionnaires have enabled her to canvass patient opinion of the study. Cards and newsletters have enabled her to maintain relationships with participants and disseminate research findings.
Year(s) Of Engagement Activity 2017,2018
 
Description Patient engegement - Nystagmus Network UK 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Talk at the open day of the Nystagmus Network UK about the use of hand-held OCT in Nystagmus. Discussions with patients and parents
Year(s) Of Engagement Activity 2019
 
Description Postgraduate Research Day, Clinical Characteristics of Albinism Carriers, Leicester, 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Research day for Postgraduate students
Year(s) Of Engagement Activity 2017
 
Description Presentation at The British Congress of Optometry and Visual Science (BCOVS) 2020 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The British Congress of Optometry and Visual Science (BCOVS) is a multi-disciplinary meeting showcasing the work of optometrists, orthoptists, ophthalmologists and vision scientists across the UK, India and Australia. Team member (HK) presented the work: "Development and validation of a deep learning algorithm to differentiate between normal and abnormal retinal development" which sparked a lot of interest and discussion. This work received the best presentation prize.
Year(s) Of Engagement Activity 2020
URL https://bcovs2020.wordpress.com/programme/
 
Description Presentation at the Houses of Parliament - STEM for Britain event (2020) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Early career researcher and team member (HK) was invited to present in the Houses of Parliament during British Science Week at the STEM for Britain event (March 9, 2020). This involved engaging with politicians and discussing the impact and implications of the work "Using Artificial Intelligence to Distinguish Between Normal and Abnormal Development of the Fovea". Broader discussions about how AI would augment clinical practice and its role in healthcare was of much interest for politicians and policymakers.
Year(s) Of Engagement Activity 2020
URL https://stemforbritain.org.uk/
 
Description Reproducibility of measurements of iridocorneal angle in children using hand-held spectral domain optial cohrence tomography, ARVO, May 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Roger Trimble Lecture 2017 Irene Gottlob 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a named lectured for service in Paediatric Ophthalmology at the BIPOSA meeting
Year(s) Of Engagement Activity 2007
URL http://www.biposa.org/trimble-lecturers.html
 
Description School Visit (Leicester Grammar School) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Big Bang Science Fair held by Leicester Grammar School is a one day event showcasing science, technology engineering and maths. Aarti organised attendance and participation of Ulverscroft Eye Unit which involved demonstrating clinical and research aspects of her work,
Year(s) Of Engagement Activity 2017
URL http://www.leicestergrammar.org.uk/Big-Bang
 
Description Subclinical changes on hand-held optical coherence tomography in apparently malaria retinopathy-negative patients with cerebral malaria, ARVO, May 2017, Baltimore USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk/presentation at ARVO annual meeting with questions and discussion
Year(s) Of Engagement Activity 2017
 
Description Third Leicester OCT course 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact OCT course to teach how to use hand-held OCT including hands on course and practical activities.
Year(s) Of Engagement Activity 2016
 
Description University of Alabama Invited talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact An invited lecturer about OCT and other visual deficits in albinism
Year(s) Of Engagement Activity 2018
 
Description Visit to Capitol Hill, Washington DC for ARVO Advocacy Day 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact As part of The Association for Research in Vision and Ophthalmology (ARVO) programming committee I attended an advocacy day to campaign for continued support for vision and eye research from the US government through funding via the Institute of Health (and the National Eye Institute). The ARVO committee wanted to use optical coherence tomography as an example of success leading to improved treatment, diagnosis and ultimately saving money for health services worldwide. I was able to use the research carried out with hand-held optical coherence tomography as funded by the MRC to highlight this point. The congressmen and senators and their office received this information enthusiastically and were particularly interested in its use in child health where it has the potential to improve diagnosis and treatment from birth onwards.
Year(s) Of Engagement Activity 2017
URL http://www.arvo.org/Advocacy_and_Outreach/toolkits/
 
Description invited lecture and discussion - American Nystagmus Network 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact Invited lecture to US Nystagmus Network. Talk and discussions with patients
Year(s) Of Engagement Activity 2019
 
Description science fair 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact We had a stand at the Science Fair of Leicester Grammar School. There have been about 600 students and visitors as well as their parents. We have made the public aware of our research and also recruited study participants. On this day we have recruited 40 children and we have distributed flyers to raise awareness of our study and for further families to participate and to visit us at the University.
Year(s) Of Engagement Activity 2017