How about adding letters in the icons?
Giant’s Blood could be GB for example.
Another thing I always found hard to spot is the difference between active buffs and ones that are recharging and have an icon, like Deadly Aim.
You can see the red background if you look closely, but in combat it’d be nice if you could immediately tell if it’s on or off.
Maybe it’s an idea to just put an X through the icon when it’s on CD, like when you don’t meet the requirements to wear an item.