Low-cost camera made to prevent diabetic vision loss claims implications for microscopy, OCT

MARCH 18, 2009--Screening for early diagnosis of diabetic retinopathy--the world's leading cause of vision loss and blindness in adult workers--could be expanded to millions of underserved people if a more affordable diagnostic camera were available, says Dr. Ann Elsner, director of Indiana University's (Bloomington, IN) Borish Center for Ophthalmic Research. The device she and her team are developing, a laser scanning digital camera, could be a trend-setter, making eye-care screenings more affordable and available for diabetes patients in a field where the driving forces have traditionally led to more features at higher costs. The patented design has been licensed to Elsner's start-up company, Aeon Imaging, LLC.

Elsner, along with IU senior scientist Benno Petrig and optical engineer Matt Muller have already made significant headway in developing a camera that is both technically user-friendly and cheaper to build than current models. Specifically, they were able to advance the optical design and the illumination and detection technologies. Implementing an affordable precision motor remained a challenge until earlier this month, when the Indiana Clinical and Translational Sciences Initiative said it would provide a $75,000 grant through a collaboration with a Purdue University mechanical engineer, Henry Zhang, who has experience creating small, precise motors.

The new camera uses near infrared light, high-contrast laser scanning, a confocal aperture that minimizes light scatter in the eye and inexpensive two-dimensional sensors to obtain a high-contrast, black-and-white image of the optic nerve head, which is the gateway for blood vessels into the eye. Veins and arteries carry blood and oxygen to different regions of the retina and diabetic retinopathy can cause hemorrhaging that allows blood to leak onto the retina and cause blind spots.

Early detection allows for peripheral, less-damaging blind spots to be treated prior to more-damaging impairment of the macula, where central vision is based. The device also images the macula, and the smaller blood vessels that nourish it.

"No matter how high the resolution of an image is, you can miss the pathology for diabetic retinopathy if the contrast isn't there," Elsner explained. "By doing more scans with better contrast, we not only improve our ability to affect a large proportion of people who are unaware they have diabetes, but we also improve diagnostics for that demographic of the population that have small pupils or that have dark eyes -- attributes that make detection more difficult."

In addition to developing a tool that will cost about one-fourth the cost of its current counterparts and also improve diagnostics, another benefit is that dilation of pupils in patients would no longer be required because infrared light, which does not affect the light-sensitive pupil, is used during the scanning process.

The camera is also designed to be easy to use so that unskilled operators in remote locations can acquire the image of the eye and then transmit it to a professional for evaluation, a system anticipated to aid in bringing eye screening to underserved populations.

IU's Research and Technology Corp. has been working with Aeon Imaging's commercialization and business plans and on prosecution of the company's patent applications, according to Bill Brizzard, director of Technology Transfer for IU Research and Technology Corp. He said IURTC not only supports development of the device, but also the philosophy behind its potential use.

"We believe Aeon's mission to provide low-cost eye care to underserved populations reflects positively on IU and capitalizes on the strengths of the IU School of Optometry," Brizzard said. "IURTC is actively seeking potential business partners for Aeon, and we're helping to facilitate Aeon's collaborations with other institutions such as Purdue."

The researchers also believe there will be broader health care implications once the camera is completed, because cost savings could be realized from any biomedical imaging device that uses the novel scanning-and-detection system. Advanced optical imagers used in confocal microscopy, two-photon microscopy, optical coherence tomography and other biomedical imaging applications could all become more affordable once the device is perfected, they said.

Since 2006, Elsner and Aeon Imaging have received more than $635,000 in support from the National Institutes of Health, along with $100,000 from the Indiana Economic Development Corp., to develop the new imaging device.

Diabetic retinopathy is the leading cause of vision loss in working adults around the world. In the U.S., diabetes rates have doubled in the past 10 years to more than 24 million; three-quarters of those who have the disease more than 10 years will have some form of diabetic retinopathy.

More information:
See the story IU researcher's company, new device looks to prevent vision loss in diabetes patients, on the Indiana University website.

Posted by Barbara G. Goode, barbarag@pennwell.com, for BioOptics World.

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