A research carried out in two referral centers for covid-19 in Rio de Janeiro (RJ) identified alteration in the retina of patients hospitalized in serious condition. The study occurred in May 2020, in the clinical hospitals Mario Lioni and from Jacarepaguá, and was published in the journalPlos One in December, the same year.
The work was also one of the first to discover retinal damage in critical cases of the disease.It is noteworthy that other Brazilian studies, from the ABC School of Medicine (FAMBC) and the Federal University of São Paulo (Unifesp) , published shortly before, also detected retinal alterations.
Researchers used the smart device Phelcom Eyer to carry out the retinography in 47 eyes of 25 patients. Coupled to a smartphone, the device carries out high-quality fundus exams, in few minutes and without need of pupil dilation.It connects to an online platform, the Eyer Cloud, which allows remote diagnosis and assures safety to data stored in the cloud.
“Our study showed that, from the patients hospitalized in serious conditions for covid-19 clinical stabilization, 12% presented some finding”, says one of the doctors responsible for the work, Rafael Lani Lozada, ophthalmology resident in Gamboa Hospital (RJ).
A 35-year-old man from the mentioned sample, who had diverse clinical complications during hospitalization, manifested bilateral nerve fiber layer infarctions and micro-hemorrhages in the papillomacular bundle; another man, 56 years old, who needed to undergo full anticoagulation, had a unilateral “flame-shaped” hemorrhage; and a third man, 49 years old and hypertensive, presented discrete and bilateral retinal micro-hemorrhages.
To Lozada, the study shows retinal alterations may occur in severe covid-19 cases.“They were probably secondary to clinical intercurrences or comorbities rather than a direct damage by SARS-CoV-2, since it was not possible to correlate the problem directly to the virus.Thus, the retinal finding may be important and easily accessible markers of therapeutic interventions, as well as sentinels of neurological and systemic diseases during the pandemic”,
The doctor highlights that new studies with more patients are necessaryto establish statistic correlations between covid-19 and retinal lesions.
Phelcom Eyer
Louzada states that Phelcom Eyer was essential to the project, since the study, as a base, evaluated hospitalized patients in isolation, with a highly contagious and little studied virus.“Using a clean easy-to-handle portable device made it possible for us to step further in the search for a better comprehension of this disease, that afflicts humanity”, he observes.
The researcher also highlights other advantages on the equipment: short learning curve, quick image backup and a possible thorough analysis from any computer with internet access.“Not to mention that the fundus exams are very beautiful, with a great resolution and the color photos are automatically duplicated with red-free images”, he analyzes.
Beyond the pandemic
Lozada also highlights that the technical ease of retina evaluation with Eyer opens new horizons to triage exams, not only in the present pandemic context, but also for other ophthalmological diseases. “The possibility to obtain retinographies in a portable, easy and practical way, through an accessible image backup, allowing their remote careful study, is fundamental for advances in ophthalmological researches and better diagnostics”, he finishes.
During the XIX Caipira Congress, in June 2029, in Bauru (SP), the ophthalmologist Flávio Augusto Schiave Germano met the newly released smart device Phelcom Eyer.
Coupled to a smartphone, the device carries out high-quality fundus exams, in few minutes and without need of pupil dilation.It connects to an online platform, enables remote diagnosis and assures safety to data stored in the cloud.
Some months later, the doctor looked for similar devices in the annual congress of the American Academy of Ophthalmology.“But the national equipment, from São Carlos, proved to be superior both in image quality and design.It is lightweight and portable – handling is quick and intuitive, which makes it easy to use in any situation”, states Germano.
In September, 2020, the ophthalmologist acquired the smart device. He currently uses it every day in his office and in the medical residence service in the Center of Excellence in Ophthalmology (CEO), in Bauru (SP).
In the last six months, he carried out more than 1,1 thousand exams, totaling around 5,5 thousand images.As the service of medical residence works with the glaucoma ambulatory, images are mostly from the optic disc and the surrounding fibers and of the visual field.
Phelcom Eyer
Germano highlights two features of the Phelcom Eyer.“it is not necessary to carry out the exam under mydriasis, which gives more safety to patients with narrow-angle glaucoma*, and it is possible to correct the degree of myopia and hyperopia up to 20 D” he highlights.
Other positive aspects evaluated by the doctor are the fast patient registration, fast imaging and the photo resolution. “It is great and, even when exams are sent to report, the image quality remains high”, he states.
The ophthalmologist sees a great cost-effectiveness in the device. “It is an investment that brings various benefits: it helps the academic department of medical residence, patients feel safer with the regular follow-up through the retinographies and the description in medical records turns more consistent and reliable”, he points out.
Eyer Cloud
Phelcom Eyer integrates to Eyer Cloud, an online platform that enables storing and managing the patient exams. All data the equipment captures synchronize with the system automatically, so that they upload to the cloud with complete safety.
“Eyer Cloud is simple, modern and intuitive,” says Germano. Main features include the possibility of gathering information of a single patient from more than one clinic and visualize them in the platform; searching patients by name or exam date; and creating report templates from pre-ready models that the system provides.
In case of no internet access during the exam, images remain stored in the device and are sent to the cloud as soon as a connection is available.
The tool may be accessed in the device itself or via cellphone, tablet or computer.
Slit lamp
Phelcom slit lamp support. Note: This photo was taken before covid-19 pandemic.
About Phelcom slit lamp support, which enables attaching Eyer to a tabletop, Germano says it eases the documentation by providing agility and optimal alignment between the patient face and the fundus camera.
“The device also offers the advantage of not needing to directly touch the eyelids and eyelashes of patients, which guarantees more safety during the pandemic”, he notes.
Phelcom Technologies
Eyer is the first equipment of Phelcom Technologies, startup that unites technology and health, headquartered in São Carlos (SP). It produces portable devices, connected and wearable, aiming to democratize access to healthcare, offering more from less and to more people.
“Phelcom can synthesize what is best in startups: agility in the communication, highly effective in technical support and innovation in favor of patients. Undoubtedly, Eyer is a great investment in a diagnostic toolbox increasingly important to the ophthalmologic practice”, evaluates Germano.
Algorithm was runned during the Itabuna Diabetes Campaign and helped the health professionals to screen and refer more than 820 Diabetic Retinopathy patients. The solution will be released to the market still in 2021.
Phelcom fundus camera, the Eyer, has been used in Itabuna Diabetes Campaign several times, but this year it was different. In the captured images was runned an Artificial Intelligence algorithm developed by Phelcom, where it could be identified with a good sensitivity and specificity patients with Diabetic Retinopathy (DR) condition.
Exam being performed using the Eyer during the Itabuna Diabetes Campaign.
The sensitivity was 97.8%, what means a high algorithm capacity in identifying patients with DR. When it was analyzed the specificity, the number reached was 61.4%, that indicates the percentage of health patients that the algorithm confirmed that really was healthy. The AUC, Area Under the Curve, was 0.89 and it shows in this scenario a high rate of the algorithm assertivity to refer just DR patients to in person consultation and not the healthy ones.
Sensitivity was high when indicating more than mild cases, the ones where the patient needs to undergo a medical treatment with a specialist – the mild ones are usually monitored at every given time period. Besides specificity was not in a higher score as sensitivity, it was a good result considering the algorithm was not only detecting DR, but other retinal alterations like hypertensive retinopathy, aged macular degeneration (AMD), toxoplasmosis, among others, while the physician was focused on this project to detect just DR cases.
Examples of the algorithm heath map enhancing the colours in regions where it was detected retinal alterations and pointing the percentage of the Retinal Alteration Score. Source: Phelcom.
The article, published in the Journal of Diabetes Science and Technology, points out that screening patients on diabetic retinopathy could be one of the most cost-effective initiatives on diabetes care, but in several scenarios there is insufficient health care structure and resources in terms of funding, trained health care human resources, and facilities.
Eyer is a portable, connected and affordable device to perform posterior and anterior eye exams, these characteristics were highly suited to capture the images during the health campaign. As the equipment offers high quality images, to run an artificial algorithm in the images was a natural step, as it could help the health professionals screen more than 820 patients.
Phelcom has been developing this solution during the past few years, it still has no commercial name, but it will be available on the market still in the first semester of 2021. José Stuchi, CEO at Phelcom, says the company aims to develop new artificial intelligence services that will be aggregated to the EyerCloud, Phelcom’s cloud system to store patients medical records. “We are sure that this new algorithm and other ones we are working on will help physicians to diagnose those challenging conditions that sometimes are difficult to be identified to the unaided eye”, he stands.
When working with scarce resources, whether human, financial or material, Phelcom is creating solutions to break down barriers to eye care access, enabling health professionals to reach patients in different scenarios and regions.
The full publication and results are available in the original article, access: https://journals.sagepub.com/eprint/H58YCATDBNT5YRZYAXKW/full
Phelcom Eyer is one winner of the renowned World Summit Awards (WSA) 2020, in the category Health & Well-Being. The global award recognizes the digital innovation that contributes to achieve the United Nations Sustainable Development Goals (UN SDGS). On the whole, this edition included 40 solutions from 26 countries.
“We are honored to receive such an importante prize. Such recognition shows that our values and efforts to change the reality of visual health worldwide are aligned to the goals of other people and institutions, such as the UN and the WSA”, states Phelcom CEO, José Augusto Stuchi.
Modern technologies – combined with a social cause and intelligent content – not only solve problems but also increase the quality, the access to information and inclusion. “The challenges this year show, more than ever, how digital means can offer progress and solutions. WSA 2020 winners presented a wonderful showcase of purpose-driven innovation and entrepreneurship”, point out the WSA president, Peter A. Bruck.
Stuchi explains that the goal of developing Eyer is to change the reality of eye healthcare worldwide. Currently, 80% of blindness cases could be avoided, according to the World Health Organization (WHO).
“We may cause a great impact with our solution, because we have a great social appeal to this global reality”. Receiving an award from a renowned institution of the size of WSA, linked to the UN Sustainable Development Goals, makes us very happy, because it shows we are aligned to the institutions we have as mirrors. In addition, it confirms the importance and impact that our solution may cause in the world”, he remarks.
Selection
To take part in the award, Phelcom subscribed Eyer in the Brazilian stage, in the Health & Well-Being category. There are eight categories, each with a single winner. In August, the startup won the local selection and qualified to the world phase, where there are five winners per category. “Competitors are evaluated by an international jury in terms of sustainability, goal, technological and strategic refinement”, says Bruck.
Phelcom will be honored in WSA Global Congress, that occurs from March 22 to 24, 2021, completely online.
Phelcom Eyer
Phelcom Eyer is the first smartdevice on the market that enables to quickly carry out fundus exams with cloud storage.
The equipment works coupled to a smartphone and is non-mydriatic. It has the same quality of a tabletop retinograph. Equipment portability allows it to be easily transported to community task forces in different locations.
Integrated to the cloud, it makes data automatically available on the EyerCloud online platform. So, a doctor located anywhere in the world can diagnose.
Eyer aims to help combat visual impairment and global blindness, which affect 2,2 billion people, according to the World Health Organization (WHO). From this total, 1 billion cases would be avoidable or remediable. That is, they occurred due to lack of access to the necessary care, such as examinations and treatments.
About WSA
WSA was founded in 2003 by Austria as part of the UN World Summit on Information Society. The global initiative recognizes that local digital content contributes to achieve the United Nations Sustainable Development Goals (UN SDG).
WSA reaches digital entrepreneurs in 182 countries countries around the world and provides a single platform for everyone interested in goal-driven digital innovation. In close cooperation to the United Nation agencies and strategically aligned to the UN SDGs, WSA is a worldwide recognized quality seal for digital innovation.
During a congress in Natal, RN, Brazil, in 2018, ophthalmologist Hélio Roberto de Melo Lima met the proposal for an innovative equipment for retina exams: Phelcom Eyer.
The handheld fundus camera works attached to a smartphone with a high-resolution camera. Therefore, it captures excellent-quality fundus images. Integrated to an online platform, the Eyer Cloud, it automatically sends data to a specialist’s report.
By that time, the device was still under development by the startup Phelcom Technologies, but it already counted on support and investment from renowned institutions, such as Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Samsumg Creative Economy Promotion Program and the incubators Supera Parque and Eretz.bio – the latter from Israeli Hospital Albert Einstein.
First Customer
Lima followed the technology evolution until its release to market, in April 2019. Moreover, he was the first customer to acquire the product. “I decided to invest in the acquisition due to its ease of use and good price”, reminds Lima.
Since then, he already carried out more than 600 exams in his office. He currently uses the equipment twice a week, on average. Retinography is the most frequent of the exams.
The ophthalmologist also emphasizes other key strengths of the product: high-quality images, and high efficiency and operability of Eyer Cloud – a cloud platform that stores all the exams and reports – as well as the price. “Cost-effectiveness is excellent. There is no other equipment on the same level. Unbeatable”, he states.
Slit Lamp
Phelcom slit lamp support
Recently, Lima has also acquired a slit lamp support for Phelcom Eyer. “It was a good acquisition, since it is very efficient and helps imaging”, he explains.
The support enables attaching Eyer to a surface, thus providing the experience of tabletop fundus cameras. More than that, it helps to keep social distancing in service, since the professional does not need to touch the patient’s forehead, as in traditional exams.
Phelcom Technologies
Phelcom Technologies is a startup that brings technology and healthcare together, headquartered in São Carlos, SP, Brazil. It manufactures connected wearable handheld devices, aiming to democratize access to healthcare, offering better services, with a compact equipment, to more people.
“It is an excellent and promising company. It does a great job in the whole sales service support for equipment use. I recommend”, he states.
Doctors’ daily routines, with medical assistance and surgeries in hospitals, as well as care in their own clinics, may be quite distressing. Moreover, other appointments leave these professionals an even tighter schedule. For example, home visits to patients, business management and taking part on congresses, seminars, inter alia.
Therefore, counting on technologies that help improving production, time optimization and cost reduction may largely simplify a doctor’s daily life.
That is why this article is on ophthalmologist Caio Regatieri’s experience with Phelcom Eyer handheld fundus camera. Understand, as follows below, how the equipment made the specialist’s daily life easier.
How does Eyer help Dr. Caio’s routine?
Around a year ago, ophthalmologist Caio Regatieri first met the proposal of a new technology developed by the Brazilian startup Phelcom Technologies: Phelcom Eyer handheld fundus camera. Attached to a smartphone, the equipment generates retina images in few minutes and sends data to a cloud platform.
Thus, it helps diagnose of eye-related diseases, such as diabetic retinopathy, glaucoma, cataract, age-related macular degeneration (AMD), retinoblastoma, retinal detachment, retinopathy of prematurity and blindness, inter alia.
Regatieri has been using the equipment for six months in his office, as well as home visits and in the Brazilian Unified Health System (SUS), in São Paulo Hospital, in the capital.
Since then, the specialist has carried out more than 500 exams, mainly to detect diabetic retinopathy. “Eyer is easy to handle and makes excellent-quality images”, he states.
Retinal examination performed by Dr. Caio with the Phelcom Eyer
Retinal examination performed by Dr. Caio with the Phelcom Eyer
As it provides exams in an online platform, the Eyer Cloud, the doctor also emphasizes the system’s ease of access. “Undoubtedly, having a cloud database makes daily life easier”.
More than that, Regatieri highlights that Eyer has the best cost-effectiveness due to its more accessible price, mainly in comparison to a traditional fundus camera, as well as the high quality. “Actually, it is a set of factors that makes it the best equipment of the market in its sector: portability, image quality, ease of use and the support Phelcom offers”, he says.
Conclusion
Undoubtedly, Phelcom Eyer’s connectivity, embedded artificial intelligence, easy operation, portability and low cost help physicians have a simpler, more agile and profitable routine related to retina exams.
Phelcom Eyer can help you live an easier daily routine. Click here and register for further information on the technology.
We use cookies to enable and improve your experience on our website. By clicking "Allow all cookies", this popup will close and you will be consenting to the collection and use of cookies. To learn more, visit our Privacy Policy and Terms of Use.
English
Português
Español
