Coronavirus and the eyes: new study points to nodules in severe cases.

Coronavirus and the eyes: new study points to nodules in severe cases.

Eyes are an open door.  Contaminated tears as a possible source of contagion.  Conjuntctivitis.  Retina alterations.  Glaucoma.

From symptoms as conjunctivitis to possible sequelae as retinopathy and glaucoma, diverse studies and reports point to the relation of the new coronavirus and the eyes.

As it is a new disease, we sill do not know for sure how it  reaches this organ.  Therefore, nowadays, researches serve mainly as an alert.

Now, a new study identified small nodules in the eyes of patients with severe covid-19. The work of the French Radiology Society (SFR) was published in the scientific journal Radiology.

Know more about the research, results and how data is important to better understand and encourage investigation of the possible sequelae of the new coronavirus to the eyes.

 

Study

 

From March to May 2020, researchers submitted 129 severe covid-19 patients, 43 women and 86 men, to brain MRI exams.  They aimed to detect possible anomalies in the eyes.

 

Results

 

Nine patients presented one or more small nodules in the posterior macular area:

  • From them, eight had anomalies in both eyes;
  • Eight were hospitalized in the ICU;
  • Seven remained prone for an extended time;
  • Six were obese;
  • Two had diabetes;
  • Two suffered from hypertension.

The team could not identify the reason for the nodules to appear.  However, they raised some hypotheses:

  • Virus-caused inflamation;
  • Poor blood circulation in the ocular veins in patients intubated in the ICU, such as damage and blockage;
  • Small eye hemorrhages;
  • Disruption of nerve fibers.

According to scientists, it is the first time there is documentation of this kind of sequelae through MRI.

 

Next steps

 

The volunteers remain under monitoring to observe possible changes of the ocular nodules or vision impairment. In addition, new severe patients from the second and third waves are under evaluation.

In fact, the study needs to deepen, in order to prove the formation of nodules in the eyes due to the new coronavirus. However, the study highlights it is important to capture images of the eyes in severe covid-19 cases and follow the patient post-treatment evolution.

Brain MRI, fundoscopy and optical coherence tomography figure as useful exams.

“Our study advocates triage for all patients hospitalized in ICU with severe covid-19. We believe they must receive specific eye protection treatments”, said in  a note the main author of the study, Augustin Lecles, associated professor at the University of Paris, and neuroradiologist* of the Department of Neuroradiology of the Adolphe de Rothschild Foundation Hospital in Paris.

 

Conclusion

 

In fact, there is still a long way to prove the correlation between coronavirus and the eyes.  However, studies are essential to encourage more attention to the eyes of infected patients, by means of exams and monitoring after the cure.

More than that, this research highlights that patients with pre-existing diseases, such as diabetes and hipertension, have a higher risk factor. Therefore, they also must undergo eye investigations.

 

Learn first-hand information on the main researches about the coronavirus and the eyes. Follow Phelcom’s blog.

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Retinal exam uses artificial intelligence for Parkinson’s early diagnosis

Retinal exam uses artificial intelligence for Parkinson’s early diagnosis

Undoubtedly, diagnosing Parkinson’s disease is a challenge. Some procedures to identify signs of the disease have high costs, such as computed tomography and magnetic resonance imaging. In addition, millions of people worldwide do not have access to these technologies. According to the World Health Organization (WHO), currently, about 6.3 million suffer from the problem.

Since the first symptoms only manifest with the progression of the disease, early detection is another challenge. A new research from the United States has developed a cheaper way to diagnose the disorder: artificial intelligence applied to the retinal exam. The results were presented at the last annual meeting of the Radiological Society of North America (RSNA).

Learn about the study, how it was done and how the results achieved help to democratize access to healthcare.

 

 

Research

 

 

Researchers at the University of Florida (USA) used the machine learning principle to create an artificial intelligence tool that learns to detect signs of Parkinson’s disease in retinal examinations. They trained the “support vector machine” with eye fundus images of patients with the disease and control participants without the disorder.

As the problem deteriorates nerve cells and, consequently, thins the retinal walls, a simple fundus examination can already diagnose it. The disease also damages the retinal microvasculature.

 

 


Results

 

 

The results show that Parkinson’s disease can be diagnosed from changes in the retina. Currently, several studies prove that damage to the brain can be observed through the eyes .

“The most important finding was that a brain disease was diagnosed with a simple eye image. The diagnosis can be made in less than a minute and the equipment costs much lower than a computed tomography or magnetic resonance imaging ”, says Maximillian Diaz, the researcher in charge.

 

 

Conclusion

 

 

Undoubtedly, by applying machine learning techniques to the artificial intelligence system used in the retinal scan, scientists can diagnose Parkinson’s disease faster, more assertively, cheaply and accessibly.

Early detection, even before the first symptoms, allows the treatment to start as soon as possible and provide the patient more life-quality.

The results of the research can also help in a better understanding of the disease ​in the search for a cure and in ways to slow the evolution.

In addition, the researchers say the new artificial intelligence tool can be used to identify other diseases that damage the brain, such as Alzheimer’s disease and multiple sclerosis.

Follow the main researches related to the eyes on Phelcom’s blog.

 

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Multiple surgery of macular hole and cataract receives scientific approval

Multiple surgery of macular hole and cataract receives scientific approval

Cataract is one of the most frequent side effects on patients who undergo macular hole surgery. For some time now, specialists already indicate that multiple surgical procedure to correct the diseases.

Now, the simultaneous treatment of macular hole and cataract has received scientific approval after a study by the University of São Paulo (USP), campus of Ribeirão Preto (SP), which proved the effectiveness of the technique.

Details on research results and the benefits of this approval – for doctors, health institutions, the Brazilian Unified Health System, and the patient – follow below.

 

The research

 

Researchers divided 65 patients with macular hole in two groups. The first one, of 33 people, underwent the multiple surgery with both techniques. The other group, with 32 patients, underwent a single procedure of cataract correction after the first surgery.

This  is the first prospective study in the world to evaluate the multiple surgeries in a single intervention.

 

Results

 

Twenty-seven patients who underwent only the macula correction surgery had cataract afterwards. Because of that, they needed a new surgery in less than one year. In general, they presented significant worsening in vision.

Patients from the first group improved their visual acuity, similar to those who underwent sequential surgery.

The results demonstrate effectiveness of joining both techniques in a single procedure.

 

Benefits

 

In most cases, cataract occurs only a few months after the macula surgery. Therefore, the multiple procedure, joining both techniques, is advantageous to doctors, hospitals, the Brazilian Unified Health System and the patient.

Offering a safer treatment, cost and time reduction and less suffering of the patient are some remarkable advantages.

 

Follow the main healthcare news on Phelcom’s blog.

 

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A cure for Diabetes? Stem cell research solves problem in mice

A cure for Diabetes? Stem cell research solves problem in mice

The search for a cure for diabetes is one of the main aspects of the health research sector. According to the World Health Organization (WHO), 422 million people suffer from the disease worldwide. It is also responsible for 1.6 million annual deaths.

Scientists at the University of Alberta, Canada, recently announced that they had discovered a possible solution for the problem. With a new stem cell process the team was able to transform the patient’s own blood into insulin-producing cells. The clinical research was carried out on mice. Learn more about the study, the results and next steps.

Research

 

Researchers at the University of Alberta in Canada are working with scientists from all around the world on a new stem cell technique.
The study basically turns the
blood of patients with type 1 diabetes into insulin-producing cells .

To do this the team adapted the technique of the 2012 Nobel Prize winner in Physiology or Medicine, Shinya Yamanaka, for the treatment of diabetes. Yamanaka discovered how to reprogram skin cells, through the use of hormones and other growth factors, in induced pluripotent stem cells (iPSCs). These could be induced to become any type of cell.

The Canadian researchers took blood samples from patients and treated the cells with a cocktail of hormones and other growth factors to “go back in time” and induce them to become insulin-producing cells. Then, they transplanted into mice with type 1 diabetes.

Results

 

The new technique achieved a cure for diabetes in mice. If successful blood cell transplantation would overcome the challenges of islet transplantation, such as the need for anti-rejection drugs and lifelong insulin applications. The project leader is physician James Shapiro, who made history 20 years ago with the “Edmonton Protocol“. The procedure places new insulin-producing cells in the patient by transplanting islets harvested from pancreases of organ donors.

However, they have significant side effects, such as an increased risk of cancer and potentially fatal infections.

But this new research believes that using the patient’s own cells should eliminate the problem.
Now the hope is that it will also generate results in humans. However, there is still a long road ahead. Undoubtedly, further evaluations in animals are still needed to demonstrate that the procedure can be possible, safe and effective. Only then should the research test people.

Obstacles

 

Financing is one of the current biggest obstacles today to continue the work. But in an interview with CTV News Edmonton, Shapiro said there are volunteers working on raising $ 22 million by 2022.

Conclusion

 

Undoubtedly, if it works, the results of the research can be considered the next major advance in the treatment of diabetes. Even if the technique is successful there is a lot of work to be done in the areas of robotic engineering, artificial intelligence and stem cell science to improve the process and make it less laborious. Mass production of iPSC and personalized medications may occur for the patient to cure diabetes in the future.

Stay in the main news about eye healthcare. Follow the Phelcom’s blog.

 

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Connected to a smartphone, Eyer handheld fundus camera offers high quality images at an affordable cost

Connected to a smartphone, Eyer handheld fundus camera offers high quality images at an affordable cost

Have you ever thought that having an eyer handheld fundus camera in your clinic can be a real advantage?

After all, having quicker access to your patients’ fundus images can assist in early diagnosis, treatment initiation and monitoring various diseases: glaucoma, diabetic retinopathy and age-related macular degeneration (AMD).

However, the equipment is expensive. There are models up to BRL 100,000 on the market. In addition to the other devices your business needs, the investment can burden your budget. Even more for professionals beginning their careers. Given that scenario, a new alternative is available: Eyer handheld fundus camera. Connected to a smartphone, the technology captures high-quality images of the fundus and sends them to an online platform. It allows reporting the exam and filing the patients’ history, among other features.

Another advantage is the price: the equipment is up to 4 times cheaper than the conventional handheld fundus camera.

The technology is national and developed by the startup Phelcom Technologies headquartered in the countryside of Sao Paulo.

Next, learn more about Phelcom Eyer handheld fundus camera, its advantages, how the Eyer Cloud platform works and how the device has been used in research projects and social actions.

Phelcom Eyer handheld fundus camera

 

retinografia para neurologistas

Released in 2019, Phelcom Eyer is a handheld fundus camera that works coupled to a smartphone with a high-resolution camera. The device captures high-quality images of the fundus, in a few minutes and without the need for pupil dilation. After that, the data is automatically sent to the Eyer Cloud online platform. It allows reporting the exam and storing patients’ history with total data security.

Check out all the features of the Eyer:

High quality

 

Phelcom’s patented technology allows high quality exams to be performed on a portable device integrated with the smartphone.

Telemedicine

 

Carried out exams are automatically synchronized with the internet and made available in the cloud, enabling remote diagnosis.

Embedded artificial intelligence

 

Eyer has intelligent functions to assist medical diagnosis and capture retinal exams.

Connectivity

 

The device is naturally connected because it is integrated with the smartphone. It eases sharing and accessing exam data in the cloud through the Eyer Cloud system.

Non-mydriatic

 

Eyers carries out retinal examinations at any location without the need to use eye drops for pupil dilation. It is more comfortable to the patient and provides a faster exam.

Autofocus 

 

With the Autofocus function it is possible to compensate refractive errors in the range of -20D to + 20D. This allows retinal examinations with a high level of details.

Accessible

 

Eyer allows the democratization of access to retinal examination technology through innovative and more accessible business models.

Easy operation

 

Any minimally trained healthcare professional can use the equipment to perform high-quality retinal exams in less than 1 minute. It guarantees faster and more accurate diagnoses.

Panoramic

 

The Eyer generates panoramic exams with a more than 100 degree visual field. The device has internal fixation points that assist capturing and generating panoramics.

Portability

 

The portable device allows performing exams anywhere with remotely-issued diagnosis. This feature helps in the democratization of health, since 85% of Brazilian cities do not have access to specialists and devices that diagnose eye diseases.

Low cost

 

Portability and small size allow Eyer to have a much lower cost compared to traditional fundus cameras. Even with cutting-edge technologies applied to the device production.

 

Recently Phelcom also released a slit lamp holder to allow Eyer attachment to a tabletop. This way, it provides the experience of a tabletop retinograph by easing image capture without movement.

In addition, it helps to maintain social distance in care, since the professional does not need to touch the patient’s forehead as occurs in the traditional exam.


Eyer handheld fundus camera – advantages

Eyer offers state-of-the-art technology which makes the device one of the most modern portable fundus cameras for the prevention and diagnosis of vision-related diseases.

Learn about the advantages of the equipment below:

  • High-quality eye exam through a smartphone;
  • Accurate and quick diagnosis;
  • Lower cost compared to traditional retinographs;
  • Exams are possible in several locations due to portability;
  • Democratization of retinal exams, especially in places with low infrastructure of quality services in the area, such as doctors, health professionals, equipment, medicines etc;
  • Faster service through computerized systems integrated to an online platform with access via computers, smartphones and tablets;
  • Tests are easy to carry out in clinics and health centers;
  • Diagnosis made by specialists and reference professionals located anywhere in the world;
  • Reduction of attendance time and operational costs;
  • Decrease in the displacement of patients to hospitals and large urban centers;
  • Improvement in the quality of the reports issued;
  • Increase in prevention and early diagnosis of diseases such as diabetic retinopathy, glaucoma, cataract, macular degeneration, retinoblastoma, retinal detachment, premature retinopathy and blindness, inter alia.

Eyer handheld fundus camera – Eyer Cloud

Eyer Cloud  is an online platform integrated with the Phelcom Eyer handheld fundus camera that allows you to store and manage patient exams. All data captured by the equipment is automatically synchronized with the system, allowing them to upload to the cloud with complete security.

Any health professional – without necessarily being a specialist – can carry out the exam in the field after a brief training. With the information available on the web, a doctor from anywhere in the world can diagnose.

In addition to ensuring data backup on a secure server, the user has all data organized in a friendly, functional and intuitive interface. Moreover, the platform can be accessed on the device itself or in a smartphone, tablet and computer.

If there is no internet access at the time of the exam the images are saved on the device and are sent to the cloud as soon as a connection is available.

Eyer handheld fundus camera – social actions

Currently there are several social actions that use the device to bring more health to the whole country.

This is the case of the project “Unidos pelo Diabetes em Ação”, in Itabuna (BA)  . The event gave rise to the collective task force “Unidos pelo Diabetes”  that needed to be cancelled due to the pandemic. On the whole, 400 patients participated in the first phase. 100 of these had more severe diabetic retinopathy or macular edema.

mutirão de Itabuna

 

The project used advanced technologies to ensure screening without agglomerations. Eyer was the main screening tool. “Phelcom was fundamental to the success of the project as it made the devices available, provided prior training, helped in the strategy of assembling reports using its Eyer Cloud program and made its team of engineers available for support during the action”, says Andrade. “In addition, in an innovative way in Brazil, it created an artificial intelligence algorithm to help sorting patients who would probably be serious and those without changes, easing the logistics through distance-reporting”, adds Andrade.

Expeditions

 

The expedition carried out by Barco Hospital São Francisco, in the region of the municipality of Terra Branca (PA),at the end of last year, also featured the Eyer. Ophthalmologist Mariana Lafetá, one of the volunteers on this trip, says that the equipment helped in the diagnosis of diseases such as cataracts, glaucoma and diabetic retinopathy, inter alia.

 

 

“It is easy to carry out the exams, take the photos, find them in the files and store them later. We can also send or print the images, which I think is very interesting, in addition to the easy access from anywhere with the internet connection ”, she analyzes. Ophthalmologist Fernando Korn Malerbi also used the Eyer on an expedition to three indigenous communities in the state of Mato Grosso earlier this year. The doctor evaluated 193 Indians. Diabetic retinopathy and cataracts figure among the main diseases found.

“The experience with the equipment was very good, mainly due to portability and ease of use”, he evaluates. He recalls that he has been involved in other projects with the Eyer handheld fundus camera for the diagnosis of diabetic retinopathy. “I believe that the Eyer is very relevant for this type of action, representing an important alternative for tracking populations that live in remote areas”, he concludes.

Do you want to know more about how technology helps with eye exams? Follow the Phelcom’s blog.

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Study uses gene therapy to regenerate damaged optic nerve

Study uses gene therapy to regenerate damaged optic nerve

Can you imagine regenerating the damaged optic nerve with gene therapy and being able to recover patients with glaucoma?

A research from the University of Cambridge (United Kingdom) has achieved promising results in this regard. Through gene therapy, scientists have rehabilitated damaged eye nerve fibers. The study was published recently in  Nature Communications Journal.

Learn about details on the research: methodology, results and how important it may be, in the future, to treat glaucoma.

However, results are still initial and require further tests to determine an effective therapy for humans.

 

Research

 

Researchers from the University of Cambridge (UK) used a gene therapy technique to stimulate, in vitro, the increase and activity of the protruding protein in the eye and optic nerve.

First, the scientists cultivated the cells in laboratory. Then, laser-injured the nerve cells (axons). Finally, they introduced the gene and followed the changes with a microscope.

The study was carried out in mice.

 

Results

 

The scientists noticed that the more the protruding protein in these cells increased in number, the greater was the retinal neuron regeneration. More than improving the protein growth, it decreased the chance of nerve cell death.

The investigation showed an almost complete “protection” of the nerve cells growing in a cell culture of one of the guinea pigs.

This protein can help healing or, at least, reducing optic nerve damage. Thus, it may assist protection against glaucoma in the future.

It is worth mentioning that further tests are needed to determine an effective treatment for humans.

 

Conclusion

 

In fact, the gene therapy study results are promising. Especially because it seemed impossible to find a way to regenerate injured optic nerve in the past.

This research gives hope, however it still requires many tests on mice, primates and humans. Only then will an effective treatment be defined to reach the population within a few years. Nevertheless, the study is still a major breakthrough against glaucoma and other diseases that affect neurons such as Alzheimer.

Stay in the main news about eye care. Follow Phelcom’s blog.

 

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