Mydriasis is common in ophthalmological exams that require a complete visualization of the eye structure. As the practice allows to evaluate the whole extension of the lens, it helps to diagnose diseases as glaucoma, diabetic retinopathy, AMD and others.
However, pupil dilation also brings some disadvantages to both doctor and patient, even more during the present pandemics. For example: less daily attendances due to the limit of people in waiting rooms, the need for a companion and discomfort to the patient.
That’s why non-mydriatic equipment earns more and more space in offices, clinics and hospitals. They assure high-quality exams, increase productivity and are, consequently, more profitable.
Read below the advantages of offering non-mydriatic exams and the devices that offer them.
Non-mydriatic: adavantages
1) Increase in the number of medical services
Complete pupil dilation requires the patient to remain in the waiting room, so that he or she can undergo the exam. This process takes considerable time. More than that, a companion is requiretd.
This already occupies two seats that could receive other people, for example. In addition, patients in the waiting room must keep adequate distancing, which decreases the full amount of people allowed in the environment.
The non-mydriatic exam eliminates the waiting time of both the eye drops effect and the exam itself, decreases the service length and the need of a companion for the patient.
That is: more schedule and more space in the office, so that you can attend more patients!
2) High-quality exam
Removing mydriasis from some ophthalmological exams does not affect the quality of the result. On the contrary, some non-mydriatic equipments offer even more sharpness in eye fundus images.
They invest in technologies that capture images through the patient’s natural dilation. Including in places with low light.
3) Less use of anesthetic eye drops
Mydriatic exams also reduce the use of anesthetic eye drops in clinics. They reduce costs with this material – made to avoid burning in patients’ eyes – which is more expensive than the non-anesthetic product.
4) Comfortable and quick exams for children
Fundus imaging is rare in children. When necessary, pupil dilation brings discomfort to the little ones. With the farewell to mydriasis, exam speed and well-being increase.
Another interesting possibility for non-mydriatic exams is the early eye-fundus imaging, so that the evolution may be followed throughout adult life.
5) Patient comfort
Non-mydriatic exam is undoubtedly advantageous to the patient: less discomfort with pupil dilation, no need to find available companion and less time in office. The latter advantages are even more relevant with the pandemic.
6) More safety to carry out the exam
In fact it is quite safe for the patient to dilate the pupil for ophthalmological exams. However, reactions as allergy to eye drops, dizziness or malaise may occur in some cases. Graver complications may occur very scarcely such as acute glaucoma crisis, mainly in patients with narrow anterior chamber angle, mainly related to a high degree of myopia (six degrees or higher).
Since possible reactions are not assertively predictable, removing mydriasis from some exams eliminates the risk of complications.
Non-mydriatic – devices
Several non-mydriatic devices are available on the market, from tabletop to portable. Phelcom Eyer smartdevice is one of them.
Phelcom Eyer is the first handheld fundus camera with the quality of a tabletop equipment. Coupled to the smartphone, it carries out high-quality retina exams, without need of pupil dilation and in less than a minute.
Since it is easily operable, even a minimally trained healthcare professional is able to carry out the exam.
The technology includes the Autofocus function, compensating refractive errors from -15D to +20D, allowing high detail retinal scans.. It utilizes the patient’s natural dilation and can capture images even in low light environments.
Another functionality are the panoramic exams with a visual field over 100 degrees, since Eyer has fixation targets that help panoramic capture and imaging.
It is also connected to an online platform, Eyer Cloud, which stores and organizes all the exams in a cloud system.
Learn the main features of this technology:
Type: Non-mydriatic digital fundus camera
Visual field: 45 degrees
Resolution: 12-Mega-Pixel Sensor
Exams: Colour, Red-free and Anterior Segment
Internal fixation targets: 9 fixation targets for peripheral mapping
Focus: -15D to +20D with autofocus
Pupil: Minimum size 3mm
Format: JPEG, PDF and DICOM
Conclusion
Non-mydriatic exams undoubtedly offer various benefits to doctors: quick exams, with more attendances and a more profitable office; high-quality results; cost reduction with anesthetic eye drops; faster exams for children and safer exams.
Follow Phelcom’s blog for main news on technologies in exams.
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
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 principleto 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.
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.
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.
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 withCTV 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.
English
Português
