In partnership with the NGO Retina Global, doctors plan to perform digital retinal exams and retinal mapping in more than 15 thousand diabetic patients in the countryside of Sergipe.
Last year, the NGO Retina Global was interested in developing a social project to diagnose and treat diabetic retinopathy in Brazil. The North-American institution acts to create sustainable solutions in controlling retinal diseases in poor areas all over the world.
Thus, the partnership with the ophthalmologists Fernando Malerbi and Gustavo Melo gave birth to “Iluminar”, a project to track and treat diabetic retinopathy in 13 municipalities in the backlands of Sergipe. The group chose the region for its history of poorness related to drought and lack of ophthalmological assistance in public health.
Up to now, more than 700 people have undergone retinal exams in the cities of Itabi, Graccho Cardoso and Canindé de São Francisco. “Approximately 150 patients have been submitted to a new retinal mapping exam with the team of retinologists on site. From those, 50 were sent to laser photocoagulation treatment”, highlights one of the project leaders, ophthalmologist Gustavo Melo.
The joint efforts count on two healthcare technicians, around ten workers from Basic Healthcare Units (UBS) from each municipality and four volunteer ophthalmologists, part of them sending remote reports.
Retinal images are made with Phelcom Eyer smartdevice. Coupled to a smartphone, the equipment carries out high quality exams, in a few minutes without need of pupil dilation. Integrated to a cloud system, it makes data available automatically in EyerCloud online platform. This way, a doctor can generate a report from anywhere in the world.
“Eyer allows optimizing time and costs by tracking the diabetic population in the countryside so that they do not need to move to the cities that have equipment and specialists. Non-midriasis is another advantage, since 90% of the cases do not need to dilate the pupil”, explains Melo.
The smart device also offers the joint efforts of an artificial intelligence that identifies diabetic retinopathy and other eye diseases with more than 95% sensitivity in just three seconds. After that, the exam is sent to the ophthalmologist for checking and reporting. The AI is at the final test stage.
Next Stage
This month, the Project will be at Poço Redondo. It aims to provide care for 15 thousand diabetic patients in 13 cities in Sergipe, in a period of two years.
“The great differential is optimization of time, essential for early diagnosis, so that chances of diabetes-related blindness lower considerably. Raising awareness of both the population and public managers about the efficiency and lower cost of this way of tracking diabetic retinopathy may stimulate the creation of health policies to treat this disease and others that affect the retina”, analyzes Melo.
Retina Global is an international, non-profit organization that seeks to enable sustainable solutions for the care of retinal diseases in underserved areas around the world.
Currently, the institution has projects in Central and South America and in Asia. It has already implemented programs in Tanzania, Kenya, Bolivia, Belize, Bahamas, Burundi, Ethiopia, Haiti and Brazil.
The NGO, in partnership with the project Iluminar, tracked and treated diabetic retinopathy in 13 municipalities in Sergipe hinterlands.
The team used the Phelcom Eyer, a smart, medical device, to carry out high-quality retinal exams (without having to dilate pupils) and make images available for remote diagnosis.
Recently, the organization has used the equipment again to track retinal diseases in Kericho, a town in rural Kenya, Africa.
Learn more about the project of Retina Global in Kenya, with the support of Eyer.
Retina Global in Kenya
For two days, the volunteer team from Retina Global made an initial evaluation, and then referred the patients for fundus exams with Eyer. Both the images and patients’ histories were
immediately available in the Eyer Cloud online platform.
Specialists in retina, based in the United States, made the reports. In total, 26 people were found to have retinal abnormalities, including a child and one young adult. “With that, we could diagnose quickly and start early treatment”, said the leader of Retina Global project in Kenya, Diane Steinhilber.
“We will keep using the equipment to identify and select the patients in need of specialized retinal care”, she highlights.
Lack of access to eye health
Steinhilber explains that the great challenge of this project is the lack of a retina specialist in this rural area of Kenya. Patients who need specialized treatment are referred to hospitals in Nairobi, the country’s capital, which is located roughly five hours away.
“To see a doctor, they face an arduous and long trip, as well as the time away from their jobs and families. Screening through Eyer allows us to quickly refer patients that are in real need of care in specialized centers”, she states.
As some patients have difficulties to get to the hospital, the project plans to send a trained team on community missions. Moreover, the project searches for a portable machine for laser treatment, as well as tools to carry out other kinds of therapies, such as intraocular injections and surgeries.
“Our team evaluated in detail the best way to implement a project that is able to provide exams and information on retinal care and also one that is sustainable in the long-term”, she says. Therefore, the project in Kenya was divided in phases to be implemented over five years.
Eyer use in Kenya
Retina Global team in Kenya took part on a remote training to learn how to handle the technology. “Eyer is extremely easy to handle. It is possible to promptly identify the images, quickly create patient database and send the photos to the doctor in the United States for review and reporting”, she says.
The project leader also highlights another advantage of Eyer: it not only has data for patient follow-up and continuous care, but also is a way to obtain information on the prevalence of retinal diseases in the region.
“Without Eyer, Retina Global would not have even started in Kenya. Further than using it in more local communities, we plan to include it in other projects to take place around the world”, she finishes.
Phelcom Eyer
Phelcom Eyer is a portable fundus camera that works to carry out high-quality fundus exams in a few minutes without the need of pupil dilation.
Integrated to an online platform, Eyer Cloud, the data is automatically sent and can be analyzed by a specialist anywhere in the world. That is, it allows remote diagnosis.
More than that, its embedded artificial intelligence provides smart features to help medical diagnosis and the capture of retinal scans. On the other hand, the portability and affordability of the technology democratize the access to retinal exams. The Eyer is about 10 times more affordable than a desktop fundus camera, which still has to be integrated into a computer.
Phelcom Technologies developed the technology, which is currently present all over Brazil and in countries such as the United States, Japan and Chile.
Ophthalmologist used Eyer to carry out exams and solve doubts on diagnostics.
Imagine a floating hospital with medical and dental offices, surgical center, complete ophthalmological room, analysis lab, medication room, vaccination room and infirmary beds. More than that: equipments for examinations as X-ray, electrocardiogram, mammograph and treadmil ergometer.
This is São Francisco Boat Hospital, built to take health and medical care to more than 1 thousand riverside communities in the Amazon Region. Associação e Fraternidade São Francisco de Assis na Providência de Deus, a Brazilian charity organization, idealized the boat and made dozens of expeditions in 2019.
One of them was in the municipality of Terra Santa, in Pará, from October 21 to 30. The expedition counted on several volunteers in different healthcare areas, such as ophthalmology, pediatrics, oncology, psychiatry, dermatology, plastic, orthodontics, inter alia.
Ophthalmologist Mariana Lafetá was one of the volunteers in that trip. “Each specialist has an office on boat and we travel from town to town offering medical care to the population. We consulted 4,052 people altogether”, she tells.
Regarding eyes, the doctor emphasizes that the main disease diagnosed was dry eye syndrome. Moreover, there were many cases of refractive errors, cataract, presbyopia (known as eyestrain), pterygium (known as surfer’s eye), blepharitis and meibomitis – these latter affecting glands around the eyelids. There were also cases of glaucoma and, in a very low rate, diabetic retinopathy.
Eyer
The doctor took Phelcom Eyer handheld fundus camera to the expedition. “Due to the great number of patients, I chose to use the device just in cases of diagnostic doubts and patients with glaucoma. Being able to email exams to the ones who had email addresses was interesting. This way, they could use them in future consultations”, emphasizes Lafetá.
The ophthalmologist says the equipment is easy to use and practical. “It is easy to carry out exams, take photos, find them among files and store afterwards. We can also send or print images, which I consider very interesting, besides getting to access them from anywhere with internet connection. I really liked it”, she analyzes.
Phelcom
“Eyer’s main goal is to democratize and take access to healthcare to locations presently suffering from infrastructure deficit in the area, such as of specialists and equipment. With portability, accessible prices and the possibility of remote diagnose, via cloud, we can help healthcare professionals to assist more people”, say startup Phelcom Technologies founders, José Augusto Stuchi, Flávio Pascoal Vieira and Diego Lencione.
According to the first World Report on Vision, developed by the World Health Organization (WHO), 2,2 billion people around the world have a vision impairment. From this sum, 1 billion cases would be avoidable or remediable, such as myopia, cataract, glaucoma and hyperopia.
Phelcom Technologies participated in the 21st National Free Diabetes Prevention Campaign, sponsored by the National Association of Diabetes Care (Anad), from November 7 to 14 in São Paulo, in partnership with the Instituto da Visão (Ipepo), Federal University of São Paulo (Unifesp) and the German multinational Bayer. The event is related to the World Diabetes Day, celebrated on November 14.
At the time, the Brazilian startup examined about 500 patients with the portable fundus camera Eyer, an innovative product with high technology that will be launched soon by the company. “One of the chronic complications of diabetes is diabetic retinopathy, an early-stage asymptomatic disease that can cause severe visual impairment or even blindness when not diagnosed,” said Phelcom’s co-founder and CTO, Diego Lencione, who represented the company in this event.
More than 18 million people have diabetes in Brazil. The number may be higher because many cases have not yet been identified. “Today, almost 85% of Brazilian cities do not have access to ophthalmologists and ophthalmological devices that help diagnose the disease and its complications. Our objective with this portable device is to enable the care of communities that have limited access to this type of examination,” says Lencione.
Exams performed by the Phelcom portable retinal camera facilitated the diagnosis of retinal lesions and early referral for proper treatment of many patients during the task force.
Eyer
Eyer is a portable retinal camera developed by Phelcom Technologies that aims to help combat severe visual impairment and blindness, which affect more than 250 million people worldwide. Currently, 75% of cases occur due to lack of prevention, early diagnosis and correct treatment.
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