Monday, May 04, 2020

AI helps spot early signs of glaucoma progression to blindness

Using Artificial Intelligence (AI), researchers have developed a quick test to identify which people with glaucoma are at risk of rapid progression to blindness.

A new test can detect glaucoma progression 18 months earlier than the current gold standard method, said the study published in the journal Expert Review of Molecular Diagnostics.

Glaucoma, the leading global cause of irreversible blindness, affects over 60 million people, which is predicted to double by 2040 as the global population ages.

Loss of sight in glaucoma is caused by the death of cells in the retina, at the back of the eye.

“Being able to diagnose glaucoma at an earlier stage, and predict its course of progression, could help people to maintain their sight, as treatment is most successful if provided at an early stage of the disease,” said study first author Eduardo Normando from Imperial College London.

The test, called DARC (Detection of Apoptosing Retinal Cells), involves injecting into the bloodstream (via the arm) a fluorescent dye that attaches to retinal cells, and illuminates those that are in the process of apoptosis, a form of programmed cell death.

The damaged cells appear bright white when viewed in eye examinations — the more damaged cells detected, the higher the DARC count.

One challenge with evaluating eye diseases is that specialists often disagree when viewing the same scans, so the researchers have incorporated an AI algorithm into their method.

In the Phase II clinical trial of DARC, the AI was used to assess 60 of the study participants — 20 with glaucoma and 40 healthy control subjects.

The AI was initially trained by analysing the retinal scans (after injection of the dye) of the healthy control participants.

The AI was then tested on the glaucoma patients.

Those taking part in the AI study were followed up 18 months after the main trial period to see whether their eye health had deteriorated.

The researchers were able to accurately predict progressive glaucomatous damage 18 months before that seen with the current gold standard OCT retinal imaging technology, as every patient with a DARC count over a certain threshold was found to have progressive glaucoma at follow-up.

“These results are very promising as they show DARC could be used as a biomarker when combined with the AI-aided algorithm,” said lead researcher Francesca Cordeiro from University College London (UCL) Institute of Ophthalmology.


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Sunday, April 30, 2017

New eye test may detect early signs of glaucoma

Researchers have developed a simple eye test that could help solve the biggest global cause of irreversible blindness, glaucoma, by detecting the onset of the disease at a very early stage.


Loss of sight in patients with glaucoma is caused by the death of cells in the retina at the back of the eye. This cell death is called apoptosis.

The new technique called DARC stands for detection of apoptosing retinal cells.

It uses a specially developed fluorescent marker which attaches to cell proteins when injected into patients. Sick cells appear as white fluorescent spots during eye examination.

In clinical trials, the pioneering diagnostic — developed by researchers at the University College London (UCL) and the Western Eye Hospital in England — allowed doctors to see individual nerve cell death in the back of the eye.

“Detecting glaucoma early is vital as symptoms are not always obvious. Although detection has been improving, most patients have lost a third of vision by the time they are diagnosed,” said led researcher Professor Francesca Cordeiro of the UCL Institute of Ophthalmology.

“Now, for the first time, we have been able to show individual cell death and detect the earliest signs of glaucoma. While we cannot cure the disease, our test means treatment can start before symptoms begin.”

Glaucoma affects an estimated 60 million people in the world, with one in 10 suffering total sight loss in both the eyes.

Initial clinical trials were carried out on a small number of glaucoma patients and compared with tests on healthy people. The initial clinical trials established the safety of the test for patients, according to a study published in the journal BRAIN.

The researchers believe the test has potential for early diagnosis of other degenerative neurological conditions, including Parkinson’s, Alzheimer’s and multiple sclerosis.

“In the future, the test could also be used to diagnose other neuro-degenerative diseases,” Cordeiro said.
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