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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The appearance of spots or a change in the texture of the skin

If you notice new spots on your body, or have ones you’ve never checked, as well as a change in their color and texture, they must be tested as they can be a warning sign of cancer. 

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Eye cancer treatment hit by lack of awareness

When a man spotted redness in his two-year-old son's eyes, 

he brushed it aside as an allergy. However, when it persisted 

for many days, he decided to consult a paediatrician, who in 

turn, referred him to a radiologist who finally diagnosed the 

child with retinoblastoma.

Commonly known as cancer of the eye, retinoblastoma 

comprises three per cent of all cancers affecting children 

aged between 1 to four years. Around 2,200 new cases of eye 

cancer are reported every year in India. However,  many 

people are still unaware of the existence of such a condition 

and hence recognize it too late.

Diabetes Complications: Eye Problems and Blindness

How Diabetes Affects Your Eyes

Diabetes can increase your risk of eye problems. Your blood sugar (glucose) levels may be high because your body can't make or use insulin properly. Too much blood sugar can build up, damaging nerves and blood vessels in your body. When the damage happens in the blood vessels in your eyes, this can lead to vision loss or blindness. Anyone with diabetes is at risk, so it’s important to get routine eye exams.

Signs and Symptoms of Eye Damage
Diabetes can affect your eyes in different ways. When your blood sugars are high or when you start insulin treatment, you may experience blurry vision or other vision problems. But your eyes may be damaged even if you don’t notice any changes. Don’t wait for symptoms to arise to get your vision checked.

Diabetic Retinopathy
The retina senses light coming into your eye and sends messages to your brain about the things you see. When blood glucose builds up, the blood vessels inside the retina may be damaged -- this is called diabetic retinopathy. At first you may not notice any changes. But over time these blood vessels may develop fragile defects in the blood vessel walls, which can leak fluid. With advanced diabetes, fragile blood vessels grow throughout the retina. This can lead to severe vision loss and even blindness

Treatment -- Laser Surgery
Retinopathy can be detected during thorough eye exams. A special type of angiogram uses dye to find leaking blood vessels. Early stages of diabetic retinopathy often can be treated with laser surgery called photo-coagulation  The laser seals the blood vessels in order to stop them from leaking and growing. The procedure can't restore lost vision. Combined with follow up care, however, surgery can lower your chances of blindness by as much as 90%.


Treatment -- Vitrectomy
In advanced stages of diabetic retinopathy -- if the retina has detached or a lot of blood has leaked into your eye -- your doctor may suggest vitrectomy. This surgical treatment removes scar tissue, blood, and cloudy fluid from inside the eye. Vitrectomy can improve your vision, especially if it's done before the disease has progressed very far.


Diabetic Retinopathy Risk Factors
Risk factors for diabetic retinopathy include how well you control your blood sugar and blood pressure. Control of blood cholesterol may also help reduce the risks. Your chances of developing diabetic retinopathy increase the longer you have diabetes. Eventually, nearly everyone with diabetes will develop some degree of retinopathy.


Diabetic Retinopathy Prevention
You can help prevent eye problems by keeping your blood sugar, blood pressure, and cholesterol under control. A major study found that people with diabetes who managed their diabetes intensely had 1/4 the rate of diabetic retinopathy as those who followed standard diabetes treatment. It also helps to stop smoking. And it's very important to get an annual dilated eye exam to detect early signs of the disease.


Glaucoma and Diabetes
While anyone over 40 is at increased risk of glaucoma, people with diabetes are 40% more likely to develop it. Your chances increase the longer you have diabetes. Glaucoma may cause bright halos or colored rings around lights, but usually has no symptoms. Untreated, it can cause an increase in eye pressure that damages the optic nerve, resulting in vision loss and blindness. Glaucoma can be treated with drops to lower eye pressure, or laser or conventional surgery.


Cataracts and Diabetes
If you have diabetes, you're 60% more likely to develop cataracts -- and you're more likely to get them at a younger age than people without diabetes. Poor control of blood sugar can speed up this condition. With a cataract, the lens in the eye becomes cloudy, which blocks light and makes everything look hazy. Cataract surgery -- when the eye's natural lens is replaced with an artificial lens -- can help vision. Sometimes diabetic retinopathy can get worse after cataract surgery.


When to See Your Doctor

Blurry or hazy vision for more than 2 days
Spots, floaters, or shadows
Severe eye pain or pressure
Sudden vision loss in one or both eyes
Sense that a curtain is coming down over your eyes
Flashing lights, double vision, or blind spots
Waviness or distortion of straight lines