epiCam: Epipole and The Search for Diabetic Retinopathy
Our research focuses on topics that are of social importance such as our current project in diabetic retinopathy. This project is co-funded by Lancaster Capital and a Scottish Enterprise SMART grant. We were recently fortunate enough to gain Round A funding to take our concept to the market.
There has been significant interest in using our hardware in the field. If you would like to do so, please register your interest by filling in the form here.
The World Health Organisation has estimated that diabetic retinopathy is responsible for almost 2 million cases of preventable blindness throughout the world.
Diabetes is a condition effecting proper blood circulation. People with diabetes are at high risk for developing a variety of eye diseases including cataract, glaucoma and diabetic retinopathy, one of the leading causes of blindness. Diabetic retinopathy is caused by damage to the small blood vessels in the patients retina (the light sensing tissue in the back of the eye). Early detection and treatment is key to preventing vision loss, making it crucial for diabetic patients to have regular photographs taken of their eyes. Through the use of retinal screening, a trained doctor should be able to accurately diagnose diabetic retinopathy as well as carefully monitor any disease progression. It is also usually possible to first discover diabetes as a result of a retinal screening.
In 2006 the WHO produced a report on the prevention of blindness from diabetes that contained the following shocking statistics:
- More than 220 million people worldwide have diabetes.
- In 2005, an estimated 1.1 million people died from diabetes.
- Almost 80% of diabetes deaths occur in low- and middle-income countries.
- Almost half of diabetes deaths occur in people under the age of 70 years; 55% of diabetes deaths are in women.
- WHO projects that diabetes deaths will double between 2005 and 2030
The WHO estimates that diabetes will double by 2030 - this increase would be approximately 42% in developed countries and approximately 150% in developing countries. The maximum increase is in expected in India. In India, diabetic retinopathy was the 17th cause of blindness 20 years ago; today it has ascended to the 6th position; by 2030 it will be the first. A third of the people with diabetes are unaware that they have the disease. A person with diabetes is 25 times more likely to go blind than a person in the general population. The annual cost of treating a person with diabetes at risk is much lower than the welfare benefits paid to a blind person per annum, particularly in some developed countries.
It is not uniquely a Developing World issue either, in the United States, the USCFP have estimated that 13 million people have diagnosed diabetes mellitus and an additional 5.2 million have the disease but it has not yet been diagnosed. A review of the literature by Mukamel et al. indicates that, in the United States, less than half of the diabetic population receives an annual eye examination and an estimated 4 million individuals in the United States currently do not undergo an annual eye examination at all.
New Data on Retinopathy
From ARVO 2011 :Global Prevalence of Diabetic Retinopathy: Pooled Data from Population Studies from the United States, Australia, Europe and Asia.
Data from the study were used to estimate the following in 2010 (2030).
- 100.8 (154.9) million people with diabetic retinopathy
- 20.6 (31.7) million with proliferative diabetic retinopathy
- 21.3 (32.8) million with diabetic macular edema and
- 33.4 (51.3) million with vision-threatening diabetic retinopathy.
Research presenters concluded, "These data highlight the substantial public health impact of diabetes."
We are building a mass market diabetic retinopathy monitoring and screening platform usable by both clinicians and non-clinicians in a home or social environment. The system will provide peace of mind for diabetes sufferers who wish to monitor their eyesight as well as a portable, low cost tool for clinicians to be able to use in tele-medicine applications.
The platform consists of three parts:
- A retinal fundus camera tuned specifically to this task.
- Safe Cloud based storage for all images.
- A sophisticated piece of software usable by non-clinicians which can run in limited-compute environments.
Will this device be able to diagnose diabetes?
Sadly, for many in rural communities who are diagnosed with diabetes for the first time, retinopathy is often already present. In these cases, the first indication that there is a problem with diabetes (or in some cases hypertension) is when sight becomes patchy, blurry or starts to degrade. For these people a retinopathy screening should not only show retinopathy but may indicate the underlying cause.