One of the many worrisome trends related to the diabetes epidemic is the growing number of people who will go blind from diabetic retinopathy, a common complication of the disease that is already the leading cause of blindness in working-age American adults. Though screening can catch it early enough to help prevent vision loss, less than half of the 21 million diabetics in the US get an annual eye exam. Reasons include lack of insurance, inconvenience and/or cost.

The good news is that a fast and inexpensive solution is currently in development at the Oak Ridge National Laboratory (ORNL) and the University of Tennessee Health Science Center (UTHSC), where engineers are testing a system that may make the screening for diabetic retinopathy as easy as getting your blood pressure checked. I asked Edward Chaum, MD, PhD, a professor of ophthalmology at UTHSC, for more details on this up-and-coming technology.

The concept evolved from a process developed at ORNL for quality control of semiconductors, in which new products are compared with a vast image database of others with known flaws. Noting that this process is actually quite similar to what he does when examining images of retinas for diabetic eye disease, Dr. Chaum began working with ORNL’s engineers to develop technology that would enable the database comparison to be done quickly and efficiently.

VISIONARY TECHNOLOGY

A major advantage of using comparative images is that patients don’t need to have uncomfortable, time-consuming dilating eyedrops to get this screening. They can sit in front of a camera that takes photographs of the retina (this takes about 90 seconds) during a routine visit to their primary care doctor. Encrypted for privacy, the photos are sent via the Internet for comparison with the retinal image database, which now houses more than 2,500 images of diabetic retinopathy and other retinal diseases. The computer is programmed to “diagnose” the image and then send it to the specialist for expert review. A report is sent electronically to the patient’s physician, who then can refer patients who require treatment to an eye-care specialist.

Given that numerous digital retina cameras are already in use around the country, Dr. Chaum’s approach may turn out to be a major step in the direction of making screening widely accessible to the growing population of people with diabetes. They’ll be able to get a low-cost scan in their own doctor’s office instead of having to pay for an additional eye doctor’s office visit just to look for diabetic retinopathy. This is one technology worth watching.