Overview
Retinopathy of prematurity is a condition that can lead to blindness in babies who are born too early. Early screening and diagnosis together with the right treatment is good at lowering the number of UK babies who lose their sight. But about 1 in 3 babies with the condition are born in countries where healthcare is good enough for them to survive but the screening system doesn’t work as well.
At the moment screening is done with cumbersome equipment that costs upwards of £50k. It needs to be touching the baby’s eye to take good pictures and the clinician has to move the eye into different positions by hand. The clinician then examines the pictures for unusual blood vessel shapes. It’s expensive, stressful for baby and relies on the clinician’s opinion.
In this study the team is developing new equipment that’s better for screening and diagnosing retinopathy of prematurity. They want:
- A new design that only costs 10% of the old price by using low-cost consumer tech
- To tell the difference between veins and arteries automatically
- To make the device no-contact, meaning less stress for baby
- To make it handheld and portable
At the end of the project the team hopes to have made a device that means babies can be diagnosed wherever they’re born. Early, accurate diagnosis will mean fewer babies go blind from retinopathy of prematurity.
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Scientific summary
Handheld oximetric ophthalmoscope for enhanced diagnosis of retinopathy of prematurity
Retinopathy of prematurity (ROP) is a potentially blinding disease of the retinal vasculature of prematurely born babies, associated with abnormal oxygenation and diagnosis of plus disease. It is one of the most common causes of vision loss and blindness in children; the most common in middle income countries and the incidence is increasing with increasing survival rates. Current screening for plus disease involves painful contact imaging, with a relatively primitive and cumbersome Retcam ophthalmoscope, followed by clinical classification of the degree of severity. Laser therapy or cryotherapy is effective for the most severe cases of plus disease, but the assessment of plus disease is somewhat subjective. Automated classification is improving objectivity, but poor discrimination between arteries and veins limits reliability.
The team is developing a low-cost, handheld, ROP-specific ophthalmoscope that will use retinal vessel oximetry to provide near-perfect discrimination between retinal veins and arteries. The ophthalmoscope will be inherently low cost (~10% of the £50k cost of a Retcam), non-contact and easy to use by non-specialists, providing scope for diversification of use within the UK and abroad and for telemedicine. The improved classification of veins and arteries will provide enhanced reliability of automated vessel-analysis software (specifically ‘VAMPIRE’) for improved objective classification of plus disease and more accurate assessment of treatment plans for ROP. Overall the proposed ROP-ophthalmoscope, addresses a pressing need for improved, lower cost and less invasive screening for ROP. The team envisages that several of the innovations proposed here will also be pertinent to conventional ophthalmoscopes in routine use.