Veterans Affairs

Goggles for early detection of retinal disease

Wearable, non-invasive diagnostic system uses ERG to detect diabetic retinopathy prior to untreatable progression

Medical & Biotechnology

Fundus photo showing scatter laser surgery for diabetic retinopathy. By the time vascular changes can be detected on a Fundus photo, treatment options are limited. Image: National Eye Institute, National Institutes of Health.

Scientists at the U.S. Department of Veterans Affairs (VA) have recently devised a goggle system for the diagnosis of various eye diseases. The technology shows promise in faster diagnosis, enhanced patient comfort, and lower cost. The patent pending technology is available via patent license agreement to companies that would make, use, or sell it commercially.

Diabetic retinopathy (DR) is a leading cause of blindness in working-age adults. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening. Fundus photography is the conventional method for diagnosing DR. However, by the time DR is evident on the fundus photo, irreversible damage and vision loss have already occurred.

Electroretinography (ERG) is a powerful tool for recording retinal function that is used in ophthalmology clinics to diagnose or monitor retinal disease. By probing for defects in rod-driven pathways, the ERG can be used to screen for DR in its earlier stages before vision threatening damage is present. But, the utility of ERG as a screening device to diagnose retinal diseases is hindered due to: (a) the need for a prolonged period of dark adaptation (upwards of 20 minutes) of the patient’s eyes in a darkened room, which is required to probe different retinal cell types; (b) the size/footprint of an ERG system; and (c) the expertise needed to interpret the results. These characteristics have limited the use of the ERG in many care settings.

Recent advances in ERG include hand-held systems that are more portable and can potentially be used outside the clinic. However, such devices are limited to evaluating one eye at a time – doubling the time necessary to assess retinal function in both eyes. Further, the dark adaptation step must still be carried out in a dark room. Since very few clinics have a designated room with a revolving dark room door for the dark adaptation period, the clinician or technician performing the exam must also work in the dark doing high dexterity tasks.

Addressing the above, VA researchers have devised a compact ERG device embodied in a pair of goggles. Electrodes within the device are configured to monitor electrical function of the eye. The system can fully cover both eyes allowing dark adaptation to occur in a controlled manner under a variety of settings (e.g., in a lighted or partially lighted room), allowing the technician to work and conduct testing while the room remains illuminated. Thus, the system can be used without the need for a dark room. The system can screen for DR using a prescribed flash protocol to probe for pathways that are affected in DR, negating the need for bulky and time-consuming conventional ERG systems. Data is automatically processed and analyzed to provide diagnostic information.

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