Biomedical engineers at Duke University have develop a low-cost; portable optical coherence tomography (OCT) scanner or retinal scanner that promises; to bring the vision-saving technology to underserve regions throughout the United States and abroad. In its first clinical trial, the new OCT scanner produced images of 120 retinas that were 95 %; as sharp as those taken by current commercial systems, which was sufficient for accurate clinical diagnosis.
In use since the 1990s, OCT imaging has become the standard of care for the diagnosis of many retinal diseases; including macular degeneration and diabetic retinopathy, as well as for glaucoma. However, OCT is rarely included as part of a standard screening exam since machines; can cost more than $100,000 meaning that usually only larger eye centers have them.
“Once you have lost vision, it’s very difficult to get it back; so the key to preventing blindness is early detection,” said Adam Wax, professor of biomedical engineering at Duke. “Our goal is to make OCT drastically less expensive so more clinics can afford the devices; especially in global health settings.”
Retinal Scanner: optical analogue of ultrasound
OCT is the optical analogue of ultrasound, which works by sending sound waves; into tissues and measuring how long they take to come back. But because light is so much faster than sound; measuring time is more difficult. To time the light waves bouncing back from the tissue being scan; OCT devices use a spectrometer to determine how much their phase has shift compare to identical light waves that have travel; the same distance but have not interacted with tissue.
The primary technology enabling the smaller, less expensive OCT device is a new type of spectrometer design by Wax and his former graduate student Sanghoon Kim. Traditional spectrometers are made mostly of precisely cut metal components; and direct light through a series of lenses, mirrors and diffraction slits shaped like a W. While this setup provides a high degree of accuracy; slight mechanical shifts caused by bumps or even temperature changes can create misalignments.
Wax’s design, however, takes the light on a circular path within a housing made mostly from 3-D-printed plastic. Because the spectrometer light path is circular; any expansions or contractions due to temperature changes occur symmetrically, balancing themselves out to keep the optical elements aligned. The device also uses a larger detector at the end of the light’s journey to make misalignments less likely.
Traditional OCT machines weigh more than 60 pounds; take up an entire desk and cost anywhere between $50,000 and $120,000. The new OCT device weighs four pounds, is about the size of a lunch box and, Wax expects, will be sold for less than $15,000. “Right now OCT devices sit in their own room and require a Ph.D. scientist to tweak them to get everything working just right,” said Wax.
Sort of retinal disease
In the new study, J. Niklas Ulrich, retina surgeon and associate professor of ophthalmology; at the University of North Carolina School of Medicine, put the new OCT scanner to the test against a commercial instrument produced by Heidelberg Engineering. He perform clinical imaging on both eyes of 60 patients; half from healthy volunteers and half with some sort of retinal disease.
To compare the images produced by both machines, the researchers used contrast-to-noise ratio; a measure often used to determine image quality in medical imaging. The results showed that, by this metric, the low-cost; portable OCT scanner provided useful contrast that was only 5.6 % less than that of the commercial machine; which is still good enough to allow for clinical diagnostics.
Wax is commercializing the device through a startup company called Lumedica; which is already producing and selling first-generation instruments for research applications. The company hopes to secure venture backing in the near future; and is also negotiating potential licensing deals with outside companies.
“There’s a lot of interest from people who want to take OCT to new parts of the globe as well as to underserve; populations right here in the U.S.,” said Wax. “With the growing number of cases of diabetic retinopathy in places like the United States; India and China, we hope we can save a lot of people’s sight by drastically increasing access to this technology.”