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Retail Clinics Offer A.I.-Enabled Eye Diagnostics

Fundus photograph

Fundus photograph of a healthy right eye (OptometrusPrime, Wikimedia Commons)

19 Nov. 2019. A chain of primary care clinics in grocery stores is adding diagnostics using artificial intelligence to detect an eye disorder resulting from type 2 diabetes. The CarePortMD chain of retail health clinics is adding IDx-DR tests developed by the company IDx in Coralville, Iowa, a spin-off enterprise from University of Iowa.

CarePortMD operates primary care clinics in supermarkets, providing walk-in services inside the stores, and telemedicine kiosks. A specialty of CarePortMD clinics is diabetes, with special programs for prevention and management. The company says five CarePortMD clinics located at Albertson’s supermarkets in Delaware and Pennsylvania added IDx-DR systems so far this year.

High levels of blood sugar can cause serious complications in people with type 2 diabetes, including vision problems. Among these issues is damage to the fine blood vessels in the retina, located in the back of the eye that detects and converts light to signals sent through the optic nerve to the brain. Diabetic retinopathy is the name given to this condition that can range from mild leakage in the eye to swelling and distortion of the blood vessels, and proliferation of new blood vessels to compensate for the damage.

One consequence of this damage is swelling in the macula, the part of the retina that provides the sharpest vision, a disorder known as diabetic macular edema. Other outcomes include cataracts, glaucoma, or permanent vision loss if the retina detaches from the eye. Centers for Disease Control and Prevention says diabetes is the leading cause of new blindness among adults in the U.S. age 20 to 74. CDC estimates 4.1 million people have diabetic retinopathy, including nearly 900,000 individuals with advanced stages of the condition threatening their vision.

The IDx-DR system analyzes images of patients’ retinas taken by a specialized fundus camera that provides high-resolution color medical images of the eyes. The images are stored on a local system and uploaded to a cloud-based server where IDx-DR software analyzes the images, and according to the company returns results in one minute or less. The analysis is based on algorithms the company says combine image analysis and deep learning that first assess image quality, then inspect for lesions and location of irregularities in the retina, resulting in an assessment of diabetic retinopathy.

Assuming images of sufficient quality, IDx-DR either returns a positive result for moderate or more severe diabetic retinopathy, or a mild case of the condition, calling for a retest in one year. As reported by Science & Enterprise, the Food and Drug Administration cleared the IDx-DR system for marketing in the U.S. in April 2018.

In an IDx statement, Ashok Subramanian, CEO of CarePortMD says, “the retinal exam provides a rich source of information, helping to identify patients who are at highest risk for complications of diabetes. If we catch these high-risk patients earlier, it can result in significant savings for the health care system and better patient outcomes.”

IDx licenses its technology based on research by company founder Michael Abramoff, Professor of Ophthalmology at University of Iowa’s medical school in Iowa City. Abramoff started IDx in 2010 and continues as the company’s CEO.

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