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Imaging System Allows for Universal Vision Screening of All Newborns

Pediatric ophthalmologists can view images remotely and provide expertise anywhere in the world.

BY KAREN APPOLD, CONTRIBUTING WRITER

Universal newborn vision screening is currently only being performed in a few hospitals in China, Taiwan, Brazil, Hungary, and Spain. However, Newborn Eye Screening Testing (NEST) studies at Stanford University indicate that up to 20% of infants have pathology at birth, which concurs with previous studies. “Other newborn tests, such as hearing, only have a 3% or less complication rate, yet they are a standard of care in the United States and in many countries worldwide,” says David Yeh, general manager, Visunex Medical Systems, Inc. (Fremont, CA). “But if a physician can identify eye complications early on, they can manage and treat them before the brain and eye have established what the newborn sees as normal.” Although the American Academy of Pediatrics recommends screening all infants within the first 30 days, there was no easy technology or process available to do so — until now.

Visunex Medical Systems’ PanoCam LT Wide-field Digital Imaging System and PanoCam Review Software, which recently received approval from the US Food and Drug Administration, consists of a portable image capturing unit (ICU) that is specifically designed to capture fundus images of newborns. Safe LED lighting with auto-intensity between viewing and image capture and 130º wide field view allows for imaging out to the peripheral. “The smart ICU also has intelligent software that assists the photographer in capturing the six images per eye that are necessary to review and diagnose the newborn eye,” Yeh says.

ABILITY TO VIEW REMOTELY IS KEY

The PanoCam ICU connects by proprietary wireless technology to a portable suitcase computer that stores patient information and images. It includes a built-in color photo printer and ICU charging system for untethered screening. The PanoCam computer can transmit images to a cloud database for telemedicine and remote review.

“Because images are pre-labeled, there is no need to do so manually, which acts as a safety measure,” says Darius M. Moshfeghi, MD, professor of vitreoretinal surgery, and director of ophthalmic telemedicine, Byers Eye Institute, Stanford University School of Medicine, who is also a paid consultant with an equity position in Visunex. “The review station then prepopulates the pre-labeled images and automatically positions them into an ideal format for quick review by a trained grader, so they can review many images in an efficient manner.” The technology is HIPAA compliant and secure.

CHECKING FOR A HOST OF CONDITIONS

The PanoCam LT Wide-field Digital Imaging System can take external images to check for eyes that look crossed, turned out, or don’t focus together. Anterior images can reveal congenital glaucoma and cataracts. Posterior imaging identifies retinopathy of prematurity, retinoblastoma, and macular and retinal hemorrhages.

“All of these conditions have a potential actionable surgical intervention,” says Dr. Moshfeghi. “In the majority of these cases, the earlier you intervene, the better the anatomic and functional outcomes.”

EASY TO OPERATE

Smart ICU software automates image capture for newborn vision screening, so even a non-ophthalmologist can take the correct images. “If you have a simple-to-operate imaging system that a nurse or obstetric/pediatric physician can use to capture images of newborn eyes and a telemedicine process to send the images to a pediatric physician for remote review, then you can handle the volume of images and identify those with vision complications, and then refer those infants to a pediatric ophthalmologist to manage,” Yeh explains.

“The entire system is portable, lightweight (just 650 grams), and battery powered, so it’s completely mobile,” Dr. Moshfeghi continues. In addition, it’s ergonomic, easy to use, and allows for a seamless delivery of images. RP