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Multi-modal, multi-scale retinal imaging

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High-tech imaging delivers hope for treating retinal diseases

Detecting retinal diseases is challenging, and many conditions can go undiagnosed. Now, new imaging technology has been developed that could lead to accurate and early diagnoses, potentially improving the quality of life of millions of patients.

Health

The retina, the sensory membrane at the back of the eye that detects light, is critical to clear vision. Retinal diseases such as age-related macular degeneration (AMD) and diabetic retinopathy (DR) are major causes of visual impairment and blindness, and can have a serious impact on patients’ quality of life. “Due in part to ageing populations, the number of patients affected by retinal diseases will double over the next 40 years,” says MERLIN project coordinator Xavier Levecq, CTO at Imagine Eyes, France. “On the bright side, new effective therapies are increasingly available for treating these pathologies.” However, a large number of patients remain undiagnosed. One reason for this is that current state-of-the-art imaging technologies are still limited in their ability to discriminate tiny details in patients’ retinas. This means that many diseases can develop ‘silently’ for years, and cause massive damage to retinal cells without being detected.

Improved retinal imaging

The MERLIN project sought to tackle this health issue by improving retinal imaging. “Our ambition was to develop a new retinal imaging device that fulfils unmet clinical needs,” explains Levecq. “First, we wanted to enable doctors to treat patients before irreversible vision loss occurs, thanks to an imaging technology that reveals early, microscopic signs of disease in the retina.” The second goal was to provide a solution for reducing the duration of drug trials, with a device able to measure microscopic changes in retinal lesions over time. “Finally, we wanted to bring a solid basis for the development of personalised therapeutic approaches, thanks to comprehensive diagnostic information at the cellular level in the retina,” adds Levecq. To achieve these aims, MERLIN built on a previous project called FAMOS, which developed a prototype device capable of 3D retinal imaging at the cellular scale. MERLIN sought to take this technology closer to market, and further improve its accuracy. This was achieved by incorporating: a scanning laser ophthalmoscope, which takes images of the retina at high speed; optical coherence tomography (OCT) technology, which can capture detailed information of the various layers of the retina; and finally OCT-angiography technology, which can analyse the 3D vascular system of the retina. “These three imaging modalities can be used at different scales,” he notes. “The device provides a wide overview of the retina, while at the microscopic scale it is able to detect damage in 3D in the retinal layers.”

Effective diagnostic devices

Levecq and his team are confident that the accuracy of this pioneering new technology will lead to the earlier detection of retinal diseases, significantly reduce the number of undiagnosed patients and lead to more timely and personalised treatments. “The MERLIN project is only the beginning of the story,” says Levecq. “We are now in the first phase of industrialising this technology. Our next milestone is to finalise a product optimised for clinical research and therapeutic trials.” Levecq and his team are also in the process of seeking industrial funding to develop a new multimodal and multiscale retinal camera, adapted for routine clinical examinations. “When my two co-founders and myself created Imagine Eyes in 2003, we wanted to bring to doctors a diagnostic tool that could help them to effectively tackle retinal diseases,” he explains. “This is why we are so excited about the possibility of bringing this new technology to market.”

Keywords

MERLIN, retina, eye, diseases, retinal imaging, cellular, optical, laser

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