Microchips to restore useful vision in RP patients
This year marks the 50th anniversary of the microchip. Aside from being a key component in computers and mobile phones, they have also been used in medicine for a range of purposes, including artificial vision, monitoring and managing illnesses and medical imaging.
One disease area which has benefited from the microchip is retinitis pigmentosa (RP), a degenerative disease that reduces the visual field over a period of years. It affects roughly one in every 3,000 to 4,000 people in the UK alone, making it the leading cause of inherited blindness and often leads to complete loss of vision.
Until recently, there have been few treatments available to RP patients compared with other eye conditions such as age-related macular degeneration. Now, microchips implanted into the retina which restore vision to a functional level,are being explored as a viable option to treat RP.
At present, several clinical trials are underway to investigate retinal implants. There are two main approaches – subretinal and epiretinal. The main difference is the location of the microchip. Subretinal implants are placed below the retina, specifically in the macular region, and perform in-line with the natural processing of images in the human brain. Epiretinal implants are placed right on the retina.
There is a growing consensus that the positioning of subretinal implants, where light-sensitive photoreceptor cells are located, produces better results for patients. Vision is restored as the eye moves allowing for the immediate focus and recognition of objects. The location also allows for superior stability, meaning the chip is unlikely to loosen. These microchips contain considerably more electrodes (1,500 vs 64) improving the contrast between light and dark compared to epiretinal devices.
Leading the way in this discovery is German company and University of Tuebingen spin-off, Retina Implant AG, whose first clinical trial of a battery-powered subretinal implant recorded previously blind patients being able to recognise objects and even reading letters to form words.
Clinical trials of Retina Implant AG’s technology began in 2005 by implanting 11 patients who have RP and the results were published in the Proceedings of the Royal Society B. The implant was left in the eye for three months and patients received training in the optimal way to use the vision they obtained. Even without training, the participants were able to distinguish objects such as windows and cutlery.
Commenting on the study, lead researcher, Professor Eberhart Zrenner, director and chairman, Institute for Ophthalmic Research at University Eye Hospital Tuebingen, said: "The results of this pilot study provide strong evidence that the visual functions of patients blinded by a hereditary retinal dystrophy can, in principle, be restored to a degree sufficient for use in daily life."
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Skin Analytics wins NHSX award for AI skin cancer tool
An artificial intelligence-driven tool that identifies skin cancers has received an award from NHSX, the NHS England and Department of Health and Social Care's initiative to bring technology into the UK's national health system.
NHSX has granted the Artificial Intelligence in Health and Care Award to DERM, an AI solution that can identify 11 types of skin lesion.
Developed by Skin Analytics, DERM analyses images of skin lesions using algorithms. Within primary care, Skin Analytics will be used as an additional tool to help doctors with their decision making.
In secondary care, it enables AI telehealth hubs to support dermatologists with triage, directing patients to the right next step. This will help speed up diagnosis, and patients with benign skin lesions can be identified earlier, redirecting them away from dermatology departments that are at full capacity due to the COVID-19 backlog.
Cancer Research has called the impact of the pandemic on cancer services "devastating", with a 42% drop in the number of people starting cancer treatment after screening.
DERM is already in use at University Hospitals Birmingham and Mid and South Essex Health & Care Partnership, where it has led to a significant reduction in unnecessary referrals to hospital.
Now NHSX have granted it the Phase 4 AI in Health and Care Award, making DERM available to clinicians across the country. Overall this award makes £140 million available over four years to accelerate the use of artificial intelligence technologies which meet the aims of the NHS Long Term Plan.
Dr Lucy Thomas, Consultant Dermatologist at Chelsea & Westminster Hospital, said: “Skin Analytics’ receipt of this award is great news for the NHS and dermatology departments. It will allow us to gather real-world data to demonstrate the benefits of AI on patient pathways and workforce challenges.
"Like many services, dermatology has severe backlogs due to the COVID-19 pandemic. This award couldn't have come at a better time to aid recovery and give us more time with the patients most in need of our help.”