AI test detects early signs of glaucoma progression

A sponsored clinical trial from University College London has suggested a new test using artificial intelligence can detect very early signs of glaucoma progression, up to 18 months earlier. 

The technology, supported by an artificial intelligence algorithm, could be used in detection and diagnostics, according to the Wellcome-funded study published in Expert Review of Molecular Diagnostics.

Professor Francesca Cordeiro, lead researcher, UCL Institute of Ophthalmology and Western Eye Hospital Imperial College Healthcare NHS Trust said “We have developed a quick, automated and highly sensitive way to identify which people with glaucoma are at risk of rapid progression to blindness.”

The test, called DARC (Detection of Apoptosing Retinal Cells), involves injecting into the bloodstream (via the arm) a fluorescent dye that attaches to retinal cells, and illuminates those that are in the process of apoptosis, a form of programmed cell death. The damaged cells appear bright white when viewed in eye examinations – the more damaged cells detected, the higher the DARC count.

The researchers said that one challenge with evaluating eye diseases is that specialists often disagree when viewing the same scans, so the researchers have incorporated an AI algorithm into their method.

In the clinical trial AI was used to assess 60 of the study participants, 20 with glaucoma and 40 healthy control subjects. The AI was initially trained by analysing the retinal scans, after injection of the dye, of the healthy control subjects and was then tested on the glaucoma patients.

Those taking part in the AI study were followed up 18 months after the main trial period to see whether their eye health had deteriorated.

Professor Cordeiro said “These results are very promising as they show DARC could be used as a biomarker when combined with the AI-aided algorithm. What is really exciting, and actually unusual when looking at biological markers, is that there was a clear DARC count threshold above which all glaucoma eyes went on to progress.”

The researchers are also assessing the DARC test in people with lung disease, and hope that by the end of this year, the test may help to assess people with breathing difficulties from Covid-19.

DARC is being commercialised by Novai, a newly formed company of which Professor Cordeiro is Chief Scientific Officer.