Medicine 2.0 Invention and Innovation in the 21st Century

Cyber Ophthalmology
Potential for Interface
Technologies
Tariq Aslam
Manchester Royal Eye Hospital
FRCSEd(Ophth), DM, PhD
Origins
Manchester I – Tech
MulitImpact
disciplinary
Interfacing
Manchester I – Tech
Impact
“Never before in history has
innovation offered promise of so much
to so many in so short a time”
- Bill Gates
Fewer in field / difficulties
Journal impact factor differences / grant streams
Complex issues IP / CE marking ; unable to talk !
Potential for rapid and substantial impact
Important Problem:
Compliance with spacer devices with young children
Distressed children / parents
Crying decreases drug
deposition by 80%
Correct inhalation in only
39%!
poor disease control,
increased risk of hospital
admissions / mortality
0.5 Million children <5
6
Response
• UK half a million children <5
Manchester I – Tech
Multidisciplinary
Impetus Driven by Clinical Need,
Multiple Skills
Multi disciplinary lead allows;
•
•
•
•
inventive steps
Rapid , focussed development
clinical input to development
Awareness of possibilities and necessities
Problem
• Age related macular
degeneration (AMD)
• Multiple unregulated
home vision testing
units available
Response
Problem
• Paracentral vision
loss
• Fore see machine
Response
• Patients with
geographic atrophy/
central island
• Patients with cataracts
• Score poorly on
illusion test
• Still score high on
illusion test
Problem
• visual fields for glaucoma and neurological
/functional abilities.
• prohibitively difficult for younger children,
with their limited attention spans and poor
compliance with instructions
Response
Paediatric game-based vision assessor
Game screen
inside castle
Problem ; MPS Corneal Opacification need for a measure
• valid and reliable index of
disease severity
• A key factor in initiating,
escalating or reducing
treatment is.
• advance research and clinical
trials in this condition
Response ; Iris recognition technology
• cameras established for
iris recognition
• Imaging amenable,
objective, valid and
reliable.
• highly sophisticated,
small and portable.
• Rapid, reliable, imaging
minimising artefacts
Manchester I – Tech
Interfacing
Importance of Technologies
interfacing with Humans
• “Computers are incredibly fast, accurate and stupid;
humans are incredibly slow, inaccurate and brilliant;
together they are powerful beyond imagination”
-Albert
Einstein
Chess Tournaments ;
1915 First automated chess player;
Spanish machine
1997 Computers beat Humans;
Kasparov v Deep Blue
2005 Hybrid Human and Computer
systems ;Cramton and Stephen beat
Hydra
AMD Modelling
• Choroid area decreases
then increases due to regrowth term
• Subsequent injections
should be given before
significant re-growth, e.g.
at the minimum point.
• Can also determine most
‘efficient’ point for
subsequent injection
OCT analysis
• mathematical shape characteristics of OCT
hypo-reflective spaces between patients with
exudative cysts of diabetic macular oedema
and those with presumed atrophic
degenerative cysts of Mactel.
ROP
• Use of topological systems to quantify vessels
difficult to segment.
Technology will not
replace Clinicians …….
But Clinicians who use best technologies
will replace those who do not .
Manchester iTech Group
Tariq Aslam – Lead
Sara Robinson - Coordinator
Co-investigators;
Ian Murray, Neil Parry , Clare Murray, Hujun Yin , Graeme Black, David Henson,
Cecilia Fenerty, Jane Ashworth, Susmito Biswas, Kon Balaskas
Rachel Clarke - Orthoptist
Krishan Parmar - Orthoptist
Sidd Subramani – 3d printing / design
Silvester Czanner - Senior Lecturer Computer Games
Marco Miranda – Post Doc Vision scientist
Terry Robinson - Software Programmer
Humza Tahir – Post Doc Vision scientist
Stephanie Tiew – Image Analysis
Idalia Dawidowska - Business Development Director
Elizabeth Crawford - IP Development and
Partnering Manager
Sally Mead - Commercialisation Executive
Richard Silvioli - Dietetics Specialist
Bronwen Reid - Software Programmer
Frank Podd – Electronics Engineer
Mahani Mohd Salleh - MSc Student
Uchechi Atsekhame - MSc Student
Kiran Aman - MSc Student