Forward Seeing

As Dr. Edward Chaum listened to Ken Tobin with the Department of Energy’s Oak Ridge National Laboratory (ORNL) speak about computers scanning images to find computer chip defects, he could see the potential answer to a growing problem he faced as a retina specialist.

Now that solution could help millions keep their sight, thanks in part to assistance from the UT Research Foundation (UTRF), which assists with inventions that come from UT research.

More than half of Chaum’s patients have been diagnosed with diabetes, which makes them susceptible to eye diseases such as diabetic retinopathy. When caught early, it can be treated. Without medical help, it can lead to blindness.

“We do a poor job of screening for diabetic eye diseases,” said Chaum, the UT Health Science Center Plough Foundation Professor of Retinal Diseases.

General practitioners routinely refer patients diagnosed with diabetes to an ophthalmologist for retina screening. However, many patients don’t get screened because they may not be experiencing vision problems or they can’t afford to take a day off of work or pay for another doctor visit, according to Chaum.

With 28 million diabetics in the United States, Chaum said less than half get the vision screening they need. It’s a problem that is expected to grow. The Center for Disease Control has estimated, based on current rates of obesity, that the number of diabetics could grow to 120 million by 2050. There aren’t enough retina specialists to see that number of patients, according to Chaum.

“It’s clear the way we screen for diabetic retinopathy doesn’t work,” he said. “Instead of forcing patients to see a specialist like myself, we need to provide a way for the primary care physician to screen them.”

That’s where Tobin’s research at ORNL sparked Chaum’s idea. To diagnose retinopathy, he mentally scans images comparing healthy retinas to diseased ones. What if a computer program, instead of looking for broken circuits on a computer chip as Tobin’s program does, could search out the disease by comparing retinas?

“I thought it was a natural extension,” Tobin said about when Chaum proposed his idea in 2004.

ORNL directed research and development funded the project for a year, which led to grants from the National Institutes of Health and support from UTRF to develop Hubble Telemedical in 2008. The team developed a computer program that surveys images of the eye, searching out the optic nerve and finding the fovea, where the highest density of cones and rods are located. It looks for microaneurysms in the blood vessels and hemorrhages in the retina that signify diabetic eye disease in the eyes.

Other grants from the Plough Foundation and the federal Health Resources and Services Administration with the Delta Health Alliance allowed Hubble to take the researchers’ idea into urban Memphis and the rural Mississippi Delta region. They found they were able to provide expert eye care to patients who had no access to ophthalmologists. General practitioners used cameras to take pictures of the retina and transmit those images to Hubble for analysis using their unique TRIAD (Telemedical Retinal Image Analysis and Diagnosis) network.

“My perspective is the best way to manage the disease is to prevent it from occurring or to find it early and treat it,” Chaum said. “It gave patients access to us.”

While the computer system correctly identifies the disease more than 90 percent of the time, because of Food and Drug Administration rules regarding diagnoses, Hubble created a network of specialists to confirm eye disease and treatment plans.

“We created a way to transmit human data around that protects people’s privacy,” said Tobin, who is the director of the reactor and nuclear systems division at ORNL.

In early 2015 their venture capital-backed idea moved out of the Delta and onto the national stage when medical diagnostic equipment supplier Welch Allyn bought Hubble Telemedical. Now renamed RetinaVue Network, the idea generated by a chance meeting at ORNL will help diabetic patients worldwide.

“This potentially decreases the cost of healthcare. If you can avoid the loss of sight, you can save a lot on the back end,” Tobin said. “It takes a company like Welch Allyn channeling it into their various markets to make a significant impact.”

Both Tobin and Chaum attributed part of their success to UTRF, which helped with the licensing of the idea.

“As academic faculty members who were new to this process, they provide the guidance, the resources and the support for making this happen,” Chaum said.

Tobin said that ORNL’s and UTRF’s encouragement of researchers ensures that new technology and ideas find their way into the public sector.

“We’re getting technology into the marketplaces that impacts people’s lives,” he said.

And that is the point, according to Richard Magid, UTRF director. The university, which receives public dollars for research, should be returning ideas and inventions to the public.

“We should pay back the public for its investment in public schools,” he said.

That return on investment can improve lives, such as helping diabetics receive better eye care so they can keep their vision.

“The goal was always to change the paradigm,” Chaum said. “The biggest problem we have is access to healthcare. That is tragic and unnecessary…Telemedicine can provide access at a very low cost.”

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The University of Tennessee is a statewide system of higher education with campuses in Knoxville, Chattanooga, Martin and Memphis; the UT Space Institute in Tullahoma; the UT Institute of Agriculture with a presence in every Tennessee county; and the statewide Institute for Public Service. The UT system manages Oak Ridge National Laboratory through its UT-Battelle partnership; enrolls about 50,000 students statewide; produces about 10,000 new graduates every year; and represents more than 360,000 alumni around the world.
 
UTRF is a non-profit 501(c)(3) organization that promotes the commercialization of UT intellectual property, encourages an entrepreneurial culture, contributes to state and regional economic development, and promotes research and education to benefit the people of Tennessee and beyond.  For more information, visit utrf.tennessee.edu.

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