Retinal birefringence imaging for pediatric vision screening

Project Summary Abstract ! Amblyopia is vision loss caused by neglect of a structurally normal eye due to strabismus asymmetric refraction anisometropia or deprivation It is irreversible if not treated by age but half of all patients in the US are undetected and untreated until after it is too late making it the leading cause of preventable vision loss REBIScan has developed retinal birefringence scanning RBS into a commercial product the RBS based Pediatric Vision Scanner PVS which detects amblyopia and strabismus with accuracy compared with accuracy of non RBS methods However RBS based scanning faces challenges including the need for moving parts and the presence of significant background noise necessitating background measurements that may limit widespread commercial acceptance of this technology REBIScan has now conceptualized a new approach toward assessment of retinal birefringence that we call retinal birefringence imaging RBI Like RBS this approach measures the polarization signature produced by the Henle nerve fibers at the center of fixation of the retina thus objectively detecting ocular fixation but it can be implemented with no moving parts and without the need for background measurements Imaging will be obtained in a fraction of a second vs seconds of scanning required for an accurate RBS measurement The design will also allow for incorporation of a photoscreening channel for assessment of refractive error in synchrony with detection of amblyopia and strabismus In this Phase I study we will test the hypothesis that RBS performance can be replicated and enhanced using retinal birefringence imaging RBI The existing RBS architecture and software will be modified to implement the concept and construct a prototype The enhanced device will then be tested in an artificial patient consisting of two yoked model eyes Successful execution of project milestones will lead to pilot studies followed by clinical trials which if successful will culminate in commercial development of an RBI device This handheld machine will serve as an objective tool with a high level of accuracy for detecting amblyopia and strabismus within primary care settings staffed with lay screeners The transition from a scanning based approach to an imaging based approach for pediatric vision screening may ultimately allow for implementation of RBI as a smartphone based mobile application further improving patient access to expert medical diagnosis Project Narrative REBIScan proposes to produce a handheld no moving parts device for providing quick noninvasive detection of amblyopia and strabismus the leading causes of preventable vision loss in children in the United States Current methods including REBIScanandapos s own Pediatric Vision Scanner require complex scanning equipment that is prone to confounding error produced by ambient light or short attention spans The image based method of this proposal will eliminate moving parts and allow for future implementation in a smartphone application format improving access to this technology for patients and providers