UI-developed technology diagnoses leading cause of blindness

University of Iowa Health Care patients are the first in the nation to have access to a new technology that uses artificial intelligence (AI) to diagnose diabetic retinopathy.

The technology, known as IDx-DR, is the only medical device authorized by the Food and Drug Administration that uses AI for the autonomous detection of diabetic retinopathy. The device’s algorithm makes the diagnosis based on imaging of the patient’s retina without the need for an eye specialist to interpret the results.

Providers at the Diabetes and Endocrinology Center at UI Health Care–Iowa River Landing in Coralville, Iowa, began using IDx-DR to screen patients on June 12. The clinic has approximately 7,200 diabetes and endocrinology patient visits each year.

Technology is Iowa-born

The technology was created by the Coralville-based company IDx, a privately held AI diagnostics company, which was founded by former UI Health Care ophthalmologist and retinal specialist Michael Abràmoff, MD, PhD, the Robert C. Watzke Professor of Ophthalmology and Visual Sciences, in 2010. Much of the research used to develop IDx-DR was conducted by Abràmoff at the UI and licensed through the UI Research Foundation.

“Dr. Abràmoff and his collaborators within the department and University of Iowa have worked hard to develop this new technology and bring it to the point of patient care. We are proud of his focused efforts and are very excited about the implications this technology has on the diagnosis and treatment of diabetic eye disease,” says Keith Carter, MD, UI professor and head of the Department of Ophthalmology and Visual Sciences.

Other UI medical firsts

IDx-DR is the latest example of a first created by University of Iowa researchers and physicians. Over the years pioneers like Abràmoff have successfully conceived, developed, and introduced medical breakthroughs that have become standards of practice.

Early detection may prevent vision loss

“Early detection of diabetic eye complications (diabetic retinopathy) is an essential component of comprehensive diabetes care. Innovative strategies such as autonomous diagnostic AI represents an important advance,” adds E. Dale Abel, MD, PhD, UI professor and head of the Department of Internal Medicine, director of the Division of Endocrinology and Metabolism with UI Health Care, and director of the Fraternal Order of Eagles Diabetes Research Center.

“Importantly, this will allow people with diabetes to be flagged for diabetic retinopathy at the same time as their regular visit with our providers,” Abel says. “Moreover, it will identify those patients with significant retinopathy who need to be referred to our eye-care providers in a timely manner and determine those who do not. This innovation further strengthens our ability to provide state-of-the-art care for our patients with diabetes.”

People with Type 1 and Type 2 diabetes are at risk for diabetic retinopathy, which affects 7.7 million Americans and is a leading cause of blindness in the United States. Early detection and treatment can reduce the risk of blindness by 95 percent, but diabetic retinopathy often lacks early symptoms, so regular retinal exams are needed to diagnose the condition.

Previously, the retinal exam would require an appointment with and a visit to an eye specialist. The new AI-based system is used by trained technicians and desk staff during routine office visits, with results available in minutes. If a patient is diagnosed with more than mild diabetic retinopathy, they are referred to an eye specialist at the UI Health Care Department of Ophthalmology and Visual Sciences for follow-up examinations and treatment.

It is important to note that the IDx-DR system only detects diabetic retinopathy; it is not designed to diagnose other forms of diabetic eye disease and not intended to replace a comprehensive eye exam with an eye care professional.

Technology offers convenience factor

IDx-DR provides a convenient option for people with diabetes to complete their recommended annual diabetic retinopathy exam. This is particularly important for the more than 50 percent of people with diabetes who are at high risk for vision loss and do not see their eye doctor on a yearly basis.

“The number of inquiries we’ve received from health care administrators and physicians since IDx-DR received clearance is remarkable,” says Abràmoff, who also is president of IDx and holds faculty appointments in the UI College of Engineering. “This high level of interest shows how badly a solution like IDx-DR is needed to improve outcomes for people with diabetes. There is simply no reason for more than 24,000 individuals to lose vision each year from diabetic retinopathy.”

The IDx-DR system is “a great example of innovative technology, based on University of Iowa research, leading to a real-world clinical application,” says Brooks Jackson, MD, MBA, UI Vice President for Medical Affairs and Tyrone D. Artz Dean of the Carver College of Medicine. “Technology transfer success takes time, investment, and collaboration, so it’s exciting when things come together in ways that ultimately benefit patients.”

IDx-DR is intended for use by health care providers to automatically detect more than mild diabetic retinopathy in adults (22 years of age or older) diagnosed with diabetes who have not been previously diagnosed with diabetic retinopathy. IDx-DR is indicated for use with the Topcon NW400 retinal camera.

After a successful launch at the UI Health Care–Iowa River Landing diabetes clinic, UI Health Care plans to expand the use of IDx-DR across the health care system.