Personalized Healthcare

When we hear personalized healthcare, we may immediately think of personalized medicine, a relatively new branch of medical practice that addresses medical conditions based on the patient’s dynamic biological information. However, for this article, we will be discussing personalized diagnostic devices or personalized point-of-care devices.

Recent technological developments and advancements in diagnostic medicine have created innovative approaches to improving healthcare in extraordinary ways. For instance, the echocardiogram, an ultrasound of the heart, is a non-invasive test that produces images used to investigate the performance of the heart. Before this non-invasive approach, the methods used to investigate the functions of the heart were not only cumbersome and intrusive, they were sometimes inaccurate. Another example that displays the advancement in technology and diagnostic medicine is retinal imaging.

A brief history of retinal imaging

A French physician Jean Mery, was the first who obtained retinal images from an animal. His approach involved immersing a live cat in water because its retinal vessels were more visible from the outside. Although this was achieved in cats, it was unrealistic in humans and resulted in the invention of the ophthalmoscope. The ophthalmoscope is an instrument used in assessing the inside of the eye, especially the retina. This instrument was invented in 1823 by a Czech scientist called Jan Evangelista Purkyně. The ophthalmoscope has been reinvented over the years by different scientists. One of such reinventions was the Liebreich ophthalmoscope in 1860.

The use of the ophthalmoscope to obtain retinal images requires the physician to be in very close proximity to the patient. With the incidence of infectious diseases, the requirement to be close to the patient during examination has made the ophthalmoscope a less desirable instrument in the diagnosis of eye diseases. Another main limitation is the degree view of the retina that could lead to a partial diagnosis and thus ineffectual treatment outcome.

However, the design and functions of ophthalmoscopes have improved over the years. Currently, there are smartphone ophthalmoscopes like the iExaminer by Welch Allyn.

Improvements in retinal imaging

Since the invention of ophthalmoscopes, there have been major improvements in retinal imaging. These include fundus photography, fluorescein angiographic imaging, and optical coherence tomography (OCT). All these innovations in retinal imaging are necessary because apart from accurately diagnosing eye diseases, some systemic diseases have been detected based on the changes in the retina of the patient. Some common ailments like diabetes mellitus and cardiovascular diseases manifest themselves in the retina. Early detection and appropriate diagnosis can lead to a better treatment outcome. For instance, the development of the OCT, a non-invasive retinal imaging approach, has helped physicians determine the extent and amount of changes in the retina.

The future of retinal imaging

From revealing images of the retina to displaying its different layers demonstrates how retinal imaging has improved over time. In the last decade, retinal imaging devices have become more portable, cost-effective, and user-friendly. Technological advancements have also created computer-based quantitative analyses of OCT outputs. The availability of this computer-support system and the increasing demand for telehealth has created a niche for personalized healthcare. Due to the onset of the pandemic last year, many clinics were not operating in their full capacities, and patients had to wait for their turns on long waitlists. The use of remote monitoring in telemedicine may yield improved healthcare by early disease detection and increased patient participation. For example, utilizing a home OCT device by a patient can produce retinal data that will be analyzed via the computer-support system and interpreted by the provider. In this scenario, patients may avoid the stress of waiting to be seen in the clinic and can receive treatment from the comfort of their homes. Also, a patient can capture retinal changes during an active visual disturbance almost immediately or in a timelier fashion than when the patient would have to wait to get an appointment in the clinic.

The constant advancement in science and technology has the potential to produce more automated devices in the monitoring of patient’s health in a non-traditional setting. For example, blood glucose levels have shifted from needle pricks in a hospital setting to a wearable pad. The future of home monitoring devices will be an exciting journey as healthcare as we know it, may be transformed.

Sources:

Abràmoff, M. D., & al. (2010). Retinal imaging and image analysis. IEEE reviews in biomedical engineering, 3, 169–208. doi:https://doi.org/10.1109/RBME.2010.2084567

iExaminer by Welch Allyn. Retrieved from https://www.neuvar.com/product/ophthalmoscope-msl11/

Image of remote monitoring. Retrieved from https://i2.wp.com/thejournalofmhealth.com/wp-content/uploads/2019/05/The-rise-of-remote-patient-monitoring.jpg

Liebrieich Ophthalmoscope. Retrieved from https://commons.wikimedia.org/wiki/File:Ophthalmoscope_designed_by_Richard_Liebreich_circa_1860._Wellcome_M0018844.jpg

Modern Ophthalmoscopes. Retrieved from https://cdn3.volusion.com/a94vt.osp7c/v/vspfiles/photos/11842-A6-2.jpg

Singh, S., & Goyal, A. (2007). The origin of echocardiography: A tribute to Inge Edler. Texas Heart Institute journal, 34(4), 431–438. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2170493/