Virtual reality

Glaucoma detection with brain-based VR device

A wearable brain-based device called NGoggle that incorporates virtual reality (VR) could help improve glaucoma diagnosis and prevent vision loss.

virtual reality goggles on plastic head
NGoggle consists of head-mounted virtual reality goggles that use light to stimulate targeted areas in patient’s visual field. The screen is integrated with wireless electroencephalography, a series of electrodes that adhere to the scalp to measure brain activity in response to the light stimulation. Such activity is analyzed by a computer-based algorithm. Diminished activity may indicate the loss of the optic nerve connection between the eyes and the brain that occurs in glaucoma.
Source: NGoggle

Duke University researchers funded by the National Eye Institute (NEI) have launched a clinical study testing the device in hopes that it could decrease the burden of glaucoma, a major cause of blindness in the U.S. The device consists of head-mounted virtual reality goggles that use light to stimulate targeted areas in patient’s visual field. NGoggle’s portability means that it could potentially be used in variety of environments: in eye care provider’s office, a community center, or in a person’s home. “Glaucoma treatment can only slow or halt disease progression, so early detection is key to preventing irreversible glaucoma-related vision loss. Timing is everything,” said Jerome Wujek, Ph.D., an NEI research resources officer who oversees grants to help small businesses bring biomedical technologies to the market.

Glaucoma leads to blindness by damaging the eye’s optic nerve – the bundle of more than a million nerve fibers that connects the eye to the brain. The disease poses a major challenge because its initial impact on vision is imperceptible, starting with subtle deficits in peripheral (side) vision. As it progresses, these deficits grow worse, eventually leading to tunnel vision and irreversible blindness. “Current methods for glaucoma screening and monitoring are relatively primitive,” said Felipe Medeiros, M.D., Ph.D., a study investigator, a co-founder of NGoggle, Inc., and a professor of ophthalmology at Duke University School of Medicine.

Standard screening tests measure pressure within the eye. Although elevated intraocular pressure is the main risk factor for glaucoma, not all cases of the disease are associated with high pressure. Screening for glaucoma based on single intraocular pressure measurements may fail to detect up to 80 percent of the patients with the disease, Medeiros said. “That’s because many people develop optic nerve damage from glaucoma at relatively low intraocular pressure levels. In addition, pressure fluctuates widely throughout the day and on different days, making it difficult to rely on a single measurement for diagnosis and screening. Importantly, many subjects may also have high intraocular pressure and never develop damage to the optic nerve.”

There are tremendous difficulties in bringing patients to be tested in clinic several times a year. In the meantime, the opportunity for treatment to preserve vision diminishes considerably

Felipe Medeiros

Eye care providers most commonly use standard automated perimetry (SAP) to monitor glaucoma progression. SAP requires patients to click a button when lights are randomly shown for a brief time in their peripheral vision. But reliability is a drawback. On average, seven years of annual testing would be needed to detect disease progression. Upping the test frequency to three times annually cuts the time to five years. “That may be an improvement, but there are tremendous difficulties in bringing patients to be tested in clinic several times a year. In the meantime, the opportunity for treatment to preserve vision diminishes considerably,” he said. In contrast to SAP, the NGoggle objectively assesses peripheral loss of vision without requiring subjective input from the patient. NGoggle gauges brain activity in response to signals received from the eyes. Diminished activity may indicate functional loss from glaucoma.

The virtual reality goggles are integrated with wireless electroencephalography (EEG), a series of electrodes that adhere to the scalp to measure brain activity. Within a few minutes, the NGoggle algorithm captures and analyzes enough data to report how well each eye communicates with the brain across the patient’s field of vision. The device’s virtual reality capabilities can be greatly leveraged, Medeiros said. People could be tested for glaucoma as they play a VR-based video game or explore a virtual art gallery. “The possibilities are endless for making it an engaging experience, which would go a long way toward ensuring that people use it and receive the treatment they need,” he said.

Recommended article

Photo

A new kind of therapy

VR goggles on prescription? Virtual reality gains a foothold in medical care

For many years, Virtual Reality (VR) has been part of the gaming sector with eye goggles for players to interact with certain scenarios. However, more recently VR has shown it can deliver specific treatments in healthcare. It is already being applied, for example, to treat phobias and as a distraction therapy for pain. Work also progresses on how it can enable better outcomes for invasive…

In a partnership with Duke University, a study is being conducted to validate the diagnostic accuracy and reproducibility of the device. In addition to comparing NGoggle to SAP, they will look at how well NGoggle discriminates among different stages of disease by comparing its assessments of the neural damage in glaucoma with standard imaging techniques such as optical coherence tomography. The investigators also plan to conduct longitudinal investigations in which patients will be followed over time to validate the ability of the device to detect disease progression. Results will inform an application to the U.S. Food and Drug Administration (FDA) to market the device.


Source: NIH, National Eye Institute (NEI)

30.01.2019

Read all latest stories

Related articles

Photo

Feasibility study

Liquid biopsy to complement early breast cancer screening

Investigators from the Biomedical Research Institute of Malaga [(IBIMA)-CIMES-UMA, Malaga Spain] and collaborators have published the first pilot study to examine the use of a non-invasive liquid…

Photo

Watching the change

Predicting cancer risk with computational electrodynamics

Researchers from Northwestern University are using Argonne supercomputers to advance the development of an optical microscopy technique that can predict and quantify cancer risks at extremely early…

Photo

Microsatellites

Stomach and colorectal cancer: AI identifyies patients for immunotherapy

Changes in certain sections of the genetic material of cancer cells, so-called microsatellites, can provide an important indication of whether immunotherapy may be successful in a patient with…

Related products

Eppendorf – Mastercycler nexus X2

Research Use Only (RUO)

Eppendorf – Mastercycler nexus X2

Eppendorf AG
Sarstedt – Low DNA Binding Micro Tubes

Research Use Only (RUO)

Sarstedt – Low DNA Binding Micro Tubes

SARSTEDT AG & CO. KG
Shimadzu – CLAM-2030

Research Use Only (RUO)

Shimadzu – CLAM-2030

Shimadzu Europa GmbH