July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Clinical implementation of malarial retinopathy screening system for improved diagnosis of cerebral malaria
Author Affiliations & Notes
  • Vinayak S Joshi
    VisionQuest Biomedical LLC, Albuquerque, New Mexico, United States
  • Jeffrey C Wigdahl
    VisionQuest Biomedical LLC, Albuquerque, New Mexico, United States
  • Sheila C Nemeth
    VisionQuest Biomedical LLC, Albuquerque, New Mexico, United States
  • Gilberto Zamora
    VisionQuest Biomedical LLC, Albuquerque, New Mexico, United States
  • Peter Soliz
    VisionQuest Biomedical LLC, Albuquerque, New Mexico, United States
  • Susan Lewallen
    Kilimanjaro center for community ophthalmology, South Africa
  • Simon P Harding
    University of Liverpool, United Kingdom
  • Benjamin Turner
    University of Liverpool, United Kingdom
  • Chatonda Manda
    University of Malawi, Malawi
  • Terrie Taylor
    Michigan State University, Michigan, United States
  • Footnotes
    Commercial Relationships   Vinayak Joshi, VisionQuest Biomedical LLC. (E); Jeffrey Wigdahl, VisionQuest Biomedical LLC. (E); Sheila Nemeth, VisionQuest Biomedical LLC. (E); Gilberto Zamora, VisionQuest Biomedical LLC. (E); Peter Soliz, VisionQuest Biomedical LLC. (I); Susan Lewallen, None; Simon Harding, University of Liverpool (E); Benjamin Turner, University of Liverpool (E); Chatonda Manda, University of Malawi (E); Terrie Taylor, Michigan State University (E)
  • Footnotes
    Support  NIH-NIAID grant 2R44AI112164-03A1
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 146. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Vinayak S Joshi, Jeffrey C Wigdahl, Sheila C Nemeth, Gilberto Zamora, Peter Soliz, Susan Lewallen, Simon P Harding, Benjamin Turner, Chatonda Manda, Terrie Taylor; Clinical implementation of malarial retinopathy screening system for improved diagnosis of cerebral malaria. Invest. Ophthalmol. Vis. Sci. 2019;60(9):146. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : To implement a fully automatic computer-based malarial retinopathy (MR) screening system as a tool to improve the diagnostic accuracy of cerebral malaria (CM).

Methods : MR is a retinal manifestation of CM. It presents as a series of highly specific (> 95%) retinal lesions that can confirm the presence of CM and reduce false-positive diagnosis of CM. We developed an artificial intelligence system named ‘Auto-detection Software for Plasmodium Infection in Retinal Exams’ (ASPIRE), that provides automated point of care screening for MR. The system interfaces a fully automated retinal image analysis software with a handheld retinal camera, Pictor-Plus by Volk Optical. We tested a clinical prototype of ASPIRE in a malaria clinic in Malawi, Africa, where we acquired and processed retinal fundus images from patients clinically diagnosed with cerebral malaria. The ground truth for the presence or absence of MR was provided by an ophthalmologist using binocular indirect ophthalmoscopy. Sensitivity and specificity of the software in detecting MR was determined against the ground truth.

Results : A retinal image dataset of 102 patients clinically diagnosed with cerebral malaria was utilized in this study, with N=72 patients with MR and N=30 subjects with no MR. ASPIRE software achieved a specificity of 100%, sensitivity of 63%, and positive predictive value of 1.0, against the ground truth. The user feedback on ASPIRE operation in the clinic confirmed its user-friendly functionality as a bedside tool that satisfies the clinical needs in Africa.

Conclusions : A fully automated system for detection of MR as a tool for improving the diagnostic accuracy of cerebral malaria will aid in reducing the false positive diagnoses, resulting in appropriate and timely treatment for CM or other underlying diseases. In the next phase, we will demonstrate a fully integrated design of ASPIRE system making it easily accessible and affordable to the affected population in Africa.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×