A Novel, Low-Cost, Wide-Field, Infant Retinal Camera, “Neo”: Technical and Safety Report for the Use on Premature Infants

Abstract

Purpose To report the technical aspects, systemic, and ocular safety of a novel, low-cost, wide-field, infant retinal camera for use on premature infants. Methods The device, the “3nethra Neo” (Neo) is a 120° portable, contact, wide-field, unibody camera, with a CMOS sensor (2040 × 2040 resolution) and a warm light-emitting diode (LED) illumination source. The Neo was used to image 140 awake, preterm infants between postmenstrual age (PMA) of 28 to 37 weeks, undergoing retinopathy of prematurity (ROP) screening. Baseline, ‘during procedure', at 5 minutes, and for 60 minutes postprocedure, readings of oxygen saturation and heart rate were recorded. The device design, optics, illumination, and software specifications were compared with the RetCam 3. Results Study defined bradycardia (9 infants, 6.4%), tachycardia (3 infants, 2.1%), and hypoxia (2 infants, 1.4%) were observed but there were no clinically significant systemic changes that required intervention during or following any of the study time intervals. There was a transient increase in heart rate by 9.68 (7.53–11.83; P < 0.0001) and marginal decrease in oxygen saturation (−1.94 [−1.60 to −2.28], P < 0.0001), which started to return to baseline 5 minutes after the procedure. Transient redness was seen in two eyes (0.7%) of two infants. No other ocular adverse effects were observed. Conclusions The Neo is easy to use in preterm infants and being compact was readily portable. There were no significant ocular or systemic adverse effects, potentially allowing it to be a viable low-cost device for ROP screening in low resource settings. Translational Relevance The camera provides a safe and affordable alternative to image the retina of infants by using novel illumination and lens mechanics and has the potential of worldwide acceptance.

The changing scenario of retinopathy of prematurity in middle and low income countries: Unique solutions for unique problems

“…A scope for improvement in the existing strategy would be: 1) a universal screening program[28] built on the tenets of tele-medicine employing low cost, easy to use, portable infant imaging cameras,[29] an accredited training program that employs a cadre of trained technicians and an integrated reading center that will provide credible and rapid diagnosis with reports for these remote screening sites which comply with clinical and medico-legal regulations. [30] This has the scope of preventing blind-person years (BPY) accounting for over 200 million USD annually in ten states of the country[31]2) Software innovations providing fully or semi-automated analysis of retinal images providing a clinical triage, machine learning, deep learning algorithms and artificial intelligence will allow better utilization of the limited number of specialists.…”

Safety and efficacy of combination of suberoylamilide hydroxyamic acid and mitomycin C in reducing pro-fibrotic changes in human corneal epithelial cells

“…This observation is further supported by the enhanced ratio of mRNA levels of Bax/Bcl2. We as well as others have a shown that the ratio of Bax/Bcl2 determines the cell susceptibility to apoptosis 71 – 74 . However, in the presence of SAHA, the MMC induced apoptosis of cells were prevented.…”

“…The fluorescent images were documented using ProgRes Capture Pro 2.5 software on fluorescent microscope (Olympus BX41). Fluorescence intensity was quantified using Image J 1.48 version software ( http://imagej.nih.gov/ij/ ; provided in the public domain by the National Institutes of Health, Bethesda, MD, USA) 74 . Primary and secondary antibodies are listed in Table 2 .…”

Commentary: Bringing frugal Indovation to eyes of babies

“…Whether to document retinopathy of prematurity (ROP) or retinoblastoma or retinal hemorrhages, a contact fundus camera, such as the RetCam, RetCam Shuttle (Natus USA, formerly Clarity, MSI, USA), or 3nethra Neo,[ 1 ] (Forus Health, Bengaluru, India) makes it easier to get a clearly focused retinal photograph. It reduces movement of the eyeball and the camera as compared to a non-contact method.…”