NYU Langone Doctors Develop New Ophthalmology Technology

December 14, 2019 at 5:00 am

At NYU Langone Health, a doctor whose groundbreaking invention changed ophthalmology in the 1990s is building on his breakthrough with new eye care research.  Dr. Joel Schuman is one of the inventors of Optical Coherence Tomography (OCT), an imaging device that allows doctors to objectively review the retina.  Now Dr. Schuman leads a team of researchers working to develop the next big ophthalmologic innovation.

Aired on December 13, 2019. 

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>> YOUR RETINA IS TISSUE IN THE
BACK OF THE EYE THAT HOLDS THE
KEY TO DIAGNOSING MOST BLINDING
DISEASES.
ITS APPEARANCE CAN INDICATE
CONDITIONS LIKE MACULAR
DEGENERATION, DIABETIC
RETINOPATHY AND GLAUCOMA.
IT WASN'T UNTIL OPTICAL
COHERENCE TOPOGRAPHY IN THE
1990s THAT REVIEWING THE RETINA
WAS EVEN POSSIBLE.
WHAT WERE PEOPLE USING BEFORE?
>> THEY WERE LOOKING.
THEY WERE LOOKING AT THE BACK OF
THE EYE AND MAKING A SUBJECTIVE
ASSESSMENT OF WHAT IT LOOKS
LIKE.
THAT WAS HOW WE DID IT.
UP UNTIL THE MID '90s.
>> THIS DOCTOR IS A PROFESSOR
AND THE CHAIRMAN OF
OPHTHALMOLOGY AT NYU.
HE WAS PART OF THE TEAM THAT
INVESTED THIS.
>> IT IS A WAY OF MAKING A THREE
DIMENSIONAL MAP OF THE BACK OF
THE EYE.
IN THIS CASE WE ARE TALKING
ABOUT EYES.
IT CAN SEE THE RETINA, WHICH IS
THE NERVE TISSUE IN THE BACK OF
THE EYE.
IT'S LIKE AN ULTRASOUND BUT
USING LIGHT INSTEAD OF SOUND
WAVES.
WHAT THAT DOES IS IT ALLOWS US
TO DIAGNOSE DISEASE MUCH EARLIER
THAN WE EVER COULD BEFORE AND TO
FOLLOW TREATMENT OF THE DISEASE.
IS MY TREATMENT WORKING OR NOT?
IS SOMETHING GETTING WORSE OR
NOT?
THE FIRST TIME THE PATIENT COMES
IN, YOU KNOW OR YOU CAN FIGURE
OUT, DOES THIS PATIENT HAVE SOME
SORT OF DISEASE?
ALL OF THESE THINGS CAN BE
MEASURED VERY ACCURATELY AND
PRECISELY WITH OCT.
>> THE DOCTOR SAYS OPHTHALMOLOGY
BEFORE OCT WAS SIMILAR TO
NEUROLOGY BEFORE THE ADVENT OF
CT SCANS OR MRIs.
WHEN NEUROLOGISTS WOULD MAKE
JUDGMENT CALLS ON WHERE IN THE
NERVOUS SYSTEM AN ABNORMALITY
ORIGINATED.
>> WHAT OCT DOES AND ONE OF THE
REASONS THAT I WAS INTERESTED IN
BEING INVOLVED IN INVESTING OCT
IS THAT IT ALLOWS US TO TAKE THE
SUBJECTIVITY OUT OF THE
ASSESSMENT OF EYE DISEASE AND
OUT OF THE QUESTION OF WHETHER
OR NOT SOMEBODY IS GETTING
WORSE.
WE CAN ACTUALLY MEASURE THE
TISSUE.
IT'S DONE OBJECTIVELY,
QUANTITATIVELY AND IT IS
NON-CONTACT AND NON-INVASIVE AND
VERY QUICK.
>> NOW DECADES AFTER OCT FIRST
CHANGED THE FIELD, HE IS
RESEARCHING WAYS TO USE THE
TECHNOLOGY AS A FOUNDATION FOR
NEW INNOVATIONS IN EYE
TREATMENT.
>> IN TERMS OF WHERE OCT IS NOW,
WE'RE ABLE TO MEASURE STRUCTURES
IN THE EYE.
WHERE WE ARE GOING IS BEING ABLE
TO MEASURE HOW THE TISSUE IS
WORKING.
THE NERVE TISSUE THAT'S IN THE
BACK OF THE EYE, THE RETINA, IS
PART OF THE BRAIN.
THE BRAIN DOESN'T REGENERATE.
BECAUSE IT DOESN'T REGENERATE,
DAMAGE TO THE RETINA IS REALLY
SERIOUS.
THE RETINA DOESN'T GET BETTER.
WE ARE DOING EXPERIMENTS HERE TO
TRY TO RESTORE FUNCTION TO
RETINA THAT'S BEEN DAMAGED.
AND WE'RE EXCITED ABOUT THAT.
>> HIS TEAM IS LOOKING INTO
UTILIZING DIFFERENT WAVELENGTHS
OF LIGHT TO DETERMINE HOW MUCH
OXYGEN IS GETTING INTO THE
ISSUE.
THEY ARE USING A TECHNOLOGY
CALLED ADAPTIVE OPTICS TO
ACTUALLY SEE DAMAGE.
THE TEAM IS COLLABORATING WITH
IBM TO DEVELOP ARTIFICIAL
INTELLIGENCE CAPABLE OF
PRODUCT
-- PREDICTING.
>> WE ARE USING DEEP LEARNING TO
ANALYZE OCT IMAGES AND ALSO
VISUAL FIELDS TO DETERMINE
WHETHER OR NOT SOMEBODY IS
LIKELY TO GET WORSE OR NOT AND
ALSO TO ANALYZE THAT IMAGE
ITSELF.
KIND OF AN AUTOMATED WAY WHERE
THE MACHINE COULD DO THE
READING.
>> THE TEAM PROVIDES IBM WITH
DATA, KEEPING PATIENTS
ANONYMOUS.
IBM WORKS ON DEVELOPING MACHINE
LEARNING.
>> THAT COLLABORATION BRINGS
THESE DIFFERENT SKILL SETS
TOGETHER IN ORDER TO CREATE A
GREATER WHOLE, WHICH IS
ALGORITHMS, THESE WAYS OF
ANALYZING OCT, ANALYZING VISUAL
FIELDS, PUTTING EVERYTHING
TOGETHER AND BEING ABLE TO SAY,
OKAY, THIS PATIENT HAS DISEASE,
THIS PATIENT DOESN'T, THIS
PATIENT IS GOING TO GET WORSE
QUICKLY, YOU BETTER ACT, THIS
PATIENT IS GOING TO GET WORSE
SLOWLY, MAYBE YOU DON'T NEED TO
SEE THEM THAT OFTEN AND TREAT
THAT AGGRESSIVELY.
>> SOME OF THE CURRENT RESEARCH
ON EYE TREATMENT IS, QUOTE,
UNQUOTE, A LITTLE FAR OUT.
EXPERIMENTS THAT VERY WELL COULD
FAIL BUT EVIDENCE SUGGESTS COULD
BE SUCCESSFUL.
>> ONE OF THE THINGS THAT WE ARE
DOING LIKE THAT IS A GENTLE
ELECTRICAL STIMULATION TO
RESTORE VISION.
SPECIFICALLY, WE ARE LOOKING AT
THIS IN PEOPLE WITH GLAUCOMA.
>> HAVE YOU HAD CHANGES?
>> NO.
>> THIS SCIENTIST HEADS UP THE
STUDY.
COLLABORATING WITH A COLLEAGUE
IN GERMANY.
TODAY SHE'S MEETING WITH A
PATIENT.
A PROFESSIONAL VIOLINIST
DIAGNOSED WITH GLAUCOMA.
>> WE ARE DOING AN EXPERIMENTAL
INTERVENTION THAT'S CALLED
REPETITIVE TRANSORBITAL
STIMULATION.
WE USE A LOW ELECTRICAL CURRENT.
WE PLACE TWO ELECTRODES AND WE
DELIVER STIMULATION OVER TEN
DAYS FOR 30 TO 45 MINUTES.
WE ARE TRYING TO MIMIC THAT
NATURAL PROCESS OF HOW THE CELLS
COMMUNICATE FROM THE EYE TO THE
BRAIN BY USING THIS ELECTRICAL
STIMULATION.
THE IDEA IS FOR THOSE CELLS IN
THE EYES IN THE RETINA THAT
AREN'T WORKING TO THEIR FULL
CAPACITY, WE WILL SEE IF WE
PROVIDE THIS EXTERNAL
STIMULATION, WE WILL HELP THEM
TO FUNCTION BETTER, MORE
EFFECTIVELY, MORE EFFICIENTLY SO
COMMUNICATION -- THE INFORMATION
THEY SEND BACK TO THE BRAIN MAY
BE IMPROVED SO PEOPLE MAY
PERCEIVE AN IMPROVED VISION.
>> OCT IMAGING WILL ALLOW THE
DOCTOR TO DETERMINE WHETHER THE
STIMULATION IS WORKING OR NOT.
SHE SAYS THE EXPERIMENTAL
MEDICAL INTERVENTION WON'T
CHANGE THE MECHANISM OF GLAUCOMA
BUT IT MAY HELP SLOW THE
PROGRESSION OF THE DISEASE.
THAT'S THE OUTCOME THAT THE TEAM
ARE HOPING FOR.
>> I CERTAINLY HOPE THAT AFTER
THESE SESSIONS ARE OVER THAT I
WILL NOTICE SOME IMPROVEMENT IN
MY VISION.
I UNDERSTAND THAT THAT MAY NOT
HAPPEN.
BUT I WOULD LIKE TO SEE IF IT
MAY.
>> RESEARCH IS OFTEN EXCITING.
IT OFTEN DOESN'T WORK.
BUT I'VE BEEN LUCKY TO BE IN
SEVERAL STUDIES THAT HAVE LOOKED
AT NEW THINGS THAT ACTUALLY DO
WORK.
>> LIKE OPTICAL COHERENCE
TOMOGRAPHY.
WHILE NYU HELPS EXPERIMENTAL
TREATMENTS AND ARE IN THE EARLY
STAGES OF RESEARCH, ONE COULD BE
THE NEXT BIG BREAKTHROUGH IN EYE
CARE.

Funders

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