The eyeHeme: A Novel

Approach to Anemia
Diagnosis

Team Dx, D-lab Health

Arianne Jong
Seema Kacker
Kristin Kuhn
Spring 2010
Overview
 Motivation – Impact of
Anemia
• Anemia is a primary contributor to the global
burden of disease
o 2 billion people worldwide
 impaired development, reduced productivity
 increased infection risk
 more rapid disease progression
o 42% of all pregnant women
 20% of maternal deaths (>120,000 per
year)
 birth complications, infant mortality
(>134,000 per year)
o 40-50% of preschool children in the
developing world are anemic
o $50 Billion in GDP lost each year
Global Health Risks Report: Mortality and burden of disease attributable to selected major risks.  W
2009.
 Motivation
Nine out of 10 anemics live in the developing world,
but anemia affects all countries and demographics
 Background
Anemia
• Definition: inability of red blood cells to carry
enough oxygen to the tissues of the body
o measured by hemoglobin concentration
• Causes: nutritional and due to infection
o Iron-deficiency: >50% of cases
o Infection (malaria, hookworms, etc.)
o Other nutritional deficiencies
• Challenge
o Treatment is known, but anemia is under-
diagnosed and undertreated
 Diagnostic Methods:
Invasive
Methods Limitations
o Complete blood count • Painful
 [Hb] • Risk of infection
 Hematocrit - volume • Training required
occupied by RBCs in • Costly
plasma • Result may not be
 Mean Corpuscular Volume:
average size of RBCs immediately available
o Alternative in-vitro methods
o HemoCue

www.hubpages.c
 Diagnostic Methods: Non-
Invasive
Methods
• Few widely available
devices
• Mostly qualitative analysis
of obvious clinical signs
– Eyelid, tongue, palmar and
nailbed observation, patient
interview
– Sensitive only to severe
anemia
– Subjective
– Requires training/experience

Karnath,
 Subcutaneous Absorbance:
Modified Pulse-Oximeter
Concept Challenges
• Beer-Lambert Law: • Sensitivity
I0 • Impure sample
A = log = [Hb]×l ×e
I (multiple species of
• Attenuation: Hb, blood, tissue, etc.)
I0
D = log = [Hb]×l ×m
I
• Measure variation in
path length with
sonomicrometer

Aldrich et al., 2002

 Occlusion Spectroscopy -
OrSense
Concept Concept
• Occlusion of blood
flow causes low signal-
noise ratio
• Measures
transmittance using
Challenges
multiple wavelengths
• Cost issues
• Appropriate?

Amir et al., 2007

Reflectance Spectroscopy

Nadeau et al., 2001

http://www.nrc-cnrc.gc.ca/eng/projects/ibd/diffuse-
 Orthogonal Polarization
Spectral Imaging
Concept • Sublingual mucosa
• Most polarized light
• Hemoscan, Cytoscan
retains polarization
• Deep-penetrating light
(to blood vessels)
becomes depolarized

Nadeau et al., 2001

 Optical Diagnosis via the
Eye
Method
• Reflectance obtained from
blood vessels in the eye
• Fundus, Conjunctiva
• Obtain/view reflected
signal
• Modified
ophthalmoscope?

Jay et al., 2007

Strategy: Goals for Appropriate
Design

-> Initial screening device

-> Quantitative, but
specific numeric output
not required
 Proposal
- Use: palpebral conjunctiva
-Why?
-Clinical signs
-Mucosal tissue

- Via: reflectance
- How?
-filter with photodiode
 Proposal
7.3 g/dL (Anemic) 12.7 g/dL (Mildly Anemic)

14.0 g/dL (Non-Anemic) 14.5 g/dL (Non-Anemic)

The Concept: Reflectance
The Concept: Reflectance
Anemic and Non-Anemic Blood
The Concept: Reflectance
Tissue and Hemoglobin
Proposal: Working Prototype
Progress
Future Directions
 Prototype Development
Increase sensitivity and precision
• multiple wavelengths 
 
• alternative surfaces
(mouth, nostril, e.g.)
 
• multimodal (combine Nathan Cooke, 2010

absorbance, reflectance,
fluorescence)
 Prototype Development
• Determine best light source 
 
 
 
 
 
• Test using Intralipid, blood
 Product Development
• Power source
• User interface Sensor

• Patient testing
o Pilot study: small NGO,
health care provider Light

o Comparison to blood tests

• Deployment Nathan Cooke, 2010

o Integration into health

system
o Two-tiered pricing system
 510(k) Predicate Devices

Orsense's absorbance-based
hemoglobin sensor
Ophthalmoscope
SPO Medical's
reflectance-based
pulse oximeter
Innovation Compass
 Impact on Global Health
Better statistics

More awareness

More funding
(fortified rice, iron supplements,
etc.)
Thank you!

Questions?