The relentless pursuit of detecting and combating the effects of Alzheimer’s disease has posed a grueling battle for families and the medical community, but a simple eye scan at an optometrist’s office may one day help ease that burden.
It’s called RetiSpec, a Toronto-based medical imaging company that uses AI and a retinal scan to help detect early signs of Alzheimer’s. The company is in the process of seeking regulatory approval for its scan in Canada and the U.S.. The technology would be the first kind to be approved in either country.
“One of the problems with Alzheimer’s is that it’s not picked up early,” said Sharon Cohen, neurologist and medical director of the Toronto Memory Program. She added that it can also be difficult to detect the first signs of the disease.
“We actually call it probable Alzheimer’s…we can be wrong a lot of the time. And with new treatments coming that are aimed at precision medicine, we need to get it right. You can’t imagine treating someone for cancer if they don’t actually have cancer,” she said.
In order to help detect early signs of Alzheimer’s, medical professionals typically use diagnostic tools like PET scans or spinal taps, Cohen explained. But these diagnostic tools can be expensive, invasive and not readily available.
That is where RetiSpec comes in. The AI technology is mounted on an optometrist camera. With a retina scan it can take a picture of the back of the eye.
“A picture of the eye gives you literally and figuratively, a window into the brain because the back of the eye is the front of the brain,” Cohen said. “And you can see the signature of amyloid…that sticky protein that builds up very early in Alzheimer’s disease.”
If amyloid is present then that person has the pathology of Alzheimer’s disease.
“With the special sensor that we use and the (AI) algorithm, we’re able to, with very strong reliability, determine who does and does not have that protein,” said Catherine Bornbaum, the head of clinical operations and partnerships at RetiSpec.
Alzheimer's in Canada
The number of Canadians living with Alzheimer’s disease is on the rise.
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As of 2022, around 600,000 Canadians were living with Alzheimer’s or dementia, according to the Alzheimer’s Society. That number is projected to reach more than 955,000 by the year 2025. And by 2050, the number of people living with dementia could reach over 1.7 million.
This is mainly because one of the biggest risk factors for dementia is age, according to the Alzheimer’s Society. For example, most people who develop dementia are over the age of 65.
Because of the aging population, dementia will become more common as the “baby boomer” generation ages into their eights and nineties.
But with the help of the Alzheimer’s Society, optometry clinics and funding through the Davos Alzheimer’s Collaborative, Cohen believes the new technology from RetiSpec can help ease the burden.
“Both of my parents had this disease. There’s nothing nice about Alzheimer’s,” Cohen said. “I feel like they would be thrilled to know there’s something for the next generations,” Cohen said. “So we’re not done. We haven’t cured the disease, but it is a very hopeful time.”
Seeking Health Canada approval
The RetiSpec study started in October 2022 in Toronto. The goal was to conduct cognitive testing and retinal scanning in the community for early detection of Alzheimer’s.
“We work with existing infrastructure. The cameras are already in doctors’ offices and we have seen very, very strong responses. Over 500 people were screened in a very short period of time in optometry settings alone,” Bornbaum said.
Negar Sohbati, an optometrist based in Toronto, is part of the study and said she has had a very positive experience using the AI technology.
“My role in this has been to help screen patients, especially the patients over the age of 55, who have some kind of memory loss or memory changes,” she said. “I’m able to screen them for changes in biomarkers in the back of their eyes that may be related to Alzheimer’s and dementia.”
It is a very quick and efficient process taking around two to three minutes, Sohbati explained.
“So scanning four or five images in each eye, just a flash of light. Tell them where to look. They look directly at a target, a little flash of light, and that’s it. I often say, ‘All right, we’re all done here.’ And they sit back and go, ‘That’s it?'”
Because the retinal scan is not yet approved by Health Canada, the scores of the scan cannot be shared with the patients yet. However, the plan would be to send the results to the patient’s family doctor to discuss the next steps if amyloid is found.
If Health Canada does approve the technology, Sohbati said the goal would be to make RetiSpec part of an optometrist’s routine eye exam.
Bornbaum hopes to hear back about approval within a year.
“(Alzheimer’s) is a very complex disease and I strongly believe we can do better,” Bornbaum said. “We owe the patients and the families who are living with this disease better options. I think there’s a really important role for technology like RetiSpec…we’re definitely doing something innovative a little bit outside the box, but I think it has a huge potential to impact so many lives.”
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