INNOVATION July-August 2018

F E A T U R E H ere’s how the Merriam-Webster Dictionary defines an engineer: “a person who has scientific training and who designs and builds complicated products, machines, systems, or structures.” That’s certainly correct, but it leaves out why the engineer is motivated to create those products, machines, systems, or structures in the first place. For many if not most engineers, including Simon Fraser University’s Dr. Marinko Sarunic, P.Eng., it’s to make a difference in the world. “I love technology,” he says. “I love computers and math and physics. But at the end of the day I want to employ technology to help people.” Sarunic’s invention is a retinal-imaging scanner about the size of a shoebox that uniquely combines image-guided adaptive optics with optical coherence tomography (OCT) to create high- resolution, three-dimensional, cross-sectional and real-time images of the retina, the innermost layer of the eye. Chances are that images as clear and precise as these could, within a few short years, allow ophthalmologists around the world to diagnose serious eye diseases far earlier than they can now, with less risk to the patient.

“The way we have been diagnosing retinal diseases, such as diabetic retinopathy and wet age-related macular degeneration, which are two of the leading causes of blindness,” says Dr. Eduardo Navajas, a vitreo-retinal surgeon in UBC’s Department of Ophthalmology, “is by fluorescein angiography. This is where we inject a dye into the bloodstream, then take a picture of the retina with a specialized camera to highlight blood vessel abnormalities and retinal damage. It works, but there is a small risk of allergic reaction with the dye. We also can’t examine the very deep capillary vessels. The technology Marinko has developed”—which Navajas has been testing in various iterations at the Eye Care Clinic at Vancouver General Hospital for almost two years now—“significantly expands our ability to detect blood vessel abnormalities early, before they cause permanent damage.” Since 75% of vision loss can be treated or prevented through early detection, this is big news, particularly for an aging population like we have here in Canada. “The older you get,” says Navajas, “the higher the chance you will experience macular degeneration or other serious eye diseases.” Sarunic first started to work on the scanner more than a decade ago, in 2006. At that time, he was focussed on making existing OCT technology, which uses light waves to take cross-sections of the retina, both faster and better. In 2010, Dr. Yifan Jian, then one of Sarunic’s graduate students and now heading to a professorship at Oregon Health and Science University in Portland, helped develop the use of a graphics processing unit (GPU) instead of a regular desktop CPU to do the processing. “This gave us real-time processing, where the GPU could keep up with the acquisition of images, which was a real step forward on speed,” says Sarunic. At the same time, the professor had also been collaborating with another university colleague, Dr. Faisal Beg, P.Eng., director of SFU’s Functional and Anatomical Image and Shape Analysis Laboratory. “As an image processing engineer,” says Beg, “my expertise is making measurements from images, so partnering with Marinko was just logical. The outputs from his images become the inputs for our work—in other words, we turn his pretty pictures into data.” And that data provides eye doctors with the ability to measure, in real time, with the patient sitting there, both eye damage and treatment progress like never before. “When an ophthalmologist shines a bright light into an eye, there is no record of what he or she sees,” says Beg. “So the first big step is recording the image. The second big step is putting numbers on that image, so the ophthalmologist can say ‘I see 1% of tissue is being lost here, and 2% there,’ for

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