MY BIZ: Putting blindness on hold

CORALVILLE — Dr. Michael Abramoff spotted the problem early in his career as an ophthalmologist.

“Patients not getting the care they need and deserve,” Abramoff said. “On the other hand, I could see the technology maybe doing what I could do.”

Abramoff, 59, moved to Iowa City in 2003 from his native Netherlands to study ophthalmology. He also earned a Ph.D. in medical image analysis and a master’s degree in computer science and is a professor at University of Iowa Hospitals and Clinics.

“It’s the best place in the world to do it, to learn from the best people,” he said. “I stayed because of the wonderful people.”

Abramoff specializes in treating the retina, the inner, light-sensitive layer of tissue in the eye. He knows people with diabetes are at special risk of damage to the retina. The condition, diabetic retinopathy, affects up to 80 percent of those with diabetes and is a leading cause of blindness in developed countries.

Early detection and treatment can prevent blindness, but just 15 percent of those with diabetes had retinal exams as part of their annual physical. The exam has to be conducted by an ophthalmologist specializing in the retina, adding the expense and inconvenience of a second appointment. Patients in rural areas might have to travel hours to a specialist.

With his computer experience, Abramoff thought artificial intelligence (AI) could be developed to detect swelling of the center of the retina, the most common early indicator of diabetic blindness.

Long process

He launched what would become Digital Diagnostics in 2010, beginning the arduous clinical trials to gain Food and Drug Administration approval for a device that would scan a patient’s retina, then analyze the resulting image to detect swelling or other flaws.

“They said ‘Well, let’s discuss this,’ ” Abramoff recalled. “How do you prove there’s no racial bias? How do you prove it’s safe and effective? We designed the clinical trial and developed the AI — autonomous artificial intelligence, we like to call it.”

In April 2018, the FDA approved Digital Diagnostics’ IDx-DR for clinical care. It’s since been adopted by the American Diabetes Association’s standard of care.

“Now it happens right then and there” during a patient’s routine physical, said Abramoff, who holds 23 patents. “They get the AI exam in about 10 minutes. You don’t need to be a specialist — anyone in the office can do those exams. Most patients will be normal, but a few have to be told, ‘You have this potentially blinding disease, you really need to see someone.’ ”

Digital Diagnostics’ staff is pursuing further medical applications for AI. Its use in the early detection of skin cancer appears promising, according to Abramoff, who is executive chairman of the company. Co-founders John Bertrand is the company’s CEO and Seth Rainford its president.

“We look for those diseases and those patients where there’s clinical evidence and proof that it can actually benefit the patient,” he said. ”Part of it is building the technology, and we’re really good at that. But if it’s not’s helping health equity, I don’t think we should be paying for it as taxpayers. We need to make sure everyone gets the care they deserve.

Digital Diagnostics recently celebrated its 100th hiring.

Abramoff describes the company’s tech staff as “computer scientists, computer engineers, people who know about machine learning, software developers.”

“But at least as important in value is what we call customer success,” he said. “They work to make sure that it’s working for (users), so it’s working for the patients. It’s one thing to have an algorithm and build it, but it’s more important that it works for the health care system and it works for the benefit of the patients.”

The company also maintains offices in Chicago and Austin, Texas, but its Iowa roots remain deep.

“It’s an awesome team,” Abramoff said. “It’s so exciting to see people who graduate from Iowa and want to stay here. The exciting work like we do wasn’t there, and now it’s there. Iowa has been so wonderful to me and my family that we wanted to give something back. Preventing blindness is important.”

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