There are 45 million blind worldwide and 135 million with poor vision. In the USA there are an estimated 1 million blind over the age of 40. The cost of eye disease and visual impairment in the US alone is estimated to be $68 billion. According to the American Optometric Association diabetes is the leading cause of acquired blindness. More than 21 million people in the US have diabetes. In addition, 40% of Americans age 40 – 74 have a condition known as pre-diabetes that puts them at high risk for developing type 2 diabetes. People with diabetes are more likely to develop glaucoma, diabetic retinopathy and AMD (Age Related Macular Degeneration) — the 3 eye diseases that account for 25% of all blindness and visual loss. Diabetic retinopathy is the leading cause of blindness in American and European adults. More than 60% of diabetes patients will develop the disease. AMD is the leading cause of blindness in older adults today, accounting for 54 percent of all blindness in white Americans and 45 percent of visual disability in the general population.

The good news is that 80% of the blindness is preventable through early diagnosis. The prevalent approach to diagnosing eye diseases is by obtaining a digital image of the inner part of the eye (the retina). The problem is that a significant percentage of those at risk are not getting their eyes examined, like the 50% of diabetic patients who are not getting their eyes examined or are diagnosed too late for treatment.

DualAlign is committed to developing software tools that assist in the detection, diagnosis and treatment of eye diseases. To that end DualAlign has developed the following 3 tools that enable clinicians to detect and diagnose eye diseases.

Retinal Montage
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i2Align Retinal Montage is a web application that automatically creates the most accurate and reliable seamless wide field of view montages in the industry. Based on novel and proprietary technology, i2Align Retinal Montage is a web application that enables the user to quickly generate retinal montages based on retinal images taken from virtually any source. Unlike other retinal montage software, i2Align retinal Montage generates accurate montages from the most difficult images.

i2Align Retinal Montage works on a set of retinal fundus images taken of one eye of a single patient at a single sitting. The images are combined into a single, seamless, wide-field-of-view image of the retina. The software automatically chooses which pairs of images show overlapping fields of view and computes the transformation that aligns each pair. It then uses these results to compute the transformations necessary to map all of the images into a single coordinate system. Finally, it blends the images seamlessly while correcting for motion, illumination artifacts and vignetting.

The web application is filled with features to make it easy for the user to create, organize and analyze multiple montages. Users are able to create multiple sets of images and then store these sets in groups, which allow for easy access and quick analysis.

Illumination Correction
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i2Align Illumination Correction is made up of two algorithms for correcting the effects of vignetting and poor illumination on retinal images.

The first algorithm works on a single image to create a modified image that is close to how the image would appear if the scene were uniformly lit and the camera lens were free of vignetting.

The second algorithm performs the same function on two or more images that have been aligned by our proprietary registration technology. In this case, relationships between aligned pixels in two or more images are used to improve the illumination and vignetting correction in all images simultaneously. As part of this illumination correction, differences in illumination, due to differences in exposure time, are also corrected automatically.

Finally, the second algorithm also develops an estimate of the intensity response curve of the camera.

Multi Image Registration
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i2Align Multi rapidly aligns and stabilizes short-duration image sequences taken of a patient's retina. Based on i2Align's novel "i2align-pairwise" registration technology and using both multi-threading and optimizations for short image sequences, this software can align 8-10 images in a sequence in under 15 seconds.