PupilScan / Yale presentation to KCL Institute of Psychiatry Psychology and Neuroscience (IoPPN) / 20 Nov 2019

1. PupilScan
PRESENTATION TO IOPPPN AT KING’S COLLEGE LONDON (AND ODSC)
BY: DEVIN HOSEA (PUPILSCAN) PROF. WADE SCHULZ (YALE UNIVERSITY SCHOOL OF MEDICINE)
AND PROF. VINCENT GIOVINAZZO (PUPILSCAN & STATE UNIV. OF NEW YORK SCHOOL OF MEDICAL SCIENCE )

2. “PupilScan” (verb, noun): Scan the patient’s eyes for 6
seconds with a smartphone to detect
neurotoxin(s) present in the brain.
 Scan: PupilScan app takes a 6000ms video of the eyes and uploads to a powerful server
in the cloud, at 30fps, creates about 180 images of both eyes
 Server functionality:
 Feature Extraction captures the pupillary lateral diameter, pupil area, iris area, inter-pupillary
distance (IPD), and other measurements
 Uses these measurements to create a Pupillary Light Reflex Graph (PLR)
 PLRs are distinctive for certain drugs (based on extensive research conducted by Dr. Irene
Loewenfeld MD at Columbia University)
 ML applied to all Feature Extracted data can classify the toxin and returns the value to the
smartphone app
 Note of caution: this is a nascent unproven application. However, based on Dr.
Loewenfeld’s work and our own proof-of-concept, we are cautiously optimistic this can
work, especially for opioids and stimulants. A clinical trial in 2020 at Yale will seek to
validate, and further train the model, with thousands of samples against a gold-
standard test (mass spectrometry).

3. Why Fluid Tests are Suboptimal to
Computational Neurotoxicology
 Inaccurate
 Specificity is the biggest problem; “utox” screens fail to recognize presence of many
dangerous psychotropic drugs
 Example: Fentanyl (a very strong synthetic opioid) is often missed in the A&E, resulting in
overdose and death
 Slow: Turnaround time (TAT) can be quite long in emergency situations where minutes
and seconds count [Dr. Thomas JS Durant, MD, Yale University, internal study, abstract submitted to College of American Toxicology, 23 April 2018]
 Expensive
 Costs can run as high as £50/test (with overheads), and an additional £100 if mass
spectrometry confirmation is required
 Total annual expenditure on drug testing in the US exceeds £10 billion
 Invasive: Drawing fluid (except blood) from comatose patients if often impossible (and
comatose pts are at highest mortality risk.) Blood has a much longer TAT, making it
impractical.

4. PupilScan Technology: Eye
scan with advanced quality
control
Smart client has functionality to
ensure quality scans that engender
high quality pupil measurements
over 6 seconds:
 Ambient light analysis
 Reflection correction/removal
 Distance and high-definition
sclera/iris/pupil capture
ensured
 Guidance is given to clinician to
position smartphone properly
before beginning scan which
gets sent to cloud

5. Facial Video -> Extract Eye Movie -> PLR

6. Facial Video -> Extract Eye Movie -> PLR
Classify PLR = [methadone]

7. Detecting opioids: oxycodone and
buprenorphine versus baseline
0
2
4
6
33
528
1023
1518
2013
2508
3003
3498
3993
4488
4983
5478
Pupillary Light Reflex of
Opioids versus baseline
Normal (no substances)
Oxycodone
Buprenorphine
Oxycodone + Buprenorphine
Millimeters of
Pupil Diameter
Scan time in milliseconds

8. PupilScan
Panel Data

9. Corresponds well to known PLR data in
literature: opioids tend to start lower and
depress the Pupillary Light Reflex as shown

10. PupilScan Technology
Client on
Smartphone
Measure pupil
diameter in each
frame
Plot Pupillary Light
Reflex Graph
Classify PLR graph
using a neural
network
Return result to
client in similar
format as utox
A PupilScan is
captured on a
smartphone and
then processed in
the cloud on a
massively parallel
virtual machine.
Only a panel of
values is returned,
corresponding to
exogenous
neurotropics.
Pending
FDA/MHRA
approval

11. PupilScan Technology: NN determines
substance(s) based on PLR data
360 input nodes
corresponding to
vector used to
create PLR graphs
Output nodes
correspond to
categories of
substance.

12. References and Contact Info
 References available upon request.
 Contact: Devin Hosea, PupilScan, dfh@pupilscan.co.uk @devin91
http://www.linkedin.com/devinhosea
 Want to beta-test it? Email support@pupilscan.co.uk
 020 7164 6274 (UK office). Or US mobile +1 609 558 8808
 iMessage/FaceTime: devin@alumni.princeton.edu

13. PupilScan
Panel Data

14. PupilScan Technology: Eye
scan with advanced quality
control
Smart client has functionality to
ensure quality scans that engender
high quality pupil measurements
over 6 seconds:
 Ambient light analysis
 Reflection correction/removal
 Distance and high-definition
sclera/iris/pupil capture
ensured
 Guidance is given to clinician to
position smartphone properly
before beginning scan which
gets sent to cloud