Seeing the Whole Story: How ZEISS Retina Workplace Transformed My Clinical Practice

As retina specialists, OCT scans are the bread and butter of our practice. So much of what we do involves careful monitoring of a disease’s response to intervention. Thus, we must track a patient’s journey over time rather than focus on just a single moment.

When I started at the Cleveland Clinic six years ago, I was happy to find that ZEISS Retina Workplace was already a longstanding system for image collection and collation. Because our institution’s imaging history is digitized and accessible across the entire Cleveland Clinic system, I can pull up scans from a decade ago as easily as I can pull up scans from last week. Further, because satellite clinics and non-retina specialty clinics are also linked to this digitized system, I can recall an image from a far-flung optometrist’s office as easily as I can recall an image from my own clinic.

The ability to quickly identify and access digital images helps me and my colleagues work efficiently while supporting thorough patient care. When working with trainees (who are learning to visually interpret a patient’s complete disease course) and when educating patients (who are learning the basics about how their disease affects them personally), image recall on ZEISS Retina Workplace helps me explain the why behind my treatment decisions.

What immediately stood out to me about ZEISS Retina Workplace is its intuitive, user-friendly interface. You just drag and drop OCT B-scans into different window panes just as you would drag and drop a file on your desktop.

By default, ZEISS Retina Workplace highlights the three most recent timepoints in a patient’s journey; this can be adjusted easily once working in the software’s interface. At the bottom of the screen, ZEISS Retina Workplace generates a line graph of central subfield thickness, with dots along the line representing each scan in the patient’s clinical history. Crucially, the graph also displays icons indicating the exact dates of anti-VEGF injections, so I can immediately correlate treatment with the anatomical response without having to go out to the EMR to find the date of a given injection. This simple, intuitive design means I spend less time wrestling with technology and more time focused on the patient.

ZEISS Retina Workplace has become a cornerstone of my patient conversations. For a new patient, it’s a powerful educational tool.

Imagine a patient newly diagnosed with wet AMD. They often don’t know how to interpret imaging scans, so I can pull up a scan from years ago—maybe from a cataract surgery workup, long before their retinal disease began—and place it next to their current scan to demonstrate, say, a significant growth in intraretinal fluid. By orienting them to what a healthy foveal contour looks like versus their current exudative state, I help them understand their diagnosis and engage them in their treatment plan.

Scenarios in which image comparison on ZEISS Retina Workplace is helpful include:

• Demonstrating Progress: I can show a patient their baseline OCT from when we first met. When they see an image full of subretinal fluid and cystic changes and compare it to today’s image of a dry retina, they understand how far we’ve come thanks to diligent therapy. This helps reinforce why we should continue treatment.
• Explaining Treatment Adjustments: For treat-and-extend patients, injection fatigue is a huge issue. If we’ve extended a treatment interval and fluid returns, I can pull up the scan from when they were at their best and compare it to today’s scan. It’s a clear, objective way to show the patient why we might need to lock them in at their previous interval.
• Providing Reassurance: If a patient whose anatomy is unchanged comes in worried that their condition has worsened, I can pull up scans from the past several years and show them, side-by-side, that everything has been stable. We can then investigate if there is some other reason for their subjective vision decline.

Visual storytelling with ZEISS Retina Workplace is an effective teaching tool for residents and fellows, too. I walk them through my clinical reasoning by showing them a series of scans and pointing to the exact morphological changes that justify a decision to treat, extend, or simply monitor a patient. It makes my rationale for a specific course of treatment clear.

The power of longitudinal comparison isn't limited to exudative diseases. In this new era of treatment for geographic atrophy (GA), it’s been invaluable. When I’m considering starting a patient on a new GA therapy, it’s helpful to see how quickly RPE atrophy has grown or in what ways GA lesions have changed shape. Thanks to our integrated system that relies on ZEISS Retina Workplace, I can pull up historical fundus autofluorescence and OCT scans from years ago, even if they were ordered by another doctor. From there, I assess whether GA is growing quickly or has been stable for years, which informs how I counsel the patient.

By seamlessly integrating, displaying, and quantitatively charting years of imaging data, ZEISS Retina Workplace helps me tell the complete story of a patient's retinal health. It’s more than just a diagnostic tool: it fosters better communication, increases patient engagement, elevates trainee education, and ultimately helps me support more personalized patient care.

^{The statements of the author reflect only his personal opinions and do not necessarily reflect the opinions of any institution with whom he is affiliated.
The author has a contractual or other financial relationship with Carl Zeiss Meditec, Inc. and has received financial support.}