ZEISS Retina Workflow Elevates Patient Care, Improves Intraoffice Connectivity, and Optimizes Efficiency

In a previous generation of retina care, practice owners were required to cobble together a clinical infrastructure built on a curated collection of imaging modalities and diagnostic platforms. These various pieces fit together sufficiently, if imperfectly. But in order to craft a more perfect patient experience, providers must address inter-device communication hiccups and practice flow inefficiencies. For a long time, such a solution was lacking.

Enter ZEISS Retina Workflow, the interconnected network of ZEISS imaging platforms and technologies designed to improve patient care, enhance connectivity, and optimize efficiency. Retina specialists who use ZEISS Retina Workflow as a central governing philosophy of their clinic can expect an efficient patient experience that accurately characterizes, treats, and tracks a patient’s eye health over time.

ZEISS Retina Workflow streamlines four key aspects of retinal care: assess & educate, plan, treat, and check. Each segment is populated with specific ZEISS technology to provide a world-class patient and provider experience.

Most patients first encounter cutting-edge technology when they sit in the chair for an examination. If your clinic uses ZEISS SL 800 Slit lamp as its preferred slit-lamp, then you’re already familiar with its distinguishing features, such as the continuous magnification steps that range from 6x to 40x, the TrueView Optics apochromatic lenses with anti-reflex coating that depict true-to-life color images, and the VarioLight integrated LED light source that pairs with a halogen filter.

Importantly, ZEISS SL 800 Slit lamp allows easy capture of high-quality images and video with its integrated 18-megapixel camera at 40 fps that providers may use to document a patient’s condition. Such images and videos may be used to educate patients about their diagnosis and may be useful when assembling clinical images for publication or presentation.

After identifying suspected pathology during initial assessment, those leveraging ZEISS Retina Workflow move next to ultra-widefield imaging (UWF) on ZEISS CLARUS 700 or to OCT imaging on ZEISS CIRRUS 6000 to further clarify the diagnosis and determine a treatment plan.

UWF imaging with ZEISS CLARUS 700 provides numerous benefits including the option of True Color imaging, fluorescein angiography, fundus autofluorescence (FAF) blue, and FAF green. AutoBright technology automatically detects and corrects images with too much saturation or too little contrast. Further, ZEISS CLARUS 700 employs GazePoint technology in patients whose fixation is insufficient to create a montage UWF image, using the optic nerve as the point of fixation.

Similarly, OCT imaging with ZEISS CIRRUS 6000 offers best-in-class technology highlighted by the inclusion of a 100 kHz laser light source, allowing incredibly fast scan times. With this updated laser light source, a typical high-density volume cube scan can be performed in 0.4 seconds. Increased scan speed both improves patient throughput and allows more detailed scanning (from increased frame averaging) and a lower rate of artifacts (from patient motion). OCT Angiography, which two sequential scans captures consecutive images at each B-scan location, benefits most from this increased speed, and stands out to me as one of the most paradigm-shifting features on ZEISS CIRRUS 6000—and is the reason every user should opt into ZEISS CIRRUS AngioPlex.

The output of these imaging modalities is fed into ZEISS Retina Workplace where advanced image analyses and longitudinal comparisons are performed. But first, let’s see how ZEISS Retina Workflow empowers you to treat patients. 

A good clinical laser has a small footprint, keeps patients safe, and offers efficient treatment. ZEISS VISULAS green fits all three of those qualifications, allowing a more convenient and efficient laser treatment experience.¹ Use of multi-spot photocoagulation makes sessions quick, and shorter pulse durations keep laser spots small.

Surgeons who are looking to take full advantage of the digital information passed from the clinic through ZEISS Retina Workplace should consider the 3D digital visualization systems from ZEISS: ZEISS ARTEVO 800 and ZEISS ARTEVO 850. My colleague Jorge Fortun, MD, wrote elsewhere in this series about the benefits of ZEISS ARTEVO visualization, and users who want to learn more can read his testimony at the link above.

Both modalities in this step of ZEISS Retina Workflow rely on images captured during the “Plan” segment, meaning that your treatment execution is closely linked with the images that constitute the basis of your treatment strategy. Recall as many images as you like from ZEISS CIRRUS 6000 in the OR, for example, or select a patient’s most recent UWF image from ZEISS CLARUS 700 before you direct laser with ZEISS VISULAS Green. Within ZEISS Retina Workflow, each step supports the steps before and after it. 

As most of our patients suffer from chronic retinal diseases, they require frequent repeated return visits to check disease status and, if needed, receive treatment. Previous non-integrated retina care workflows required providers to manually track longitudinal anatomic changes through multiple software interfaces requiring many logins, clicks, and window toggles.

That has changed with ZEISS Retina Workplace. Because ZEISS Retina Workplace collates every image used within ZEISS Retina Workflow, users can seamlessly pull up multimodal images captured at any point along the patient journey and can compare up to 3 images at a time. Quantitative data is graphed longitudinally, and users can zoom into specific segments of the patient journey to assess the effects of intervention. This both informs clinical decision-making and allows providers to educate patients about their ophthalmic journey.

ZEISS Retina Workplace also has several novel image analysis tools that provide greater insights into chronic retinal disease. Advanced RPE Analysis, a feature exclusive to ZEISS CIRRUS, compares the current OCT images to baseline images to characterize progression of geographic atrophy. Similarly, OCT cube scans from prior visits are registered and tracked against the current OCT cube scan, allowing rapid comparisons of macular thickness changes in wet AMD, DME, and other cases of edema.

ZEISS Retina Workplace functions as the epicenter for the entire ZEISS Retina Workflow: as the central depository for all data from baseline to the present, providers can capture a comprehensive view of a patient’s changing pathology, thereby allowing efficient, customized medicine.

If you are struggling to assemble a comprehensive technologic solution to your clinical workflow problems, or you simply want to elevate the efficiency and quality of your care, consider how ZEISS Retina Workflow could change your practice. With this solution, my clinic runs smoothly and accurately, meaning I spend more time caring for patients and less time interacting with a computer.

^{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.}