ZEISS welcomed key thought leaders in Asian ophthalmology to discuss optimizing their retinal practices with ZEISS technology, from AI-enabled OCT to the latest in 3D surgical visualization.

A Day 2 ZEISS-sponsored symposium at the 17th Congress of the Asia-Pacific Vitreo-retina Society (APVRS 2024) raised some of the most pressing questions facing retinal ophthalmology—and how ZEISS technology is helping to tackle them.
For Head of Surgical Retina at Singapore National Eye Centre (SNEC) and session chair Assoc. Prof. Gavin Tan, ophthalmologists around the world face myriad challenges in the near future. The need for streamlined workflows and optimizing patient outcomes with surgical precision and speed has never been greater.

Over the course of the symposium, Assoc. Prof. Tan was joined by some of the region’s biggest names, including Dr. Vivek Dave (India) and Clin. Assoc. Prof. Harvey Uy (Philippines), to see how ZEISS technology is designed to meet the demands of modern retina.
Workflow efficiency with AI and CIRRUS PathFinder
According to Assoc. Prof. Tan, artificial intelligence-enabled tools, like the ZEISS CIRRUS PathFinder deep learning decision support tool, are key to tackling rising patient numbers and the resulting increase in volume of optical coherence tomography (OCT) scans to sift through.

“OCTs are really part of our daily work now, but the need for timely interpretation of these OCTs presents a barrier,” Assoc. Prof. Tan said.
The solution to this OCT conundrum? AI-enabled tools like the ZEISS CIRRUS PathFinder, which is the first and currently the only AI decision support tool embedded in an OCTmachine, according to Assoc. Prof. Tan. “This doesn’t replace you or your diagnosis,” he emphasized, “but it does streamline the review of macular OCT scans by automatically identifying those that may need closer review.”
CIRRUS PathFinder does this by flagging abnormal scans with pathological features. The tool can also detect subtle pathologies where human scanners might miss it—or flag suspicious scans so that physicians know when to take a closer look, according to Assoc. Prof. Tan.
CIRRUS PathFinder adds up to helping physicians find more pathologies faster and more accurately. “It is impossible for us to scrutinize every single B-scan, but it is easy when we focus on foveal-involving pathologies or subtle lesions in the fellow eye. CIRRUS PathFinder, when it becomes available commercially, will be a very effective tool that can provide accurate identification of abnormalities, allowing you to focus on what’s really pathological,” he said.
“CIRRUS PathFinder can improve your efficiency, reduce the chance of missing pathologies and improve overall physician quality of life not just for retina specialists and more so for general ophthalmologists, glaucoma specialists and optometrists because they would be able to identify what they could have missed. We benefit because the patient can be referred earlier in the pathology where treatment is more likely to be successful in achieving better long-term trajectory outcomes,” Assoc. Prof. Tan concluded.
The power of Retina Workplace and multimodal imaging
ZEISS Retina Workplace image management ecosystem, according to Clin. Assoc. Prof. Uy, helps him manage his patients with diagnostic accuracy, clinic efficiency and confidence demanded by modern retinal medicine.
One of the keys, he explained, is the effective deployment of multimodal imaging, from ultra-widefield fundus photography to fluorescein angiography, OCT and OCT angiography (OCT-A). “An image management system should be accurate, efficient and give you confidence that your images are telling the truth. The Retina Workplace does all of these,” Clin. Assoc. Prof. Uy said.

Gathering various images into one coordinated scan bears many advantages, according to Clin. Assoc. Prof. Uy. In particular, he pointed to a feature that allows the overlaying of fundus scans. “With the overlay, you can move the crosshair into an area of interest, and then below see what’s happening on the B-scan in that area.”
In addition to its multimodal image analysis features, Clin. Assoc. Prof. Uy also discussed how Retina Workplace facilitates temporal change analysis—correlating treatment with outcomes and planning treatments.
But in the end, it all comes down to the patient—and Clin. Assoc. Prof. Uy believes that one of the Retina Workplace’s greatest contributions to his practice and patient outcomes is how it helps with patient education.
Not only does it free up the time to speak to the patient about their condition and treatment, but it also gives an easy-to-follow visualization of the patient’s condition. “The Retina Workplace provides an accurate assessment of the patient’s disease status and an idea of how they respond to treatment,” he said.
“It helps you educate the patient better, improves conversion rates and greatly improves review time efficiency. I think we should all try to get this system into our practice.”
The cutting edge in vitrectomy
Image analysis can go a long way towards improving clinical efficiency, but there is also much that can be done in the operating theatre. Dr. Dave believes that the features of the ZEISS DORC EVA NEXUS are designed to do just that with vitrectomies—and his presentation showed how.

For Dr. Dave, an efficient vitrectomy is all about the interplay of fluid dynamics and instrumentation, with surgical skill being the great coordinator between the two. For fluid dynamics, the DORC EVA NEXUS advantage lies in the successful marriage of venturi and peristaltic pump designs into two modes—vacuum and flow with the VTI pump.
“This ensures you have optimal pressure balance,” he said. “You can toggle between vacuum mode and flow mode depending on your tolerance of fluctuation or turbulence inside the eye on the tissue you are operating on.”
Dr. Dave explained that vacuum mode can be used when more pull on the tissue is required, whereas flow mode can be used when attempting to shave in the retinal periphery or when close to a detached retina.
The second half of the equation is the EVA NEXUS cutter, and Dr. Dave explained how valuable the system’s two-dimensional cutting (TDC) technology is to his surgeries. “The cutter port stays open in both movements of the guillotine, raising the overall efficiency of the probe removing the vitreous because the overall open time increases,” he explained.
Dr. Dave also pointed to another feature of the EVA NEXUS– its Smart IOP function’s utility in maintaining chamber stability. “Smart IOP’s constant pressure monitor ensures that you neither have your anterior chamber collapse nor do you have undue pressure building up and causing corneal edema during the surgery,” he said.
Visualization in the digital OR
The final essential piece for optimizing efficiency and patient outcomes in modern retinal surgery is 3D visualization, and Dr. Dave and Assoc. Prof. Tan wrapped up the session by talking about ZEISS ARTEVO, and especially the latest ARTEVO 850, a heads-up 3D microscope.
“All the advantages of your DORC system get amplified when your operating platform includes ZEISS ARTEVO,” Dr. Dave said. Besides the myriad advantages gained with ARTEVO’s DigitalOptics™ and the information overlay with AdVision™’s augmented reality display, the real difference for Dr. Dave is intraoperative OCT.

“One of the most important add-ons for this machine is intraoperative OCT, and with more complicated and delicate cases near the macula and fovea, this becomes an invaluable tool in your OR,” he said.
Assoc. Prof. Tan echoed these sentiments in his presentation on the ZEISS ARTEVO 850. Besides intraoperative OCT, Assoc. Prof. Tan put particular emphasis on the utility of ARTEVO 850’s Digital Color Assistance capabilities. “You really get all the color enhancement you need for membranes and tissues,” he said, “ and I think the potential is there to reduce our reliance on stains.”
Overall, each presentation in this session echoes a similar message—that cutting-edge technology from ZEISS empowers clinicians to deliver exceptional patient care and achieve optimal outcomes. As we look tothe future, the commitment from ophthalmic companies like ZEISS to innovative solutions that address the challenges faced by ophthalmologists worldwide will undoubtedly drive further advancements in the field of retina.
Disclaimer: Not all products or features are available in all regions. CIRRUS PathFinder is not commercially available yet.