NEW PRODUCT APPLICATIONS: Streamlining the Image Review Process

New platform can analyze images from different instruments.

The Zeiss Integrated Diagnostic Imaging (IDI) platform is a digital solution that integrates and transforms data from diagnostic devices by combining modalities to develop simple individualized assessments. This helps physicians make optimal treatment decisions quickly and efficiently, according to the company. IDI works with Zeiss’s gold-standard instruments such as the CIRRUS OCT, the Humphrey Field Analyzer 3, the CLARUS 500 ultrawidefield retinal camera, and the new VISULAS green therapeutic laser.

Eric Schneider, MD, a vitreoretinal specialist at Tennessee Retina, PC in Nashville, Tennessee, who has helped validate the Zeiss IDI platform in the clinical practice setting, notes that retina specialists are under increasing pressure to improve clinical efficiency due to larger patient volumes and greater reliance on imaging data to provide optimal treatment decisions. “These two trends — more patients and more imaging — have created a ‘data overload’ issue that is difficult to tackle with current image management solutions,” he says. “Retina providers are challenged with sensitively analyzing imaging data while continuing to efficiently use clinic time in a patient-focused and interactive manner.”

The IDI display showing results in a case of branch retinal vein occlusion.

The Zeiss IDI addresses both of these challenges. It can analyze and manage multiple imaging modalities across many visits while presenting the information in an easily digestible and intuitive format for both physician and patient review. “It works with a wide variety of imaging devices and has enough horsepower to efficiently display large file sizes generated by today’s higher resolution and wider field imaging devices,” Dr. Schneider says.

In the past, providers who wanted to follow best practices and actively review imaging in exam lanes were forced to use a host of device-specific review software, which resulted in wasted time and effort from duplicated clicks, passwords, and processing utilization. “This inefficient practice pattern begged for an all-in-one solution, which the Zeiss IDI platform offers,” Dr. Schneider says.

“Digitalization of eye care provides physicians with integrated and data-driven solutions, allowing them to help patients every step of the way,” says Jim Mazzo, global president ophthalmic devices at Carl Zeiss Meditec, Inc. “Our comprehensive portfolio provides a connected multimodality approach to patient data that spans across assessment, diagnostics, and treatment.”


The Zeiss IDI platform combines an all-in-one review software called Forum Review with an advanced retina analytics suite called Retina Workplace. Forum Review is a fully featured image review software program capable of displaying and manipulating a DICOM image from any imaging device. “Multimodality images from a single visit are grouped together, allowing for an easy visit-to-visit comparison of fundus photograph, angiograms, and autofluorescence images using only a few clicks,” Dr. Schneider says.

Retina Workplace provides next-generation optical coherence tomography (OCT) analysis for Zeiss OCT devices through several unique features. The default macular thickness analysis allows active scrolling through 3 different OCT exams and uses eye tracking to provide accurate point-to-point comparison, Dr. Schneider says. Via simple click-and-drag functionality, providers can quickly select any 3 visits for comparison and active review.

“The most unique aspect of this software, however, is the provision of longitudinal data analytics for macular thickness, retinal pigment epithelium dropout, and angiometric parameters,” Dr. Schneider says. The software plots, for example, macular thickness values over time for all OCT exams in the database for a single patient in line-graph format. “This produces a broad overview of a patient’s history or response to treatment at a single glance.”


Zeiss carefully considered the end user when creating its IDI platform. Forum Review acts as a single, easily navigable repository of all patient images. All images are listed in chronologic order by visit. With a few clicks, a quick comparison of selected images can be displayed on a single screen. “There is also an option to navigate through a series of full-screen images with single clicks, similar to the manner in which traditional image-review software displays an image series such as a fluorescein angiography,” Dr. Schneider says.

The advanced analytics within Retina Workplace are also easily accessible. “Each specific analysis is preset and accessible by simply clicking the desired metric to be reviewed,” Dr. Schneider says. This brings up the 3 exam active comparison windows as well as the longitudinal analysis on the same screen. Users can customize the analysis to greater extent depending on their needs.


The IDI was designed to be used for certain conditions, including glaucoma and retinal diseases. For patients with glaucoma, multiple metric graphs show retinal pigment epithelium and ganglion cell thickness plots, mean deviation, and cup-to-disc ratio on one screen.

For retinal disease, the system provides an instantaneous synched overlay of OCT, OCT angiography, ultrawidefield, fluorescein angiography, indocyanine green, and other color photos. IDI helps physicians to easily view treatment results over time, with data from multiple visits correlated on a single screen, according to Zeiss. A graphical data display tracks macular thickness and other metrics used to gauge the effects of treatment.

Physicians can compare up to 15 data points over time, adjust baselines after treatment, and see statistical analysis of changes. The system also has similar modules for diabetic retinopathy, AMD, and other diseases and pathologies.

Dr. Schneider adds, “I find the power of the platform is most apparent when reviewing complex patients with a large volume of images, but I do not find it any less capable of reviewing a single OCT cube scan or fundus photograph.”


Today, patients play a bigger role in their disease management. Information regarding treatment choices is more accessible, and patients want to be a part of the decision-making process with their condition. IDI supports patient education by displaying images in a single easy-to-view display. In addition, it helps doctors optimize disease management and treatment plans, which translates to improved patient care. RP