Would you like to see all retreatment parameters at a glance when you see your patients with neovascular AMD?

The RetInSight Fluid Monitor provides a concise PDF report by a mouse click:


• Fluid compartments, volume, fluctuations between visits, distribution and thickness together with the original and annotated images of the central OCT scan; all retreatment parameters at one glance.


• Time saved by avoiding the need to look up and review images and/or data from the previous visit.


• May be used as a patient hand-out, to create transparency and potentially improve compliance.


• While Fluid Monitor processes the images of patient A, the images of patient B can be taken (no idle time).

Then take the next evolutionary step in the management of nAMD with theRetInSight Fluid Monitor

An updated comprehensive version of Fluid Monitor is available from February 27, 2023, for the monitoring of patients with neovascular age-related macular degeneration (nAMD).


In addition to precise fluid volume measurements using routine OCT images, the novel Fluid Monitor also provides the fluid volume changes compared to the previous visit. Fluctuations are indicative of decreased or increased disease activity, which guides retreatment decisions.


The RetInSight Fluid Monitor fulfills all MDR 2017/745 requirements for class IIa medical devices as a Clinical Decision Support System (CDSS) and may be used in clinical routine in the EU.


It is intended to be compatible with all leading OCT systems, starting with the Heidelberg Engineering SPECTRALIS® OCT/Heyex/AppWay platform.

The RetInSight Fluid Monitor is a unique CE-certified AI-based fluid activity meter

The accumulation of fluid in the retina can be observed in OCT-images as reliable indicator of disease activity.1


The RetInSight Fluid Monitor is an AI-based fluid activity meter for the monitoring of disease progression and treatment response in patients with nAMD.


It supports the optimisation and personalisation of therapy, with the aim to improve patient outcomes and enhance the workflow to increase clinical efficiency and reduce cost.


The concise Fluid Monitor report can be generated by the OCT-operator under the supervision of the eye care specialist in just a few minutes, while the patient is on site.

It provides precise fluid location and volumes in nanoliters

1mm6mm
RedIRF77.19 nl368.39 nl
YellowSRF31.9 nl37.05 nl
BluePED60.73 nl595.37 nl

The RetInSight Fluid Monitor identifies, localizes, and quantifies retinal fluid by assigning a label to each OCT pixel in an entire OCT volume.

It denotes its fluid type as intraretinal fluid (IRF), subretinal fluid (SRF) or pigment epithelial detachment (PED) when present, as well as its location within the central 1-mm and 6-mm macular area.

And converts the automated segmentations into precise volumes in nanoliters.2,3

And easy to interpret fluid volume changes

The RetInSight Fluid Monitor provides fluid volume changes compared to the previous visit, which are clinically relevant:

Greater fluctuations in retinal fluid volumes during the maintenance phase of anti-VEGF treatment in nAMD is associated with worse VA by 2 years. 4

Most relevant for an optimized fluid management is a precise assessment of fluid dynamics to distinguish stable from recurrent SRF and novel from persistent, IRF i.e., degenerative, IRF, which is enabled by the accuracy of AI-based fluid measurement in nl. 5

By fluid compartment

IRF, SRF and PED compartments have a different impact on visual function and show a different fluid resolution during therapy:

Intraretinal fluid was the only variable that reflected VA increase and decrease over time. 3

To optimally manage nAMD, clinicians should understand the impact of fluid compartments on visual acuity. After initial treatment, anti-vascular endothelial growth factor regimens that tolerate stable subretinal fluid (if visual acuity is stable/improved) but not intraretinal fluid may enable patients to achieve their best possible visual acuity. 6

This study suggests that levels of SRF up to around 150 lm thickness on OCT have minimal impact on vision. Greater levels of SRF have greater impact on vision, unless associated with significant amounts of atrophy or SHRM, when the additional effect of the SRF on vision remains low. 7

The most relevant biomarker for BCVA was the horizontal extension of IRF in the foveal region, whereas SRF and PED ranked low. 8

86% of responders considered the development of subretinal and/or intraretinal fluid on the OCT as a reason to initiate anti-VEGF therapy in a patient with wet AMD. 9

With highly reliable and consistent accuracy

The volume measurement accuracy of the RetInSight Fluid Monitor is comparable to the manual reading by expert-readers and the reported automated measurements in the literature.10

The Fluid Monitor measurements are objective and consistent, unlike manual reading:

Our findings highlight the variability in the performance of human expert OCT grading and the need for AI-based automated feature analyses.11

And unprecedented speed

On average, the manual annotation of an OCT volume of 97 B-scans by an experienced expert-reader takes 2 hours and 49 minutes.

The RetInSight Fluid Monitor requires only 2 minutes and 8 seconds. The entire Fluid Monitor processing, from the receipt of the OCT image up to the generation of the report, takes on average 3 minutes and 6 seconds (excluding variable up- and download time).10

An opportunity to save time during clinical routine and improve patient throughput without compromise on patient safety.

And an efficient, secure and GDPR compliant workflow

​The details of the workflow will vary between the different OCT platforms.

Which potential value does the RetInSight Fluid Monitor bring?

Eye Care Specialists

• A solid basis for confident treatment decisions

• The possibility to document the new hard data points facilitates long-term monitoring

• The ability to optimise and personalise treatment regimens, thereby reducing the risk and deficiencies of over- and under-treatment

• A more efficient workflow, resulting in higher patient throughput

​

72% of responders believed that artificial intelligence will significantly assist their ability to diagnose and monitor  retina diseases in the next 2-3 years. 75% said would use AI-based healthcare tools in their practice, on a case-by-case basis.9

Payer

• Gaining better insight into the budget spent on nAMD and improving resource allocation

• Reducing the cost per patient, which, combined with a better patient flow and throughput, results in enhanced patient access 

Patients

• Shorter waiting times before getting an appointment with and seeing the eye care specialist

• Less inconvenience and lower cost associated with travel and absence from work caused by over-treatment, and reduced risk of vision loss caused by under-treatment

• Increased trust and compliance with the therapy, resulting from receiving an understandable personal Fluid Monitor report as evidence of disease progression and treatment response​

Hospitals and Clinics

An opportunity to finetune internal treatment protocols, demonstrate quality of care and strengthen the reputation as innovative eye care provider, becoming or remaining:​

• An attractive and competitive workplace for the AI-generation

• A preferred eye care provider for patients and referring general practitioners

• A valuable partner to insurance companies and/or Ministries of Health

Read in Ocular Surgery News how the RetInSight Fluid Monitor drives breakthrough changes in management of neovascular AMD according to clinical and ophthalmic AI expert Ursula Schmidt-Erfurth.

Request a demo of the RetInSight Fluid Monitor

If you are interested to get a demo of the Fluid Monitor, please fill out this short form with your contact details and we will be in touch.

If you have other questions, please contact us.

We look forward to hearing from you.

References

  1. Waldstein SM, Philip AM, Leitner R, Simader C, Langs G, Gerendas BS, Schmidt-Erfurth U. Correlation of 3-Dimensionally Quantified Intraretinal and Subretinal Fluid With Visual Acuity in Neovascular Age-Related Macular Degeneration. JAMA Ophthalmol. 2016 Feb;134(2):182-90. doi: 10.1001/jamaophthalmol.2015.4948. PMID: 26661463.
  2. Gregor S. Reiter et al. Performance of an Artificial Intelligence Decision Support Tool, The Vienna Fluid Monitor in Neovascular Age-Related Macular Degeneration. Presentation at Euretina 2022.
  3. Gerendas, Bianca S. et al. VALIDATION OF AN AUTOMATED FLUID ALGORITHM ON REAL-WORLD DATA OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION OVER FIVE YEARS. Retina 42(9):p 1673-1682, September 2022. | DOI: 10.1097/IAE.0000000000003557.
  4. Chakravarthy, U. et al. Impact of macular fluid volume fluctuations on visual acuity during anti-VEGF therapy in eyes with nAMD. Eye 35, 2983–2990 (2021). https://doi.org/10.1038/s41433-020-01354-4
  5. Ursula Schmidt-Erfurth et al. AI-based monitoring of retinal fluid in disease activity and under therapy. Progress in Retinal and Eye Research. Volume 86, 2022, 100972, ISSN 1350-9462, https://doi.org/10.1016/j.preteyeres.2021.100972.
  6. Chaudhary, Varun et al. IMPACT OF FLUID COMPARTMENTS ON FUNCTIONAL OUTCOMES FOR PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: A Systematic Literature Review. Retina 42(4):p 589-606, April 2022. DOI: 10.1097/IAE.0000000000003283.
  7. Aslam, T.M., Mahmood, S., Balaskas, K. et al. Statistical Modelling of the Visual Impact of Subretinal Fluid and Associated Features. Ophthalmol Ther 10, 127–135 (2021). https://doi.org/10.1007/s40123-020-00327-w
  8. Ursula Schmidt-Erfurth et al. Machine Learning to Analyze the Prognostic Value of Current Imaging Biomarkers in Neovascular Age-Related Macular Degeneration. Ophthalmology Retina, Volume 2, Issue 1,2018, Pages 24-30, ISSN 2468-6530. DOI: https://doi.org/10.1016/j.oret.2017.03.015.
  9. Euretina 2021 Clinical Survey Outcomes.
  10. Data on file RetInSight.
  11. Michl M et al. A systematic evaluation of human expert agreement on optical coherence tomography biomarkers using multiple devices. Eye (Lond). 2022 Dec 28. doi: 10.1038/s41433-022-02376-w. Epub ahead of print. PMID: 36577804.

Clinical Decision Support System (CDSS)​

The RetInSight Fluid Monitor is a fully automated comprehensive AI-based Clinical Decision Support System, consisting of:​

  • The artificial intelligence software​
  • The web-based customer portal​
  • The Instruction for Use in the required languages​
  • The secure cloud-based image analysis server​
  • The secured data exchange via internet connection​
  • The cloud-based web service for back-end data storage and maintenance​
  • Compliance with the current EU medical device regulation ​
  • Customer support​

As a CDSS, the RetInSight Fluid Monitor facilitates decision-making in patient management, but it does not provide an autonomous recommendation.​

Request a demo of the RetInSight Fluid Monitor

If you are interested to get a demo of the Fluid Monitor, please fill out this short form with your contact details and we will be in touch.

If you have other questions, please contact us.

We look forward to hearing from you.

​