Diabetic retinopathy screening and treatment: a complete guide

Table of Contents

1. What are the diabetic retinopathy screening methods?
2. Fundus images in DR screening
3. Can OCT detect diabetic retinopathy?
4. What does diabetic retinopathy look like on OCT?
5. What is optimal diabetic retinopathy screening frequency?
6. What is the best treatment for diabetic retinopathy?
7. Diabetic retinopathy management: key takeaways

Diabetic retinopathy (DR) remains the leading cause of irreversible vision loss among working-age adults worldwide. According to the International Diabetes Federation (IDF), one in three patients with diabetes shows signs of DR, and 10% develop diabetic macular edema (DME). Early diagnosis, systematic screening, and individualized monitoring are essential to prevent vision loss.

What are the diabetic retinopathy screening methods?

Modern methods of DR screening include:

• Telemedicine platforms – enable automated transmission of fundus images
• Mobile fundus cameras – Wi-Fi–enabled devices for field examinations
• Smartphone-based platforms – use specialized lenses for retinal imaging
• Optical coherence tomography (OCT) – used to detect early retinal changes and diabetic macular edema, complementing fundus photography
• AI-based systems – FDA-approved solutions for automated image analysis

In practice, these methods are often combined. For example, patients may undergo fundus photography, after which images are sent to telemedicine centres and analysed by AI algorithms. More complex cases are then referred to ophthalmologists.

DR screening is frequently incorporated into annual diabetes check-ups conducted by primary care physicians trained in basic fundus photography. This approach, already successfully implemented in several EU countries, has reduced the incidence of severe DR.

Innovations in DR screening have broadened access for rural residents, older adults, and individuals with limited mobility. Integration into national e-health systems enables automated reminders and electronic medical record linkage, incorporating laboratory data (HbA1c, blood pressure) alongside retinal images.

Fundus images in DR screening

Fundus photography is the optimal primary screening method due to its high diagnostic yield, cost-efficiency, simplicity, and ability to integrate with AI and telemedicine solutions. 

It enables detection of microaneurysms, hemorrhages, exudates, and neovascularization, often before symptoms arise. National screening programs rely heavily on digital fundus imaging, which, when combined with AI, provides an efficient platform for mass DR detection.

Advances in fundus imaging for diabetic retinopathy have improved efficiency. Modern non-mydriatic cameras deliver high-quality images without pupil dilation, while automated image analysis supports rapid identification of suspicious cases. Cloud storage and telemedicine platforms facilitate remote evaluation, increasing coverage in regions with limited ophthalmology services.

Next-generation wide-field cameras further enhance detection by capturing peripheral pathology. Some devices also generate automated annotations, reporting lesion type, DR stage, and DME presence, thereby standardizing interpretation and expediting clinical decision-making.

Can OCT detect diabetic retinopathy?

Yes. OCT can detect early structural changes in the retina and is increasingly used to complement standard diabetic retinopathy screening.

• Role in DR screening – While not a primary screening tool, OCT is now widely applied alongside fundus photography. It is especially valuable for detecting early diabetic macular edema (DME) and subtle morphological changes in the central retina not visible during ophthalmoscopy.
  
• High-resolution imaging – OCT visualizes changes such as photoreceptor layer disruption, subclinical intraretinal fluid, neurosensory retinal thickening, and foveal edema. These findings often appear before clinically significant macular edema.
  
• Differential diagnosis – OCT also helps identify other causes of vision loss in diabetic patients, for example, ruling out age-related macular degeneration.
• Clinical evidence – Studies confirm that combining OCT with fundus photography increases diagnostic accuracy for DME. Experts therefore recommend this approach for patients with long-standing diabetes, poor glycemic control, or vision complaints.

What does diabetic retinopathy look like on OCT?

On OCT, diabetic retinopathy (DR) can appear as a combination of retinal structural damage, fluid accumulation, and microvascular changes that may not be visible on fundus photography.

Typical OCT findings in DR include:

• Photoreceptor damage – loss of outer retinal layers, especially the ellipsoid zone
• Intraretinal hyperreflective foci, hard exudates
• Microaneurysms – visible as small, round changes within the retina
• Retinal thickness changes and neuroepithelial layer atrophy
• Diabetic macular edema  – with intraretinal hyporeflective cystoid spaces and neuroepithelial swelling
• Subretinal fluid  – resulting from increased vascular permeability
• DRIL – disorganization of inner retinal layers, associated with poor prognosis
• Epiretinal membranes – potential precursors to retinal detachment

Advanced findings
OCT can also reveal proliferative changes and tractional zones, which may progress to tractional retinal detachment.

OCTA insights
Beyond structural analysis, OCT angiography (OCTA) allows visualization of retinal microvascular changes without the contrast injection. OCTA helps identify areas of neovascularization, capillary network disruption, and the degree of macular ischemia.

What is optimal diabetic retinopathy screening frequency?

The screening frequency for diabetic retinopathy is tailored to diabetes type, disease stage, and risk factors:

Type 1 diabetes

• First screening: 3–5 years after diagnosis (due to onset in children and young adults)
• Then annually, if no DR is detected
• If DR is present, frequency depends on severity

Type 2 diabetes

• Screening at diagnosis, as DR may already be present.
• If no DR, repeat every 1–2 years.

Patients with confirmed DR

• No visible DR, mild non-proliferative diabetic retinopathy (NPDR), no DME — every 1–2 years
• Moderate NPDR — every 6–12 months.
• Severe NPDR — every 3 months.
• Proliferative DR (PDR) — monthly, with regular OCT monitoring of the macula.
• DME — monthly if center-involving, every 3 months if not.

Pregnant women with type 1 or type 2 diabetes

• Screening before conception or in the first trimester, with follow-up each trimester and postpartum
• Screening is not required for gestational diabetes without pre-existing diabetes

Post-treatment patients (laser or vitrectomy)

• Typically, every 3–6 months during the first year, individualized based on retinal stability

Monitoring of diabetic retinopathy progression

Ongoing diabetic retinopathy monitoring is essential to detect early signs of progression and guide treatment decisions. A key focus in monitoring is diabetic macular edema (DME), which represents fluid accumulation in the macula due to leakage from damaged retinal vessels. DME is a common complication of DR and the leading cause of vision loss in diabetic patients. OCT plays a central role in detecting DME and identifying structural changes that indicate disease progression.

OCT biomarkers in DME

OCT enables precise visualization of retinal layers with micron resolution, confirming DME presence and providing prognostic biomarkers for treatment selection and monitoring. 

The main OCT biomarkers in DME include:

• Cystoid hyporeflective intraretinal spaces – usually in the inner nuclear layer (INL) or outer plexiform layer (OPL). Their number, size, and location correlate with edema severity. Large or confluent spaces may indicate chronicity and a worse prognosis.
• Subretinal fluid – accumulation between the neurosensory retina and retinal pigment epithelium. Often associated with a better visual prognosis, but requires close monitoring and consideration in anti-VEGF therapy.
• Central macular thickening – a key marker of treatment effectiveness and disease activity.

OCT red flags in DR progression

Beyond DME, OCT helps identify broader signs of DR worsening that require therapy reassessment:

• Progressive central macular thickening despite treatment
• Increase in intraretinal or subretinal fluid, or enlargement of cystoid spaces
• New hyperreflective foci, reflecting inflammatory activity (these may precede hard exudates or RPE changes)
• Development or progression of disorganization of inner retinal layers (DRIL), an independent predictor of poor prognosis, even when orphological improvement is seen on OCT
• Ellipsoid zone disruption, indicating photoreceptor damage
• Signs of macular ischemia, although better evaluated with OCTA, indirect signs on OCT may include thinning of the inner retinal layers.
• Tractional changes, such as epiretinal membranes, inner retinal stretching, or macular traction

The appearance of these OCT features should prompt clinicians to reconsider therapy, whether by switching anti-VEGF agents, introducing steroids, using combination therapy, or referring patients for surgical evaluation when traction is present.

What is the best treatment for diabetic retinopathy?

The treatment of diabetic retinopathy is based on a comprehensive approach that takes into account not only the disease stage, but also individual patient characteristics, OCT findings, comorbidities, and prognostic biomarkers. Modern strategies combine preventive, pharmacological, and surgical methods, as well as personalized medicine tools based on retinal imaging.

Criteria for treatment selection

The choice of therapy is guided by the following parameters:

• DR stage –  non-proliferative, proliferative, with or without DME
  
• Form of macular edema –  focal, diffuse, with or without subretinal fluid
  
• Presence of DRIL, EZ disruption, ischemic changes on OCTA
  
• Response to previous treatment –  anti-VEGF, steroids, laser
  
• Comorbidities –  renal insufficiency, hypertension, poor adherence

For low-risk patients, observation or focal laser may be sufficient. Patients with significant DME usually require anti-VEGF or steroid injections. Those with proliferative DR often undergo panretinal laser photocoagulation or vitrectomy.

Diabetic retinopathy treatment methods

The main treatment options for diabetic retinopathy include pharmacotherapy, laser therapy, surgical intervention, and personalized approaches based on OCT.

1. Pharmacotherapy: anti-VEGF and steroids

Anti-VEGF agents such as aflibercept, ranibizumab, and bevacizumab are the first-line therapy for diabetic macular edema. They are especially effective in patients with pronounced edema and without ischemia.

New drugs with extended duration of effect, including port delivery systems, are becoming available.

Steroids are used when DME is persistent, when patients do not respond to anti-VEGF therapy, or in cases with an inflammatory phenotype.

2. Laser therapy

Injections have largely replaced laser therapy in the treatment of DME. However, panretinal photocoagulation remains the standard treatment for proliferative DR.

Subthreshold micropulse laser is increasingly applied for focal edema, as it minimizes tissue damage.

3. Surgical treatment

Vitrectomy is recommended in cases of tractional macular edema, vitreous hemorrhage, or retinal detachment.

4. Personalization with OCT

Modern treatment protocols use OCT biomarkers to tailor therapy and improve prognosis.

AI-based systems can also generate treatment plans from OCT data, which is particularly valuable in regions with limited access to retina specialists.

Patient education and multidisciplinary care

DR treatment outcomes strongly depend on adherence. Patients must be informed about the need for regular injections, monitoring, and systemic control. Coordinated care involving ophthalmologists, endocrinologists, and family doctors helps maintain stable glycemic control and slows DR progression.

Diabetic retinopathy management: key takeaways

Diabetic retinopathy is a progressive disease, but modern diagnostics and treatments make it possible to preserve vision and improve outcomes. OCT and OCTA have become essential tools for early detection, risk assessment, and personalized therapy planning. Effective management combines pharmacotherapy, laser treatment, surgery, and patient education. Multidisciplinary care and strong patient adherence remain crucial for long-term success. With timely monitoring and tailored treatment, the progression of diabetic retinopathy can be significantly slowed.

Altris AI introduces Flags to instantly identify OCT scans with specific retina pathologies or biomarkers

Chicago, IL – August 26, 2025 – Altris AI introduces an advanced flagging system to search through the large volumes of OCT scans, including historical data.

Now, with Altris AI’s new functionality, eye care professionals can instantly identify OCT scans with specific retina pathologies or biomarkers from the list of over 70 conditions. For example, clinicians can locate OCT scans of all patients with a Soft Drusen or Dry AMD, forming cohorts for clinical or research purposes.

For those who work with Geographic Atrophy biomarkers, it is also possible to exclude the presence of GA biomarkers in 1, 3,6 mm ETDRS zones to spot early development of this pathology.

The flagging system is precise and enables fast, targeted searches across historical records and large datasets – including OCT scans from different devices. This advancement supports a more efficient workflow and enhances access to critical data for both diagnostics and research.

“Flags are a clinical shortcut. Instead of manually searching through thousands of scans, you can now filter precisely for what you need—whether that’s subretinal fluid, GA progression, or early glaucoma indicators. It’s about making the data work for you.” Maria Znamenska, MD, PhD, Chief Medical Officer at Altris AI.

With flags for smart filtering, eye care specialists can:

• Track risk-related biomarkers and set reminders for patient follow-ups
• Quickly identify eligible candidates for clinical studies by searching through large volumes of data
• Confidently introduce new treatments by finding the right patient profiles
• Filter rare or complex cases to study unique combinations of pathologies and biomarkers and their progression

“Flags make it possible to build patient cohorts in minutes,” Maria Znamenska, Chief Medical Officer at Altris AI, comments on this new feature. “Whether it’s for the research or for introducing the new therapy, you now have a reliable tool to search for the right patients efficiently.

For example, the FDA has recently approved the first treatment for Macular Telangiectasia Type 2, so eye care specialists can now search through their whole patient database and find those who have this particular pathology in minutes to offer them a new treatment.”

The release of flags reinforces Altris AI’s position as a leading AI decision support platform for OCT analysis for both clinical care and research purposes. By enabling customizable filtering across over 70 pathologies and biomarkers, flags support better disease tracking, faster research, and more personalized treatment planning.

About Altris AI
Altris AI is a vendor-neutral, web-based AI Decision Support for OCT Analysis platform. It supports early diagnosis, treatment planning, and research across more than 70 biomarkers and retinal pathologies. Altris AI is used by leading clinics and research centers worldwide.

22.08.2025

Altris AI Achieves MDSAP Certification, Strengthening Global Presence and Clinical Credibility

Altris Inc., a leading AI decision support platform for OCT scan analysis, proudly announces that it has passed the Medical Device Single Audit Program (MDSAP) audit. 

Based on the objective evidence reviewed, this audit enables a recommendation for Initial certification to ISO 13485:2016 MDSAP, including the requirements of Australia, Brazil, Canada, the USA, and Japan, and EU 2017/745, and that the scope was reviewed and found to be appropriate for ISO 13485:2016/MDSAP and EU MDR 2017/745.

The results of this audit are suitable for obtaining the EU MDR 2017/745 certificate, which we are currently in the process of pursuing.

ISO 13485:2016/MDSAP enables Altris Inc. to “design, manufacture, and distribute medical software for the analysis and diagnosis of retinal conditions globally.” It is recognized by leading global health regulators and signals trust and credibility to public and private hospitals, eye care networks, and optometry chains worldwide. 

MDSAP Certification also opens the door for Altris Inc. to enter new international markets, including Asia-Pacific, Latin America, and additional parts of North America. The MDSAP certification allows a single regulatory audit of Altris AI’s Quality Management System (QMS) to be recognized by multiple major health authorities, including:

• FDA (United States)
• Health Canada
• TGA (Australia)
• ANVISA (Brazil)
• MHLW/PMDA (Japan)

MDSAP enforces that the Quality Management System for developing, testing, and maintaining AI Decision Support for OCT complies with international medical device standards. Altris AI Decision Support for OCT Analysis system that facilitates the detection and monitoring of over 70 retinal pathologies and biomarkers, including early signs of glaucoma, diabetic retinopathy, and age-related macular degeneration. 

“Achieving ISO 13485:2016 certification under the stringent MDSAP requirements is a significant accomplishment for our team,” said Maria Znamenska, MD, PhD, Chief Medical Officer at Altris AI. “As a practicing ophthalmologist, I understand that the safety of patients is the absolute priority. Especially when implementing such an innovative technology as AI for decision support in OCT analysis. That is why we did everything possible to build quality processes that guarantee the highest level of safety for the patients.

This certification enables Altris AI to expand its presence and offer eye care specialists upgraded functions such as GA progression monitoring, flags for smart patient filtering, or automated drusen count.”

“This is more than a regulatory milestone for our team  – it’s a signal to the global eye care community that Altris AI is a trusted clinical partner,” said Andrey Kuropyatnyk, CEO of Altris AI. 

About Altris AI

Founded in 2017, Altris AI is at the forefront of integrating artificial intelligence analysis into ophthalmology and optometry.

The company’s platform is designed to assist eye care professionals in interpreting OCT scans with greater objectivity and make informed treatment decisions. It’s a vendor-neutral platform compatible with OCT devices from 8 major global manufacturers. With a commitment to innovation and compliance, Altris AI continues to develop solutions that set higher standards in the eye care industry and improve patient outcomes.

Glaucoma OCT Monitoring Guide: From Detection to Long-Term Care

Table of Contents

1. Glaucoma detection: why early diagnosis is critical
2. How to detect glaucoma in early stages: key approaches
3. Advanced imaging for glaucoma: OCTA
4. OCT glaucoma monitoring after diagnosis
5. Additional tools for monitoring glaucoma treatment
6. Glaucoma OCT: the foundation of long-term glaucoma care

Optical Coherence Tomography (OCT) has fundamentally changed glaucoma diagnostics over the past two decades. It enables non-invasive, micron-level imaging of retinal microstructures and provides objective measurements of the retinal nerve fibre layer (RNFL), ganglion cell complex (GCC), and optic nerve head (ONH) parameters. Moreover, the advent of OCT angiography (OCTA) has introduced a new dimension in assessing microcirculation—complementing structural analysis and potentially predicting glaucoma progression.

Today,  OCT is the standard for early detection, monitoring, and risk stratification of glaucoma progression, as recognised in international clinical guidelines. When combined with functional tests, tonometry, and anterior chamber angle assessment, OCT becomes the foundation for personalised glaucoma management.

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Glaucoma detection: why early diagnosis is critical

Early glaucoma diagnosis is vital, as optic nerve damage caused by the disease is irreversible. Many patients seek care only after significant vision loss has occurred, at which point treatment may slow progression but cannot restore lost function. This is why ophthalmologists emphasise the importance of glaucoma detection at preclinical or pre-perimetric stages.

How does OCT help in early glaucoma detection?

OCT provides high-resolution imaging of the retina and optic nerve head. Unlike subjective functional tests, OCT delivers objective, quantitative data on ganglion cells, nerve fibre layers, and the neuroretinal rim, enabling recognition of even subtle structural changes.

Recent OCT models go further, allowing detailed visualisation of the lamina cribrosa, a structure known to be altered in glaucoma. Today, OCT is recognised as a key diagnostic tool in the guidelines of both the European Glaucoma Society and the American Academy of Ophthalmology.

How to detect glaucoma in early stages: key approaches

Early glaucoma detection relies on evaluating structural and functional parameters of the eye, supported by advanced imaging techniques. The three main parameters assessed with glaucoma OCT are:

• Ganglion Cell Complex (GCC) thickness and asymmetry
• Retinal Nerve Fibre Layer (RNFL) thickness
• Optic nerve head parameters with the DDLS scale

In addition, OCT Angiography (OCTA) provides complementary insights into ocular microvasculature that may indicate early glaucomatous damage.

Glaucoma detection parameter 1: GCC thickness and asymmetry

One of the most sensitive preclinical biomarkers of glaucomatous damage is thinning of the ganglion cell complex (GCC), which includes the ganglion cell layer (GCL), inner plexiform layer (IPL), and macular RNFL (mRNFL). It is assessed through macular OCT scans. Damage in this area is particularly critical, as 50–60% of all ganglion cells are concentrated within the central 6 mm zone.

Assessing asymmetry between the superior and inferior halves of the macula within the GCC is a key diagnostic indicator. Studies show that minimum GCC thickness and FLV/GLV indices (Focal Loss Volume / Global Loss Volume) are predictors of future RNFL thinning or emerging visual field defects. Asymmetry maps significantly ease clinical interpretation.

A newer approach—vector analysis of GCC loss—also allows clinicians to visualise the direction of damage, which often correlates with future visual field defects.

Glaucoma detection parameter 2: RNFL thickness analysis

RNFL analysis is among the most widely used glaucoma diagnostic methods. The RNFL reflects the axons of the ganglion cells and is readily measured in optic nerve scans. Temporal sectors are the most sensitive and often show the earliest changes.

Even when the overall thickness appears normal, localised defects should raise suspicion. Sectoral thinning of ≥5–7 μm is considered statistically significant. Age-related RNFL decline (~0.2–0.5 μm/year) must also be considered.

Glaucoma detection parameter 3: optic nerve head parameters and the DDLS scale

Evaluating the optic nerve head (ONH) is essential. OCT enables automated assessment of optic disc area, cup-to-disc ratio (C/D), cup volume, rim area, and the lamina cribrosa.

The Disc Damage Likelihood Scale (DDLS) classifies glaucomatous ONH changes based on the thinnest radial rim width or, if absent, the extent of rim loss. Unlike the C/D ratio, DDLS adjusts for disc size. When combined with OCT, DDLS significantly enhances objective clinical assessment.

In high myopia, automatic ONH segmentation often misclassifies anatomy. Here, newer deep learning–based segmentation models improve accuracy.

Advanced imaging for glaucoma: OCTA

OCT Angiography (OCTA), an advanced glaucoma OCT technique, provides unique insights into ocular circulation. It enables evaluation of:

• Vessel density in the peripapillary region
• Optic nerve and macular vascularisation
• Retinal versus ONH perfusion in both eyes

Studies confirm that reduced vessel density correlates with RNFL loss and visual field deterioration, and often precedes both.

OCT glaucoma monitoring after diagnosis

Glaucoma can progress even with stable intraocular pressure (IOP), making regular structural assessment of the optic nerve and inner retina crucial for therapy adjustment.

Glaucoma OCT is not only a diagnostic tool but also the primary method for monitoring glaucomatous damage. Unlike functional tests, OCT can detect even minimal RNFL or GCL thinning months or even years before visual field loss appears. With serial measurements and built-in analytics, OCT allows clinicians to track glaucoma progression rates and identify high-risk patients.

Methods for glaucoma progression monitoring

There are two main approaches to monitor glaucoma progression with OCT:

Method 1: event-based analysis

This method compares current scans with a reference baseline, identifying whether RNFL or GCL thinning exceeds expected variability.

? Example: Heidelberg Eye Explorer (HEYEX) highlights suspicious areas in yellow (possible loss) or red (confirmed loss).

Limitations include sensitivity to artifacts, image misalignment, and segmentation quality. A high-quality baseline scan is essential.

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Method 2: trend-based analysis

This approach accounts for time. The software plots RNFL/GCL thickness trends over time in selected sectors or globally and calculates the rate of progression.

Examples:

• RNFL thinning >1.0 μm/year is clinically significant.
• Thinning >1.5 μm/year indicates active progression.

It also accounts for age-related changes, helping differentiate physiological vs. pathological decline.

Visual assessment in glaucoma OCT

Qualitative analysis also plays an important role in detecting glaucoma progression. Key aspects include:

• Focal RNFL thinning (localised defects)
• Changes in the neuroretinal rim
• Alterations in ONH cupping
• GCL/GCIPL comparison (superior vs. inferior) on macular maps
• New segmentation artifacts (may mimic progression)

OCT glaucoma findings that indicate true progression

Five OCT findings suggest true glaucomatous progression:

1. RNFL thinning >10 μm in one sector or >5 μm in several sectors
2. New or worsening GCL asymmetry (yellow to red colour shift)
3. Emerging or expanding RNFL defects on colour maps
4. Increasing C/D ratio with concurrent rim thinning
5. New localised areas of vessel density loss on OCTA

Particular attention should be paid to the inferotemporal and superotemporal RNFL sectors, where 80% of early changes occur.

Frequency of glaucoma OCT monitoring

According to the AAO and EGS, the recommended frequency for OCT glaucoma monitoring is:

• High-risk patients: every 6 months
• Stable patients: once a year
• For trend analysis: at least 6–8 scans over 2 years to ensure statistical reliability

Looking ahead, broader use of AI for glaucoma is expected to support earlier and more accurate detection, while also reducing false positives.

Additional tools for monitoring glaucoma treatment

While glaucoma OCT is essential for detecting structural changes, a comprehensive glaucoma assessment requires a multimodal approach. Additional tools include perimetry, tonometry, optic disc fundus photography, and gonioscopy.

Perimetry (visual field testing)

Functional assessment of the optic nerve remains crucial. Standard Automated Perimetry (SAP), most often performed with Humphrey Visual Field Analyzer protocols (24-2, 30-2, 10-2), is the most widely used method.

Key indices:

• MD (mean deviation): average deviation from normal values
• PSD (pattern standard deviation): highlights localised defects
• VFI (visual field index): summarises global visual function; useful for tracking glaucoma progression
• GHT (glaucoma hemifield test): automated analysis of field asymmetry

? Important: In 30–50% of cases, structural changes such as RNFL thinning on OCT precede visual field defects; in others, functional loss appears first. Best practice relies on integrated OCT and perimetry to correlate damage location and monitor glaucoma progression more precisely.

Combined OCT and perimetry remains the gold standard for progression monitoring.

Tonometry

Intraocular pressure (IOP) is the only clearly modifiable risk factor associated with both glaucoma onset and progression.

• Goldmann applanation tonometry remains the gold standard.
• A single IOP reading is insufficient — diurnal fluctuations are an independent risk factor, particularly in normal-tension glaucoma.

Optic disc fundus photography

Although subjective, fundus imaging remains valuable for documenting glaucomatous changes, especially in borderline cases. Unlike OCT, it does not provide quantitative data but helps visualise morphology over time.

What to assess:

• Progressive disc cupping
• Changes in neuroretinal rim shape or colour
• Disc margin haemorrhages (linked to faster RNFL thinning and visual field loss)
• Inter-eye comparisons

Gonioscopy

Gonioscopy evaluates the anterior chamber angle and helps exclude angle-closure, pigmentary, or pseudoexfoliative glaucoma. It also identifies:

• Neovascularisation
• Trabecular meshwork abnormalities
• Other angle anomalies

Patient education: a key to successful glaucoma management

Accurate glaucoma detection and therapy are not enough; adherence to monitoring and treatment is equally critical.

The challenge:

• Early-stage glaucoma is asymptomatic.
• Many patients underestimate its seriousness, leading to poor compliance, missed follow-ups, and discontinuation of therapy.

The goals of patient education:

• Explain that glaucoma progresses silently but can lead to irreversible blindness if untreated.
• Use real-life examples (before/after OCT scans, visual field comparisons) to illustrate progression.
• Teach patients to recognise warning signs (vision changes, eye pain).
• Visualise disease progression with AI tools showing RNFL loss and future risk.

Educational resources may include:

• Printed brochures in patient-friendly language
• Videos featuring OCT images with explanations
• Doctor–patient in-clinic discussions
• Telemedicine platforms with reminders and follow-up prompts

? According to the AAO, patients who understand glaucoma are 2.5 times more likely to adhere to treatment and attend check-ups.

Glaucoma OCT: the foundation of long-term glaucoma care

Glaucoma OCT now plays a central role in both diagnosis and monitoring. Its ability to detect subtle structural changes before measurable functional loss makes early intervention possible and increases the chances of preserving vision.

But technology alone is not enough. Accurate interpretation, combined with strong patient education, is essential. When patients understand their disease and the role of glaucoma OCT in treatment, adherence improves and outcomes are better.

OCT is not just a diagnostic device; it is the cornerstone of an integrated glaucoma management strategy, from initial screening to long-term monitoring and treatment optimisation.

Inside the Power Hour: Altris AI’s Take on AI Innovation in Eye Care

Our Vice President of Business Development, Grant Schmid, took part in The Power Hour podcast to discuss how AI and automation are shaping the future of patient experience. We turned that conversation into an interview and pulled out the most compellinsubtle anatomical g insights on tech-enabled practice growth and innovation in eye care.

Eugene Shatsman: Can you start by introducing Altris AI and what problem you’re solving in eye care?
Grant Schmid: Altris AI was founded in 2017 in Chicago, with the University of Chicago as our first investor. But most of our team — and the heart of our development — is based in Ukraine.

We focus on AI for OCT analysis. Our goal is to provide decision support that helps identify over 70 different pathologies and biomarkers, no matter what OCT device a clinic uses. The idea is to speed up image interpretation, ensure nothing is missed, and support doctors in delivering top-quality care.

Eugene: What initially inspired the development of Altris AI?
Grant: Our co-founder is a retina specialist from Kyiv. She wanted a way to improve the referral process and increase the OCT knowledge of those referring patients to her. That’s how the idea of a clinical decision support platform was born.

We actually started with an educational OCT app that you can still download — many doctors come to our booth at trade shows not realizing that the app is also part of what we’ve built.

Eugene: What does a typical OCT workflow look like with and without Altris AI?
Grant: In many modern practices, every patient now gets an OCT. It’s used to screen for diseases like AMD, glaucoma, or diabetic retinopathy. But subtle anatomical differences can confuse even experienced clinicians.

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With Altris AI, the doctor gets an analysis almost immediately — color-coded overlays, pathology markers, optic disc assessments, all in one place. This speeds up the review process and supports clinical decision-making without disrupting workflow.

Eugene: What do you say to clinicians who say, “I already know how to read OCTs — why do I need AI?”
Grant: Many doctors are confident in interpreting OCTs, and that’s great. But the value isn’t just in identifying disease — it’s in validation and patient education.

We’re not here to replace what doctors do. Altris AI validates what you already know and makes it easier to communicate with patients. We highlight what might be missed, and we provide visual tools that help explain findings clearly — which leads to better patient understanding and trust.

Eugene: Can you give an example of how this helps patient education?
Grant: Absolutely. Let’s take glaucoma. Many patients on drops don’t feel or see any change, so they think, “Why bother?” But if you can show them a progression or show that things are stable, it becomes real to them.

We launched an Optic Disc Analysis feature that lets you compare up to eight past visits side-by-side. So when a patient asks, “Is this working?” you can say, “Yes, here’s the proof.” That drives adherence and builds trust.

Eugene: Are practices today ready to embrace AI-based tools? Or are they still cautious?
Grant: There’s a lot of curiosity, a lot of interest. Some are still figuring out how to implement AI in a way that makes sense for them.

But AI is everywhere now — whether it’s in search engines, smartphones, or how we shop. Patients expect that kind of intelligence in their healthcare, too. In fact, a 67-year-old tugboat captain with AMD once called me asking about our software and offered to pay for his doctor’s subscription. That tells you how fast expectations are changing.

Eugene: Can AI actually improve the patient experience beyond just diagnosis?
Grant: Absolutely. Patients want to understand what’s happening with their health. When you can show them their scan results with overlays and simple visuals, they feel included in the process.

It’s not just about detecting disease, it’s about building trust. Clear visual communication boosts confidence, reduces anxiety, and increases compliance.

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Eugene: Some fear AI will replace clinicians. What’s your perspective on that?
Grant: That’s one of the biggest myths out there. AI won’t replace clinicians — it enhances what they do.

We’re not cleared to diagnose. We’re a decision-support tool. Doctors still make the final decision, but we give them more data, faster and more clearly. Human clinical judgment is still irreplaceable — we just help sharpen it.

Eugene: What barriers are you seeing when introducing Altris AI to new practices?
Grant: The main one is comfort — many doctors feel confident reading OCTs and don’t immediately see the need.

The other is simply awareness. We’re a fast-growing startup, but many still don’t know about us. That’s why opportunities like this podcast are important.

In terms of logistics, there’s no barrier. Altris AI is web-based, nothing to install, and takes just 20 minutes to learn. We’re designed to be plug-and-play.

Eugene: If a practice wants to engage patients more using AI in eye care, how should they approach it?
Grant: One great idea is to run a recall campaign for patients who haven’t had an OCT in the last 6 or 12 months. Something like, “We now use AI to enhance your OCT scan — come see how it works.”

AI is a differentiator. It shows your clinic is modern, patient-focused, and using the best available tools.

Eugene: What do you think the optometry practice of 2028 will look like?
Grant: I think you’ll see AI systems talking to each other. Imagine our platform detecting something on a scan and automatically triggering a patient reminder or a suggested follow-up.

There will be less manual work and more focus on human care. The doctor will be able to walk in and focus completely on the patient — the AI will handle the background tasks like charting or longitudinal comparisons.

Ultimately, better care, less burnout.

Eugene: What’s one myth you’d like to bust about AI in optometry?
Grant: That AI will replace people. It won’t. What it does is make you more effective. You’ll have sharper insights, clearer visuals, and faster decision-making — all without replacing your clinical experience.

Eugene: And finally, how can practices get started with Altris AI?
Grant: Just go to  altris.ai or connect with us on LinkedIn. We offer live demos and can use your real OCT scans to show exactly how it works.

There’s no software to install, no major investment, and we operate on a subscription basis — so there’s no long-term risk. If you’re curious, reach out. We’d love to show you what’s possible.

Watch the complete Power Hour podcast episode below for more insights on AI, automation, and innovation in eye care:

Dry AMD Treatment: Modern Ways to Slow Progression

Table of Contents

1. What are the dry macular degeneration treatment breakthroughs?
2. How to monitor dry AMD progression with OCT?
3. What are the challenges of dry age-related macular degeneration monitoring?
4. How do I organize efficient dry AMD monitoring in my clinic?
5. Why are optometrists on the front line of early AMD detection?
6. How can OCT insights help support patients emotionally?
7. Conclusion

For many years, dry or non-exudative AMD was seen as untreatable. Most research focused on wet AMD and anti-VEGF therapy.

Today, this paradigm is shifting. Around 30% of patients with age-related macular degeneration are affected by the dry form, which makes finding effective therapies critical. Recently, the first FDA-approved drugs for dry macular degeneration injections have appeared, offering hope to patients with geographic atrophy (GA). Alongside, new physiotherapeutic methods, such as multi-wavelength photobiomodulation, are showing promising results.

Geographic atrophy (GA) is an advanced, irreversible form of dry AMD. It occurs when parts of the retina undergo cell death, leading to progressive vision loss. But even the best dry AMD treatment is incomplete without objective measurement. That’s where modern tools for macular degeneration monitoring come in, and optical coherence tomography (OCT) is now at the core of this process.

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What are the dry macular degeneration treatment breakthroughs?

The latest dry macular degeneration treatment breakthroughs include:

• Multiwavelength photobiomodulation
• FDA-approved injectable drugs
• AREDS 2-based supplements

In the past, recommendations focused only on reducing risks — quitting smoking, managing blood pressure, and eating a healthy diet.
Now, new approaches to dry AMD treatment combine prevention with active therapies to slow AMD progression and especially the advance of GA.

1. Dry AMD treatment using multiwavelength photobiomodulation

Multiwavelength photobiomodulation for AMD is a promising new treatment. It uses specific red and near-infrared light wavelengths (~590–850 nm) and helps reduce oxidative stress, inflammation, and pigment epithelial cell death.

One of the best-known systems is Valeda Light Therapy, which delivers controlled multiwavelength light directly to the retina.

The LIGHTSITE III clinical trial showed that photobiomodulation can slow the decline in visual acuity and reduce the rate of GA expansion.

Limitations:

• Only 3–5 years of long-term data available
• Requires costly equipment and training
• Effectiveness in late-stage GA remains unclear

2. Dry AMD treatment using FDA-approved injectable drugs

AMD injection drugs approved by the FDA include Izervay and Syfovre.

• Izervay (avacincaptad pegol): A C5 complement protein inhibitor that targets the complement cascade involved in chronic retinal inflammation and damage. Izervay, approved for geographic atrophy secondary to dry AMD, has demonstrated a reduced rate of GA progression in clinical trials.
• Syfovre (pegcetacoplan): A C3 complement inhibitor that blocks the central component of the complement system to reduce inflammation. Syfovre is the first FDA-approved treatment for GA that targets complement component C3, showing a clinically meaningful slowing of GA progression.

Both dry macular degeneration injections have shown the ability to slow GA progression compared to placebo. Although they do not restore vision, slowing vision loss is a meaningful clinical outcome.

Key considerations for injections:

• Administered intravitreally, usually monthly or every other month
• Require doctor training and patient education on risks (e.g., endophthalmitis, increased intraocular pressure)
• Cost and access may limit use

3. Dry AMD treatment using AREDS 2-based supplements

AREDS 2 supplements are antioxidant supplements containing lutein, zeaxanthin, vitamins C and E, zinc, and copper. They can reduce the risk of progression to late-stage AMD by around 25% over five years, according to the AREDS 2 study.

Pros:

• Widely available
• Safe, with low side effect risk
• Supported by strong clinical evidence

Cons:

• Do not directly treat GA
• Cannot replace active therapies such as dry macular degeneration injections or photobiomodulation

How to monitor dry AMD progression with OCT

Effective macular degeneration monitoring relies on OCT. It is the gold standard for tracking retinal changes and predicting GA development.
Without OCT, clinicians are essentially “flying blind” when assessing AMD progression.

Key monitoring parameters of AMD progression

The key monitoring parameters of AMD progression include GA area, drusen, and distance to fovea.

1. GA area

This is the main metric when using intravitreal eye injections. Modern OCT systems provide GA measurements in mm², allowing doctors to objectively track changes over time.

Even if patients don’t notice symptoms, a growing GA area signals disease progression. In FDA trials for Syfovre and Izervay, the GA area was the primary endpoint.

2. Drusen

Drusen vary in number, size, and shape. A reduction or disappearance of drusen on OCT may seem like an improvement, but could actually indicate a transition to the atrophic stage. Regular monitoring helps detect this early.

3. Distance to fovea

The closer GA is to the fovea, the greater the risk of sudden vision loss.

Early detection enables:

• Referral to an ophthalmologist
• Timely conversations about potential vision loss

OCT outputs for AMD progression monitoring and communication

Useful OCT outputs for AMD progression monitoring and communication are heat maps and progress charts.

1. Heat maps

Modern OCT systems use color-coded heat maps to show pigment epithelium thickness and drusen distribution. This visual format helps in several ways:

• Makes interpretation easier for clinicians
• Helps patients better understand their condition
• Encourages patients to stay engaged with treatment

In clinical practice, it serves as a highly effective communication tool.

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2. Progress charts

Most OCT systems can compare results across visits

• For doctors: Helps guide treatment decisions
• For patients: Provides visual proof of stabilization or worsening

The role of objective evidence in patient treatment

Patients may question the value of long-term treatments or costly procedures.

OCT is the gold standard for patient motivation. When patients see actual changes, they’re more likely to agree to treatment.

What are the challenges of macular degeneration monitoring?

Monitoring dry AMD presents technical, organizational, and psychological challenges. Doctors of all levels of experience should be aware of them.

1. Invisible microchanges

Early atrophy or drusen changes may be subtle. Patients may not notice them due to eccentric fixation or slow adaptation.

Without OCT, doctors may miss early GA, delaying treatment.

It is necessary to perform OCT even when there are only minor changes in visual acuity or if the patient reports image distortion (metamorphopsia).

2. Subjective assessment

Ophthalmoscopy reveals only obvious changes. Subtle drusen or early atrophy might be missed.

Relying on patients’ complaints is risky — many don’t notice issues until it’s too late.

That’s why even small optical practices should establish clear referral pathways for OCT exams.

3. Unnecessary referrals

Optometrists or primary care doctors often refer patients to ophthalmologists “just in case,” because they don’t have access to OCT or lack experience interpreting it.

This puts unnecessary strain on specialists. In many cases, nothing new is done after the exam because there are no previous images for comparison.

4. Limitations of OCT devices

Not all OCT devices measure GA or track drusen equally well. Older models may lack automated measurements of atrophy area.

In some cases, referral to a center with advanced OCT is necessary.

How do I organize efficient dry AMD monitoring in my clinic?

Practical tips:

1. Create a baseline chart with OCT images during the first visit.

2. Monitor regularly:

• Every 6–12 months in the early stages
• Every 3–6 months with GA
• Before each intravitreal injection

3. Standardise scanning protocols to minimise variability.

4. Use OCT software tools for image comparison, GA calculation, heat maps.

5. Communicate clearly with patients about drusen, atrophy, and treatment goals.

Why are optometrists on the front line of early AMD detection?

Optometrists play a key role in spotting the early signs of AMD, as they are often the first point of contact in eye care.

They perform initial screenings, provide guidance on lifestyle and supplements, and ensure regular OCT monitoring.

If drusen, pigment epithelial changes, or signs of GA are present, they refer patients to ophthalmologists for confirmation and treatment planning.

How can OCT insights help support patients emotionally?

Patients with dry AMD often ask: “Why bother if it can’t be cured?”
Here, OCT plays an emotional as well as clinical role. Showing OCT scans can:

• Prove the value of slowing AMD progression
• Emphasise patients’ role in preserving sight
• Reassure them that long-term care makes a difference

Dry macular degeneration treatment breakthroughs: key takeaways for slowing AMD progression

Modern dry macular degeneration treatment breakthroughs, including FDA-approved injections, photobiomodulation, and AREDS 2 supplements,  have changed the outlook for patients.
Yet treatment alone is not enough. Without consistent macular degeneration monitoring using OCT, the benefits of these therapies may be lost.

The future of dry AMD treatment  lies in a partnership between optometrists, ophthalmologists, and patients. Together, with breakthrough therapies and precise monitoring, we can slow AMD progression and give patients the best chance of preserving vision.

AI for Decision Support with OCT: An Interview with Clara Pereira, Optometrist from Franco Oculista

About Franco Oculista Optometry in Portugal.

Franco Oculista is the optometry center with a 70-year-old history: its roots date back to the mid-1950s in Luanda, where it was founded by Gonçalo Viana Franco. Having left behind a career in pharmacy, Gonçalo pursued his entrepreneurial vision by opening an optician’s bearing his name in the heart of the Angolan capital. Driven by a thirst for knowledge and a deep sense of dedication, he turned his dream into reality. With a commitment to professionalism and a forward-thinking approach, he integrated the most innovative technologies available at the time. This blend of passion, expertise, and innovation established Franco Oculista as a benchmark for quality and excellence in the field. In 1970s, the family returned to Portugal and opened the new FRANCO OCULISTA space on Avenida da Liberdade.

How do Franco Oculista describe their mission?

“Through individualized and segmented service, we seek to respond to the needs of each client. We combine our knowledge with the most sophisticated technical equipment and choose quality and reliable brands. We prioritize the evolution of our services and, for this reason, we work daily to satisfy and retain our customers with the utmost professionalism.”

Clara Pereira is one of the optometrists at Franco Oculista and has been an optometrist for nearly two decades. Based in a private clinic in Portugal, she brings years of experience and calm confidence to her consultations. We talked with her to learn how her clinical practice has evolved, particularly since integrating OCT and, more recently, Altris AI – AI for Decision Support with OCT.

Altris AI: Clara, can you tell us a bit about your daily work?

Clara: “Of course. I’ve been working as an optometrist for 19 years now. My practice is quite comprehensive—I assess refractive status, binocular vision, check the anterior segment with a slit lamp, measure intraocular pressure, and always examine the fundus.

Clara: “In Portugal, we face limitations. We’re not allowed to prescribe medication or perform cycloplegia, so imaging becomes crucial. I rely heavily on fundus photography and OCT to guide referrals and detect early pathology.”

Altris AI: How central is OCT diagnostics to your workflow?
Clara: “OCT is substantial. I perform an OCT exam on nearly every patient, on average, eight OCT exams per day. It’s an essential part of how I gather information. With just one scan, I can learn so much about eye health.”

Altris AI: What kind of conditions do you encounter most frequently?
Clara: “The most common diagnosis is epiretinal membrane—fibrosis. But I also manage patients with macular degeneration and other retinal pathologies. Having the right tools is key.”

Altris AI: And what OCT features do you use the most?
Clara: “I regularly use the Retina, Glaucoma, and Macula maps. But if I had to choose one, the Retina Map gives me the most complete picture. It’s become my go-to.”

Altris AI: You’ve recently started using Altris AI. What has that experience been like?
Clara: “At first, I didn’t know much about it. But when Optometron introduced Altris AI to me—a company I trust—I didn’t hesitate. And I’m glad I didn’t. From the beginning, it felt like a natural extension of my clinical reasoning.

Clara: “Altris AI gives me an extra layer of certainty. It helps me extract more from the OCT images. I usually interpret the scan myself first, and then I run it through the platform. That way, I validate my thinking while also learning something new.”

Altris AI: Have any standout cases where Altris AI made a difference?

Clara: “Yes. I’ve had a few. One was a case of advanced macular degeneration, in which the AI visualization really helped me explain the condition to the patient. Another was using anterior segment maps for fitting scleral lenses—Altris was incredibly useful there, too. I do a lot of specialty lens fittings, so that was a big advantage.”

Altris AI: Would you recommend Altris AI to your colleagues?

Clara: “I would recommend Altris AI to my colleagues. For me, it’s about more than just the diagnosis. It’s about feeling confident that I’m seeing everything clearly and giving my patients the best care possible. Altris AI helps me do exactly that.”

Why This Matters: Altris AI in Real Practice

Clara’s story reflects the real value of AI in optometry—not as a replacement for clinical judgment, but as a powerful companion. With every OCT scan, she strengthens her expertise, improves diagnostic accuracy, and gives her patients the reassurance they deserve.

Whether identifying early signs of fibrosis, supporting complex scleral lens fittings, or acting as a second opinion, Altris AI seamlessly fits into the modern optometrist’s workflow, making every scan more meaningful.

AI for Decision Support with OCT: Transforming Retinal Diagnostics

Artificial Intelligence (AI) is revolutionizing the field of ophthalmology, particularly through its integration with Optical Coherence Tomography (OCT). OCT is a non-invasive imaging technique that captures high-resolution cross-sectional images of the retina, enabling early detection and monitoring of various ocular conditions. However, interpreting these scans requires time, expertise, and consistency—factors that AI-based decision support systems are uniquely positioned to enhance.

Altris AI (AI for OCT decision support platform) analyzes thousands of data points across B-scans, automatically detecting retinal pathologies, quantifying biomarkers, and identifying patterns that may be subtle or overlooked by the human eye. By providing objective, standardized assessments, Altris AI reduces diagnostic variability and improves clinical accuracy, especially in busy or high-volume practices.

For optometrists and ophthalmologists, AI acts as a second opinion, flagging early signs of diseases such as age-related macular degeneration (AMD), diabetic retinopathy, and glaucoma. It streamlines workflows by highlighting areas of concern, prioritizing cases that require urgent attention, and offering visual explanations that are easy to communicate to patients.

Moreover, Altris AI enableS longitudinal tracking of pathology progression. By comparing OCT scans over time ( even from various OCT devices), clinicians can monitor subtle changes in drusen volume, retinal thickness, supporting timely clinical decisions and tailored treatment strategies. The integration of AI into OCT interpretation not only enhances diagnostic confidence but also supports evidence-based care, early intervention, and improved patient outcomes. As AI continues to evolve, it will play a vital role in advancing precision medicine in ophthalmology, empowering eye care professionals with tools that are fast, reliable, and scalable.

In essence, AI for OCT decision support is not replacing clinical expertise; it is augmenting it, elevating the standard of care through speed, accuracy, and actionable insights.

Best AI for OCT: 10 Essential Features Your Platform Must Have 

So you’ve decided to trial AI for OCT analysis and wondering how to choose among all the available platforms. To save you some time, we’ve collected 10 most essential criteria according to which you can assess all existing AI platforms. Using this criteria you will be able to make an informed and rational choice.

As an ophthalmologist, I am interested in finding innovative and modern approaches that could help me to enhance the workflow and improve patient outcome as a result.Analyzing various platforms, I realized that these 10 criteria are crucial for the right choice.

1. Regulatory Compliance and Clinical Validation

In healthcare, safety is always first. Regulatory approval and clinical validation are essential for AI-powered platforms for OCT scan analysis.

The best AI OCT platforms should meet regulatory standards set by authorities such as the FDA, HIPAA, CE, and ISO. 

Adhering to regulatory guidelines enhances credibility and fosters trust among healthcare professionals. Check if the AI for OCT analysis tool has all these certificates in place and if they are valid.

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2.Wide range of biomarkers and pathologies detected

Some AI for OCT platforms concentrate on certain pathologies, like  Age-Related Macular Degeneration (AMD) or Diabetic Retinopathy, because of the prevalence of these conditions among the population. It mostly means that eye care specialists must know in advance that they are dealing with the AMD patient to find the proof of AMD on the OCT.

The best AI for OCT tools should have a wide variety of biomarkers and pathologies, including rare ones that cannot be seen daily in clinical practice, such as central retinal vein and artery occlusions, vitelliform dystrophy, macular telangiectasia and others. Altris AI, the leader of OCT for AI analysis, detects 74 biomarkers and pathologies as of today. 

3.Cloud-Based Data Management and Accessibility

To ensure seamless integration into clinical workflows, the AI OCT platform should offer cloud-based data management and accessibility. Cloud storage allows for easy retrieval of patient records, remote consultations, and multi-location access. Secure cloud computing also enhances collaboration between ophthalmologists, optometrists, and researchers by enabling data sharing while maintaining compliance with data privacy regulations such as HIPAA and GDPR. 

Many clinics have strict policies regarding patient data storage as well: it is crucial that the data is stored on the servers in the region of operation. If the clinic is in EU, the data should be stored in the EU.

4.Real-world usage by eye care specialists

When choosing the best AI for OCT analysis, real-world usage by eye care specialists is the most critical factor. Advanced algorithms and high accuracy metrics mean little if the AI is not seamlessly integrated into clinical workflows and actively used by optometrists and ophthalmologists. There are thousands of research models available, but when it comes to the implementation, most of them are not available to ECPs.

Eye care professionals are not IT specialists. They require AI that is intuitive, fast, and reliable. If a system disrupts their workflow, generates excessive false alerts, or lacks clear explanations for its findings, adoption rates will be low—even if the technology itself is powerful. The best AI solutions are those that specialists trust and rely on daily to enhance diagnostic accuracy, streamline patient management, and support decision-making.

Moreover, real usage generates valuable feedback that continuously improves the AI. Systems actively used in clinical settings undergo rapid validation, refinement, and adaptation to diverse patient populations. This real-world data is far more meaningful than isolated test results in controlled environments.

5. Customizable Reporting and Visualization Tools

Reports are the result of the whole AI for OCT scan analysis that is why customizable and comprehensive reports are a must.

A high-quality AI OCT platform must offer customizable reporting and visualization tools. Clinicians should be able to adjust parameters, select specific data points, and generate detailed reports tailored to individual patient needs.

Heatmaps, 3D reconstructions, and trend analysis graphs should be available to help visualize disease progression. These tools improve the interpretability of AI-generated insights and facilitate patient education.

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6.AI for Early Glaucoma Detection

Glaucoma is a leading cause of irreversible blindness, and since OCT is widely used to assess the retinal nerve fiber layer (RNFL), Ganglion Cell Complex ( GCC), optic nerve head (ONH), AI can significantly enhance early detection and risk assessment.

Therefore, the best AI for OCT analysis tools have an AI for early glaucoma detection module available to assess the risk of glaucoma especially at the early stage. Moreover, tracking the progression of glaucoma with the help of AI should also be available for eye care specialists.  

Clear and bright notifications about glaucoma risk are also vital for making AI glaucoma modules easy to use.  AI can provide proactive insights that enable early intervention and personalized treatment plans

7.User – Friendly Interface and Intuitive Workflow Integration

A well-designed AI OCT platform should feature a user-friendly interface that integrates seamlessly into existing clinical workflows. 

It means that even non-tech-savvy eye care specialists should be able to navigate it effortlessly. 

The interface should be intuitive, reducing the learning curve for healthcare providers. Features such as automated scan interpretation, voice command functionality, and guided step-by-step analysis can enhance usability and efficiency.

8.Integration with Electronic Health Records (EHRs)

For a seamless clinical experience, the AI OCT platform should integrate with existing electronic health record (EHR) systems. Automated data synchronization between AI analysis and patient records enhances workflow efficiency and reduces administrative burden. This feature enables real-time updates, streamlined documentation, and easy access to past diagnostic reports.

9. Universal AI solutions compatible with all OCT devices

Uf you want to use AI to analyze OCT, this AI should be trained on data received from various OCT devices and therefore should be applicable with various OCT devices. A vendor-neutral AI tool for OCT analysis provides unmatched advantages over proprietary solutions tied to specific hardware. By working seamlessly with multiple OCT devices, it eliminates the need for costly equipment upgrades and ensures broader accessibility across clinics and hospitals.

This approach also fosters greater innovation, allowing AI models to continuously improve based on diverse datasets rather than being limited to a single manufacturer’s ecosystem. Vendor-neutral solutions integrate effortlessly into existing workflows, reducing training time and boosting efficiency. Clinicians benefit from unbiased, adaptable technology that prioritizes patient outcomes rather than locking users into restrictive ecosystems.

10. Cost-Effectiveness and Accessibility

To maximize its impact, an AI-powered OCT platform should be cost-effective and accessible to a wide range of healthcare providers. Affordable pricing models, including subscription-based or pay-per-use plans, can make AI technology available to smaller clinics and developing regions. Accessibility ensures that AI-driven OCT analysis benefits as many patients as possible, improving global eye health outcomes.

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Conclusion

What is the best  AI for OCT scan analysis? The best AI for OCT must be a comprehensive, intelligent, and adaptable platform that enhances diagnostic accuracy, streamlines clinical workflows, and supports proactive eye care. Key features such as high-accuracy automated analysis, multi-modal imaging integration, real-time decision support, cloud-based data management, interoperability, and explainable AI decision-making are crucial for an effective OCT AI system. By incorporating these attributes, AI-driven OCT platforms can revolutionize ophthalmology, enabling early disease detection, personalized treatment planning, and improved patient outcomes. As AI technology continues to advance, its integration with OCT will play an increasingly vital role in shaping the future of eye care.

Future of Ophthalmology: 2025 Top Trends

In a recent survey conducted by our team, we asked eye care specialists to identify the most transformative trends in ophthalmology by 2025. The results highlighted several key areas, with artificial intelligence (AI) emerging as the clear frontrunner, cited by 78% of respondents.

However, the survey also underscored the significant impact of optogenetics, novel AMD/GA therapies, and the continuing evolution of anti-VEGF treatments. This article will explore the practical implications of these advancements, providing an overview of how they are poised to reshape diagnosis, treatment, research, and, ultimately, patient outcomes in ophthalmology.

In this article, we will also discuss Oculomics, a very promising field that is gaining momentum.

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Top AI Technology for Detecting Eye-related Health Risks 2025

Building upon the survey’s findings, we begin with the most prevalent trend: top AI technology for detecting eye-related health risks in 2025

AI in Clinical Eye Care Practice

With the increasing prevalence of conditions like diabetic retinopathy and age-related macular degeneration, there is a growing need for efficient and accurate screening tools. And AI is already valuable for eye-care screening: algorithms can analyze retinal images and OCT scans to identify signs of these diseases, enabling early detection and timely intervention.

Source

AI-powered screening tools can also help identify rare inherited retinal dystrophies, such as Vitelliform dystrophy and Macular telangiectasia type 2. These conditions can be challenging to diagnose, but AI algorithms can analyze retinal images to detect subtle signs that human observers may miss.

AI also starts to play a crucial role in glaucoma management. Early detection of glaucoma demands exceptional precision, as the early signs are often subtle and difficult to detect. Another significant challenge in glaucoma screening is the high rate of false positive referrals, which can lead to unnecessary appointments in secondary care and cause anxiety for patients, yet delayed or missed detection of glaucoma results in irreversible vision loss for millions of people worldwide. So, automated AI-powered glaucoma analysis can offer transformative potential to improve patient outcomes.

One example of promising AI technology is Altris AI, artificial intelligence for OCT scan analysis, which has introduced its Advanced Optic Disc (OD) Analysis that provides a comprehensive picture of the optic disc’s structural damage, allowing detailed glaucoma assessment for treatment choice and monitoring.

This OD module evaluates optic disc parameters using OCT, providing personalized assessments by accounting for individual disc sizes and angle of rim absence. Such a tailored approach eliminates reliance on normative databases, making evaluations more accurate and patient-specific.

Furthermore, it enables cross-evaluation across different OCT systems, allowing practitioners to analyze macula and optic disc pathology, even when data originates from multiple OCT devices. Key parameters evaluated by Altris AI’s Optic Disc Analysis include disc area, cup area, cup volume, minimal and maximum cup depth, cup/disc area ratio, rim absence angle, and disc damage likelihood scale (DDLS).

AI for Clinical Trials and Research

AI is revolutionizing clinical trials and research in ophthalmology. One such key application of AI is biomarker discovery and analysis. Algorithms can analyze large datasets of medical images, such as OCT scans, to identify and quantify biomarkers for various eye diseases. These biomarkers can be used to assess disease progression, monitor treatment response, and predict clinical outcomes.

AI is also being used to improve the efficiency and effectiveness of clinical trials. By automating the process of identifying eligible patients for clinical trials, AI can help researchers recruit participants more quickly and ensure that trials include appropriate patient populations, accelerating the development of new treatments.

Algorithms can analyze real-world data (RWD) collected from electronic health records and other sources to generate real-world evidence (RWE). RWE provides valuable insights into disease progression, treatment patterns, and long-term outcomes in everyday clinical settings, complementing the findings of traditional randomized controlled trials.

Oculomics

Integrating digitized big data and computational power in multimodal imaging techniques has presented a unique opportunity to characterize macroscopic and microscopic ophthalmic features associated with health and disease, a field known as oculomics. To date, early detection of dementia and prognostic evaluation of cerebrovascular disease based on oculomics has been realized. Exploiting ophthalmic imaging in this way provides insights beyond traditional ocular observations.

For example, the NeurEYE research program, led by the University of Edinburgh, is using AI to analyze millions of anonymized eye scans to identify biomarkers for Alzheimer’s disease and other neurodegenerative conditions. This research can potentially revolutionize early detection and intervention for these devastating diseases.

Another effort spearheaded by researchers from Penn Medicine, Penn Engineering is exploring the use of AI to analyze retinal images for biomarkers indicative of cardiovascular risk. AI systems are being trained on fundus photography to detect crucial indicators, such as elevated HbA1c levels, a hallmark of high blood sugar, and a significant risk factor for both diabetes and cardiovascular diseases.

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AI analysis of retinal characteristics, such as retinal thinning, vascularity reduction, corneal nerve fiber damage, and eye movement, has shown promise in predicting Neurodegenerative diseases. Specifically, decreases in retinal vascular fractal dimension and vascular density have been identified as potential biomarkers for early cognitive impairment, while reductions in the retinal arteriole-to-venular ratio correlate with later stages.

Moving from AI, we now turn to another significant trend identified in our survey:

Optogenetics

Optogenetics represents a significant leap forward in ophthalmic therapeutics, offering a potential solution for vision restoration in patients with advanced retinal degenerative diseases, where traditional gene therapy often falls short. While gene replacement therapies are constrained by the need for viable target cells and the complexity of multi-gene disorders like retinitis pigmentosa (RP), optogenetics offers a broader approach.

This technique aims to circumvent the loss of photoreceptors by introducing light-sensitive proteins, known as opsins, into the surviving inner retinal cells and optic nerve, restoring visual function through light modulation. This method is particularly advantageous as it is agnostic to the specific genetic cause of retinal degeneration.

By delivering opsin genes to retinal neurons, the technology enables the precise manipulation of cellular activity, essentially transforming these cells into new light-sensing units. This approach can bypass the damaged photoreceptor layer, transmitting visual signals directly to the brain.

Several companies are pioneering advancements in this field. RhyGaze, for example, has secured substantial funding to accelerate the development of its lead clinical candidate, a novel gene therapy designed for optogenetic vision restoration. Their efforts encompass preclinical testing, including pharmacology and toxicology studies, an observational study to define clinical endpoints, and a first-in-human trial to assess safety and efficacy. The success of RhyGaze’s research could pave the way for widespread clinical applications, significantly impacting the treatment of blindness globally.

Source

Nanoscope Therapeutics is also making significant strides with its MCO-010 therapy. This investigational treatment, administered through a single intravitreal injection, delivers the Multi-Characteristic Opsin (MCO) gene, enabling remaining retinal cells to function as new light-sensing cells. Unlike earlier optogenetic therapies that required bulky external devices, MCO-010 eliminates the need for high-tech goggles, simplifying the treatment process and enhancing patient convenience. The ability to restore light sensitivity without external devices represents a major advancement, potentially broadening the applicability of optogenetics to a wider patient population.

Source

Another critical area of innovation highlighted in our survey is the advancement of treatments for AMD and GA.

New AMD/GA Treatment

Age-related macular degeneration (AMD) and geographic atrophy (GA) represent a significant challenge in ophthalmology, demanding innovative therapeutic strategies beyond the established anti-VEGF paradigm.

Source

Gene Correction

Gene editing is emerging as a powerful tool in the fight against AMD and GA, potentially correcting the underlying genetic errors that contribute to these diseases. Essentially, it allows us to make precise changes to a patient’s DNA.

Traditional gene editing techniques often rely on creating ‘double-strand breaks’ (DSBs) in the DNA at specific target sites, which are like precise cuts in the DNA strand. These cuts are made using specialized enzymes, like CRISPR-Cas9, which act as molecular scissors. While effective, these methods can sometimes introduce unwanted changes at the cut site, such as small insertions or deletions.

After a DSB is made, the cell’s natural repair mechanisms kick in. There are two main pathways:

• Non-Homologous End Joining (NHEJ): This is the cell’s quick-fix method. It essentially glues the broken ends back together. However, this process can sometimes introduce errors, leading to small insertions or deletions that can disrupt the gene’s function.
• Homology-Directed Repair (HDR): This is a more precise repair method. It uses a ‘donor’ DNA template to guide the repair process, ensuring accuracy. However, HDR is more complex and less efficient, especially in non-dividing cells.

To overcome these limitations of traditional gene editing, researchers have developed more precise techniques:

• Base Editing: This technique allows scientists to change a single ‘letter’ in the DNA code without creating DSBs.
• Prime Editing: This advanced technique builds upon CRISPR-Cas9, allowing for a wider range of precise DNA changes. It can correct most disease-causing mutations with enhanced safety and accuracy.
• CASTs (CRISPR-associated transposases): This method enables larger DNA modifications without creating DSBs, offering a safer approach to genetic correction.

Why does this matter for AMD and GA? These advancements in gene editing are crucial for addressing the genetic roots of these pathologies. We can potentially develop more effective and targeted therapies by precisely correcting the faulty genes that contribute to these diseases. The technologies are still being researched, but they hold great promise for the future of ophthalmology.

Cell Reprogramming

Cell reprogramming offers a novel approach to regenerative medicine, with the potential to replace damaged retinal cells. This technique involves changing a cell’s fate, either in vitro or in vivo. In vitro reprogramming involves extracting cells, reprogramming them in a laboratory, and then transplanting them back into the patient. In vivo reprogramming, which directly reprograms cells within the body, holds particular promise for retinal diseases. This approach has succeeded in preclinical studies, demonstrating the potential to restore vision in conditions like congenital blindness.

Vectors and Delivery Methods

The success of gene therapy relies on efficiently delivering therapeutic genes to target retinal cells. Vectors are essentially delivery vehicles, designed to carry therapeutic genes into cells. These vectors can be broadly classified into two categories: viral and non-viral. Vectors, both viral and non-viral, are crucial for this process.

Viral vectors are modified viruses that have been engineered to remove their harmful components and replace them with therapeutic genes. They are highly efficient at delivering genes into cells, as they have evolved to do just that. Adeno-associated viruses (AAVs) are the most commonly used viral vectors in ocular gene therapy due to their safety profile and cell-specificity. The diversity of AAV serotypes allows for tailored gene delivery to specific retinal cell types.

Non-viral vectors, on the other hand, are synthetic systems that don’t rely on viruses. They can be made from lipids, polymers, or even DNA itself. While they may be less efficient than viral vectors, they offer safety and ease of production advantages.

Advances in vector design, whether viral or non-viral, are focused on enhancing gene expression, cell-specificity, and carrying capacity.

Now, let’s examine the ongoing evolution of anti-VEGF treatments, a cornerstone of modern retinal care.

New Anti-VEGF drugs

The landscape of ophthalmology has undergone a dramatic transformation since the early 1970s when Judah Folkman first proposed the concept of tumor angiogenesis. His idea sparked research that ultimately led to the identification of vascular endothelial growth factor (VEGF) in 1989 and the development of anti-VEGF therapies, revolutionizing the treatment of neovascular eye diseases, dramatically improving outcomes for patients with wet AMD, diabetic retinopathy, and retinal vein occlusions.

Population-based studies have shown a substantial reduction (up to 47%) in blindness due to wet AMD since the introduction of anti-VEGF therapies. However, significant gaps remain despite this progress, especially regarding treatment durability. Anti-VEGF drugs require frequent intravitreal injections, which can be difficult for patients due to time commitments, financial costs, and potential discomfort. Although newer agents have extended treatment intervals, patient adherence and undertreatment challenges persist in real-world settings. Innovative approaches are being investigated to address these unmet needs to increase drug durability and reduce the treatment burden.

Tyrosine Kinase Inhibitors

One approach to increasing treatment durability is using tyrosine kinase inhibitors (TKIs). TKIs are small-molecule drugs that act as pan-VEGF blockers by binding directly to VEGF receptor sites inside cells, offering a different action mechanism than traditional anti-VEGF drugs that target circulating VEGF proteins.

Currently, TKIs are being investigated as maintenance therapy, primarily in conjunction with sustained-release delivery systems. Two promising TKIs for retinal diseases are axitinib and vorolanib. In a bioresorbable hydrogel implant, Axitinib is being studied for neovascular AMD and diabetic retinopathy. Vorolanib, in a sustained-release delivery system, is also being investigated for neovascular AMD. These TKIs offer the potential for less frequent dosing, reducing the treatment burden for patients.

Port Delivery System

The Port Delivery System (PDS) is a surgically implanted, refillable device that provides continuous ranibizumab delivery for up to 6 months. While it’s FDA-approved for neovascular AMD, it’s also being investigated for other retinal diseases, such as diabetic macular edema and diabetic retinopathy.

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Although the PDS faced a voluntary recall due to issues with septum dislodgment, it has returned to the market with modifications. The PDS offers the potential for significantly reduced treatment frequency for a subset of patients. However, challenges remain, including the need for meticulous surgical implantation and the risk of endophthalmitis.

Nanotechnology

Nanotechnology offers promising solutions to overcome limitations of current ocular drug delivery. The unique structure of the eye, with its various barriers, poses challenges for drug delivery. Topical administration often fails to achieve therapeutic concentrations, while frequent intravitreal injections carry risks. Nanotechnology can improve drug solubility, permeation, and bioavailability through nanoparticles, potentially extending drug residence time and reducing the need for frequent injections. Several nanoparticle systems, lipid and polymeric, are being studied for ocular drug delivery, offering hope for more effective and less invasive treatments.

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Summing up

The advancements discussed in this article, encompassing AI, optogenetics, novel AMD/GA therapies, and refined anti-VEGF treatments, collectively signal a transformative era for ophthalmology. As highlighted by the survey results, AI probably encompasses most of the changes by redefining diagnostic and clinical workflows through its capacity for image analysis, biomarker identification, and personalized patient management.

Optogenetics offers a distinct pathway to vision restoration, bypassing limitations of traditional gene therapy. The progress in AMD/GA treatments, particularly gene editing and cell reprogramming, presents opportunities for targeted interventions. Finally, the evolution of anti-VEGF therapies, with innovations in drug delivery and sustained-release mechanisms, addresses persistent challenges in managing neovascular diseases.

These developments, driven by technological innovation and clinical research, promise to enhance patient outcomes and reshape the future of ophthalmic care.