Assoc. Prof. Dr. Marion Munk, Specialist in Ophthalmology FMH - FEBO and Head Physician at Gutblick Research, is pioneering the integration of Artificial Intelligence (AI) in retinal disease management. At the heart of this integration is the RetinAI Discovery® platform, which has become an integral part of daily patient management and clinical trials at the clinic.
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With a keen focus on imaging, Enhanced Media Display (EMD), retinal vascular diseases, and AI, Dr. Munk leverages the Discovery platform not only for research but as a fundamental element in daily patient care.

‍"When we assess a patient, our evaluation is directly conducted on the Discovery platform. This integration is not limited to research – it’s part of our everyday patient workflow" she states.

In this article, we explore how the Discovery platform is reshaping patient management and clinical trials in Dr. Munk’s workflow at the Gutblick Clinic. Featuring case studies and unique functionalities, this blog delves into the practical application of AI in eye care. 

Reading time: 7 minutes

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Optimizing Patient Management
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Within Dr. Munk's clinical practice, RetinAI Discovery® has become central to the clinic's operations, significantly enhancing physicians’ ability to provide precise, personalized care for various retinal diseases. Every step from patient registration to the final consultation is integrated within Discovery, ensuring a smooth and efficient patient journey. 

One key aspect of the Discovery platform is its efficiency for organizing patient data. Dr. Munk highlights this by detailing their approach to patient categorization. "As soon as a patient arrives, they are greeted at the registration desk. Based on whether they are new or returning, different procedures follow," she explains.
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For new patients, this involves completing an initial questionnaire and signing a general informed consent form, which permits the use of their data for research purposes. Upon arrival, each new patient undergoes standard assessments, including refraction and visual acuity checks, supplemented by additional imaging as required. ‍

"For returning patients, thanks to the Discovery platform, we already have a history from their previous visits, which informs what assessments need to be done before they see the physician", explains Dr. Munk. 

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Discovery differentiates between new and returning patients, enabling tailored consultations based on patient history. Essential data, such as detailed imaging and electronic health records, are promptly processed and organized. This streamlined approach enhances the effectiveness and precision of patient-physician interactions. 

Real-time data processing and accessibility
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‍"As soon as the patient's details are entered by the nursing staff, they are instantly uploaded to the electronic medical record (EMR) and images are automatically uploaded to the Discovery platform." highlights Dr Munk.

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This rapid data upload means that by the time a patient enters the consultation room, all their information, including detailed imaging and anatomical evaluations, is already processed and accessible.

Dr. Munk further describes the consultation setup she’s using: "When a patient enters the consulting room, we have their electronic health record open on one side, and the Discovery platform ready on the other,". "This dual-view setup allows us to simultaneously consult the patient's historical data, like visual acuity trends from the EMR, and analyze current imaging results, including OCT scans and fluid volumes in Discovery, without any delay." 

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Enhancing Patient Education & Engagement

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At the heart of Dr. Munk’s clinical practice is a strong focus on patient education, a process greatly enhanced by the Discovery platform, simplifying complex medical information, making it more accessible and understandable for patients.

A prime example of this is the explanation of retinal conditions using fluid volumes, which has markedly improved patient comprehension and involvement in their own care.

Dr. Munk often utilizes Discovery to demystify medical conditions for her patients, transforming abstract concepts into tangible metrics. She recalls an incident where a patient was particularly appreciative of having their macular fluid condition explained in volumetric terms via the platform. 

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She shares, “What's really transformative is using the platform to articulate a patient's condition. It's simpler to convey the idea of 'this much fluid in nanoliters' rather than pointing out hyperreflective lesions on a scan. It becomes a volume they can visualize. I remember a patient who missed seeing this on the platform and asked if we could revisit it for a clearer understanding.”
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Real-World Applications and Case Studies

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Dr. Munk’s clinic demonstrates the practical application of the Discovery platform, transforming it into a powerful tool for real-world scenarios, particularly in assessing a phase II clinical trial for an innovative drug treating diseases like exudative AMD and diabetic macular edema, a departure from the conventional anti-VEGF therapy.

Through detailed case studies, Dr. Munk showcases how Discovery is revolutionizing patient care and advancing the field.

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Case Study 1: Exudative AMD 

In a case involving a patient with exudative AMD, Dr Munk was impressed by Discovery platform’s precision in tracking fluid volumes. In this case, the patient, naive to treatment, exhibited substantial fluid accumulation: 32 nanoliters of intraretinal fluid and 780 nanoliters of subretinal fluid, alongside a significant presence of PED due to fibrovascular PED.

The platform distinctly visualizes these fluid volumes in each B-Scan of the OCT, providing an in-depth understanding of fluid distribution over the OCT.

The Discovery platform's comparison mode, along with its advanced fluid volume analysis, was instrumental in closely monitoring the patient's response over time. The fluid volume graphs displayed a 'saw tooth' pattern in both the intraretinal and subretinal fluid compartments, reflecting the dynamic nature of the patient's active macular neovascularization (MNV). 

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Each increase in fluid volume, signaling a surge in disease activity, was effectively managed with rescue treatments, as evidenced by subsequent reductions in fluid volumes easily visible inside Discovery.

This pattern provided insightful visual confirmation of the novel drug's gradual yet impactful role in diminishing fluid levels, underscoring the platform's efficacy in tracking and managing complex retinal conditions.

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Case Study 2: Diabetic Macular Edema (DME) 
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In another instance, Dr. Munk had a treatment-naive patient with diabetic macular edema. Utilizing the Discovery platform, Dr. Munk could track a close to 30% reduction in fluid volume from 563 to 410 nanoliters, underscoring the therapy's efficacy.

The graphical representation of fluid changes over time facilitated a clear interpretation of the patient’s response to treatment. For example, a subsequent increase in intraretinal fluid to 660 nanoliters signaled the need for additional vascular treatment, clearly visible through the platform's comprehensive fluid progression dashboard.

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This dashboard not only presents a holistic view of fluid volumes across various visits but also allows clinicians to observe changes in both eyes simultaneously, enhancing the understanding of disease progression. 

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Moreover, the versatility of the Discovery platform extends beyond OCT image analysis. It supports the upload and integration of a variety of image formats, including DICOM compliant and other types such as fundus and fluorescein angiography.

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This capability ensures that all pertinent patient information is centralized, aiding in the detailed and comprehensive assessment of retinal conditions. Clinicians can perform quantitative measurements and evaluate leakage or atrophy effectively, even in non-OCT images, making the Discovery platform an all-encompassing tool for retinal disease management.

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Feature Focus: The Comparison Mode 

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Dr. Marion Munk spotlights the Discovery platform's 'Comparison Mode' as a particularly impactful feature. This mode facilitates side-by-side comparisons of patient data across various visits, providing a panoramic view of each patient's disease progression or response to treatment.

Its capacity to juxtapose data from different visits, rather than restricting comparisons to a single baseline, offers a nuanced perspective that is instrumental in informed clinical decision-making.

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This feature's versatility extends beyond individual patient analysis. The Comparison Mode enables the juxtaposition of images and data from different patients, fostering a more comprehensive understanding of disease patterns and treatment responses. 

Dr. Munk's application of this mode in real-world clinical scenarios showcases the Discovery platform's multifaceted utility. It not only streamlines patient management but also doubles as an educational resource.

By simplifying complex medical data into a more digestible format, the platform significantly enhances patient comprehension and involvement in their own care journey.

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Transforming Retinal Care

Dr. Marion Munk's innovative use of RetinAI's Discovery platform in her practice is a testament to the potential of AI and technology in enhancing healthcare decisions. Her efforts in integrating this advanced tool in clinical settings are not just improving patient care but are also paving the way for future advancements in ophthalmology.

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As she navigates the complexities of retinal diseases, Dr. Munk not only elevates the standard of patient treatment but also charts a course towards groundbreaking advancements in the field using Discovery. 

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Interested in exploring how the Discovery platform can revolutionize your approach to patient, disease management or clinical studies? Reach out to us for a personalized discussion on implementing Discovery in your practice & research and witness firsthand the future of ophthalmic care.

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This article written by Léa Errog, Sr. Brand Marketing Manager at RetinAI

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