Navilas: Innovative Technology in Support of Tele-Ophthalmology

Navilas is a device that integrates highly innovative software and medical technologies, applicable both in the field of retinal imaging diagnostics and in retinal laser treatment. The integration of these cutting-edge technologies makes Navilas the most advanced tool currently available for telemedicine applied to ophthalmology (tele-ophthalmology).

Telemedicine, born from a simple yet revolutionary idea—to receive and provide healthcare regardless of physical distance between doctor and patient—relies on telematics to transmit information, images, and reports, and represents a valuable tool for optimizing the healthcare system, especially concerning the growing demand for care and treatment of many chronic diseases, a demand that continues to rise with increased life expectancy.

Until very recently, the main areas of application of tele-ophthalmology were limited exclusively to diagnostics. Navilas represents a true innovation in this regard because it allows for remote therapy (therapeutic tele-ophthalmology), with real-time interaction between patients and the most renowned specialists in the field of ophthalmology, as well as potential consultations between multiple experts, regardless of the geographical distance between them, for precise diagnosis and the most appropriate therapeutic planning for the patient in question.

Navilas integrates three fundamental components into a single device:

1. a next-generation imaging diagnosis system,

2. innovative hardware and software applications, and

3. a high-level laser technology for delivering therapeutic procedures such as retinal photocoagulation (PRP, Panretinal Photocoagulation), essential for patients with diabetic retinopathy and retinal neovascularization, which requires both exceptional skill from the ophthalmologist and top-tier performance from the device.

The Navilas imaging system includes a high-resolution digital retinal angiograph with Confocal Digital Imaging Technology (CDIT) for retinal exams in color (mydriatic and non-mydriatic modes), fluorescein angiography (FA), red-free, and infrared modes, providing extremely sharp and accurate images even in the presence of moderate opacity of the cornea, lens, or vitreous.

Un’altra applicazione software innovativa presente in Navilas, denominata Contact, permette l’importazione e l’integrazione di immagini diagnostiche effettuate con altre apparecchiature: le immagini diagnostiche importate (FA, ICG-A, colore, mappe di spessore OCT o immagini di autofluorescenza) sono integrate nel sistema e utilizzate per la programmazione dell’intervento di fotocoagulazione retinica utilizzando gli altri componenti di Navilas.

Another innovative software application included in Navilas, called Contact, allows the import and integration of diagnostic images acquired from other devices. Imported diagnostic images (FA, ICG-A, color, OCT thickness maps, or autofluorescence images) are integrated into the system and used for planning the retinal photocoagulation procedure using the other components of Navilas.

The most remarkable innovation of Navilas lies in the software that enables retinal photocoagulation planning and laser treatment control in what is referred to as “navigated” mode, meaning that it is performed under the guidance of an application that tracks the patient’s eye movements (eye-tracking) and allows the laser to act only when it is certain to hit the preplanned points on the retina.

The eye-tracking mode ensures laser precision and accuracy regardless of involuntary eye movements, thanks to the continuous transparent overlay of the pre-processed retinal images (by the surgeon) with the real-time images of the patient’s retina during the treatment. Eye-tracking is a highly valuable asset for patients with diabetic retinopathy and especially for those with diabetic macular edema, where the treatment is applied to the macula—the most central, specialized, and delicate part of the retina—where even an error of a few microns could cause serious damage to both the retina and vision.

Navilas is also equipped with another feature that makes it unique among currently available ophthalmic laser instruments: a dedicated internal laser unit for retinal photocoagulation, featuring a controlled and adjustable system for light spot emission. This allows the automatic advancement of the laser spots and pulse duration control. The photocoagulation treatment is performed using infrared light to illuminate the patient’s eye, without the need for a contact lens, offering a significantly more comfortable experience for the patient.

Among other features of Navilas is the availability of detailed digital documentation of all laser spots applied during each treatment. This provides the surgeon with the ability to review their own work at any time, share it with a more experienced colleague for teleconsultation, and retrieve data from past treatments of a given patient in case a follow-up procedure is needed.

Thanks to Navilas, therapeutic tele-ophthalmology is now a reality capable of delivering technology and expertise from one side of the globe to the other in real time. It helps contain national healthcare costs by reducing unnecessary hospital visits, speeding up administrative processes in the healthcare system, and improving care services for patients with real diagnostic and treatment needs.