Q&A: Marion Munk on IntRIS symposium at EURETINA 2025

Photo of Marion Munk, MD, PhD, at EURETINA 2025 in Paris, France

Marion Munk, MD, PhD, a medical retina and uveitis specialist from the Gutblick Group in Switzerland, spoke to the Eye Care Network about the International Retinal Imaging Society (IntRIS), a unique organization that brought together retina specialists, ophthalmologists, PhDs, and biomedical engineers. The society is dedicated to advancing retinal imaging through collaborative efforts. Munk highlighted the IntRIS symposium at the 2025 EURETINA meeting.

Note: The following conversation has been lightly edited for clarity.

Ophthalmology Times: You are involved with the International Retinal Imaging Society (IntRIS) and its symposium here at EURETINA 2025. Can you share what this organization does and what will be presented here?

Marion Munk, MD, PhD: First of all, I really want to thank the EURETINA for making it possible for us to have a symposium at EURETINA. So what is IntRIS? So IntRIS is the International Retinal Imaging Society, and we are really dedicated to retinal imaging. So you can already tell from the title, and what we're actually doing is members of IntRIS are retina specialists, but also ophthalmologists with a strong interest in retinal imaging. But what is unique, we also have PhDs and biomedical engineers. It's like really 50/50, so also you have a lot of members who are actually developing the devices we are using in order to do retinal imaging. And this really brings a very, very interesting mix up in terms of what we are seeing at our society, in terms, when we have our meetings, and as well as [what] we going to present at the upcoming IntRIS symposium at the EURETINA this year.

Also this year, I think we have an amazing program. This will be chaired by me and Nadia Waheed, and we have really top speakers, who are all members of the IntRIS group. And so first of all, for example, Giovanni Staurenghi, he will talk about color autofluorescence. I'm sure, like a lot of people, have never even heard about color autofrescence, and what impact it could have on your daily retinal clinic. Another very interesting talk, I think, from my perspective, is the talk from Phil Rosenfeld. He will talk about the impact of ocular perfusion on the development and progression of geographic atrophy. And I don't want to tell you too much, but it's really, it's really eye opening, and I think everyone who will listen to it will start to look at the ocular perfusion status of our patients, because it really seems to have a significant impact. If you, kind of, improved ocular perfusion, you can also get a very significant impact on the growth rate of geographic atrophy. But I listened to his talk. It's really amazing. Another very interesting talk will be given by Srinivas Sadda. He will be talking about the metabolic activity in RPE cells using adaptive optics FLIO. So it's not only adaptive optics, and it's not only fluorescein lifetime imaging, it's really adaptive optics fleo. So really a device I think not a lot of people have heard of and with the use of this, you can really dive into the metabolic activity of individual cells in the retina in a non invasive way. And we have more and more talks. So one talk will be also from Jamie Zhang. She will be giving an overview of our current recommendation guidelines in terms of fibrosis, in terms of fibrosis development, and also in terms of how to best catch fibrosis, how to quantify fibrosis, and also what image modalities are or should be used, so similar, like the CALM group, where we where they try to really standardize the way we see geographic atrophy. This is now an effort with fibrosis, and this is also under the head of IntRIS. Hopefully, soon we [will] have submitted the first paper on that, and we have a lot of other very interesting talks and speakers. So I'm sure it will be of interest for the people attending EURETINA.

OT: The society's membership comes from a variety of backgrounds. Can you speak to the impact that has?

Munk: I think what we see from the society is because we have such a close exchange. First of all, for the bioengineers, it's very important to understand if there is a clinical impact, and what kind of clinical impact it has. Because you always, if you want to bring a device really to the market, not only develop a prototype, to really bring something to the market, it has to have a clinical impact. With the close exchange with physicians and biomedical engineers, we really get this kind of cutting edge experience where bioengineers really understand what is needed in clinic, and based on this, can develop and move forward with their individual devices.

On the other hand, of course, with the collaboration with the biomedical engineers, we get, like, first prototypes [that] we can really use in clinic and try out in clinic. Then work side-by-side with the biomedical engineers; I think it's a great opportunity. Another thing, I think, which is very interesting is the recommendation guidelines we come up with, because when we kind of do this, for example, fibrosis is one example, but we have a lot of different initiatives and standardizations is going on. What is seen here, if you start to include not only retina specialists, for example, but really also biomedical engineers and pathologists, for example, because these are all part of our group, then you get a complete different perspective, and you really can think differently of a disease. Sometimes you get to a completely different outcome than when you would only include, for example, physicians or retina specialists. So I think the exchange is really great and has been a great success so far.

OT: What do you think is important for ophthalmologists to know in regards to imaging?

Munk: I think one thing which is very important is ultrawidefeild imaging. I think this should be used more, because we understand and learn more and more that it really has an impact in clinic. On the other hand, of course, there's, there are 2 sides. So first of all, we have image modalities in order to understand the disease better and in order to get more knowledge. Of course, these kind of image modalities will never make it to the clinic, because in a clinic, everything is based on decision making. So as soon as you have a device which changes, or would change, your decision making, this is of interest and of need. This goes side by side with drug development. So I think if you, if you, for example, have a drug against non-perfusion, of course, then we need robust imaging in order to show non-perfusion, in order to quantify it, and have like fast and also accessible and also cheaper devices in order to do this. If we have a drug against fibrosis, for example, we need a device to definitely show where fibrosis is. When everyone who has looked at an OCT and looked at fibrosis, everyone knows it's very hard to differentiate it. I mean, it just looks like separate and hyper-reflective material. It can be still active. It can be fibrosis. It can be a fiber vascular VD. We can't differentiate it based on OCT, as long as we don't have any drug, which is really targeting fibrosis, for example, there is no need to kind of quantify and show it. So it really goes side-by-side with the drug development and the new endpoints we're going to have.