A core issue ophthalmologists routinely face in imaging is the ability to easily identify, localize, and structurally assess peripheral retinal lesions within a single system. In a bid to remedy this daily workflow hurdle, optical device company Optos has developed the Silverstone RGB system. First launched in October 2025, the newly upgraded imaging system was publicly debuted at the American Academy of Ophthalmology (AAO) meeting in Orlando, Florida, and looks set to build upon Optos’s reputational legacy as a leading manufacturer of retinal imaging devices.

Building on Solid Foundations

Rather than replacing the core architecture of Optos’s existing flagship Silverstone platform, the upgraded Silverstone RGB model retains a major benefit—ultrawidefield (UWF) imaging plus lesion-guided swept-source OCT—while also featuring 8 other imaging modalities, including RGB color, RG color, sensory retina (green laser), choroidal (red laser), green autofluorescence (AF), blue AF, fluorescein angiography (FA), and indocyanine green angiography (ICG), all centered within one device. Combined, these modalities allow ophthalmologists greater freedom to perform surface to deep tissue imaging (RGB, RG, red/green views), functional and metabolic imaging (FAF, BAF), vascular imaging (FA, indocyanine green angiography [ICG]), and structural cross-sectional imaging (SS-OCT), all within the one system.

Integration Is Key

“Silverstone RGB was developed in response to a growing clinical need for more comprehensive, multimodal retinal assessment within a single, efficient platform,” explains Dana Keane, vice president of clinical affairs at Optos. “Traditional imaging approaches often require multiple devices or are limited in their ability to visualize the peripheral retina and deeper structures simultaneously. This integrated approach supports a more comprehensive assessment of pathology, more informed clinical decision-making, reliable longitudinal monitoring, and improved outcomes.”

Having these modalities co-registered within the same platform allows ophthalmologists to efficiently review and compare images without the need for switching between devices, while supporting faster clinical decisions without compromising on diagnostic depth. “Clinicians can capture a 200° ultrawidefield image in less than half a second and use that image to guide OCT scanning anywhere across the retina, including the periphery,” Ms. Keane says. “This eliminates the need to move patients between devices or perform multiple acquisitions, reducing chair time and improving patient throughput.”

"My first impression of Silverstone RGB was how seamlessly integrated the system is," explains Paulo-Eduardo Stanga, MD,  chief medical officer and professor at The Retina Clinic in London. "The main advantage is not just the number of modalities, but how they are integrated and aligned within a single platform. Instead of piecing together information from multiple devices, everything is available within a single platform, aligned and easy to interpret. This improves efficiency, but also enhances clinical confidence. You can evaluate vitreoretinal, retinal, choroidal, and vascular findings in context, without having to reconcile separate datasets. In a busy clinic, that level of integration makes a meaningful difference in both workflow and decision-making."

Improving on Previous Models

What most differentiates Silverstone RGB from its predecessors, notes Ms. Keane, is its combination of true-color, 200° single-shot UWF imaging with fully integrated swept-source OCT. “While previous systems introduced multimodal imaging and UWF-guided OCT, Silverstone RGB advances this further with enhanced color fidelity, deeper tissue penetration, and the ability to evaluate pathology across every retinal layer, including the far periphery, with precision,” Ms. Keane adds. “Silverstone RGB’s integrated SS-OCT technology provides the ability to capture a 23-mm line scan, as well as navigated volume scans, out to the edges of the UWF field of view. This enables clinicians to assess structure and pathology in a more complete and clinically intuitive way, improving both confidence and efficiency in diagnosis and management.”

"The ability to capture a high-quality, true-color ultra-widefield image so quickly, followed by precise OCT evaluation of areas of interest, including in the periphery, stood out right away," confirms Dr. Stanga. "It felt like a more efficient and clinically intuitive way to characterize pathology."

True-to-Life Color

Additionally, a blue channel added to the established red/green imaging approach of previous iterations of Silverstone now produces true-to-life color retinal images, according to the company, with the blue laser also enabling blue autofluorescence (AF)—a modality used to assess the health and function of the retinal pigment epithelium—which was not seen in earlier generations of Silverstone’s core proposition.

Dr. Stanga explains how the color fidelity of Silverstone RGB is "noticeably improved" and more clearly representative of what clinicians can expect to see when operating. "That matters, as subtle differences in color and contrast may provide additional context when interpreting certain pathology, particularly in conditions where pigmentary changes are involved," he adds. "We noted in early evaluations of Optomap RGB that it is particularly valuable for evaluating pathology at the vitreoretinal interface as well as more superficial lesions, while Optomap RG provides benefit when assessing deeper lesions in the RPE. When you combine that with navigable swept-source OCT, it provides a more complete picture of both retinal structures, which are imperative for proper treatment planning."

Professional Advice

Clinician feedback like that provided by Dr. Stanga played a central role in the evolution of Silverstone RGB, particularly in refining Optos’s understanding of how multimodal imaging could be most efficiently integrated into real-world clinical workflows.

Ms. Keane explains how, during the initial feedback rounds, eyecare professionals consistently emphasized the need for 3 main areas of improvement: greater access to peripheral pathology without any added complexity; more intuitive ability to switch between different imaging modalities; and faster, high-quality image capturing that would create minimal burden on their patients.

“These insights informed the development of a platform that not only expands imaging capabilities, but also ensures those capabilities are accessible, efficient, and clinically meaningful in everyday practice,” adds Ms. Keane.

What stood out most for Dr. Stanga, he says, is how the system could expand diagnostic capabilities in otherwise challenging scenarios. "The ability to image through media opacities, such as cataracts, with swept-source OCT allows for more consistent visualization of deeper retinal structures, even when clarity is compromised," he says. "In addition, blue autofluorescence provides valuable insight into metabolic changes at the level of the RPE, supporting earlier detection and more precise monitoring of disease. Together, these capabilities add meaningful clinical depth, particularly in cases where traditional imaging may be limited."

The Future of Retinal Imaging

Ultimately, the upgraded Silverstone RGB model combines UWF, true-color representation, and advanced OCT into a single platform that aims to provide clinicians with a more comprehensive view of a patient's retinal health, without the need for constantly changing modalities. Ms. Keane says the company’s positioning of the model represents a genuinely new benchmark in retinal imaging.

“Silverstone RGB represents a meaningful step forward in how clinicians can visualize and understand retinal disease,” she concludes. “The goal is to support clinicians with tools that enhance confidence, improve efficiency, and contribute to better patient outcomes, whether through more comprehensive assessment, more precise monitoring, or more informed treatment planning.” OM