DRI OCT Triton and Triton (plus) User Manual Rev 9 July 2019

User Manual

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File Name: DRI OCT Triton and Triton (plus) User Manual Rev 9 July 2019.pdf

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USER MANUAL 3D OPTICAL COHERENCE TOMOGRAPHY

DRI OCT Triton DRI OCT Triton (plus)

INTRODUCTION Thank you for purchasing the TOPCON DRI OCT Triton 3D Optical Coherence Tomography.

INTENDED USE / INDICATIONS FOR USE The TOPCON DRI OCT Triton is a non-contact, high-resolution tomographic and bio-microscopic imaging device. It is indicated for in-vivo viewing, axial cross-sectional and three dimensional imaging, and measurement of posterior ocular structures, including the retina, retinal nerve fiber layer, ganglion cell plus inner plexiform layer, ganglion cell complex, macula, optic nerve head, and choroid. The DRI OCT Triton is intended for use as a diagnostic device to aid in the detection and management of ocular diseases including, but not limited to, macular holes, cystoid macular edema, diabetic retinopathy, age-related macular degeneration, and glaucoma.

FEATURES This instrument is a special photography device to observe, photograph and record the image and tomogram of fundus and the image of anterior segment and to present its electronic image for diagnosis. By mounting the anterior segment attachment kit, which is an optional accessory, you can observe, photograph and record the tomogram of anterior segment. After photographing, the images and tomograms of fundus and anterior segment can be recorded in a personal computer where the analysis software or IMAGEnet 6 for OCT is installed. This instrument is classified into two types depending on the combination of the installed functions: DRI OCT Triton: Not equipped with the FA photography function and with the FAF photography function. DRI OCT Triton plus*: Equipped with the FA photography function and with the FAF photography function. (* "plus" is a catalog symbol.) DRI OCT Triton without the photography function of fundus image/ anterior segment image/ fundus tomogram for OCT Angiography/anterior segment tomogram (hereinafter, "the instrument without the fundus photography function") also exists.

PURPOSE OF THIS MANUAL This manual outlines the DRI OCT Triton 3D Optical Coherence Tomography, including operating procedures, troubleshooting, maintenance and cleaning. Before using the instrument, carefully read the "DISPLAYS AND SYMBOLS FOR SAFE USE" and the "GENERAL SAFETY INFORMATION" to familiarize yourself with the features of the TOPCON DRI OCT Triton 3D Optical Coherence Tomography and to ensure that you operate it safely. Always keep this User Manual at hand.

0123

Trademarks • DRI OCT™ is a trademark of TOPCON CORPORATION.

IPA Font License IPA font is used in some parts for DRI OCT Triton. Any and all terms and conditions of "IPA Font License Agreement v1.0" shall be deemed to be accepted and agreed by you if you use DRI OCT Triton. For IPA Font License v1.0, refer to the following URL. http://ipafont.ipa.go.jp/ipa_font_license_v1.html

1. No part of this manual may be copied or reprinted, in whole or in part, without prior written permission. 2. The contents of this manual are subject to change without prior notice and without legal obligation. 3. The contents of this manual are correct to the best of our knowledge. Please inform us of any ambiguous or erroneous descriptions, missing information, etc. 4. Original Instructions This manual was originally written in English. ©2015 TOPCON CORPORATION ALL RIGHTS RESERVED

CONTENTS INTRODUCTION ......................................................................................................................... 1 DISPLAYS AND SYMBOLS FOR SAFE USE .................................................................... 5 GENERAL SAFETY INFORMATION .................................................................................... 6 HOW TO USE THIS MANUAL ................................................................................................ 8 GENERAL MAINTENANCE INFORMATION ...................................................................... 8 DISCLAIMERS ............................................................................................................................ 8 POSITIONS OF WARNING AND CAUTION INDICATIONS .......................................... 9 STANDARD ACCESSORIES ................................................................................................ 10 COMPONENTS .................................................................................................................................. 11 COMPONENT NAMES .................................................................................................................. 11 COMPOSITION OF PARTS WHICH CONTACT THE HUMAN BODY .......................................... 11 CONTROL PANEL COMPONENTS .............................................................................................. 12 OPERATION METHOD OF TOUCH DISPLAY .............................................................................. 13 NAMES ON THE TOUCH DISPLAY .............................................................................................. 14

PREPARATIONS ............................................................................................................................... 31 INSTALLING THE INSTRUMENT .................................................................................................. 31 CONNECTING THE POWER CORD ............................................................................................. 32 CONNECTING THE EXTERNAL DEVICE ..................................................................................... 33 RESET FROM POWER SAVE STATE .......................................................................................... 34

BASIC OPERATIONS ....................................................................................................................... 35 FLOW OF OPERATION ................................................................................................................. 35 PREPARATION FOR PHOTOGRAPHY ........................................................................................ 36 FUNDUS TOMOGRAPHY ............................................................................................................. 37 DELETING DATA ........................................................................................................................... 51 SAVING DATA ............................................................................................................................... 51 PRINTING DATA ............................................................................................................................ 51 HOW TO FINISH ............................................................................................................................ 52

OBJECTIVE OPERATIONS ............................................................................................................ 53 COLOR FUNDUS PHOTOGRAPHY .............................................................................................. 53 FUNDUS PERIPHERAL PHOTOGRAPHY .................................................................................... 57 STEREOSCOPIC PHOTOGRAPHY .............................................................................................. 59 FA PHOTOGRAPHY (DRI OCT Triton plus) .................................................................................. 63 FAF PHOTOGRAPHY (DRI OCT Triton plus) ................................................................................ 66 ANTERIOR SEGMENT TOMOGRAPHY ....................................................................................... 68

DETAILS OF THE SETTING MENU ............................................................................................. 76 MAINTENANCE ................................................................................................................................. 93 DAILY CHECKUPS ........................................................................................................................ 93 ORDERING CONSUMABLES ....................................................................................................... 93 REPLACING THE XENON LAMP ................................................................................................. 94 REFILLING THE Chinrest tissue .................................................................................................... 95 MAINTENANCE BY THE DEALER ................................................................................................ 95

CLEANING ........................................................................................................................................... 96 CLEANING THE EXTERNAL COVER, TOUCH DISPLAY AND OTHERS ................................... 96 CLEANING OF THE PARTS WHICH COME INTO CONTACT WITH THE PATIENT .................. 96 CLEANING THE TOUCH DISPLAY ............................................................................................... 96

CLEANING THE OBJECTIVE LENS ............................................................................................. 97

BEFORE REQUESTING SERVICE .............................................................................................. 98 TROUBLESHOOTING ................................................................................................................... 98

SPECIFICATIONS AND PERFORMANCE ............................................................................... 105 SYSTEM DIAGRAM ..................................................................................................................... 105 SPECIFICATIONS ....................................................................................................................... 106 OTHER SPECIFICATIONS .......................................................................................................... 108 SPECIFICATIONS OF THE PERSONAL COMPUTER (COMMERCIAL PRODUCT) TO BE CONNECTED ............................................................................................... 108 SAFETY OF LASER PRODUCT .................................................................................................. 109

GENERAL INFORMATION ON USAGE AND MAINTENANCE ......................................... 112 INTENDED PATIENT POPULATION ........................................................................................... 112 INTENDED USER PROFILE ........................................................................................................ 112 ENVIRONMENTAL CONDITIONS FOR USE .............................................................................. 112 STORAGE, USAGE PERIOD ...................................................................................................... 112 ENVIRONMENTAL CONDITIONS FOR PACKAGING IN STORAGE ......................................... 112 ENVIRONMENTAL CONDITIONS FOR PACKAGING IN TRANSPORTATION ......................... 112 ELECTRIC RATING ..................................................................................................................... 113 DIMENSIONS AND WEIGHT ....................................................................................................... 113 SYSTEM CLASSIFICATION ........................................................................................................ 113 OPERATION PRINCIPLE ............................................................................................................ 114 CHECKPOINTS FOR MAINTENANCE ........................................................................................ 114 DISPOSAL ................................................................................................................................... 115 PATIENT’S ENVIRONMENT ....................................................................................................... 116 Requirements for the EXTERNAL DEVICE ................................................................................. 117 ELECTROMAGNETIC COMPATIBILITY ..................................................................................... 118

RELATION BETWEEN THE SETTING OF THE ILLUMINATION/FLASH LEVEL AND MAXIMUM RADIANCE ................................................................................................................... 125 OPTIONAL ACCESSORIES ......................................................................................................... 127 ANTERIOR SEGMENT ATTACHMENT KIT AA-1 ...................................................................... 127

REFERENCE MATERIAL .............................................................................................................. 128 TYPE OF PLUG ........................................................................................................................... 130 ABOUT THE BARCODE OF THE USER MANUAL BACK COVER ............................................ 130

DRI OCT Triton SOFTWARE LICENSE TERMS .................................................................... 131

DISPLAYS AND SYMBOLS FOR SAFE USE To encourage safe and proper use and to prevent injury to the operator and others or potential damage to property, important messages are put on the instrument body and inserted in the manual. We suggest that everyone understand the meaning of the following displays, icons and text before reading the "GENERAL SAFETY INFORMATION" and observe all listed instructions.

DISPLAY Display

Meaning

CONTRAINDICATION

Situations in which the device should not be used because the risk of use clearly outweighs any possible benefit.

WARNING

Indicates a potentially hazardous situation which, if not avoided, could result in death or serious injury.

CAUTION

Indicates a potentially hazardous situation which, if not avoided, may result in minor or moderate injury.

NOTE

Useful functions to know. Paying attention to these will prevent the noted problems.

SYMBOL Symbol

IEC/ISO Publication

Description

Description (French)

IEC 60417-5032

Alternating Current

Courant alternatif

IEC 60417-5008

Off (power: disconnection from the mains)

Éteint (courant: coupure avec le secteur)

IEC 60417-5007

On (power: connection to the mains)

Allumé (courant: raccordement sur le secteur)

IEC 60878-02-02

Type B applied part

Partie appliquée du Type B

ISO 7010-W001

General warning sign

Symbole d'avertissement général

ISO 7010-M002

Refer to instruction manual/ booklet

Voir le manuel/la brochure

ISO 7000-2497

Date of manufacture

Date de fabrication

ISO 7000-2498

Serial number

Numéro de série

ISO 7000-3082

Manufacturer

Fabricant

ISO 15223-1

Authorised Representative in the European Community

Représentant autorité pour l’Union européenne

GENERAL SAFETY INFORMATION CONTRAINDICATION When used for red-free photography only, this instrument must not be used for the following patients. • Patients who are hypersensitive to light • Patients who recently underwent photodynamic therapy (PDT) • Patients taking medication that causes photosensitivity.

WARNING Ensuring the Safety of Patients and Operators Be careful not to hit the patient's eyes or nose with the instrument during operation. The patient may be injured. Modification of this instrument is not permitted. Modifying the instrument may cause people to be injured, make the burden on the human body, lower the reliability of the measurement results or cause the devices to malfunction. Preventing Electric Shocks and Fires To avoid fire and electric shock, install the instrument in a place free of water and other liquids. To avoid fire and electric shock, do not put cups or vessels containing liquids near the instrument. To avoid fire in the event of an instrument malfunction, immediately turn OFF ( ) the Power switch and unplug the cable if you see smoke coming from the instrument or if you detect other problems. Don't install the instrument where it is difficult to unplug the cable from the instrument body. Ask your dealer for repairs. Preventing Electric Shocks To avoid electric shock, do not open the instrument. Request service from an authorized Topcon distributor.

CAUTION Ensuring the Safety of Patients and Operators Use this instrument carefully on the following patients. • Patients who have epidemic corneitis, conjunctivitis or any other infectious disease • Patients who are taking medications that cause light hypersensitivity. When operating the chin-rest up/down button, be careful not to pinch the patient's hand to avoid possible injury To avoid injury of the patient, be careful not to bump the patient's eye or nose with the instrument when operating the touch panel. Preventing Electric Shock To avoid electric shock, do not insert metal objects into any vents and/or slots. Do not put any substance over the vent on the top surface of the power supply unit. If the vent is covered, the temperature of the power supply unit may rise abnormally to cause a malfunction. To prevent the instrument from malfunction, do not drop any liquid into the vent. Electromagnetic Compatibility (EMC) This instrument has been tested (with 100V/120V/230V) and found to comply with IEC60601-1-2: 2007. This instrument radiates radio frequency energy within standard and may affect other devices in the vicinity. If you have discovered that turning on/off the instrument affects other devices, we recommend you change its position, keep a proper distance from other devices, or plug it into a different outlet. Please consult the dealer from whom you purchased the instrument if you have any additional questions.

HOW TO USE THIS MANUAL • Read the instructions on pages 1 to 9 before using the machine. • Regarding connection to various devices, see "CONNECTING THE EXTERNAL DEVICE"on page 33. • If you would like an overview of the system, begin by reading "BASIC OPERATIONS" (page 35).

GENERAL MAINTENANCE INFORMATION USER MAINTENANCE To ensure the safety and performance of the instrument, all maintenance work, unless specified in this manual, shall be conducted by trained service engineers. The following maintenance tasks may be done by the user. For details, see the relevant part of this manual.

Cleaning the objective lens: The objective lens may be cleaned by the user. For details, see "CLEANING THE OBJECTIVE LENS" on page 97.

DISCLAIMERS • TOPCON shall not take any responsibility for damage due to fire, earthquakes, actions by third persons and other accidents, or damage due to negligence and misuse by the user and any use under unusual conditions. • TOPCON shall not take any responsibility for damage derived from inability to properly use this instrument, such as loss of business profit and suspension of business. • TOPCON shall not take any responsibility for damage caused from using this instrument in a manner other than that described in this Instruction Manual. • Diagnoses made shall be the responsibility of pertaining doctors and TOPCON shall not take any responsibility for the results of such diagnoses. • The customer shall take the responsibility to save data and perform backup in case data should be lost. When the customer has obtained data through this software and has saved or backed up the data in a server or personal computer, TOPCON shall not take any responsibility for the loss of the data, loss of profit or other damages on the customer.

POSITIONS OF WARNING AND CAUTION INDICATIONS To ensure safety, this machine provides warning displays. Use the instrument correctly by observing the display instructions. If any of the following display labels are missing, contact your TOPCON dealer at the address listed on the back cover.

3 No.

Optional accessory: Attachment kit for Anterior segment (Anterior segment lens unit)

Label

Meaning

Signification

WARNING

MISE EN GARDE

WARNING

MISE EN GARDE

CAUTION

PRÉCAUTION

To avoid electric shock, do not open Pour éviter un choc électrique, ne pas ouvrir the instrument. l'appareil. Demander le service d'un concesRequest service from an authorized sionaire autorisé de Topcon. Topcon distributor. To avoid potential injury during opera- Pour éviter une blessure pendant le fonctiontion, do not touch the patient’s eyes or nement, ne pas faire toucher l'appareil aux nose with the instrument. yeux ou au nez du patient. When operating the chinrest up/down Quand vous fonctionnez le bouton pour button, be careful not to pinch the élever/baisser le mentonniére, faire attention patient's hand to avoid possible injury. de ne pas pincer la main du patient, ce qui causerait une blessure.

CAUTION

Pour éviter une blessure du patient, faire attention de ne pas heurter les yeux ou le nez du patient contre l'appareil pendant le fonctionnement du touche-panneau. ATTENTION RAYONNEMENT LASER INVISIBLE DE CLASSE 3B - EN CAS D’OUVERTURE EXPOSITION AU FAISCEAU DANGEREUSE

CAUTION

PRÉCAUTION

To avoid injury, be careful not to pinch Pour éviter une blessure, faire attention de ne your fingers when operating the main pas se pincer les doigts pendant le fonctionunit up and down. nement vers le haut et vers le bas de l’unité principale. Degree of protection against electric Degré de protection contre les chocs élecshock triques : TYPE B APPLIED PART : TYPE B PARTIE D'APPLICATION

CAUTION

PRÉCAUTION

To avoid injury of the patient, be careful not to bump the patient's eye or nose with the instrument when operating the touch panel. CAUTIONCLASS 3B INVISIBLE LASER RADIATION WHEN OPEN AVOID EXPOSURE TO THE BEAM.

To avoid injury of the patient, be careful not to bump the patient's eye or nose with the lens unit when operating the instrument.

PRÉCAUTION

Pour éviter une blessure, faire attention que l’unité de lentille ne heurte pas les yeux ou le nez du sujet pendant le fonctionnement de l’unité principale.

STANDARD ACCESSORIES Upon unpacking, make sure that all the following standard accessories are included. Figures in ( ) are the quantities. Power cord (1)

Chinrest tissue (1)

Dust cover (1)

External fixation target (1)

Monitor cleaner (1)

User manual (3) Analysis software DVD* (1)

USER MANUAL

3D OPTICAL COHERENCE TOMOGRAPHY

DRI OCT Triton DRI OCT Triton plus T C IO R D n ito Tr

Unpacking and assembly manual (1)

Accessory case (1)

Chinrest tissue pins (2)

UNPACKING AND ASSEMBLY

3D OPTICAL COHERENCE TOMOGRAPHY

DRI OCT Triton DRI OCT Triton plus

LAN cable (1)

* The software (OCT Grabber, OCT Analysis), which will be used in IMAGEnet 6 for OCT, is included in "Analysis software DVD".

COMPONENTS COMPONENT NAMES External fixation target Diopter compensation lens selector Focusing knob

Main unit External cover Lamp house cover screw Lamp house cover Touch display Photography button Control lever

Vertical position mark Control panel

Base clamping knob Power lamp Sliding board

External connection terminal

Power supply unit

Forehead rest *1 Eye height mark

Objective lens (Laser aperture)

Forehead rest base Chinrest tissue pin

Chinrest unit

Power switch Chinrest *1

*1: Contacting part (class B)

COMPOSITION OF PARTS WHICH CONTACT THE HUMAN BODY Forehead rest Chinrest Chinrest tissue Chinrest tissue pin

: Silicone rubber : Acrylonitrile butadiene styrene resin : Paper : Polyamide resin

COMPONENTS

CONTROL PANEL COMPONENTS Small pupil diaphragm selector button Split button External fixation target selector button

Chinrest up/down button

Photography button Internal fixation target position move button (Up/Down/Left/Right/Reset)

Base clamping knob

Power lamp

Chinrest up/down button

: Adjusts the chinrest up/down movement.

Internal fixation target position move button

: Adjusts the internal fixation target position finely.

Power lamp

: Displays "power ON" (this lamp is ON), "power OFF" (this lamp is OFF) and "power save" (this lamp blinks).

Photography button

: Starts photography.

Base clamping knob

: Locks and unlocks the base.

Small pupil diaphragm selector button

: Sets the small pupil diaphragm to ON/OFF.

Split button

: Sets the split lines to ON/OFF.

External fixation target selector button

: Sets the external fixation target to ON/OFF.

COMPONENTS

OPERATION METHOD OF TOUCH DISPLAY NOTE

Operate the touch display by your fingers. Don't use any sharp tool such as a ball point pen. The touch display may be damaged to cause an incorrect operation.

Tap  To select any relevant item.

Touch the screen softly with a finger.

COMPONENTS

NAMES ON THE TOUCH DISPLAY  Display areas and functions on the touch display Information is displayed on the touch display and you can perform a variety of operations by touching the screen.  Capture icon selection screen You can select the optimal mode for various types of photography. Patient ID display area

Message display area

Capture icon tab

[Follow-up] button

Capture icon display area

[SET UP] button

Patient ID display area

: Displays the patient ID.

Capture icon tab

: By selecting a tab, the capture icons registered in each tab are displayed.

[SET UP] button

: Shifts to the setting menu screen.

Message display area

: Displays the message.

Capture icon display area

: Displays the capture icons.

[Follow-up] button

: • Each time you press this button, "Follow-up ON" (button is orange) and "Follow-up OFF" (button is black) is changed each other. In case of "ON", Follow-up photography is done. In case of "OFF", it is not done. • Follow-up photography is applied to the following cases. • Line ("12mm" is not the object of Follow-up photography.) • 5 Line Cross ("12mm" is not the object of Follow-up photography.) • Radial ("12mm" is not the object of Follow-up photography. In the case of 6mm, "scan resolution 1024×6" is excluded.) • 3D Macula(H) • 3D Disc • 3D Macula(V) • HD Raster • OCT Angiography For follow-up photography in 3D and HD Raster, SMARTTrack is used. OCT Angiography follow-up photography can be used in IMAGEnet 6 for OCT only.

COMPONENTS

• When selecting the photography icon to which Follow-up photography is unapplied, Follow-up photography is not done even if this button is set to "ON". • When the [Follow-up] button is set to "ON", "Follow up" is displayed in yellow on the capture icon which is applicable to Follow-up photography.]

NOTE

Follow-up photography function in DRI OCT Triton is as follows: the system searches the same position as the scan position of the latest data captured in the past including the preceding day by using the live IR image of the present photography to decide the scan position. * Follow-up photography cannot be performed with the data captured on the current day.

Reading the base line data for Follow-up photography  Tap the photography icon (to which the Follow-up mode is applied) on condition that the [Follow-up mode] button is ON (orange). The system reads the last photography data (base line data) that is relevant to the entered patient ID and the selected photography icon.

処理中です。しばらくお待ちください。

 The following message is displayed when the relevant data does not exist. • One eye data of the relevant data does not exist.

• Both eyes data of the relevant data does not exist.

COMPONENTS

Photography screen (OCT photography) Patient ID display area

Timer button

Area 1

Fundus/anterior segment live image area

Tomogram live image area

Area 2

Patients ID display area

: Displays the patients ID.

Timer button : Used in FA photography. (Refer to page 64.) (Only in DRI OCT Triton plus) Area 1

: Displays the operation mode buttons and changes the modes.

Area 2

: Changes the internal fixation target and performs other operations.

Tomogram live image area

: Displays the tomogram live image. You can perform a variety of operations on the live image. (Refer to page 24.)

Fundus/anterior segment live : This area displays the live image of fundus or anterior segment and image area the graphic image of the scan pattern, which is set on the selected capture icon, with an interrupted line. The right/left eye, flash level and illumination level are displayed around the image. You can adjust the flash level and illumination level with the touch display. (Refer to page 22.) In the scan position adjustment mode, the scan position adjustment range and fine adjustment buttons are displayed. So you can adjust the scan position with the touch display. (Refer to page 41.)

COMPONENTS

Area 1 Area1 displays the operation mode buttons.You can change to each mode. The current operation mode is highlighted in orange. The mode that cannot be selected according to the current status is displayed in gray unclearly. The mode cannot be selected even if you touch the button in this status.

Menu button

Capture mode button

Preview mode button

Menu button

: Returns to the photography icon selection screen.

Capture mode button

: Shifts to the photography screen to take a picture.

Preview mode button

: It is displayed by highlight during a preview.

Area 2 In Area 2, set or change the internal fixation target and adjust the scan position. Set or change data with the buttons. Color fundus photography button

Tracking button

OCT-LFV image button

FAF photography button

Tomogram live image H/V selector button

Tracking level selector button

Scan position button

Internal fixation target position selector button

Internal fixation target shape selector button

 Tracking button <"Line" scan/"Radial" scan/"5 Line Cross" scan> Set the TRACKING button to "ON". The system searches the position specified by the scan position adjustment mode according to IR image. In Follow-up photography, the tracking button is always ON and this status cannot be changed. The system searches the same position as the base line according to IR image. <OCT Angiograpy or SMARTTRACK> When selecting "OCT Angiography" as the scan pattern, the TRACKING button is automatically set to "ON" and this status cannot be changed. When photographing, the position specified in the scan position adjustment mode is searched according to the IR image and OCT image.  Color fundus photography button: Displays the color fundus photography status (ON/OFF). You can change ON/OFF of color fundus photography. * Color fundus photography button is NOT available in the instrument without the fundus photography function.  FAF photography button: (Only in DRI OCT Triton plus) Displays the FAF photography status (ON/OFF). You can change ON/OFF of FAF photography.

COMPONENTS

 OCT-LFV image button: You can set whether the OCT-LFV image should be displayed on the live image. When "ON" is selected for "ON/OFF" after selecting "Setting menu"  "Page 2"  "OCT·FLV"  "ON/OFF", the tomogram is optimized and then "OFF" is changed to "ON" automatically. So the OCT-LFV image is displayed.  Tracking level selector button: You can select and change the tracking level when selecting "OCT Angiography" or "SMARTTrack". There are three levels, "High", "Medium" and "Low". Medium: This is standard level and is set in the initial status. High: This is high level. When you want to get a high-quality image with minimal noise or distortion, select "High". However, the photographing time is prolonged or you cannot perform photographing smoothly depending on the patient's eye or fixation status, etc. from time to time. Low: This is low level. When you cannot perform photographing smoothly due to the patient's eye or fixation status, etc. with "Medium", select "Low". However, the image quality accuracy is lowered.

NOTE

It is possible to change the tracking level during photographing.

 Tomogram live image H/V selector button: You can change the horizontal and vertical directions of the tomogram displayed on the tomogram live image area. H-Live: Horizontal direction

V-Live: Vertical direction

NOTE

COMPONENTS

• Display status on photography screen when changing the horizontal/vertical direction of tomogram live image by pressing the [Tomogram live image H/V selector] button • On the fundus/anterior segment live image area, the horizontal/vertical status of the scan position display (linear arrow) about the scan pattern is changed and the arrow's color is changed from green to pink. • The frame color of the tomogram live image area is changed to pink. • Changing the horizontal/vertical direction of tomogram live image does not influence the direction of the scan that will be executed in photography. When photographing, the instrument takes a picture with the scan pattern set by the selected capture icon. • In the case of line scan, it is not possible to change the horizontal/vertical direction of tomogram live image. [Tomogram live image H/V selector] button is grayed out and cannot be switched even by pressing the button.

 Scan position button The scan position adjustment mode is accessed. The selected scan pattern, the scan position adjustment range, the scan possible range (only in "Radial", "5 Line Cross", "3D: 3×3mm" and "OCT Angiography: other than12×12mm" scans) and other fine adjustment buttons are displayed on the fundus live image area. Radial scan Fine adjustment button (up) Button to reset the change of position

Scan possible range (red/blue)

Scan pattern display (green and yellow) Fine adjustment button (left)

Fine adjustment button (right)

Fine adjustment button (down)

5 Line Cross scan

Rotation button * Displayed only in Line/5 Line Cross scan. (This is not displayed in "5 Line Cross scan: 12mm".)

Scan pattern display (green and yellow) Displays the graphic image of the scan pattern kinds. The green line shows the scan position, and the arrow shows the scan advance direction. (In case of "Radial" and "5 Line Cross", the arrow direction for the right eye is reversed for the left eye.) The yellow line is displayed for the scan pattern except "Line" . For "3D", the yellow line shows the scan range and, for other scan patterns, the scan position in addition to the position indicated by the green line. When scan is performed once, it is done at the positions indicated by the green and yellow lines.

Line

Radial

5 Line Cross

COMPONENTS

Scan position adjustment range (blue) Displays the "Scan width × Scan width" range at the focal point on fundus. (Displays only for "Line", "Radial" and "5 Line" scans.) In the "Scan width × Scan width" range, it is easy to obtain the sufficient output sensitivity for tomograms. Scan possible range (red/blue) Displays the limit range where you can get a tomogram by using this instrument for the following scan pattern. <"Radial" scan/"5 Line" scan/"OCT Angiography"(6×6mm, 9×9mm)> The red frame shows the "12.0mm×12.0mm" range at the focal point on fundus. If a tomogram exceeds the range indicated by the scan position adjustment range (blue frame), you cannot always get the sufficient output sensitivity because the pupil and others obstruct the photography. <"3D" scan (3×3mm)> The blue frame shows the "6mm×6mm" range at the focal point on fundus. <"OCT Angiography" (4.5×4.5mm, 3×3mm)> The blue frame shows the "9mm×9mm" range at the focal point on fundus. Fine adjustment buttons (up/down/right/left) Each time you touch these buttons, the scan position is moved by about 0.03mm (on fundus) in the arrow direction. Rotation buttons (clockwise/counterclockwise) Displayed only for "Line" and "5 Line Cross" scans. Each time you touch these buttons, the scan line is rotated by 1° in the arrow direction. RESET button Press this button. The changes for the position, which were performed by the fine adjustment buttons and rotation buttons, are reset. The initial position is set again.  Internal fixation target position selector button When selecting the fundus capture icon, the internal fixation target position (one of "D", "C" and "M") is displayed according to the setting. The fixation target position is changed to "D", "C" and "M" in turn by touching this button. In "Wide" scan, "Wide" is fixed. D (Disc): Optic disc is the center of the screen. C (Center): The middle position between macula and optic disc is the center of the screen. M (Macula): Macula is the center of the screen.  Internal fixation target shape selector button Displays the selected internal fixation target shape. You can select the internal fixation target shape among the following five shapes by pressing this button. • 1 dot/4-dot rectangle/4-dot rhomb/×/cross

COMPONENTS

For OCT Angiography, the following buttons are displayed.

Peripheral photography selector button

 Peripheral photography selector button: This is enabled in OCT Angiography 9×9mm and 12×12mm. When switched to ON, the following buttons are displayed, and fixation position can be changed in seven directions with the buttons. On the button, the capture count at each fixation position is displayed.

COMPONENTS

Fundus/anterior segment live image area This area displays the fundus live image, the right/left eye, illumination level and besides, the graphic image of the scan pattern, which is set on the selected capture icon, with an interrupted line. You can set ON/OFF of the illumination level by the touch display. In the scan position adjustment mode, the interrupted line of the scan pattern display is changed to the solid line display. The scan position adjustment range and fine adjustment buttons are displayed. You can adjust the scan position by the touch display. Right/left eye display Scan pattern display (green and yellow) * Dotted line

Live image

Illumination level display

Flash level display

 Live image: Displays the fundus live image.  Scan pattern display (green and yellow): Displays the graphic image of the scan pattern, which is set on the selected capture icon. The green line shows the scan position, and the arrow shows the scan advance direction. (The arrow direction for the right eye is reversed for the left eye.) The yellow line is displayed for the scan pattern except "Line". For "3D", the yellow line shows the scan range and, for other scan patterns, the scan position in addition to the position indicated by the green line. When scan is performed once, it is done at the positions indicated by the green and yellow lines. The length and size of the lines are changed according to the set value of scan size.

3D (H)

Line

Radial

5 Line Cross

 Right/left eye display: In the case of left eye, "OS(L)" is displayed at the upper right position of the live image. In the case of right eye, "OD(R)" is displayed at the upper left position.  Illumination level display: Displays the illumination level (level) by five steps (value: 1 to 5). You can adjust the illumination level by touching the screen. (Refer to P.42.)

COMPONENTS

 Flash level display: Displays the flash level (level) by nine steps (value: 1 to 9). You can adjust the flash level by touching the screen. (Refer to P. 42.)  Tracking photography <"Radial" scan/"Line" scan/"5 Line Cross" scan> The display color of the scan pattern on the IR fundus image shows whether tracking is successful or not. • When tracking is OFF, the green dotted line is displayed. • When the scan position is not specified on condition that tracking is ON or when the base is pulled forward, the yellow dotted line is displayed. • After tracking is ON and the scan position is specified or when tracking is OK in Follow-up photography, the light blue solid line is displayed. • After tracking is ON and the scan position is specified or when tracking is NG in Follow-up photography, the red solid line blinks.

<When selecting "OCT Angiography" or "SMARTTrack"> The display color of the scan pattern on the IR fundus image and the frame color of the fundus/anterior segment live image area show whether tracking is successful or not. • When the scan position is not specified or when the base is pulled forward, the yellow dotted line is displayed. • When tracking is OK after the scan position is specified and photographing is started, the light blue solid line is displayed. Then, tracking moves from the scan start point to the end point according to the photography progress. • When tracking is NG during photographing, the red solid line is displayed. At this time, when tracking of the IR image has failed, the outer frame of the fundus/anterior segment live image area is displayed in yellow and, when tracking of the OCT image has failed, the outer frame of the tomogram live image area is displayed in yellow.

NOTE

In the case of "OCT Angiography" or "SMARTTrack", when pressing the PHOTOGRAPHY button again during tracking photography, the system cancels tracking and continues photography. The scan position is displayed by a right blue solid line. The outer frames of the fundus/anterior segment live image area and the tomogram live image area are displayed in purple. If the computer is under high load due to analysis etc., the scan may temporarily stop halfway without progressing continuously, but it resumes automatically according to the load situation.

COMPONENTS

Tomogram live image area This area displays the tomogram live image. Perform the operation on the live image.

Z lock position display bar Live image

Z lock position [Image Quality] level meter

[Optimize] button

Image Quality value (IQV) Stereoscopic image

[Focus offset] button [Manual] button

 Z lock position : Displays the center position of the displayed tomogram.  Z lock position display bar : Indicates the Z lock position changeable range. By touching an optional position on the bar, you can move the center position of the displayed tomogram to the touched position.

Z lock position is moved.

COMPONENTS

 Image Quality value (IQV) : Displays the "Image Quality" level with a value.

NOTE

• Image Quality value (IQV) is the image quality evaluation standard peculiar to TOPCON. IQV shows the image quality of the tomograms obtained by the DRI OCT Triton with a value quantitatively. When you need a tomogram applicable to image analysis or other processing, the IQV must be 40 or higher. If the IQV is 40 or higher, the tomogram has a proper image quality. If the IQV is less than 40, image analysis can be performed for the tomogram but the reliability on the analysis result is reduced. So the tomogram is not applicable for analysis. • If only the images of poor image quality are obtained, contact your dealer or TOPCON listed on the back cover.

 [Image Quality] level meter

: Displays the "Image Quality" level with meter.

 Live image

: Displays the live tomogram image.

 Stereoscopic image

: Displays the image of the anterior segment stereoscopic camera.

 [Optimize] button

: After detecting the retina position automatically, this button optimizes the image output sensitivity to display a clear tomogram. Moreover, this button performs the OCT auto focus operation according to the setting (default).

 [Manual] button

: If the tomogram is not found automatically by the Optimize button, tap the Manual button and operate the Z lock position. You can search the retina position.

 [Focus offset] button

: Displays the offset status (ON/OFF) of the OCT focus position. You can change ON/OFF of this status. When the offset is set to ON, the OCT focus position is offset to the anterior segment side by the set amount (setting menu  page 2  OCT  OCT focus offset (D)).

NOTE

• When pressing the Manual button, the Z lock position indicates the position against the reference mirror operating range. The Z lock position when pressing the Manual button does not have the function to move the displayed tomogram center position. • RNFL signal at the top of the image may be weakened due to inclination of the optic disc. In this case, by turning on the Focus offset button, it is possible to move the focus position to the anterior segment side (upper side of the image), and the RNFL signal at the top of the image may be improved. When the Focus offset button is ON, the operation of the Focusing knob is OCT focus adjustment.

COMPONENTS

Preview screen (OCT photography) After OCT photography, the preview screen shown below appears.

Tomogram preview area Fundus photographed image Scanned range

OCT-LFV display area

Delete button

Tomogram preview area

: Previews the photographed tomograms. When there are two or more images in "3D" or "Radial" scan, the typical image is displayed in this area. In "3D" scan, the three images at center and at both ends are regarded as the typical images. The [Alt] button is displayed for "3D: Wide (H)" and "3D: Wide (V)". Press the [Alt] button, and the images at both ends are changed to the ones that are positioned a little (about 1.5mm) inward from both ends.

OCT-LFV display area

: Displays the OCT-LFV image captured during photography. When "OCT-LFV (3D)" is set to "Enlarge" for "Preview" on "PAGE 2" in the setting menu in the case of "3D" scan, it is possible to display the OCT-LFV image in an enlarged size. In this case, the display positions of "Tomogram on the center line (tomogram preview area)" and "OCT-LFV image (OCT-LFV display area)" are changed to each other.

Fundus photographed image : Displays the fundus image taken by each photographing action. Delete button

: Deletes the photography result.

• On this preview screen, make sure that the instrument takes a picture at the intended shooting position.

NOTE

COMPONENTS

• Confirm that scan was done at the intended position from this preview screen. • When the displayed image is moved from center and both ends by re-scanning (supplementary scan), the frame of the image is displayed with a dotted line. • When selecting "OCT Angiography" or "SMARTTrack (except HD Raster)", the B-Scan image is not displayed on the preview screen. The OCT-LFV image is displayed in an enlarged size on the area where the tomogram preview area and the OCT-LFV display area are united. • When selecting "3D scan", "OCT Angiography" or "SMARTTrack", the scanned range on the photographed color fundus image is not always fitted to the position specified in the scan position adjustment mode due to the fixation status during photographing. In such a case, check if the obtained OCT-LFV image includes the specified position. If not, take a picture again.

 Setting menu screen You can set many kinds of data for this instrument on this screen. On the capture icon selection screen, which is the initial screen, press the [SET UP] button. This screen appears.  Capture select screen Set the icon display on the capture icon select screen and the parameters for each capture icon. Function button

Menu selector button

Capture icon tab

Capture icon list

Icon layout setting area [Add icon] button [Reset to default] button

[Edit Tab name] button

[Edit Capture] button

Page number

[Delete icon] button Page forward/backward button

Function button

: Saves and cancels the setting.

Menu selector button

: You can change the setting screens for the photography mode and for the information to each other.

Capture icon list

: Displays all the capture icons. You can view the hidden capture icons using the scroll bar at the right.

Page number

: Displays the current setting menu page's number in page order.

Icon layout setting area

: Sets the icons that will be displayed on the Capture icon selection screen, which is the initial screen.

Page forward/backward button

: Shifts to the other pages in the setting menu.

[Edit Capture] button

: Shifts to the parameter setting screen to check and change the parameters for the capture icon selected in the icon layout setting area.

Capture icon tab

: Select a tab, and the photography icons, which are registered in each tab, are displayed.

COMPONENTS

[Add icon] button

: Adds the icon, which is selected on the capture icon list, to the icon layout setting area. When you select a capture icon in the icon layout setting area, the icon is added to the left side or upper right corner of the capture icon.

[Delete icon] button

: Deletes the capture icon, which is selected in the icon layout setting area. After deleting, the remaining capture icons are placed in order on the left.

[Edit Tab name] button

: Changes the name of the capture icon tab.

[Reset to default] button

: Returns the changed capture icon to the default.

COMPONENTS

 Parameter setting screen

Set the parameters for the capture icon selected in the icon layout setting area. Capture icon name

Item name

Item value selector button Cancel button

OK button

Display of the capture icon : Displays the selected capture icon name. name Item name

: Displays the objective items of the parameters for the selected capture icon.

Item value selector button

: Displays the set value of each item. Select the desired item.

OK button

: Validates the changed contents and returns to the menu screen.

Cancel button

: Returns to the menu screen. The changed contents are not validated.

COMPONENTS

 Photography setting screen  Auto operation setting screen  System setting screen You can set data about photography and system. Function button

Item button Utility button

Item value display area

Page number

Page forward/backward button

Function button

: Saves and cancels the setting.

Page number

: Displays the current setting menu page's number in page order.

Utility button

: Displays the objective items on the current setting menu page. Select the desired item.

Page forward/backward button

: Shifts to other pages in the setting menu.

Item button

: Changes the set status of the selected item.

Item value display area

: Displays the current set status of each item.

COMPONENTS

PREPARATIONS INSTALLING THE INSTRUMENT

CAUTION

1 2

• To prevent the instrument from falling and to avoid injury during carrying, be sure to secure the instrument with the base clamping knob at the bottom. • To avoid injury or damage, two people should be employed for supporting the instrument from the underside. Carrying by one person may result in personal injury and/or damage to the instrument should the person slip or fall. If you support any other part except the underside, you may be pinched by the instrument or injured by falling. • To avoid falling and injury while moving the table with the instrument on top of it, be sure to use an approved automatic instrument table. • To prevent the instrument from falling and to avoid injury, install the instrument on a level surface.

Turn the base clamping knob clockwise as pushing it to lock the instrument body. (When unpacking, the instrument body is locked.) Firmly hold the instrument body at the specified positions, and put it on the automatic instrument table. Base clamping knob

Holding positions

Holding the instrument body

After installing, turn the base clamping knob counterclockwise to unlock the instrument body.

PREPARATIONS

CONNECTING THE POWER CORD

1 2

WARNING

To avoid fire and electric shock in case of leakage, be sure to use a power supply equipped with a 3-pin plug AC receptacle for proper grounding.

CAUTION

To avoid electric shock, do not handle the plugs with wet fingers.

Make sure that the

POWER SWITCH

of the instrument body is OFF (

Attach the power cord to the instrument body.

Plug the power cord into the 3-pin plug AC receptacle.

PREPARATIONS

CONNECTING THE EXTERNAL DEVICE The connection terminals for external devices are arranged on the base unit.

LAN terminal

NOTE

USB terminal

• Use the external device complying with IEC60950-1. Do not connect any device that is not specified as a system. For details about connecting the external devices, contact your dealer or TOPCON (see the back cover). • USB terminal is provided for maintenance. Others except service engineers must not use it.

Connecting to a personal computer

Connect the LAN cable, which is the accessory of the instrument, from the personal computer to the LAN terminal of the instrument.

NOTE

You must install the analysis software or IMAGEnet 6 for OCT, which is the accessory of the instrument, to the connected personal computer.

PREPARATIONS

RESET FROM POWER SAVE STATE This machine adopts the power save method for power saving. When the instrument body (excluding the chin-rest up/down button and focusing knob) is not operated for a period of time, the power save function stops power supply to the touch display, illumination light source and photography light source.

Tap the control panel or press the PHOTOGRAPHY BUTTON . In a few seconds, the touch display is displayed and ready for photographing.

NOTE

PREPARATIONS

When shipped, the power save set time is 5 minutes.

BASIC OPERATIONS

BASIC OPERATIONS FLOW OF OPERATION

FLOW OF OPERATION

Turning on the power (P.36)

Preparation for personal computer (P.36) • Inputting the patient information

Setting the capture icon (P.37)

Setting the patient (P.39)

Setting the illumination level (P.42)

Changing the diopter compensation lens (P.43)

Alignment and photography (P.44)

Transferring the data to the external personal computer

Saving data Printing data *by the external personal computer

Finish procedure (P.52)

BASIC OPERATIONS

PREPARATION FOR PHOTOGRAPHY Connecting the power supply

PREPARATION FOR PHOTOGRAPHY

1 2 3

Check the power cord connection. For details, see "CONNECTING THE POWER CORD" on page 32. Turn ON ( ) the

POWER SWITCH

of the instrument.

Confirm that the Title screen is displayed and then in a few seconds the capture icon selection screen should be displayed. If the personal computer is not ready, the message "Select patient and start capture." is displayed. When the preparation for the personal computer has been completed by the following procedure, the message automatically disappears.

NOTE

Preparation for personal computer

1 2 3 4 5

Connect the instrument to the personal computer in which the analysis software or IMAGEnet 6 for OCT, the accessory of the instrument, is installed. Turn on the personal computer. Start the analysis software or IMAGEnet 6 for OCT. Enter the patient information. Select

Capture

The preparation of the DRI OCT Triton for photography is finished.

NOTE

BASIC OPERATIONS

For details, refer to the instruction manual (for software) or (for IMAGEnet 6 for OCT).

NOTE

• Caution in photography Under the following photography conditions, there is a bright spot on the center of the picture. • The patient's pupil is small. (This condition includes the case of "When the small pupil diaphragm is set to ON".) • The flash level is high. • Alignment is not adjusted properly. To improve these conditions, carry out the following operations. • Darken the room to enhance dilation. When using mydriatic, follow the judgment of a doctor and the instruction manual about medicine. • Adjust alignment for the position where the flare is the least visible on the monitor screen. • Set the flash level to the lowest setting the environment will allow. Then, take a picture. • To ensure correct imaging, adjust the table height so the patient can relax with his/her chin placed centrally on the chin-rest.

Selecting the capture icon On the capture icon selection screen, which is the initial screen, touch and select the fundus tomogram capture icon.

BASIC OPERATIONS

CAUTION

To avoid injury of the patient, be careful not to bump the patient's eye or nose with the instrument and external fixation target when operating the touch display.

FUNDUS TOMOGRAPHY

BASIC OPERATIONS

Capture icon

FUNDUS TOMOGRAPHY

Capture icon name

Scan length

Scan resolution

Fixation position

Myopia Mode

Over Scan Dynamic Re-scan Count Focus

Line (H)/ Line (V)

9.0mm

1024H/ 1024V

Macula

OFF

128

OFF

5 Line Cross

6.0mm

1024×10

Macula

OFF

Radial

Dir. 6.0mm

1024×12

Macula

OFF

3D: Macula (H) 7.0×7.0mm

512×256

Macula

OFF

Rescan

3D: Macula (V) 7.0×7.0mm

512×128

Macula

OFF

3D: Optic disc

6.0×6.0mm

512×256

Disc

OFF

Rescan

3D: Wide (H)

12.0×9.0mm 512×256

Wide

OFF

Rescan

3D: Wide (V)

12.0×9.0mm 512×256

Wide

OFF

Rescan

OCT Angiography *

3.0×3.0mm

320×320

Macula

OFF

HD Raster

6.0×6.0mm

1024×33

Macula

OFF

SMARTTrack

* To display the analysis image of "OCT Angiography", "Ophthalmic Data System IMAGEnet 6", which is sold separately, is necessary.

NOTE

BASIC OPERATIONS

The set value of the capture icon in the table is the initial value when adding a new capture icon. The set value of a capture icon, which has already been initially registered to each tab, is different from the initial value. It is possible to change the set value on the parameter setting screen. For details about setting a capture icon, refer to "DETAILS OF THE SETTING MENU" on P.76.

NOTE

1 2 3 4

• If the patient wears glasses or contact lenses, have him/her remove them first.

Peel off one chinrest paper. If there is not chinrest paper, supply it. (Refer to P.95.) Wipe off dust on the forehead rest. Seat the patient comfortably on an exam stool or chair in front of the instrument. Adjust the table height or chair height so the patient can relax with his/her chin placed centrally on the chinrest. Let the patient rest his/her chin on the chinrest.

Adjust the chinrest height by adjusting the CHINREST UP/DOWN button so the outside corner of the patient's eye is level with the Canthus marker on the chinrest post. Let the patient rest his/her forehead on the forehead rest.

Canthus marker

BASIC OPERATIONS

CAUTION

• To avoid electric shock, do not touch the external connection terminal, the cable terminal from the external device and the patient at the same time. • When moving the chinrest up and down, be careful not to pinch the patient's hand to avoid possible injury. • When moving the main unit, the external fixation target will be pushed by the measuring head. To avoid injury of the patient, be careful to prevent the external fixation target from hitting the patient.

FUNDUS TOMOGRAPHY

Setting up the patient

BASIC OPERATIONS

Setting the picture position

CAUTION

To avoid injury of the patient, be careful not to bump the patient's eye or nose with the instrument when operating the control lever or touch display.

FUNDUS TOMOGRAPHY

You can change the default picture position, which is set according to the selected capture icon. If necessary, you can change the default position to the external fixation target. There are the following three changing methods. Please change the picture position by your desired method.  Changing by using the internal/external fixation target selector button (touch display) This method is used to change the internal fixation target position and to change the internal fixation target to the external fixation target.

Touch the INTERNAL FIXATION TARGET POSITION SELECTOR BUTTON on Area 2 of photography screen (OCT photography) to change the picture position. Press the EXTERNAL FIXATION TARGET SELECTOR BUTTON on the control panel, and the target is changed to the external fixation target. Change to the desired picture position. For the details of display, refer to P.17.

Scan position button Internal fixation target position selector button

NOTE

When the external fixation target is used, operate the arm to guide the patient's eye to the correct position.

 Changing by using the internal fixation target position move button (control panel) Change the picture position by adjusting the internal fixation target position finely.

As watching the fundus live image area, press the INTERNAL FIXATION TARGET POSITION MOVE BUTTON up, down, right and left on the control panel to adjust the internal fixation target position.

BASIC OPERATIONS

Tap the SCAN POSITION BUTTON on Area 2 of the photography screen (OCT photography) to access the scan position adjustment mode. On the fundus live image area, the graphic image of the selected scan shape and range is displayed with a solid line. For the details of display, refer to P.19. Scan position adjustment range (blue)

Scan pattern display

Touch the scan position adjustment range indicated by a blue frame to move the scan position. For details, refer to P.19.

NOTE

• To adjust the picture position finely, use the fine adjustment buttons around the image. To use "rotation", which can be adjusted only for "Line" scan and "5 Line Cross" scan, perform the rotating adjustment with the rotation buttons (clockwise/counterclockwise) indicated around the image. For details, refer to P.19. • For "3D: 3×3mm" and "Angiography: 3×3mm, 4.5×4.5mm", the scan position can also be adjusted. • When 3 seconds have passed since the last operation, the scan pattern display status is automatically changed from "solid line" to "interrupted line". In addition, the scan position adjustment range and fine adjustment buttons disappear on the screen. The instrument exits from the scan position adjustment mode. You can change "3 seconds" by selecting "Setting menu"  "Page 2"  "OCT"  "Scan ADJ Duration Time". It is possible to select "1, 2, 3, 5 sec".

BASIC OPERATIONS

FUNDUS TOMOGRAPHY

 Changing by using the scan position button (touch display) Use this method when changing the scan position.

BASIC OPERATIONS

Setting the illumination level Tap the "+" of the [Illumination level] display on the fundus/anterior segment live image area, and the illumination level increases. Tap the "-", and the illumination level decreases. Illumination level decreases.

Illumination level increases.

FUNDUS TOMOGRAPHY

Illumination level display

Setting the flash level

CAUTION

To avoid discomfort to the patient, do not brighten the photography light more than necessary.

Tap the “+” of the [Flash level] display on the fundus/anterior segment live image area, and the flash level increases. Tap the “-”, and the flash level decreases. When color fundus photography is set to OFF or when the instrument without the fundus photography function is used, the flash level is not displayed and cannot be adjusted. Flash level decreases.

Flash level display

BASIC OPERATIONS

Flash level increases.

Diopter compensation lens selector

NOTE

• When the patient's eye has a strong myopia, turn the diopter compensation lens selector and set it to (-). • When the patient's eye has a strong hyperopia, turn the diopter compensation lens selector and set it to (+). Compensation range: 0 : -13 – +12D - : -12 – -33D + : +11 – +40D • When the diopter compensation lens is set to a value other than "0", the split lines disappear. At the same time, the function of the auto focus is invalidated.

BASIC OPERATIONS

Turn the diopter compensation lens selector to compensate the dioptric power for the patient's eye.

FUNDUS TOMOGRAPHY

Changing the diopter compensation lens

BASIC OPERATIONS

Alignment and photography

CAUTION

• To avoid injury while moving the instrument body, do not put your hand into the gap between the main unit and power supply unit. • To avoid injury to the patient's eyes and nose while moving the instrument body, be attentive to the distance between the patient and the objective lens.

FUNDUS TOMOGRAPHY

The alignment operation is done with the control lever. • Fine movements of the base, back and forth and right and left, are done by tilting the control lever. Before performing this operation, free the base by turning the Base clamping knob to the left. To lock the base, turn the Base clamping knob to the right.

Operating the control lever (in back and forth/right and left directions)

Base clamping knob

• To move the instrument body up/down, turn the control lever right for upward movement, and left for downward movement. The vertical position mark indicates the standard for the instrument's vertical position.

Vertical position mark

BASIC OPERATIONS

Operating the control lever (in a vertical direction)

Move the instrument body in right and left / up and down directions with the control lever until you get the patient's eye in the center of the fundus live image area. OD(R)

OS(L)

NOTE

BASIC OPERATIONS

Hold the control lever and pull the instrument to the utmost limit toward the operator. As the internal fixation target turns on, instruct the patient to look at the fixation target in the center. Observe the anterior segment image on the touch display.

FUNDUS TOMOGRAPHY

Now hold the control lever upright, which will facilitate the total alignment process.

On the touch display, bring the ( ) scale towards the patient's pupil, and make sure that the pupil is larger than the ( ) scale.

NOTE

Comparison of the ( ) scale and the pupil tells you whether the pupil is large enough for fundus photography. Use this comparison to get the standard for photography. The diameter of the ( ) scale is approx. 4.0mm.

Well dilated.

Narrowly dilated for photography.

Pupil diameter > 4.0mm Pupil diameter = 4.0mm

Pupil diameter is too small: darken the room and further dilate the pupil. Pupil diameter < 4.0mm

BASIC OPERATIONS

NOTE

FUNDUS TOMOGRAPHY

When the pupil diameter is small, press the SMALL PUPIL DIAPHRAGM SELECTOR BUTTON on the control panel to set the small pupil diaphragm to "ON".

Bring the base slowly toward the patient side, and the fundus image appears on the fundus live image area. OD(R)

5 6

Instruct the patient to look at the green light (internal fixation target). While watching the image on the touch display, adjust the brightness of the image by touching the [Illumination level] display on the touch display.

NOTE

OS(L)

For details about the illumination level setting, see page 42.

Bring the base straight toward the patient side. Two alignment bright spots for the working distance alignment and the split lines for the focal distance alignment become visible on the fundus live image area. OD(R)

OS(L)

Alignment bright spot

Split lines

BASIC OPERATIONS

OD(R)

OS(L)

Alignment bright spot

Split lines

NOTE

• When the auto focus function does not work smoothly or when it is OFF, operate the focusing knob to change the split lines into one line. If you cannot align the split lines into one line by turning the focusing knob, change the diopter compensation lens. Refer to "Changing the diopter compensation lens" on page 43. Since the split lines are off when the diopter compensation lens is anything other than (0), turn the focusing knob so that the fundus image can be seen clearly on the touch display. The auto focus function is invalidated because the split lines are off. • When you operate the focusing knob, the auto focus operation is suspended. To resume it, pull the base toward the operator and then push it toward the patient side again.

Focusing knob

Move the control lever back and forth until the two bright spots are changed to one spot. OD(R)

BASIC OPERATIONS

When the auto focus function is ON, the instrument automatically changes the split lines into one line. At this time, the fundus is almost in focus. The auto focus mechanism does not work for ocular pathology (e.g. strong cataract), myopia and hyperopia (beyond -13 to +12D), etc. from time to time.

OS(L)

BASIC OPERATIONS

FUNDUS TOMOGRAPHY

BASIC OPERATIONS

Operate the control lever up and down, right and left to bring the alignment bright spot into the ( ) scale. OD(R)

FUNDUS TOMOGRAPHY

Each auto function works and the tomogram is automatically displayed on the tomogram live image area. The preparation for photography is finished.

NOTE

OS(L)

• If the patient blinks frequently, the auto functions do not work smoothly from time to time. Ask the patient not to blink as far as circumstances allow. • When the auto functions do not work or are OFF and the diopter compensation lens is anything other than (0), tap the Optimize button on the tomogram live image area to detect the retina position automatically and optimize the image output sensitivity. • You can change the Z lock position (tomogram display position) by touching the tomogram live image area if necessary. For details, refer to P.24.

Right before taking a picture, tell the patient that you are about to take a picture of his/her eye and ask him/her not to blink and to keep watching the green light (internal fixation target). Set the system to detect the retina position automatically and optimize the image output sensitivity.

BASIC OPERATIONS

Photography button

NOTE

In the case of "OCT Angiography" or "SMARTTrack", the photography time is longer than usual. Perform the following operations according to the need during photography. • When the tomogram is moved to the top, tap the tomogram live image area to modify the Z lock position (tomogram display position) downward. • When the tomogram's surface layer is dark, adjust focus manually to brighten it. • In order to prevent the IR image from flare, perform photographing as aligning the instrument. • When the IR image is dark or there is much noise, raise the illumination level. • When you cannot carry out photographing smoothly however hard you try due to the patient's eye/fixation status or others, press the PHOTOGRAPHY BUTTON again. You can take a picture under the condition that tracking is canceled.

BASIC OPERATIONS

Make sure that the alignment bright spot and split line are correctly positioned on the touch display. Then, press the PHOTOGRAPHY BUTTON . By pressing the PHOTOGRAPHY BUTTON , OCT photography is done and then the fundus photography is automatically done.

FUNDUS TOMOGRAPHY

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TOPCON

OCT Devices

DRI OCT Triton and Triton (plus) User Manual Rev 9 July 2019