Users Manual
152 Pages
Preview
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USER’S MANUAL Viewer Software for the OCT
OCT Viewer Version 6.4X
INTRODUCTION Thank you for purchasing the TOPCON OCT Viewer.
FEATURES The user's manual is made so that the customer can refer to this manual when learning how to operate the OCT Viewer software and when using it. This manual does not describe how to take a picture and how to diagnose the photographed image. For the photographing method, refer to the description about "Capture" in the instruction manual that is attached to each hardware. This manual is provided for the following products. Objective products: OCT Viewer This manual is provided for the following products. Objective products: 3D OCT-1000, 3D OCT-1000 MarkII, 3D OCT-2000, 3D OCT-2000 (FA), 3D OCT-2000 (FA plus), OCT Viewer
PURPOSE OF THIS MANUAL This manual explains the details of the function and use method to make a good use of the OCT Viewer. Before using the software, carefully read this manual to ensure that you operate it efficiently and safely. Always keep this manual at hand to make a good use of it.
ATTENTION • Before using this software, carefully read this manual. Then, use the software according to "LICENSE TERMS" and this manual. Topcon Corporation owns the copyright of the software. Reproduction and copying of the software and/or the User's Manual, in whole or in part, without permission from Topcon Corporation, is strictly prohibited. • The User's Manual is made on an assumption that the user already has knowledge about the operation system of the personal computer and Microsoft Windows. The User's Manual does not describe the details on how to handle common operation procedures of the personal computer and Microsoft Windows. Topcon Corporation shall not take any responsibility for the results caused by wrongly operating the personal computer and/or Microsoft Windows. • The specifications of the software and description of the User's Manual are subject to change without advance notice. CAUTION : Federal laws restricts this device to the sale by or on the order of a physician.
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TABLE OF CONTENTS INTRODUCTION ....................................................................................................................................... 1 Displays for Safe Use ........................................................................................................................... 5 SAFETY CAUTIONS ................................................................................................................................. 6 User maintenance ................................................................................................................................. 8 Environment for Operation .................................................................................................................... 8 ESCAPE CLAUSES .............................................................................................................................. 9 1. STARTING ......................................................................................................................................... 10 1.1. Starting and Exiting the OCT Viewer Program ........................................................................... 10 1.1.1. To Start the OCT Viewer Program: ............................................................................................. 10 1.1.2. To Exit the OCT Viewer Program: ............................................................................................... 10 1.1.3. Main Menu and Tool bar Icons .................................................................................................... 11 1.1.4. Options Settings .......................................................................................................................... 13 2. DISPLAYING TOMOGRAMS ............................................................................................................. 22 2.1. Selection Mode Window ............................................................................................................. 22 2.1.1. Grid interface ............................................................................................................................... 23 2.1.2. Thumbnail Interface .................................................................................................................... 28 2.1.3. Date Interface .............................................................................................................................. 29 2.2. Selecting and Retrieving the Patient ........................................................................................... 30 2.2.1. Selecting the patient .................................................................................................................... 30 2.2.2. Retrieving the patient .................................................................................................................. 30 2.3. Operating through Data List ........................................................................................................ 33 2.3.1. Contents on Data list ................................................................................................................... 33 2.3.2. Arranging Data Records .............................................................................................................. 34 2.3.3. Comparing Data from the Data list .............................................................................................. 34 2.3.4. Analyzing Data from the Data list ................................................................................................ 34 2.3.5. Making Reports from the Data list ............................................................................................... 35 2.4. View Mode Window .................................................................................................................... 36 2.4.1. A-1: Thumbnail area .................................................................................................................... 37 2.4.2. A-2: Image Processing Controls area ......................................................................................... 37 2.4.3. A-3: Fundus/Anterior Segment Image Display Area ................................................................... 39 2.4.4. A-4: Thickness Graph Area ......................................................................................................... 50 2.4.5. A-5: Tomogram display area/Auxiliary tomogram display area ................................................... 51 2.4.6. A-6: 3D tomogram display area .................................................................................................. 59 2.5. Volume ........................................................................................................................................ 62 2.5.1. Cropping ...................................................................................................................................... 62 2.5.2. Subvolume .................................................................................................................................. 63 2.6. Slicing ......................................................................................................................................... 65 2.7. ILM/RPE/(IS/OS)/(BM) ................................................................................................................ 67 2.8. Bookmark and Right-click Menu ................................................................................................. 69 2.8.1. Bookmark .................................................................................................................................... 69 2.8.2. Right-click Menu .......................................................................................................................... 70 2.9. Pin-point Registration™ .............................................................................................................. 72 2.9.1. Shadowgram ............................................................................................................................... 72 2.9.2. Automatic Positioning .................................................................................................................. 72 2.9.3. Manual Positioning ...................................................................................................................... 72 2.9.4. Pin-point Registration™ .............................................................................................................. 73
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2.9.5. Reference Image ......................................................................................................................... 74
3. ANALYZING TOMOGRAMS .............................................................................................................. 78 3.1. Analyzing and Modifying Layers ................................................................................................. 78 3.2. Analyzing the Optic Disc ............................................................................................................. 81 3.3. Analyzing the Anterior Segment Image ...................................................................................... 84 3.3.1. How to analyze ............................................................................................................................ 84 3.3.2. Analyzing the center corneal thickness ....................................................................................... 85 3.3.3. Analyzing the corneal thickness distribution ............................................................................... 85 3.3.4. Analyzing the center curvature radius ......................................................................................... 86 3.3.5. Analyzing the curvature radius distribution ................................................................................. 86 3.3.6. Manual angle measurement ........................................................................................................ 87 3.4. Fundus Image Analysis ............................................................................................................... 89 3.4.1. How to analyze ............................................................................................................................ 89 3.4.2. A variety of measurement ........................................................................................................... 90 3.5. Red-free Fundus Image Analysis ................................................................................................ 91 3.5.1. How to analyze ............................................................................................................................ 91 3.5.2. A variety of measurement ........................................................................................................... 92 3.6. RNFL Trend Analysis .................................................................................................................. 93 3.6.1. How to use this function .............................................................................................................. 93 3.6.2. Explanation of Window ................................................................................................................ 94 3.6.3. How to see the trend analysis result graph ................................................................................. 95 3.6.4. Changing the image data ............................................................................................................ 96 3.6.5. Outputting/saving the report ........................................................................................................ 97 3.7. Glaucoma Analysis in the Macula .............................................................................................. 98 3.7.1. How to use this function .............................................................................................................. 98 3.7.2. Outputting/saving the report ........................................................................................................ 99 3.8. Drusen Analysis ........................................................................................................................ 101 3.8.1. How to use this function ............................................................................................................ 101 3.8.2. Explanation of Window .............................................................................................................. 102 3.8.3. Outputting/saving the report ...................................................................................................... 104 4. COMPARING ANALYSIS RESULTS ............................................................................................... 105 4.1. Types of Comparison ................................................................................................................ 105 4.2. Both Eyes Display ..................................................................................................................... 105 4.2.1. Selection of both eyes from the OCT data list ........................................................................... 105 4.2.2. Changing one eye display to both eyes display ........................................................................ 106 4.3. Comparison ............................................................................................................................... 107 4.3.1. Comparison ............................................................................................................................... 107 4.4. Comparison: Advanced ............................................................................................................. 108 4.4.1. Comparison ............................................................................................................................... 108 4.5. 3D Mosaic Comparison Results (3D Mosaic) ........................................................................... 110 4.5.1. 3D Mosaic Comparison Results ................................................................................................ 110 4.6. Saving Analyzed Results .......................................................................................................... 112 5. OUTPUTTING RESULTS ................................................................................................................. 113 5.1. Making / Saving Movies ............................................................................................................ 114 5.1.1. Making Movies - Automatic ....................................................................................................... 115 5.1.2. Making Movies - Manual ........................................................................................................... 116 5.2. Exporting Images ...................................................................................................................... 117 5.3. Printing Images ......................................................................................................................... 118
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5.4. Making Reports ......................................................................................................................... 119 5.4.1. To make a Report ..................................................................................................................... 119 5.4.2. List of Report Output Form ........................................................................................................ 119 5.4.3. Patterns that invalidate the output buttons ................................................................................ 121 5.4.4. Example of report ...................................................................................................................... 121 6. MACRO FUNCTION ......................................................................................................................... 127 7. MANAGING DATA ........................................................................................................................... 129 7.1. Database Structure ................................................................................................................... 129 7.1.1. System Database ...................................................................................................................... 129 7.1.2. Data Drive ................................................................................................................................. 129 7.1.3. Changing Database .................................................................................................................. 129 7.2. Editing/Deleting Patient Records .............................................................................................. 130 7.2.1. Editing Patient Information ........................................................................................................ 130 7.2.2. Copying Patient Records .......................................................................................................... 131 7.2.3. Deleting Patient Records .......................................................................................................... 131 7.3. Archive and Back Up ................................................................................................................ 133 7.3.1. Archiving Process ..................................................................................................................... 133 7.3.2. Copying Image Files ................................................................................................................. 134 8. TROUBLE SHOOTING .................................................................................................................... 136 8.1. Messages during Operation ...................................................................................................... 136 9. OCT Viewer SOFTWARE LICENSE TERMS ................................................................................... 137 10. APPENDIX 1 .................................................................................................................................. 144 10.1. 3D OCT: Axial Length Compensation Range ......................................................................... 144 10.2. Changing/Adding Database .................................................................................................... 145
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Displays for Safe Use To encourage safe and proper use and to prevent harm to the operator and others or potential damage to property, important messages are put on the instrument body and inserted in the User Manual. We suggest that everyone understand the meaning of the following displays, icons and text before reading this user manual and observe all listed instructions.
Display Display
Meaning
WARNING
Incorrect handling by ignoring this display may lead to a risk of death or serious injury.
CAUTION
Incorrect handling by ignoring this display may lead to personal injury or physical damage.
Injury refers to cuts, bruises, burns, electric shock, etc. which do not require hospitalization or extended medical treatment. Physical damage refers to extensive damage to the building, nearby equipment and/or surrounding furniture.
ICON Icon
Meaning Prohibition Specific content is expressed with words or a picture near the
icon.
Mandatory Action Specific content is expressed with words or a picture near the
icon.
Caution Specific content is expressed with words or a picture near the
icon.
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SAFETY CAUTIONS CAUTIONS Icon
6
Prevention item
Page
The necessary capacity of memory and hard disk are changed depending on the CPU in the personal computer or environment.
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If the number of "Thread" in CPU is beyond 4, the processing may be delayed. Reduce the number of "Thread" to use this software.
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When the object to be displayed is changed, start this software again.
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When analysis is performed again by selecting “Tools” and then “Fine Analysis”, the recalculated result is validated in FDA by pressing the [Save] Button.
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For "B-2: Filter", the data of the image being displayed are used and so you cannot change the values of "Filter" directly.
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When modifying the data in optic disc analysis (refer to "3.2. Analyzing the Optic Disc" (P.81), the circle center is calculated again.
47
When the "Basic" analysis data modified manually is analyzed again by "Fine Analysis", the data modified manually is erased and the "Disc" calculated automatically by "Fine Analysis" is applied.
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If you want to return the data, which has been modified manually and saved, to the original status, perform "Fine Analysis" or "Basic Analysis" again. The automatically detected data can be reproduced. (The manually modified data is erased.)
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The Measure Image function is based on the theoretical Gullstrand eye model. If the parameters of the actual patient's eye, such as the diopter or axial length, are different from the Gullstrand eye model, the measurement results may be different from the length and size in reality. The clinician will be solely responsible for the diagnoses and treatments based on the measurement results.
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As the result of automatic positioning, the fundus image is sometimes deformed to the oval shape on the fundus image display area (A-3). This is the result of the high level positioning process and there is no problem.
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After analysis, the images are automatically positioned. If sufficient data required for overlapping are not provided, automatic positioning may not be done correctly.
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When you have finished the modification process ("Exit Modify"), the modification is decided. Consequently the system cannot return to the condition before the modification. When you use scrolling, the process is same. But, as the modification is not saved yet, you can restart modification by selecting data from the Thumbnail View panel.
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Icon
Prevention item
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You cannot perform "Modify" for the image photographed by "OverSampling". When the "OverSampling" image is selected, the "Modify" function is OFF. "OverSampling" means the data photographed by specifying the scan resolution 2048/4096 in 3D OCT-1000, 3D OCT-1000Mark II and 3D OCT2000 (Ver.4.x, Ver.5.x).
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In the automatic optic disc analysis, sometimes errors occur due to the photographed condition as shown below. In this case, using the menu "Disc Modify" displayed when selecting "Disc Segmentation", you can modify the analysis result. Refer to "Disc Modify" on P.48 in addition to this page.
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In anterior segment analysis, the data except the center corneal thickness of the measuring function are reference values.
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When RPE was not detected correctly (If the patients blinked, his/her fixation moved during scan, the tomogram overlaps the top edge of the image area, or the image quality is low, this may occur), the analysis result may not be correct.
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The result of registration is as follows: Double-click an optional point on the two tomogram display areas, the two fundus image display areas and the upper right "Compare Window". The green line with a cross mark appears. (Pin-point Registration™) Sometimes this green line with a cross mark appears out of the 3D scan area (green frame).
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There are two probable causes. • On the two fundus image display areas, the fundus image is not aligned with the "Overlay" image correctly. • On "Compare Window", the two "Shadowgram" images are not aligned with each other correctly. To obtain the correct results, check the alignment on the two fundus image display areas and on "Compare Window". If the images are not aligned correctly, carry out "Reposition" and repeat Step 2 and 3. The insufficient memory error may occur when selecting ten tomograms depending on the environment.
111
After clicking [Run] in the "Register" menu, Thickness Map is not displayed from time to time. In this case, click [On/Off] in the "Thickness" menu.
111
To display Thickness Map, the same layers in the selected image as those in "Image 1" must be analyzed. If the different layer has been analyzed, click the layer detection display selector buttons properly (refer to "A-2: Image Processing Controls area" on P.37) and analyze the necessary layer. Then, try the operation again to display Thickness Map.
111
Make sure that no other windows or images are blocking or placed over the Volume window during the movie-saving/recording procedure.
114
When the analysis has failed, it is probable that the instrument did not take a picture correctly. It is possible that the analysis will be successful if the instrument takes a picture again.
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User maintenance To ensure the safety and performance of this software, all maintenance works, unless specified in this manual, shall be conducted by trained service engineers. The following maintenance task may be done by the user. For details, refer to the relevant part of this manual. • Archive and Back Up (Refer to P.133 in this manual.)
Environment for Operation
CAUTION
The necessary capacity of memory and hard disk are changed depending on the CPU in the personal computer or environment.
CAUTION
If the number of "Thread" in CPU is beyond 4, the processing may be delayed. Reduce the number of "Thread" to use this software.
Item
Operation spec.
Recommended spec.
PC
IBM PC/AT compatible machine
OS
Windows XP Professional SP3 32bit Windows 7 Professional 32bit / 64bit
Windows 7 Professional 32bit / 64bit
CPU
Core2 DUO
Core i7 (equivalent to 2600)
Clock
3GHz
3.4GHz
Core
-
4
RAM
4GB
4GB for Windows 7 32 bits 8GB for Windows 7 64 bits
Hard disk
At least 500GB (At least 7200RPM)
Drive (for installation/ backup of data)
DVD-Multi drive
Display
SXGA (1280×1028) and 32-bit color
WSXGA+ (1680×1050) and 32-bit color
Graphics board
VRAM of 256MB with OpenGL capability
VRAM of 512MB with OpenGL capability
Network card
On-board LAN (to connect with LAN) Expansion LAN card (applicable to PCI Express Gigabit: for connecting OCT)
Expansion slot
At least one free slot of PCI Express ×1 (for increasing the network card)
Database
Microsoft SQL Server 2005 (*1 SP2 or higher) Microsoft SQL Server 2008 (*1 SP1 or higher) Microsoft SQL Server 2008 R2 *1) When OS is Windows 7
When using Express Edition, it does not operate correctly if the system manages an enormous amount of patients/photographed data. In this case, please use Standard Edition, etc. Others
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RAID control (to protect data)
ESCAPE CLAUSES 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 the inability to properly use this software, such as loss of business profit and/or suspension of business. TOPCON shall not take any responsibility for damage caused from using this software in a manner other than that described in this User Manual. In the case of software products, the license terms enclosed supersede any other understandings. Diagnosis made shall be the responsibility of the pertaining doctors and TOPCON shall not take any responsibility for the results of such diagnoses.
3D OCT-2000 and IMAGEnet are the trademarks of TOPCON CORPORATION. Microsoft, MS and Windows are the registered trademarks of Microsoft Corporation. Windows 2000 and XP are the registered trademarks of Microsoft Corporation. SQL Server 2005 and SQL Server 2008 are the registered trademarks of Microsoft Corporation. Pentium is the registered trademark of Intel Corporation. Matrox is the registered trademark of Matrox Electronic Systems Ltd. IBM is the registered trademark of International Business Machines Corporation
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1. STARTING 1.1. Starting and Exiting the OCT Viewer Program 1.1.1. To Start the OCT Viewer Program:
1
Double-click the [OCT Viewer] icon on the desktop.
Main screen
When you start OCT Viewer and "Failed to check the license. Please contact TOPCON." is displayed, double-click the [OCT Viewer] icon to start it again. (If the above message is displayed on condition that the OCT Viewer program is registered in "Startup" and you start it, delete the program from "Startup". Then, start the OCT Viewer manually.)
1.1.2. To Exit the OCT Viewer Program:
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10
Click the Close icon
STARTING
.
1.1.3. Main Menu and Tool bar Icons The OCT Viewer program is organized into the following two categories: Analyze and Data Management. The user can select the desired operation by clicking on the respective icon on the start screen. Icons on the tool bar Overwrite/Save
When the image is changed, the current image is overwritten and saved.
Select
Returns to the patient selection window.
Viewer
The user can perform analysis.
Compare
Displays the comparison screen.
Output
Prints the report or makes and saves movies.
Tomogram layer
Changes the layer in the tomogram.
Color set
Displays the color adjustment window of the OCT image.
Layer
Displays and hides the layer in the tomogram.
Utility bar
This is provided to use the added functions.
Close
Closes Data Management subcategory.
OD / OU / OS
Changes the OD/OU/OS screens to each other.
If, after photographing, you click the "Close" icon without saving data, the main screen appears again and the OCT Viewer software is finished, the error message is sometimes displayed. This does not mean a problem.
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STARTING
The user can manage data.
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STARTING
Edit/Delete
Allows the user to modify patient demographic information fields and to delete saved tomogram data.
Archive/Backup
Archives tomogram data into juke-box-like archive folders.
Close
Closes Data Management subcategory.
1.1.4. Options Settings The user can make changes as desired to the following 3D OCT options.
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From the Menu Bar, select ToolsOptions. The Options dialog box displays. Display Tab
On Display Tab, you can set the following items. • Volume Scale Retina "1:4" is initially set. You can select one of "1:1", "1:2", "1:3" and "1:4". • B-Scan Scale Retina "1:2" is initially set. You can select one of "1:1", "1:2", "1:3" and "1:4". For "Anterior", only "1:1" is usable for "Volume Scale" and "B-Scan Scale". • Color Scale Setting Set the compensation value against the maximum and minimum values after normalizing the color scale. You can change this value by operating the color scale bar on the "View" screen. • Default Color Set the initial display color of the B-Scan tomogram. You can select one of "Color", "B/W" and "Reverse of B/W".
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STARTING
• Circle Direction (only for fundus) Set the display direction of the "Circle" B-scan image. You can select one of "TSNIT" and "NSTIN". (TSNIT)
(NSTIN)
Volume Tab
On Volume Tab, you can set the following items. • Enable advanced cropping • Background Color Mode You can set "Color Mode" and "B/W Mode".
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STARTING
Thickness Tab
On Thickness Tab, you can set the following items. • Colormap "Topcon Style" is initially set. You can select one of "Topcon Style" and "Zeiss Style". • Grid You can set color for "Grid Color" and "Text Color". • Layer Modification "Pointing Mode" is initially set. You can select one of "Pointing Mode" and "Drawing Mode". • Layer Detection This item is applied to only "Circle" scan. "Smoothing" is initially set. • Polynomial Fitting Place a check mark and perform analysis. If unevenness is found during layer detection, the layer is drawn with an approximate curve. • Smoothing Place a check mark and perform analysis. If unevenness is found during layer detection, the layer is drawn with a smooth line. • Thickness Preference Select "Retina", "RNFL" or the like in the panel. You can check the layer displayed in the selected place. The check marks are initially placed for the following two items. • Show thickness layers only Remove the check mark. Other layers are displayed in addition to the Thickness layer.
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STARTING
• Don't show layers on startup Remove the check mark. When selecting data, the tomogram is displayed while the layer is displayed. For the anterior segment data, only "Don't show layers on startup" on Thickness Tab is valid.
Patient Tab
On Patient Tab, you can set the following item. • Target of Display The check mark is initially placed for "Patients captured today". • Number of Display You can set the maximum number of the patients to be displayed on the "Search Patient" panel. "1000" is initially set. Remove the check mark, and all the patients that meet the retrieval conditions are displayed.
CAUTION
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STARTING
When the object to be displayed is changed, start this software again.
Export Tab
On Export Tab, you can set the following items. • Action Specify the operation of "Export". (1) Save on DB: Registers the data to the set database of the IMAGEnet. (2) Export: Outputs the data as a file to the set folder path. (3) Save on DB & Export: Executes (1) and (2) at the same time. (4) Show file save dialog when exporting Specifies whether the "Save" dialog box should be displayed or not in export. Only when (2) or (3) is selected, you can set this item. • Images You can select the type of the image to be exported. The check marks are initially placed for all the items. Because report is not the object of batch export, only specifying the procedure name is needed. Place a check mark for "DICOM", and it is possible to export the OCT photography data to the DICOM format file. Only when DICOM is installed from the "Options" folder, the check column of "DICOM" is displayed. • Procedure Names The name classified in IMAGEnet is displayed. • Export File Type "JPEG" is initially set. You can select one of "JPEG", "BMP", "PNG" and "TIFF".
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STARTING
• Trimming of Full Size Fundus image Set On/Off for trimming the full-size color fundus/red-free image. The form of filename is "Patient ID_Date_Time_Procedure name_R (right) or L (left)_Number.extension". The following table shows the forms of the patient ID, date, time, procedure name, right/left and number. Example) 12345_20100203_152816_Color Retina_R_01.jpg 12345_20100203_152816_R_01.jpg (when the "Procedure name" place is blank) 1 2 3 4 5
Output information Patient ID Date Time Procedure name Right/Left
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Number
Contents The ID number of the patient is outputted. This is outputted in the form of "yyyymmdd". This is outputted in the form of "hhmmss". The procedure name is outputted. "R" for right eye, "L" for left eye or "N" when there is no information is outputted. The number is automatically outputted not to make two or more image files having the same name.
When you select "Flip (Original)" of "Exported JPEG image form", the original image taken by the camera is output. When you select "Normal", the archived image is output.
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STARTING
AnalysisTab
You can set the following items in this tab: • 3D Disc Analysis Mode You can select an analysis mode for 3D Optic disc data with 512×128 resolution. • 3D Macula Analysis Mode You can select an analysis mode for 3D Macula data with resolutions shown in the dialog. • 3D Wide Analysis Mode You can select an analysis mode when analyzing the 3D Wide data There are two analysis modes: Fine and Basic. Execution time is shorter in Basic, and precision is higher in Fine. Your selection is reflected on the caption of the analysis button in the Data list. Basic analysis is valid only when the scan width is "6.0×6.0mm" and "7.0×7.0mm" for "3D" and "12.0×9.0mm" for "3D Wide".
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STARTING
Disc Topo tab
On Disc Topo tab, you can set the following items. • Reference plane height You can change the height of the reference plane to decide the cup margin in optic disc analysis. "120µm" is initially set. You can change it to "60µm", "90µm" and "Custom (-90 - +210)". When the changed reference plane height is not the same as the setting when analyzing the displayed FDA data, the optic disc analysis result is calculated again. If the reference plane height is changed by "Options" while the result is displayed, the result is recalculated when the change is applied.
CAUTION
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STARTING
When analysis is performed again by selecting "Tools" and then "Fine Analysis", the recalculated result is validated in FDA by pressing the [Save] Button.
Print tab
On Print tab, you can set the following items. • Practitioner You can set the name output under "Comments" in the report. • Technician You can set the name output on "Technician" in the report.
2
After selections are made, click
.
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STARTING
2. DISPLAYING TOMOGRAMS This chapter will explain how to select the patient and tomogram data ("Selection Mode Window", "Selecting and Retrieving the Patient" and "Operating through Data list") first. Next, it will explain the "View" mode window that is the display screen ("View Mode Window"). At last, it will explain the positioning process of images ("Pin-point Registration™").
2.1. Selection Mode Window The selection mode window has three types of interfaces and you can select them by the following tabs (at the upper left corner on the screen). 1) Grid (default) 2) Thumbnail 3) Date
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DISPLAYING TOMOGRAMS
2.1.1. Grid interface A-5: Patient Information Panel A-1: Search Patient Panel
A-6: Patient Info button
A-2: Data list
A-4: Preview Panel
A-3: Report list
[Selection] mode window (Grid interface) The [Selection] mode window (Grid interface) consists of the following five items. ID
Name
Description
A-1
Search Patient Panel
Displays the patient list.
A-2
Data list
Displays the photographed image list of the selected patient.
A-3
Report list
Displays the report list of the selected patient.
A-4
Preview Panel
Displays the thumbnails and photography information of the image selected on the Data list.
A-5
Patient Information Panel
Displays the information of the selected patient.
A-6
Patient Info button
Displays the patient information.
Hereafter, these seven items will be explained.
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DISPLAYING TOMOGRAMS
A-1: Search Patient Panel The Search Patient Panel consists of the following four items.
Calendar
Patient Search Box
Patient List
Database Selection
[Patient Search Box] Refer to "Selecting and Retrieving the Patient" on P.30. [Patient List] The Patient List section is arranged by the ID, Last Name, First Name, Sex, and DOB attributes. The user may sort any attribute by clicking on that category tab (sorting).
[Database Selection] The "System" database is selected by default when the software starts. The user can switch to "Data Drive" if necessary. [Calendar] Refer to "Selecting and Retrieving the Patient" on P.30.
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DISPLAYING TOMOGRAMS
A-2: Data list The Data list displays the photography information of the patient selected from the Search Patient Panel.
A-3: Report list The Report list displays the list of the reports already made. The report, which was made by the selected scan data, is highlighted.
Select All Export Print Print Preview
: Selects all the reports. : Export the selected report. : Prints the selected report. : Displays the print image of the selected report.
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DISPLAYING TOMOGRAMS
A-4: Preview Panel
The Preview Panel displays the thumbnails and photography information of the image selected on the Data list. The following photography information is displayed. • • • • • • • • • • • • • •
Segment Scan Size Scan Length Site ID Machine s/n Date Time Fixation Image Quality Color Fundus Thickness Analysis Disc Analysis Analysis mode OCT Focus Position In "Radial Scan" of the anterior segment photography, "Signal Strength" is displayed instead of "Image Quality". "Disc Analysis" is valid for the data of "3D Scan, 6.0×6.0mm, 512×128 pixels, and Fixation: Disc". For details of "Disc Analysis", refer to "Analyzing the Optic Disc" on P.81.
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DISPLAYING TOMOGRAMS
A-5: Patient Information Panel
The Patient Information Panel displays the information of the selected patient. You can change the data to be displayed. Click [Patient Information Panel], and the following menu appears. Place a check mark for the desired item. Remove the check mark from the undesired item.
You can display or hide the following information. • • • • • •
ID Name Date of Birth Sex Physician 1,2,3,4 Diagnosis 1,2,3,4
A-6: Patient Info button Click the [Patient Info] button, and the following "Patient Information" window is displayed.
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DISPLAYING TOMOGRAMS
2.1.2. Thumbnail Interface Check and select the tomogram data by using the Thumbnail Interface. The thumbnail images recording the analysis data are displayed.
[Selection] mode window (Thumbnail Interface)
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DISPLAYING TOMOGRAMS
2.1.3. Date Interface The Date interface uses a specific date or ranges of dates to locate a patient's record. Click a date on the calendar at the left or specify a date range by dragging the mouse to highlight the date or range. To select patient data, click on a specific date or highlight a date range (by dragging the mouse). All 3D tomogram data records captured during the specified date range will display on the Data list.
[Selection] mode window (Date Interface)
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2.2. Selecting and Retrieving the Patient Select and retrieve the patient from the Search Patient Panel.
2.2.1. Selecting the patient
1
Click the patient (name) whose image should be displayed on the patient list of the Search Patient Panel. You can select the data of only one line (only one patient) at a time. The selected name is highlighted in blue, and his/her tomogram data are displayed on the Data list.
2.2.2. Retrieving the patient You can retrieve the patient list by using the following items in the Patient Search Box; • ID • First Name • Last Name • Diagnosis • Physician and the following item on Calendar. • Last Photo Date
[Retrieving with ID, First/Last Name, Diagnosis Code and Physician]
1 2
Input the data to be retrieved to the items in the Patient Search Box. Click [Search]. You can search using the first letter only. For example, if you type in "A" in the Last Name field, all patients with the last name beginning with "A" will display.
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[Show patient dialog box for new registration when no patient is found.] On condition that a check mark is placed for [Sow patient dialog box for new registration when no patient is found.] on the "Patient" tab of "OCTSet.exe" (OCT software environment setting), if the desired patient is not found by retrieving, the new registration screen for the patient is displayed.
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[Retrieving with "Last Visit" (One date)"]
1
Click the date to be retrieved on Calendar.
2
Click [Search].
[Retrieving with "Last Visit" (Date range)]
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1
Select a date range by dragging the mouse.
2
Click [Search].
DISPLAYING TOMOGRAMS
2.3. Operating through Data List 2.3.1. Contents on Data list Once you select the desired patient on Search Patient Panel, the photography data are classified by the following items and are displayed on Data list. Date: Scan Mode: Eye: Analyzed:
The date when the picture was captured Scan mode used for photographing Right eye (OD (R)) or left eye (OS (L)) Indicates whether or not the data was analyzed. (Refer to "Saving Analyzed Results" on P.112.) Archive Disk: The archive disk number where the data resides
You can select an image to be displayed by operating the following buttons. • [Open Original] :Displays the original image. • [Open Analyzed] :Displays the analyzed image. Double-click the one-line data. This data is displayed and the [View] mode is accessed. If the image has already been analyzed and the original image does not exist, [Open Original] is invalidated.
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2.3.2. Arranging Data Records The user may arrange the tomogram data records by dragging any of the column headings into this space:
1
Drag the Scan Mode column header into place.
2
The data records are then sorted by Scan Mode.
To return the sorting display to the original, finish this process with the this screen again.
button. Then, access
2.3.3. Comparing Data from the Data list Select the data of the right and left eyes captured by the same scan mode and click the You can compare the data.
button.
For details of comparison, refer to "COMPARING ANALYSIS RESULTS" on P.105.
2.3.4. Analyzing Data from the Data list There are two analysis buttons for analysis in the Data list. The left one is for Fine analysis mode and the right one is for the analysis mode selected in the analysis tab in the option setting dialog. Select data and click an analysis button, analysis of the selected analysis mode will be performed with Macro Function. Click refresh button and the checks in the panel will be updated. For analysis buttons, see "Options Settings" on P.13.
For details of Macro Function, refer to "MACRO FUNCTION" on P.127.
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2.3.5. Making Reports from the Data list Select data and click the [Report] or [OU Report] button. The report is made and previewed.
OU Report Select the scan data corresponding to [OU Report] (refer to "Patterns that invalidate the output buttons" on P.121) and click the [OU Report] button. The data selection dialog box where the selectable data are displayed appears. Select another eye from the dialog box and click [OK]. The reports for both eyes are made and previewed.
When you specify one OS (L) data and one OD (R) data that can be output as the both eyes report and click the [OU Report] button, the both eyes report is made and previewed without displaying the [Select Record] dialog box. When the Disc Topo reference plane height of the data selected here is different from the value set by "Options", "Disc Topo" on the report is recalculated and displayed.
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2.4. View Mode Window Once a tomogram is selected, the View mode is automatically accessed. On View Window, in 3D/Radial Scan, the 2D/3D tabs are displayed and you can change the displayed tomogram. In the case of other scans, the tomogram is displayed in 2D mode. (The 2D/3D tabs are not displayed.) See "Drusen Analysis" on P. 101. about the View Mode window when you use Drusen analysis.
The View Mode window consists of the following areas. 2D mode
2D/3D tabs
3D mode A-5. Tomogram display area
A-1. Thumbnail area
36
A-3. Fundus/anterior segment image display area
2D/3D tabs
A-2. Image processing controls area
A-6. 3D tomogram display area A-4. Thickness graph area
A-5. Auxiliary tomogram display area
ID
Area
2D/3D
A-1
Thumbnail area
2D/3D
A-2
Image processing controls area
2D/3D
A-3
Fundus/anterior segment image display area
2D/3D
A-4
Thickness graph area
2D
A-5
Tomogram display area
2D
A-5
Auxiliary tomogram display area
3D
A-6
3D tomogram area
3D
DISPLAYING TOMOGRAMS
2.4.1. A-1: Thumbnail area B-1: Thumbnail
B-2: Filter
ID
Name
Description
B-1
Thumbnail
Displays the thumbnail images of the data applicable to the conditions of B-2.
B-2
Filter
You can specify one of the three conditions.
Eye
You can specify the right or left eye.
Scan
You can specify the type of scan used for photography.
Date
You can specify the date of photography.
CAUTION
For "B-2: Filter", the data of the image being displayed are used and so you cannot change the values of "Filter" directly.
2.4.2. A-2: Image Processing Controls area [Scale adjustment] Scale set: Press the [Scale set] button, and the "OCT Color Setting" window.
It is possible to adjust the color map of tomogram by adjusting the scale on the "OCT Color Setting" window.
Noise Floor (NF)
Max
The data lower than the value of "Noise Floor" (NF) (noise reference surface) is displayed in black. The data higher than the value of "Max" is displayed in white. "25%" of the data range is the initial value for "NF", and "75%" for "Max". The changed value is held by the [Set] button. The initial value is set again by the [Reset] button.
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[Selection of layer detection display] Fundus Retina: RNFL:
Calculates the thickness between the ILM-RPE layers. Calculates the thickness between the ILM-NFL layers.
Retina: RNFL: GCL++: GCL+
Calculates the thickness between the ILM-RPE layers. Calculates the thickness between the ILM-NFL layers. Calculates the thickness between the ILM-IPL layers. Calculates the thickness between the NFL-IPL layers
Fundus
You can select Retina, RNFL, GCL++ and GCL+ only when you open the 3D (V) and 3D-Wide data. Anterior segment Cornea: CorneaIEpi:
Calculates the corneal thickness. Calculates the corneal epithelium thickness.
[Showing/Hiding layers]
When the [Layers] button is selected, layers are displayed. This button corresponds to On/Off of the menu [ILM]/[RPE] of "A-5: Tomogram display area/Auxiliary tomogram display area". Refer to "A-5: Tomogram display area/Auxiliary tomogram display area" on P.51.
[Utility button] Disc Topo Drusen
: Disc Segmentation : Drusen Analysis
The functions of Utility buttons correspond to those of the "Tools" menu. The functions of the "Tools" menu can be added or deleted. When the software is installed, the Utility buttons correspond to the above functions. The functions related to the Utility buttons may be changed due to the addition or deletion on the "Tools" menu.
[OD / OU / OS button] OD (R) : Right eye OU (R/L) : Both eyes OS (L) : Left eye The OD/OU/OS icons indicate the eye data displayed on the "View" screen. Moreover you can change the displayed eye data by these icons.
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2.4.3. A-3: Fundus/Anterior Segment Image Display Area Explanation of Window This window displays the fundus or anterior segment image. The positional correlation between the image on the fundus/anterior segment image display area and the tomograms on the 3D/auxiliary tomogram display areas is indicated, including the "overlay" image. For details, refer to "Pin-point Registration™" on P.72. In this chapter, the fundus image will be explained as an example. C-5: Maximize
C-6: Menu
C-7: Tomogram location indicator
C-8: 3D scanning area
C-4: Tumbnail overlay C-2: Red-free mode
C-1: Color / B/W selection
C-3: Analysis of fundus image
ID
Name
Description
C-1
Color and B/W selection
Select the color or B/W image. ("Color" is selected as default.)
C-2
Red-free mode
Shifts to the red-free image. (When a mark is placed in the check box at the right of "Red-free", the red-free image is automatically displayed in the next photography and after.)
C-3
Fundus image analysis
Shifts to the fundus image analysis screen.
C-4
Thumbnail overlay image
The images which can selected from the "overlay" menu are displayed as thumbnails.
C-5
Maximize
Maximize this sub-window to the whole screen or return to its original size.
C-6
Menu
Menu (This will be explained in "How to use the menu"on P. 41.)
C-7
Tomogram location indicator
The tomogram of the part shown by this indicator is displayed on Window A.
C-8
3D scanning area
This shows the 3D scanning area.
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How to ... Zoom In/Out of Color Fundus Images Hold down the right mouse button and drag it up/down. Move (Pan) Color Fundus Images Hold down the mouse wheel button and drag it up/down and right/left. Select the color fundus image, IR fundus image and red-free (fundus image). Click "Color Fundus", "IR Fundus" and "Red-free". Color fundus image
B/W fundus image
Red-free
Pin-point Registration™ See “Pin-point Registration™” on P. 72 for details about Pin-point Registration. Overlay function Refer to "How to use the menu" on P. 41. Grid function Refer to "How to use the menu" on P. 41. Circle function Refer to "How to use the menu" on P. 41.
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How to use the menu The menu displays up to three items, "Overlay", "Grid" and "Circle". The menu is changed depending on the scan pattern and photography mode. In the sub-menus of these three menu items, the menu is changed depending on the scan pattern and photography mode. [Overlay] When the Overlay function is used, the user can display one of the projection image, shadowgram image and Thickness Map in the overlap status with the color fundus image or B/W fundus image. Overlay image type
Meaning
Projection image
Image made by integrating the reflection strength in the Z direction of tomogram (This is valid when pressing the [Open Original] button on "OCT Data List".)
Shadowgram image
Image made by integrating 50 pixels under RPE of tomogram.
Thickness Map image
The two-dimensional map for the selected thickness. (See "A-2: Image Processing Controls area"on P. 37.)
The examples are shown below for the projection and shadowgram images.
Projection image
Shadowgram image
To access the Overlay image, click the desired image in the [Overlay] menu or click [Thumbnail overlay image]. To erase the Overlay image, press "On/Off" in the [Overlay] menu or click [Thumbnail overlay image] again.
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To rearrange the Overlay image, click [Overlay] and then [Reposition]. Place the cursor on the image. As pressing the left mouse button, drag the image to an optional position.
After rearranging the projection image (The 3D scanning area has been moved to the upper right.)
To make transparent the Overlay image, click [Overlay] while the Overlay image is on the screen and press [Transparent]. Press it again, and the image returns to its original status. The table below shows the relation between the Overlay image and the usable scan patterns. Only the Projection image is displayed for 3D Scan of anterior segment. Scan pattern
Line/ Cross/ 5Line Cross
Radial
7Line Raster/ 7Line RasterV
Projection
-
-
-
#1
-
Shadowgram
-
-
-
#2
-
Thickness Map
-
-
#2
-
Overlay image
3D/ 3D (V)
3D Wide
Circle
#1: The Overlay image can be displayed only for the original image. #2: The Overlay image can be displayed only for the analyzed image. The table below shows the relation between the Reposition and Transparent functions and the usable scan patterns. Scan pattern
Line/ Cross/ 5Line Cross
Radial
7Line Raster/ 7Line RasterV
Reposition
-
-
-
-
Transparent
-
-
-
Overlay image
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3D/ 3D (V)
3D Wide
Circle
[Grid] The Grid function displays the thickness between selected layers in each grid as the average value.(See "A-2: Image Processing Controls area"on P. 37.) The result of the comparison with normal data can also be displayed as a colormap. Grid is defined as follows. Grid type
Grid definition
Rectangular
• 10×10 grid where the length of one side is equal to 1/10 of 6mm (in "3D Vertical" scan) • 24×24 grid where the length of one side is equal to 1/24 of one side length of 3D scan area (in "3D Disc 512×128 6×6mm" scan) • 6×6 grid where the length of one side is equal to 1/6 of one side length of 3D scan area (in 3D scan except the above-mentioned scans)
ETDRS
The nine fields separated from the three concentric circles (diameter: 1, 3 and 6mm) by the ±45-degree line.
RNFL4
The area divided into four sections equally on the circumference. The circle radius can be changed by selecting "On" of [On/Off] in the [Circle] menu.
RNFL6
The area divided into six sections equally on the circumference by 45 degrees in vertical direction and by 90 degrees in horizontal direction. The circle radius can be changed by selecting "On" of [On/Off] in the [Circle] menu.
RNFL12
The area divided into twelve sections equally on the circumference. The circle radius can be changed by selecting "On" of [On/Off] in the [Circle] menu.
Circle-4
The area divided into four sections equally on the circumference. The circle radius is the scan radius.
Circle-12
The area divided into twelve sections equally on the circumference. The circle radius is the scan radius.
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The examples are shown below.
Grid - Rectangular
Grid - RNFL6
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Grid - ETDRS
Circle-4
The following tables show the correspondence between the above-mentioned grids and scan modes. Scan pattern
Line/ Cross/ 5Line Cross
Radial
7Line Raster/ 7Line RatserV
Rectangular
-
-
-
ETDRS
-
RNFL4
-
RNFL6
Function
3D
3D (V)
3D Wide
Circle
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
RNFL12
-
-
-
-
-
-
Circle-4
-
-
-
-
-
-
Circle-12
-
-
-
-
-
-
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The [Grid] menu also has the following four functions. Function
Description
Show Volume
Displays the volume of the divided area between selected layers ( See "A-2: Image Processing Controls area"on P. 37. )
Show Invariant
Displays the normalized RNFL thickness concerning the distance from the optic disc.
Show Normative
Displays the result of the comparison with Normative data on the Grid.
Reposition
Moves the Overlay image on the fundus image to an optional position.
The tables below show the relation between these functions and the usable scan patterns. Scan pattern Function
Line/ Cross/ 5Line Cross
Radial
7Line Raster/ 7Line RasterV
3D (V)
3D Wide
Circle
-
-
-
-
-
-
-
-
-
Show Volume
-
Show Invariant
-
-
-
Show Normative
-
-
-
Reposition
-
-
-
The [Grid] menu is not displayed for anterior segment.
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3D
-
Circle The Circle function can be used only in 3D scan. The Circle function is used to display the tomogram of the circle with an optional radius, whose center is set near the optic disc. (When the eye fixation is set at others except "Disc", the circle whose center is at the middle of the scan area is displayed.) Function Circle (can be used with combination of Overlay/Grid functions.)
Navigation On Click Circle.
Navigation Off To turn off the Circle function, click Circle again.
Click an optional place on Window A. You can change the radius with the mouse wheel button (scroll wheel).
CAUTION
When modifying the data in optic disc analysis (refer to "3.2. Analyzing the Optic Disc" (P.81), the circle center is calculated again.
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Disc Modify The user can modify "Disc" manually. "Disc segmentation" (refer to P.81) is recalculated according to the modified "Disc". The "Disc Modify" function can be used only when "Disc segmentation" is applied. Function
Navigation On
Navigation Off
Disc Modify (can be used with combination of "Shadowgram" of "Overlay".)
Click [Disc Modify] [Modify (Point7)] or [Modify (Point18)].
To turn off the "Disc Modify" function, use one of the following methods: • Click [Disc Modify] [Exit Modify]. • Click [Disc Modify] [Cancel]. (The difference between operations is shown below.)
Start of the "Disc Modify" mode
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Using the mouse, drag the modification point to an optional position. The modification point cannot be moved to the outside of the scan area. After dragging the modification point, the image is automatically modified so that the "Disc" edge line can pass the modification point. (The following figures are the example of "Modify (Point7)".
Drag an optional modification point.
[Disc Modify]: [Exit Modify]: [Cancel]:
After moving and dragging, modification is performed.
You can select one of "Modify (Point7)" and "Modify (Point18)". Saves the modification and exits from the "Disc Modify" mode. After finishing, the recalculation result is displayed on "Fundus". When the result is saved, it is saved in FDA. Discards the modification and exits from the "Disc Modify" mode. The check message is displayed. Press [OK]. The modification is not validated and the system returns to the status before "Disc Modify" starts.
CAUTION
When the "Basic" analysis data modified manually is analyzed again by "Fine Analysis", the data modified manually is erased and the "Disc" calculated automatically by "Fine Analysis" is applied.
CAUTION
If you want to return the data, which has been modified manually and saved, to the original status, perform "Fine Analysis" or "Basic Analysis" again. The automatically detected data can be reproduced. (The manually modified data is erased.)
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