INSTRUCTION MANUAL 3D OPTICAL COHERENCE TOMOGRAPHY

Transcription

1 INSTRUCTION MANUAL 3D OPTICAL COHERENCE TOMOGRAPHY 3D OCT-2000

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3 INTRODUCTION Thank you for purchasing the TOPCON 3D OCT D Optical Coherence Tomography. This instrument is a special photography device to observe, photograph and record the image and tomogram of fundus and to present its electronic image for diagnosis. By mounting the attachment for anterior segment, you can observe, photograph and record the image and tomogram of anterior segment. After photographing, the images and tomograms of fundus and anterior segment can be recorded in a commercial personal computer connected to this instrument, a personal computer connected through network and a commercial recording device (flash memory, hard disk, etc.) connected to this instrument. The analysis software to be installed to a personal computer is provided in order to display the threedimensional tomograms of fundus and anterior segment and to measure the quantity. Moreover, there are special cables (camera link cable and USB cable) to connect with a personal computer. This instrument has the following innovative features: High-quality digital imaging Easy operation Enhanced computerized features This manual outlines the 3D OCT D Optical Coherence Tomography, including operating procedures, troubleshooting, maintenance and cleaning. Before using the instrument, carefully read the "DISPLAY FOR SAFE USE" and the "SAFETY CAUTIONS" to familiarize yourself with the features of the TOPCON 3D OCT D Optical Coherence Tomography and to ensure that you operate it efficiently and safely. Always keep this Instruction Manual at hand. [Warning] Be careful not to hit the patient's eyes or nose with the instrument during operation. [The patient may be injured.] [Caution] 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. This symbol is applicable for EU member countries only. To avoid potential damage to the environment and possibly human health, this instrument should be disposed of (i) for EU member countries - in accordance with WEEE (Directive on Waste Electrical and Electronic Equipment), or (ii) for all other countries, in accordance with local disposal and recycling laws. CAUTION : Federal laws restricts this device to the sale by or on the order of a physician. WARNING : Handling the cord on this product or cords associated with accessories sold with this product, will expose you to lead, a chemical known to the State of California to cause birth detects or other reproductive harm. Wash hands after handling. This Product Contains Mercury in the backlighting of the LCD display. Prior to disposal remove of otherwise ensure that this is disposed of in accordance with Local, State and Federal Laws. This information is applicable in U.S.A only. This product contains a CRL Litium Battery which contains Perchlorate Material-special handling may apply. See Note;This is applicable to California,U.S.A.only CLASS IEC

4 CAUTIONS FOR USE Important cautions 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. Basic caution When operating the chin-rest up/down switch, 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. To avoid electric shock, do not open the instrument. Request service from an authorized Topcon distributor. Electric shock may cause burns or a possible fire. Turn the power switch OFF and unplug the power cord before replacing the fuses. Replace only with fuses of the correct rating. To avoid injury, do not touch the focusing knob in auto focus operation. Disposal When disposing the instrument and/or parts, follow the local regulations for disposal and recycling. ENVIRONMENTAL CONDITIONS FOR USE Temperature : 10 C - 40 C Humidity : 30% - 90% (non-condensing) Air pressure : 700hPa hPa STORING PLACE, USAGE PERIOD AND OTHERS 1. Environmental conditions for installation (without package) * Temperature : 10 C - 40 C Humidity : 10% - 95% (non-condensing) Air pressure : 700hPa hPa * THIS INSTRUMENT DOES NOT MEET THE TEMPERATURE REQUIREMENTS OF ISO FOR STORAGE. DO NOT STORE THIS INSTRUMENT IN CONDITIONS WHERE THE TEMPERATURE MAY RISE ABOVE 40 C OR FALL BELOW 10 C. 2. When storing the instrument, ensure that the following conditions are met: (1) The instrument should not be splashed with water. (2) Store the instrument away from the environment where air pressure, temperature, humidity, ventilation, sunlight, dust, salty/sulfurous air, etc. could cause damage. (3) Do not store or transport the instrument on a slope or uneven surface or in an area where it is subject to vibrations or instability. (4) Do not store the instrument where chemicals are stored or gas is generated. 3. Usage period 8 years from delivery providing regular maintenance is performed (according to the self-certification [Topcon data]) 2

5 ENVIRONMENTAL CONDITIONS FOR PACKAGING IN STORAGE Temperature : -20 C - 50 C Humidity : 10% - 95% ENVIRONMENTAL CONDITIONS FOR PACKAGING IN TRANSPORTATION Temperature : -40 C - 70 C Humidity : 10% - 95% CHECKPOINTS FOR MAINTENANCE 1. Periodically inspect the instrument and its parts. 2. Before using the instrument after a long period of inactivity, make sure that it operates safely and normally. 3. Be careful not to stain the objective lens with fingerprints, dirt, etc., as this will affect the quality of pictures. 4. When the instrument is not in use, cap the objective lens and apply the dust cover to the instrument. 5. If the objective lens is stained, clean it according to "Cleaning the objective lens" in this manual. 3

6 DISPLAY 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 instruction manual. We suggest that everyone understand the meaning of the following displays, icons and text before reading the "SAFETY CAUTIONS" and observe all listed instructions. DISPLAYS 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. ICONS 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. 4

7 SAFETY CAUTIONS WARNINGS Icon Prevention item Page 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. To avoid electric shock, do not attempt disassembling, rebuilding and/or repairs on your own. Ask your dealer for repairs. Do not remove the covers from the main unit, chin-rest unit or power supply unit except for the lamp house cover. You may receive an electric shock. Do not remove the covers from the main unit except for the lamp house cover. Your eye or skin may be exposed to the laser radiation. To avoid electric shock, be sure to remove the power cord from the instrument body before removing the fuse cover. Also, do not connect the power cord to the instrument body with the fuse cover left open. To avoid fire, use a properly rated fuse (Europe: 110/120V T 5A 125V, 230/240 T 2.5A 250V Outside Europe: 100/110/120V T 5A 125V, 220/230/240V T 2.5A 250V) which matches the display provided on the fuse holder. 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 electric shock, do not insert metal objects into any vents and/or slots. 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. Ask your dealer for repairs

8 SAFETY CAUTIONS CAUTIONS Icon Prevention item Page To prevent the instrument from falling and to avoid injury, install the instrument on a level surface. 29, 95 To avoid electric shock, do not handle the plugs with wet fingers. After turning on the power, do not press the shutter button of the digital camera. Each time you press the shutter button, the image is saved in the digital camera. Then, the image is displayed as the color fundus image that should be obtained by photographing the patient's eye on the 3D OCT To avoid discomfort to the patient, do not brighten the illumination lamp more than necessary To avoid discomfort to the patient, do not brighten the photography light more than necessary. 57 To avoid injury, do not place your fingers into the gap between the instrument body and the power supply unit. 59 To avoid electric shock and burns, do not replace the lamp by yourself. Ask your dealer for repairs. To avoid damage to the instrument or injury due to an electric shock, turn off the power switch and remove the power cord before cleaning the instrument

9 SAFETY CAUTIONS CAUTIONS Icon Prevention item Page To prevent the instrument from falling and to avoid injury during carrying, be sure to secure the instrument with the fixing 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. 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. When moving the chin-rest up and down, be careful not to pinch the patient's hand to avoid possible injury. 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. 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. Do not put any substance over the vent on the top surface of the power supply unit. If the vent is covered with something, 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. This instrument has been tested (with 120V/230V) and found to comply with IEC Ed.3: 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 ,

10 USAGE AND MAINTENANCE USAGE The 3D OCT D Optical Coherence Tomography is an electric instrument for medical use. Use this instrument under a doctor's guidance. 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. Replacing fuses: The fuses on the instrument body may be replaced by the user. For details, see "CHANGING THE FUSE" on page 97. Cleaning the objective lens: The objective lens may be cleaned by the user. For details, see "CLEANING THE OBJECTIVE LENS" on page 100. 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 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. 8

11 WARNING DISPLAYS AND POSITIONS 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. To avoid injury, do not touch the focusing knob in auto focus operation. CAUTION When operating the chin-rest up/down switch, be careful not to pinch the patient's hand to avoid possible injury. CAUTION To avoid potential injury during operation, do not touch the patient's eyes or nose with the instrument. Do not put any substance over the vent on the top surface of the power supply unit. If the vent is covered with something, 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. WARNING To avoid electric shock, do not open the instrument. Request service from an authorized Topcon distributor. CAUTION 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. CAUTION-CLASS 3B LASER RADIA- TION WHEN OPEN AVOID EXPOSURE TO THE BEAM. WARNING Electric shock may cause burns or a possible fire. Turn the power switch OFF and unplug the power cord before replacing the fuses. Replace only with fuses of the correct rating. 9

12 CONTENTS 10 INTRODUCTION...1 CAUTIONS FOR USE...2 ENVIRONMENTAL CONDITIONS FOR USE...2 STORING PLACE, USAGE PERIOD AND OTHERS...2 ENVIRONMENTAL CONDITIONS FOR PACKAGING IN STORAGE...3 ENVIRONMENTAL CONDITIONS FOR PACKAGING IN TRANSPORTATION...3 CHECKPOINTS FOR MAINTENANCE...3 DISPLAY FOR SAFE USE...4 DISPLAYS...4 ICONS...4 SAFETY CAUTIONS...5 SAFETY CAUTIONS...6 SAFETY CAUTIONS...7 USAGE AND MAINTENANCE...8 USAGE...8 USER MAINTENANCE...8 ESCAPE CLAUSES...8 WARNING DISPLAYS AND POSITIONS...9 COMPONENTS...12 COMPONENT NAMES...12 COMPOSITION OF PARTS WHICH CONTACT THE HUMAN BODY...12 CONTROL PANEL COMPONENTS...13 SCREEN LAYOUT...14 STANDARD ACCESSORIES...28 PREPARATIONS...29 INSTALLING THE INSTRUMENT...29 INSTALLING THE DIGITAL CAMERA...30 HOW TO CONNECT THE CABLES...30 CONNECTING THE POWER CORD...31 CONNECTING THE EXTERNAL DEVICE...32 SETTING MENU...33 RESET FROM POWER SAVE STATE...50 BASIC OPERATIONS...51 FLOW OF OPERATION...51 PREPARATION FOR PHOTOGRAPHY...52 FUNDUS TOMOGRAPHY...54 ANTERIOR SEGMENT TOMOGRAPHY...67 COLOR FUNDUS PHOTOGRAPHY...73 PREVIEW SCREEN...76 DISPLAY FORM OF PREVIEW SCREEN...77 SAVING DATA...80 PRINTING DATA...80 HOW TO FINISH...80 BEFORE REQUESTING SERVICE...81 TROUBLESHOOTING...81 SPECIFICATIONS AND PERFORMANCE...85

13 SYSTEM DIAGRAM...85 SPECIFICATIONS...86 OTHER SPECIFICATIONS...87 ELECTROMAGNETIC COMPATIBILITY...88 Requirements for the EXTERNAL DEVICE...91 PATIENT S ENVIRONMENT...92 SPECIFICATIONS OF THE PERSONAL COMPUTER (COMMERCIAL PRODUCT) TO BE CONNECTED...92 ELECTRIC RATING...93 SYSTEM CLASSIFICATION...93 DIMENSIONS AND WEIGHT...93 INTENDED USE...94 OPERATION PRINCIPLE...94 MAINTENANCE...95 DAILY CHECKUPS...95 ORDERING CONSUMABLES...95 REPLACING THE ILLUMINATION LAMP...96 REPLACING THE XENON LAMP...96 CHANGING THE FUSE...97 REFILLING THE CHIN-REST PAPER SHEET...98 ADJUSTING THE MONITOR...98 MAINTENANCE BY THE DEALER...98 CLEANING...99 CLEANING THE EXTERNAL COVER, CONTROL PANEL AND OTHERS...99 CLEANING OF THE PARTS WHICH COME INTO CONTACT WITH THE PATIENT...99 CLEANING THE MONITOR SCREEN...99 CLEANING THE OBJECTIVE LENS REFERENCE MATERIAL TYPE OF PLUG SYMBOL RELATION BETWEEN THE SETTING OF THE ILLUMINATION/FLASH LEVEL AND MAXIMUM RADIANCE INFORMATION ABOUT THE OPTICAL RADIATION HAZARD FOR THE USER END USER LICENSE AGREEMENT

14 COMPONENTS COMPONENT NAMES External fixation target Main unit Diopter compensation lens selector Focusing knob Brightness volume IR filter selector Base brake knob Control panel External connection terminal (left side) Main unit external cover Monitor Photography switch Control lever Vertical position mark Power lamp Sliding board Power supply unit Fixing knob (for carrying) Forehead rest Canthus marker Forehead rest base Objective lens Chin-rest unit Chin-rest paper pin Chin-rest Lamp house cover screw Lamp house cover Power switch Fuse holder External connection terminal (right side) COMPOSITION OF PARTS WHICH CONTACT THE HUMAN BODY Forehead rest : Silicone rubber Chin-rest : Acrylonitrile butadiene styrene resin Chin-rest paper sheet : Paper 12 COMPONENTS

15 CONTROL PANEL COMPONENTS Base brake knob Chin-rest up/down switch Photography switch Internal fixation target position move switch (Up/Down/Left/Right/Reset) Power lamp Chin-rest up/down switch: Adjusts the chin-rest up/down movement. Internal fixation target position move switch: Adjusts the internal fixation target position finely. Power lamp: Displays "power ON" (this lamp is ON) and "power OFF" (this lamp is OFF). Photography switch: Starts photography. Base brake knob: Locks and unlocks the base. 13 COMPONENTS

16 SCREEN LAYOUT Display areas and functions of monitor screen The monitor screen is a touch panel. The monitor displays information, and you can perform a variety of operations by touching its screen. For the details of the monitor screen, refer to the page relevant to each area. Area 1 Area 2 Area 3 Area 4 Area 5 OCT live image area Fundus/anterior segment live image area Area 1...Displays the ID of the patient. (Refer to P.15.) Area 2...Displays the scan modes. You can change the modes. (Refer to P.15.) Area 3...Displays each scan pattern (icon) corresponding to the scan mode selected in Area 2. You can change the scan patterns. (Refer to P.16.) Area 4...Changes the small pupil diaphragm, the internal fixation target and others. (Refer to P.18.) Area 5...Displays the message corresponding to the current status. (Refer to P.21.) Tomogram live image area... Displays the tomogram live image. Perform the operation on the live image. (Refer to P.22.) Fundus/anterior segment live image area...displays the fundus or anterior segment live image and the graphic image of the selected scan pattern with an interrupted line. Displays the right/left eye, flash level and illumination level around the live image. You can adjust the flash level and illumination level by the touch panel. (Refer to P.24.) Displays the scan position adjustment range and the fine adjustment buttons in the scan position adjustment mode. You can adjust the scan position by the touch panel. (Refer to P.55.) 14 COMPONENTS

17 Area 1 Area 1 displays the ID of the patient. Patient icon Patient ID Area 2 In Area 2, you can access a desired scan mode, the fundus photography mode and the setting menu. Scan mode setting button Setting menu button Fundus photography button Scan mode setting button...displays all the scan modes. You can change to a desired scan mode. The selected scan mode is highlighted. Macula Shifts to the scan mode which regards macula as the center. Glaucoma Shifts to the scan mode applicable to the glaucoma diagnosis with the optic disc as the center. Anterior Seg. Shifts to the mode to scan the anterior segment. Fundus photography button. Shifts to the mode which performs only color fundus photography without tomography. Setting menu button...shifts to the setting menu. (Refer to P.33.) 15 COMPONENTS

18 Area 3 Area 3 displays each scan pattern (total three types) corresponding to the scan mode selected in Area 2 by icon. You can access a desired scan pattern. The selected scan pattern is highlighted. Macula In the macula photography mode, the following scan patterns are set as default. In the setting menu, the setting of these scan patterns can be changed in turn from the left by setting items for "Macula1", "Macula2" and "Macula3". The "Circle" scan pattern cannot be selected. (Refer to P.33.) Scan Pattern : Cross Scan Size : 6mm Scan Resolution : 1024 Over Scan Count : 4 Fixation Position : Macula Scan Pattern : 7Line Raster Scan Size : 6mm Scan Resolution : 4096 Over Scan Count : None Fixation Position : Macula Scan Pattern : Radial Scan Size : 6mm Scan Resolution : 1024 Over Scan Count : None Fixation Position : Macula Glaucoma In the glaucoma mode, the following scan patterns are set as default. In the setting menu, the setting of these scan patterns can be changed in turn from the left by setting items for "Glaucoma1", "Glaucoma2" and "Glaucoma3". (Refer to P.33.) Scan Pattern : Line Scan Size : 6mm Scan Resolution : 1024 Over Scan Count : 4 Fixation Position : Disc Scan Pattern : Circle Scan Size : 3.4mm Scan Resolution : 1024 (Fixed) Over Scan Count : None Fixation Position : Disc Scan Pattern : 3D Scan Size : 6 6mm Scan Resolution : Over Scan Count : None Fixation Position : Disc 16 COMPONENTS

19 Anterior Seg. In the anterior segment photography mode, the following scan patterns are set as default. In the setting menu, the setting of these scan patterns can be changed in turn from the left by setting items for "Anterior Seg.1", "Anterior Seg.2" and "Anterior Seg.3". For the scan pattern, select one of "Line", "Radial" and "3D". (Refer to P.33.) Scan Pattern : Line Scan Size : 6mm Scan Resolution : 1024 Over Scan Count : 4 Fixation Position : External fixation target Scan Pattern : Radial Scan Size : 6mm Scan Resolution : 1024 Over Scan Count : 4 Fixation Position : External fixation target Scan Pattern : 3D Scan Size : 6 6mm Scan Resolution : Over Scan Count : None Fixation Position : External fixation target 17 COMPONENTS

20 Area 4 In Area 4, set or change the small pupil diaphragm and the internal fixation target and adjust the scan position. Set or change data with the buttons. Small pupil diaphragm selector button Internal fixation target shape selector button Internal fixation target position selector button Scan position adjustment mode button Optic disc auto search button Small pupil diaphragm selector button Displays the small pupil diaphragm status (ON/OFF). You can change ON/OFF of the small pupil diaphragm. When the pupil diameter of the patient is small (pupil diameter is approx. φ4.0mm or less), set to ON and take a picture. (Refer to P.60.) Only when the fundus photography mode is selected, the automatic small pupil (diaphragm) function is used. While this function is working, the small pupil diaphragm is automatically set to ON and the instrument takes a color picture of fundus if the pupil diameter is small (pupil diameter is approx. φ4.0mm or less). After taking a picture, it is set to OFF. In the fundus photography mode, it is not necessary to set the small pupil diaphragm to ON with this button even if the pupil diameter is small. 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 Internal fixation target position selector button Displays the current internal fixation target position. You can select the internal fixation target position among the following four positions by pressing this button. 18 COMPONENTS 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. External fixation target (graphic image): The internal fixation target is OFF and the external fixation target is ON. You can set a desired position by moving the external fixation target position. In the scan mode for the anterior segment photography, all the buttons are not displayed from time to time. Moreover, in the scan modes for macula photography and glaucoma, the buttons are displayed in gray unclearly depending on the scan pattern set status. Under this condition, you cannot set or change the data.

21 Scan position adjustment mode button The scan position adjustment mode is accessed. The selected scan pattern, the scan position adjustment range, the scan possible range (only in "Cross" and "Radial" scan), the fine adjustment buttons, the reset button (except when the optic disc auto search function is ON in "Circle" scan), the optic disc auto search effective range and OK button (only when the optic disc auto search function is ON in "Circle" scan, for both the range and button) are displayed in the fundus/anterior segment live image area. When you want to change manually the circle scan position that is automatically detected by the optic disc auto search function to the desired position, use this scan position adjustment mode button. Fine adjustment button (up) Scan pattern display (green and yellow) Fine adjustment button (left) Reset button *Displayed in others except Circle scan. Scan possible range (red) * Displayed only in Cross/Radial scan. Scan position adjustment range (blue) Fine adjustment button (right) Fine adjustment button (down) Line scan Rotation button (counterclockwise) * Displayed only in Line scan. Rotation button (clockwise) * Displayed only in Line scan. Circle scan OK button * Displayed only when the optic disc auto search function is ON in "Circle" scan. Optic disc auto search effective range (red) * Displayed only when the optic disc auto search function is ON in "Circle" scan. 19 COMPONENTS

22 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. (The arrow direction for the right eye is reversed for the left eye.) The yellow line is displayed for the scan patterns except "Line" and "Circle". 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. 3D Line Circle Cross Scan position adjustment range (blue) Displays the "6.0mm 6.0mm" range at the focal point on fundus. Touch this range, and the scan position is moved to the touched point. For the "Cross" and "Radial" scan patterns, the intersection (center of the displayed scan pattern) of lines is the limit of the movable range. For other scan patterns, the edge position of lines is the limit of the movable range. In the case of the tomogram within the "6.0mm 6.0mm" range, you can get the output sensitivity enough. Scan possible range (red) Displayed only for "Cross" and "Radial" scan patterns. This range shows the "12.0mm 12.0mm" range on fundus. This is the limit range where you can get a tomogram by using this instrument. If a tomogram exceeds the "6.0mm 6.0mm" range indicated by the blue line, you cannot always get the sufficient output sensitivity because the pupil and others obstruct the photography. 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. Reset button Displayed only for others except "Circle" scan. Returns the scan position to the center of the scan position adjustment range (blue). Rotation buttons (clockwise/counterclockwise) Displayed only for "Line" scan. Each time you touch these buttons, the scan line is rotated by 5 in the arrow direction. OK button Displayed only in "Circle" scan of glaucoma mode. Press this button after adjusting the scan position to exit from the scan position adjustment mode. * The circle scan position after adjusting (the circle scan position before pressing the [OK] button) is stored while you are taking pictures with the same patient ID. If you take a picture with other patient ID or exit from the photography mode ([Capture Data] mode), the stored circle scan position is automatically cleared and the scan position is reset to the default. 20 COMPONENTS 7Line Raster 7Line Raster (V) Radial

23 * When you want to return the scan position to the original position after adjusting it, do not press the [OK] button but press one of the scan pattern icons, which are displayed in Area 3 of the monitor screen, to exit from the scan position adjustment mode. If you have already exited from the scan position adjustment mode by pressing the [OK] button, you need to perform any of the following procedures: You should shift to the photography with the other patient ID or exit from the photography mode ([Capture Data] mode) and return the scan position to the default. You should access the scan position adjustment mode again and readjust the scan position to the desired one. Optic disc auto search effective range (red) Displayed only when the optic disc auto search function is ON in "Circle" scan of glaucoma mode. This indicates the "4.0mm 4.0mm" range at the focal point on fundus. Use this range to adjust the "Circle" scan position manually to the optic disc center. To put the patient's optic disc into this range, move the fixation position (move the optic disc) by the internal fixation target position move switch on the control panel. Then, adjust the circle scan position so that the circle center may be aligned with the optic disc center. By adjusting the "Circle" scan position to put the optic disc into this range, the optic disc is automatically detected by the optic disc auto search function thereafter. Optic disc auto search button This button can be set to ON/OFF only in "Circle" scan of glaucoma mode. When this button is set to ON, the optic disc position is automatically tracked and detected. Even if the optic disc moves slightly due to the minute fixation move, you can always perform "Circle scan" with the optic disc as the center. Sometimes the optic disc cannot be automatically detected due to the optic disc shape of the patient or the image contrast. In this case, follow the countermeasure (search OFF or manual set), which is displayed with the error message, and perform photography again. For details of the countermeasure (search OFF or manual set), refer to "MEMO" on page 65. Area 5 Area 5 displays the message corresponding to the current status. This area displays mainly the messages for the current processing and for the operation guide. Message for the current processing When a message for the current processing is displayed, wait until the message disappears. Message for the operation guide When a message for the operation guide is displayed, operate the instrument according to the message. 21 COMPONENTS

24 Tomogram live image area This area displays the tomogram live image. Perform the operation on the live image. Z lock position display bar Warning line (orange) for the tomogram display position Z lock position Live image [Optimize] button [Image Quality] level meter Image Quality value (IQF) Z lock position : Displays the center position of the displayed tomogram. After the processing of "Auto Z", "Auto Z Lock" and "Auto Polarization", this is always displayed on the 2/3 position on the bar. In the scan mode for the anterior segment photography, all the auto functions are invalidated and the Z lock position is not displayed. Instead of the Z lock position, the frame (fixed) indicating the optimal display position for the photographed part appears. Optimal display position frame 22 COMPONENTS

25 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. Image Quality value (IQF) : Displays the "Image Quality" level with a value. * In the scan mode for the anterior segment photography, the Image Quality value is not displayed. Image Quality value (IQF) is the image quality evaluation standard peculiar to TOPCON. IQF shows the image quality of the tomograms obtained by 3D OCT-2000 with a value quantitatively. When you need a tomogram applicable to image analysis or other processing, IQF must be 45 or higher. If IQF is 45 or higher, the tomogram has a proper image quality. If IQF is 70 or higher, the tomogram has an excellent image quality. If IQF is less than 45, 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. [Image Quality] level meter Live image [Optimize] button Warning line (orange) for the tomogram display position : Displays the "Image Quality" level with meter. * In the scan mode for the anterior segment photography, the [Image Quality] level meter is not displayed. : Displays the live tomogram image. In the scan mode for the macula photography and glaucoma, the live image is displayed in color. In the scan mode for the anterior segment photography, it can be displayed not in color but also monochrome. "Monochrome display" is initially set. : Starts "Auto Z", "Auto Z Lock" and "Auto Polarization" and detects the retina position automatically. Then, this button optimizes the image output sensitivity to display a clear tomogram. * In the scan mode of the anterior segment photography, all the auto functions are invalidated and so the [Optimize] button is not displayed. : This is displayed when part of the tomogram overlaps the top edge of the tomogram live image area. If you take a picture in the condition that this line (orange) is displayed, analysis after photographing may not be successful. Therefore, lower the Z lock position until this line disappears. Then, take a picture. * In the scan mode of the anterior segment photography, if the tomogram is displayed within the optimal display position frame and then you take a picture, analysis is successful. So, the warning line (orange) is not displayed. 23 COMPONENTS

26 Fundus/anterior segment live image area This area displays the fundus or anterior segment live image, the right/left eye, flash level and illumination level and besides, the graphic image of the selected scan pattern with an interrupted line. You can adjust the set data of the flash level and illumination level by the touch panel. Only when the optic disc auto search function is ON in "Circle" scan of glaucoma mode, the range frame where the optic disc can be automatically tracked (optic disc tracking frame) is displayed. In the scan position adjustment mode, the selected scan pattern is displayed with a solid line, and the scan position adjustment range and fine adjustment buttons are displayed. You can adjust the scan position by the touch panel. Right/left eye display Scan pattern display (green and yellow) * Interrupted line Live image Illumination level display Flash level display Live image: Displays the fundus or anterior segment live image. Scan pattern display (green and yellow): Displays the graphic image of the selected scan pattern. 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 patterns except "Line" and "Circle". 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 Line Circle Cross 24 COMPONENTS 7Line Raster 7Line Raster (V) Radial

27 Right/left eye display: In the case of left eye, "L" is displayed at the upper right position of the live image. In the case of right eye, "R" is displayed at the upper left position. Flash level display: Displays the flash level (compensation value) by -4 to +4. ±0 is not displayed. You can adjust the flash level by touching the screen. (Refer to P.57.) While the xenon lamp power supply is being charged, the icon blinks. After charging has been finished, it is lit. Illumination level display: Displays the illumination level (level) by five steps. You can adjust the illumination level by touching the screen. (Refer to P.57.) Optic disc tracking frame (blue) Displayed only when the optic disc auto search function is ON in "Circle" scan of glaucoma mode. This frame shows the optic disc auto search possible range. Put the patient's optic disc into this frame by operating the internal fixation target position move switch on the control panel. So, the optic disc auto search function works to detect the optic disc automatically. Optic disc tracking frame (blue) 25 COMPONENTS

28 Menu screen On this screen, set a variety of data for this instrument. Press the SETTING MENU BUTTON in Area 2, and this screen appears. Function button Page number Page name Utility button Page Page forward/backward button Item button Item value display area Item value selector button Function button... Decides and cancels the setting. Page... The whole setting display area under the function buttons is called "Page". Page name... This is the name of the current page (object of setting). Page number... Displays the current page's number in the page order. Page forward/backward button... Shifts to other pages. Utility button... Displays the objective items of setting in the page. Select the desired item. Item button... Displays the objective items of setting in the utility button. Select the desired item. Item value display area... Displays the current set status of the item buttons. Item value selector button... Displays the items to be set for each item button. Select the desired item. 26 COMPONENTS

29 Outline of operation on the menu screen Press the PAGE FORWARD/BACKWARD BUTTON to select a page. 2 Press the UTILITY BUTTON to select the desired utility. 3 Press the ITEM BUTTON to select the desired item. 4 Press the ITEM VALUE SELECTOR BUTTON to select the item value. 5 Press the OK BUTTON among the function buttons to decide the item value. When you press the CANCEL BUTTON, the value before selection is set again. 27 COMPONENTS

30 STANDARD ACCESSORIES Upon unpacking, make sure that all the following standard accessories are included. Figures in ( ) are the quantities. Power cord (1) Fuses (6) Chin-rest paper sheet (1) External fixation target (1) Monitor cleaner (1) Instruction manual (for main unit/software), Unpacking and assembly manual (1 each) and DVD for analysis software (1) INSTURUCTION MANUAL 3D OPTICAL COHERENCE TOMOGRAPHY 3D OCT-2000 Software Kit 3D OCT-2000 Software Kit Setup Disk Dust cover (1) Spare parts case (1) Chin-rest paper pins (2) USB cable (1) Rail covers (2) Phillips screwdriver (1) Camera link cable (1) Attachment for anterior segment (1) 28 COMPONENTS

31 PREPARATIONS INSTALLING THE INSTRUMENT CAUTION CAUTION CAUTION To prevent the instrument from falling and to avoid injury during carrying, be sure to secure the instrument with the fixing 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. 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. CAUTION To prevent the instrument from falling and to avoid injury, install the instrument on a level surface. 1 Fasten the fixing knob. 2 Firmly hold the instrument body at the specified positions, and put it on the automatic instrument table. Holding positions Fixing knob Holding the instrument body 3 After installing the instrument, fully loosen the fixing knob. The instrument body is free to move. 4 If the instrument body is slightly unlevel, fine-adjust the height by properly operating the four adjusters. Do not extend the adjuster past 1cm. Adjuster 29 PREPARATIONS

32 INSTALLING THE DIGITAL CAMERA 1 Remove the cap from the digital camera to be installed. 2 Align the positioning mark of the instrument with the mark on the digital camera's mount. 3 Turn the digital camera clockwise until a "click" is heard. When taking out the digital camera from the instrument, turn the digital camera counterclockwise while pressing its lens lock release button. For some types of the digital cameras to be installed, a mount conversion adapter or tele converter is necessary. HOW TO CONNECT THE CABLES Connect the cables for the digital camera, which come out of the instrument. USB terminal Remote cord connection terminal Synchro terminal DC input terminal When connecting the cables, refer to the instruction manual of the digital camera. If you have a question about the digital camera, contact your dealer or TOPCON (listed on the back cover). 30 PREPARATIONS

33 CONNECTING THE POWER CORD 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. 1 Make sure that the POWER SWITCH of the instrument body is OFF ( ). 2 Attach the power cord to the instrument body. 3 Plug the power cord into the 3-pin plug AC receptacle. 31 PREPARATIONS

34 CONNECTING THE EXTERNAL DEVICE NOTE Use the external device complying with IEC60950/IEC or UL60950/UL For details about connecting the external devices, contact your dealer or TOPCON (see the back cover). The connection terminals for external devices are arranged at the right and left of the base unit. External connection terminals (Right side) USB terminal 2 USB terminal 3 USB terminal 1 External connection terminals (Left side) Digital video terminal Trigger terminal LAN terminal USB terminal 4 Video terminal Connecting to the monitor 1 Connect the VGA cable from the monitor to the Video terminal of the instrument. Connecting to the external memory 1 Connect the external memory such as the USB storage to the USB terminals 1-3 of the instrument. Connecting to the printer 1 Connect the USB cable from the printer to the USB terminals 1-3 of the instrument. 2 Connect the Trigger communication cable from the printer to the Trigger terminal of the instrument. Connecting to a personal computer 1 Connect the USB terminal 4 of the instrument to the personal computer through the USB cable, which is the accessory of the instrument. 2 Connect the digital video terminal of the instrument to the personal computer with the camera link cable, which is the accessory of the instrument. You must install the analysis software, which is the accessory of the instrument, to the connected personal computer. Connecting to LAN This instrument can be connected to Local Area Network through the LAN terminal. 1 Connect the LAN cable from the Network to the LAN terminal of the instrument. 32 PREPARATIONS

35 SETTING MENU On the setting menu screen, you can set a variety of data. Preparation for setting 1 Check the power cord connection. For details about the connection, see "CONNECTING THE POWER CORD" on page Turn the POWER SWITCH ON (I). Displaying the setting menu screen 1 Check the monitor screen. 2 Press the SETTING MENU BUTTON in Area 2. Setting menu button Area 2 Check the setting menu screen. Returning to the Monitor screen 1 Press the CANCEL BUTTON. 33 PREPARATIONS

36 PAGE 1/PAGE 2: Scan Setting On the "PAGE 1" and "PAGE 2" screens, set scanning. For the outline about the operation of the menu screen, refer to "Menu screen" on page 26. PAGE 1: Initial screen 34 PREPARATIONS

37 On PAGE 1, the items shown in the following table are assigned to the buttons on each layer. Page name Utility button Item button Remarks At shipment Scan Set1 Default Default Scan Mode This is the scan mode selected on the initial screen when the power is ON. (Note 1) Glaucoma Macula1 Macula2 Macula3 Glaucoma1 Glaucoma2 Scan Pattern Count: Macula The count of the selectable scan patterns when the "Macula" mode is selected Scan Pattern Count: Glaucoma The count of the selectable scan patterns when the "Glaucoma" mode is selected Scan Pattern Count: Anterior Seg. The count of the selectable scan patterns when the "Anterior Seg." mode is selected. Default Scan Pattern: Macula This scan pattern is set as default when the "Macula" mode is selected. Default Scan Pattern: Glaucoma This scan pattern is set as default when the "Glaucoma" mode is selected. Default Scan Pattern: Anterior Seg. This scan pattern is set as default when the "Anterior Seg." mode is selected. This is one of the scan patterns which can be selected in the "Macula" mode. (It is displayed at the left end in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. This is one of the scan patterns which can be selected in the "Macula" mode. (It is displayed at the center in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. This is one of the scan patterns which can be selected in the "Macula" mode. (It is displayed at the right end in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. This is one of the scan patterns which can be selected in the "Glaucoma" mode. (It is displayed at the left end in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. This is one of the scan patterns which can be selected in the "Glaucoma" mode. (It is displayed at the center in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. (Note 2) Max. 3 (Note 2) Max. 3 (Note 2) Max. 3 Note 1 : You can select "Macula", "Glaucoma", "Anterior Seg." and "Fundus Photo". Note 2 : The displayed button quantity is changed depending on the registration count. (For details, refer to the next page.) Macula1 Glaucoma1 Anterior Seg.1 Refer to P.49. Refer to P.49. Refer to P.49. Refer to P.49. Refer to P PREPARATIONS

38 Scan Pattern Count: Glaucoma 3 The "Glaucoma 3" button is displayed. Scan Pattern Count: Glaucoma 2 The "Glaucoma 3" button is not displayed. 36 PREPARATIONS

39 PAGE 2: Initial screen On PAGE 2, the items shown in the following table are assigned to the buttons on each layer. Page name Utility button Item button Remarks At shipment Scan Set2 Glaucoma3 This is one of the scan patterns which can be selected in the "Glaucoma" mode. (It is displayed at the right end in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. Refer to P.49. Anterior Seg.1 This is one of the scan patterns which can be selected in the "Anterior Seg." mode. (It is displayed at the left end in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. Anterior Seg.2 This is one of the scan patterns which can be selected in the "Anterior Seg." mode. (It is displayed at the center in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. Anterior Seg.3 This is one of the scan patterns which can be selected in the "Anterior Seg." mode. (It is displayed at the right end in Area 2 of the monitor screen.) For details of the item buttons, refer to "Scan setting" on page 42. Fundus Photo Eye Fixation Select the fixation position in the fundus photography mode. Image size Select the size for the photographed color fundus image. Center Disc Macula L ( ) M ( ) S ( ) Refer to P.49. Refer to P.49. Refer to P.49. You can set the size of the photographed color fundus image only in the fundus photography mode. In other scan modes, "S" ( ) is fixed as the image size. 37 PREPARATIONS

40 PAGE 3: Photography Setting On the "PAGE 3" screen, set the photography information. For the outline about the operation of the menu screen, refer to "Menu screen" on page 26. PAGE 3: Initial screen On PAGE 3, the items shown in the following table are assigned to the buttons on each layer. Page name Utility button Item button Item selector button Picture Inf. Fixation Set Retina Photography Type: Changes lighting/blinking of the internal fixation target. Speed Normal (Hz) This is valid when the internal fixation target is set to "FLICKERING" (Blinking). Set the blinking speed for other status except when photographing. Speed Measure (Hz) This is valid when the internal fixation target is set to "FLICKERING" (Blinking). Set the blinking speed for photographing. FLASH LEVEL: Sets the reference value of the compensation value for flash level. BLINK DETECT LEVEL If the patient blinks when taking a color picture of fundus, the blink detection function stops photographing. For this function, set the detection sensitivity level. CONSTANT (Lighting) FLICKERING (Blinking) At shipment (Note) OFF LOW NORMAL Note : When "0" is set at shipment, the maximum radiance is 35% and the light intensity level is 9.4W s. Refer to "RELATION BETWEEN THE SETTING OF THE ILLUMI- NATION/FLASH LEVEL AND MAXIMUM RADIANCE" on page PREPARATIONS

41 Page name Utility button Item button Item value selector button D90 Initial value Picture Inf. Set CAMERA Image quality JPEG Basic JPEG Nomal JPEG Fine Chroma Auto Profile emphasis Auto Gradation Auto Color space srgb AdobeRGB Hue Brightness PREPARATIONS

42 Page 4: Auto Operation On the "PAGE 4" screen, set the Auto functions. For the outline about the operation of the menu screen, refer to "Menu screen" on page 26. In the anterior segment photography mode, all the auto functions are invalidated (OFF). PAGE 4: Initial screen 40 PREPARATIONS

43 On PAGE 4, the items shown in the following table are assigned to the buttons on each layer. Page name Utility button Item button Auto Operation Focus Sets the focus automatically. Shoot This function is usable only in the fundus photography mode. Put the alignment bright spot, which has been changed to one spot in the focusing status, into ( ). The instrument takes a color picture of fundus automatically even if you do not press the photography switch. Small Pupil (Diaphragm) This function is usable only in the fundus photography mode. When the pupil diameter of the patient is small (pupil diameter is approx. φ4.0mm or less), the small pupil diaphragm is automatically set and the instrument takes a color picture of fundus. After taking a picture, the small pupil diaphragm is automatically removed. When you set the small pupil diaphragm selector button to "ON" on Area 4 of the monitor screen, the above automatic setting is not done. Auto Z (Z Lock) Detects the retina position automatically, and always displays the fundus tomogram clearly during observation. (After displaying, the photographed fundus image is automatically fixed.) Auto Pola (Auto Polarization) Adjusts the output sensitivity of the fundus tomogram to the optimum automatically. Auto Search This function is usable only in "Circle scan" of glaucoma mode. Detects and tracks the optic disc position automatically. Even if the optic disc moves slightly due to the minute fixation move, it is always possible to perform "Circle scan" with the optic disc as the center. ON/OFF ON/OFF ON/OFF ON/OFF Z Lock After Auto Z ON/OFF ON/OFF Item selector button OFF ON OFF ON OFF ON OFF ON OFF ON OFF ON OFF ON At shipment 41 PREPARATIONS

44 Scan setting Scan setting item buttons (1) Scan Pattern Scan pattern means the shape or kind to be scanned. It is classified into the following seven kinds. However, in the scan mode for the anterior segment photography, only three scan patterns, "Line", "3D" and "Radial" can be used. Line: Scans linearly. Circle: Scans circumferentially. 3D: You can scan the set range (Scan Size) with the set resolution (Scan Resolution) and display the scanned object as a stereograph. Radial: Scans radially with the set radial lines (Radial Scan Count). Cross: Scans in a horizontal or vertical cross shape. 7Line Raster: Scans horizontally with seven lines at regular intervals (Raster Scan Step). 7Line Raster (V): Scans vertically with seven lines at regular intervals (Raster Scan Step). Selectable scan pattern When you set the scan pattern, the following icons are displayed in Area 3 of the monitor screen. Line Circle 3D Radial Cross 7Line 7Line (V) 42 PREPARATIONS

45 (2) Scan Size "Scan Size" means the length or range to scan. The selectable scan size is changed according to the scan pattern. For details, refer to "Setting the scan protocol" on page 48. (3) Scan Resolution "Scan Resolution" means the data quantity to be read by scanning. In the "Line", "Radial", "Cross", "7Line Raster" and "7Line Raster (V)" scan, it is the data for one line. In the "Circle" scan, it is the data for one circumference. In the "3D" scan, it is the data for each side of "Length Breadth". As the scan resolution is higher, a more detailed tomogram can be obtained and at the same time the data quantity is increased. So, it takes a longer time to process the read data and the saved data are increased. The selectable scan resolution is changed according to the scan pattern and scan size. For details, refer to "Setting the scan protocol" on page 48. (4) Over Scan Count "Over Scan Count" means the following function: The data are read several times at one position for one scanned line. Two or more tomograms at one position are obtained and are displayed in the overlapped status. Consequently the tomogram with better contrast than usual can be obtained. At "Over Scan Count" on the screen, set the count of the overlapped tomograms. The selectable overlap count is changed according to the scan pattern and scan resolution. For the "3D" scan pattern, overlap cannot be done. For other scan patterns, when the scan resolution is set to a higher value except "1024", overlap cannot be done. For details, refer to "Setting the scan protocol" on page 48. In the initial setting of this instrument, "Over Scan Count" is set to "4" for all the scan patterns except "3D" for which overlap cannot be done, "7Line Raster" (scan resolution: 4096), "Radial" and "Circle". (5) Reference Position You can select one of the following items according to the scan mode to be set. Macula1-3 and Glaucoma1-3 There are two selectable items, "Vitreous" and "Choroidal". When you set "Vitreous", you can obtain a tomogram with the reduced noise at the vitreous body side from the retinal epithelium. When you set "Choroidal", you can obtain a tomogram with the reduced noise at the choroid side which is inner from retina. To obtain a clear tomogram at the epithelium such as retina, you should set to "Vitreous". To obtain a clear tomogram at the inner place from retina (e.g. choroid or optic disc), you should set to "Choroidal". In the initial setting of this instrument, "Vitreous" is set. Selectable reference mirror position 43 PREPARATIONS

46 Anterior Seg.1-3: Only for the "Line" scan patterns, you can select one of "Cornea" and "Lens" (crystalline lens). For the "3D" and "Radial" scan patterns, "Lens" is not usable and "Cornea" is fixed. In the initial setting of this instrument, "Lens" is set. "Cornea" is applicable to take a tomogram of the tissues behind cornea. "Lens" is applicable to take a tomogram of the tissues behind the crystalline lens. To take a picture of cornea and crystalline lens, you should set to "Cornea". To take a picture of anterior chamber angle, you should set to "Lens". By setting so, you can obtain a clear tomogram. (6) Radial Scan Count This is valid only when "Radial" is selected as the scan pattern, and it means the count of the radial lines for scan. In principle, one of "6" and "12" can be set. In the initial setting of this instrument, "12" is set. In the scan mode for the anterior segment photography, "6" is not usable and "12" is set. Selectable radial scan count (7) Raster Scan Step This is valid only when one of "7Line Raster" and "7Line Raster (V)" is selected as the scan pattern, and it means the interval of the vertical or horizontal seven scan lines. The settable range is 0.15mm to 0.35mm, and you can set it by 0.05mm. In the initial setting of this instrument, "0.35mm" is set. Selectable raster scan count 44 PREPARATIONS

47 (8) Fixation Position Set the fixation position of the patient in the scan mode for others except the anterior segment photography. In the anterior segment photography mode, only the external fixation target is used and so this item is not displayed. There are three selectable items, "Disc", "Center" and "Macula". When "Disc" is set, the optic disc is positioned at the center of the photography screen for the fixation position. When "Center" is set, the middle position between the optic disc and macula is positioned at the center, and when "macula" is set, macula is positioned at the center. In the initial setting, "Macula" is set for the "Macula" scan mode and "Disc" is set for the "Glaucoma" scan mode. In "Circle scan" for the glaucoma mode, "Disc" is fixed. For the "Fundus Photo" mode for which only color fundus photography is done without tomography, "Center" is initially set. Selectable fixation position (9) Distortion Adjust This item is valid only in the following conditions: In the "3D" scan mode for the macula photography and glaucoma, "Scan Size" is 6.0mm 6.0mm, "Scan Resolution" is , and "Fixation Position" is "Disc". If the patient blinks and his/her fixation position moves during scan, the obtained tomogram is partly deviated or missing. This function automatically detects the deviated or missing data and, after normal scan, scans again at the position of the deviated or missing data. In the initial setting of this instrument, "ON" is set. 45 PREPARATIONS

48 (10) Color Photograph This item is valid only in the scan mode for the anterior segment photography. You can set whether color photography of anterior segment should be done after taking its tomogram. (In the scan mode for the macula photography and glaucoma, color photography is always done.) In the initial setting of this instrument, "OFF" (color photography is not done) is set only for "Line scan" and, "ON" (color photography is done) for "Radial scan" and "3D scan". (11) Live Display Color This item is valid only in the scan mode for the anterior segment photography. You can set whether the live image should be displayed in color or monochrome. In the initial setting of this instrument, "Mono" is set. 46 PREPARATIONS

49 "Valid/invalid" of the scan setting item buttons When a scan setting item button is invalid because of the scan mode, scan pattern item, etc., it is not displayed even if it is selected. List about "display/non-display" of item buttons Scan pattern Item button Line Circle 3D Radial Cross 7Line Raster 7Line Raster (V) Scan Size Scan Resolution (Note 1) (Note 1) Over Scan Count (Note 2) (Note 5) (Note 2) (Note 2) (Note 2) Reference Position (Note 1) (Note 1) Radial Scan Count (Note 1) Raster Scan Step Fixation Position (Note 1) (Note 1) (Note 1) Distortion Adjust (Note 4) Color Photograph (Note 3) (Note 3) (Note 3) Live Display Color (Note 3) (Note 3) (Note 3) : The button is displayed. : The button is not displayed. Note 1: It is not displayed in the scan mode for the anterior segment photography. Note 2: Displayed only when the scan resolution is Note 3: Displayed only in the scan mode for the anterior segment photography. Note 4: Displayed only when "Scan Size" is 6.0mm 6.0mm, "Scan Resolution" is and "Fixation Position" is "Disc". Note 5: Displayed only when the scan resolution is The selection range is changed according to "Radial Scan Count". When the count is 6, the selection range is "None", 4 and 8. When the count is 12, it is "None" and 4. Example 1: When the scan pattern is "Radial" and the scan resolution is 1024, the [Over Scan Count] button is displayed. (See the lower left figure.) Except when the scan pattern is "Radial" and the scan resolution is 1024, the [Over Scan Count] button is not displayed. (See the lower right figure.) Displayed. Scan resolution = 1024 Not displayed. Scan resolution = PREPARATIONS

50 Setting the scan protocol The following table shows the settable scan protocol. The selectable items for "Scan Size", "Scan Resolution" and "Over Scan Count" are limited by the set data of the scan mode, "Scan Pattern" and others. Scan Pattern Line (Note1) Circle (Note2) 3D (Note1) Radial (Note1) Scan Size Scan Resolution Radial Scan Count Over Scan Count 6.0mm 1024H = Horizontal "None", "4", "8", "16", "32" and "50" can be selected. 4096H Overlap cannot be done. 1024V = Vertical "None", "4", "8", "16", "32" and "50" can be selected. 4096V Overlap cannot be done. 3.0mm 1024H = Horizontal "None", "4", "8", "16", "32" and "50" can be selected. 1024V = Vertical "None", "4", "8", "16", "32" and "50" can be selected. 3.4mm 1024 (Fixed) "None", "4", "8", "16", "32" and "50" can be selected mm Overlap cannot be done mm Overlap cannot be done Overlap cannot be done Overlap cannot be done mm Overlap cannot be done mm Overlap cannot be done. 6.0mm "None", "4" and "8" can be selected. 12 "None" or "4" Overlap cannot be done. 12 Overlap cannot be done. Raster Scan Step Cross 6.0mm 1024 "None", "4", "8" and "16" can be selected Overlap cannot be done. 7Line 8.2mm 1024 "None", "4" and "8" can be selected. "0.15", "0.20", Raster 4096 Overlap cannot be done. "0.25", "0.30" and "0.35" can 6.0mm 1024 "None", "4" and "8" can be selected. be selected Overlap cannot be done. 4.5mm 1024 "None", "4" and "8" can be selected Overlap cannot be done. 7Line 6.0mm 1024 "None", "4" and "8" can be selected. Raster (V) 4096 Overlap cannot be done. 4.5mm 1024 "None", "4" and "8" can be selected Overlap cannot be done. Note1: In the scan mode for the anterior segment photography, you can select only three kinds, "Line", "3D" and "Radial". Note2: This item can be selected for only the glaucoma scan mode. 48 PREPARATIONS

51 List of initial values for scan setting items The following table shows the initial values for scan setting items in this instrument. : Set value, : Cannot be set, Blank: Setting can be changed. Item button Scan Pattern Scan Size Scan resolution Over Scan Count Reference Position Radial Scan Count Raster Scan Step Fixation Position Distortion Adjust Color Photograph Live Display Color Item value selector button Line Circle 3D Radial Cross 7Line Raster 7Line Raster (V) Raster: 8.2mm 6.0mm 4.5mm 3.0mm Circle 3.40mm 3D D D D D D D D None Choroidal Vitreous Cornea Lens Glaucoma Glaucoma Glaucoma Macula1 Macula2 Macula mm (fixed) 6.0mm (fixed) Circle 3.4mm (fixed) 1024 (fixed) None (fixed) Anterior Seg (fixed) Anterior Seg.2 6.0mm (fixed) 1024 (fixed) Cornea (fixed) 6 12 (fixed) Center Disc Macula ON OFF ON OFF Color Monochrome External fixation target (fixed) External fixation target (fixed) Anterior Seg.3 None (fixed) Cornea (fixed) External fixation target (fixed) Fundus Photo 49 PREPARATIONS

52 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 switch) is not operated for a period of time, the power save function stops power supply to the monitor, illumination light source and photography light source. When power save mode sets in, the power lamp on the control panel flickers and the monitor screen goes off. 1 Press the PHOTOGRAPHY SWITCH. In a few seconds, the monitor is displayed and ready for photographing. When shipped, the power save set time is 10 minutes. 50 PREPARATIONS

53 BASIC OPERATIONS FLOW OF OPERATION Turning on the power (P.52) Preparation for personal computer (P.52) Inputting the patient information Selecting the scan mode Setting the patient (P.53) Selecting and setting the scan mode/pattern (P.54) Setting the illumination level (P.57) Setting the flash level (P.57) Changing the diopter compensation lens (P.58) Alignment and photography (P.59) Preview (P.76) Transferring the data to the external personal computer Saving data Printing data * By the external personal computer Finish procedure (P.80) 51 BASIC OPERATIONS

54 PREPARATION FOR PHOTOGRAPHY Connecting the power supply CAUTION After turning on the power, do not press the shutter button of the digital camera. Each time you press the shutter button, the image is saved in the digital camera. Then, the image is displayed as the color fundus image that should be obtained by photographing the patient's eye on the 3D OCT Check the power cord connection. For details, see "CONNECTING THE POWER CORD" on page Turn ON ( ) the POWER SWITCH of the instrument. 3 Confirm that the Title screen is displayed and then in a few seconds the Monitor screen should be displayed. If the personal computer is not ready, the message "Capture software is not active. Please set the software active." is displayed. When the preparation for the personal computer has been completed by the following procedure, the message automatically disappears. Preparation for personal computer 1 Install the analysis software, which is the accessory of the instrument, to a personal computer and connect the personal computer to the instrument. Then, turn on the power of the personal computer. Click the [3D OCT-2000] icon on the desktop to start the software. 2 Click the photography icon Capture Data on the title screen. 3 Input the patient information. 4 Select the scan mode (Macula/Glaucoma). The scan mode set on the instrument is changed to the scan mode selected on the personal computer. Then, you can change the scan mode on the instrument. 5 The preparation of the 3D OCT-2000 for photography is finished. For details, refer to the instruction manual (for software). 52 BASIC OPERATIONS

55 IR Setting up the patient CAUTION When moving the chin-rest up and down, be careful not to pinch the patient's hand to avoid possible injury. NOTE If the patient wears glasses or contact lenses, have him/her remove them first. 1 Make sure the main Monitor screen is on. 2 Make sure that the IR filter selector is pushed in. IR filter selector pushed in Do not observe the fundus in the condition that the IR filter selector is pulled out. 3 Seat the patient comfortably on an exam stool or chair in front of the instrument. 4 Adjust the table height or chair height so the patient can relax with his/her chin placed centrally on the chin-rest. Let the patient rest his/her chin on the chin-rest. 5 Adjust the chin-rest height by adjusting the chin-rest up/down switch so the outside corner of the patient s eye is level with the Canthus marker on the chin-rest post. Let the patient rest his/her forehead on the forehead rest. Canthus marker 53 BASIC OPERATIONS

56 FUNDUS TOMOGRAPHY CAUTION 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. NOTE 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 scan mode/pattern The scan modes and patterns shown below are set as default. For the details of the setting, refer to "List of initial values for scan setting items" on page 49. Touch the desired scan mode button on Area 2 of the monitor screen. Touch the desired scan pattern icon on Area 3. Even if you select a scan mode which is not the same as the mode selected on the personal computer, the mode on the personal computer is automatically changed. It is not necessary to change the set mode again on the personal computer. "Macula" mode Scan pattern: Cross Scan pattern: 7Line Raster Scan pattern: Radial "Glaucoma" mode Scan pattern: Line Scan pattern: Circle Scan pattern: 3D 54 BASIC OPERATIONS

57 Setting the picture position If necessary, you can change the default picture position, which is set according to the selected scan mode. There are the following three changing methods. Please change the picture position by your desired method. Changing by using the internal fixation target position selector button Change the picture position by selecting one of "D" (Disc), "C" (Center), "M" (Macula) and "External fixation target". 1 Touch the INTERNAL FIXATION TARGET POSITION SELECTOR BUTTON on Area 4 of the monitor screen to change the picture position. Each time you press the INTERNAL FIXATION TARGET POSITION SELECTOR BUTTON, the button display is changed from "D" to "C" to "M" to "External fixation target (graphic image)". Change to the desired picture position. For the details of display, refer to P.18. Internal fixation target position selector button 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. 1 As watching the fundus/anterior segment live image area, press the INTERNAL FIXATION TARGET POSITION MOVE SWITCH up, down, right and left on the control panel to adjust the internal fixation target position. Changing by using the scan position adjustment mode button Use this method when changing the scan position in a great degree or changing it by fine adjustment. 1 Press the SCAN POSITION ADJUSTMENT MODE BUTTON on Area 4 of the monitor screen to access the scan position adjustment mode. On the fundus/anterior segment 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.18. Scan position adjustment range (blue) Scan pattern display 55 BASIC OPERATIONS

58 2 Touch the scan position adjustment range indicated by a blue frame to move the scan position. For details, refer to P.18. To adjust the picture position finely, use the fine adjustment buttons around the image. To use "rotation", which can be adjusted only for "Radial" scan, perform the rotating adjustment with the rotation buttons (clockwise/counterclockwise) indicated around the image. For details, refer to P.18. For the scan pattern of "3D ", the scan position cannot 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. 56 BASIC OPERATIONS

59 Setting the illumination level CAUTION To avoid discomfort to the patient, do not brighten the illumination lamp more than necessary. Touch lightly the end of the [Illumination level] display on the fundus/anterior segment live image area by your finger. You can increase and decrease the illumination level by sliding your finger right and left. Illumination level is increased. Illumination level is decreased. Illumination level display The illumination level can be set in 5 steps. When the instrument is first turned on, the illumination level is set to level 3. If the illumination level is too high, it is difficult to see the split lines or alignment bright spot. So, "Auto Focus", "Auto Z (Z Lock)" and "Auto Pola (Auto Polarization)" do not work smoothly. If these auto functions do not work smoothly, set the illumination level as low as possible. Setting the flash level CAUTION To avoid discomfort to the patient, do not brighten the photography light more than necessary. Touch lightly the end of the [Flash level] display on the fundus/anterior segment live image area by your finger. You can increase and decrease the flash level by sliding your finger up and down. Flash level is increased. Flash level is decreased. Flash level display The flash level compensation value can be adjusted in 4 steps in both the (+) and (-) directions from the reference value "0". When the instrument is first turned on, the flash level compensation value is set to the reference value "0". You can adjust the reference value of the flash level compensation value by 4 steps in both (+) and (-) directions. Refer to "PAGE 3: Photography Setting" on page BASIC OPERATIONS

60 The flash level display can also display the light intensity level (unit: W s) in addition to the compensation value. For details, contact your dealer or TOPCON (see the back cover). When the flash level compensation value is raised by 1 step, the flash level is increased by about 20%. Changing the diopter compensation lens Pull out the diopter compensation lens selector and change the diopter compensation lens for the patient's eye. When the patient's eye has a strong myopia, pull out the diopter compensation lens selector by one step and set it to (-). When the patient's eye has a strong hyperopia, pull out the diopter compensation lens selector by two steps and set it to (+). Compensation range: 0 : D - : D + : D When the diopter compensation lens is set to a value other than "0", the split lines disappear. At the same time, the functions of the auto focus, auto shoot and auto small pupil (diaphragm) are invalidated. 58 BASIC OPERATIONS

61 Alignment and photography CAUTION CAUTION To avoid injury, do not place your fingers in the gap between the instrument body and the 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. The alignment operation is done with the control lever. Moving the instrument body 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 brake knob to the left. To lock the base, turn the base brake knob to the right. Base brake knob Operating the control lever (in back and forth/right and left directions) To move the instrument body up/down, turn the control lever right for upward movement, and left for downward movement. The vertical position of the instrument body can be checked with the vertical position mark. Vertical position mark Operating the control lever (in a vertical direction) 59 BASIC OPERATIONS

62 1 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 monitor. 2 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/anterior eye segment live image area. Now hold the control lever upright, which will facilitate the total alignment process. 3 On the monitor, bring the ( ) scale towards the patient s pupil, and make sure that the pupil is larger than the ( ) scale. Comparison of the ( ) scale and the eye tells you whether the pupil is large enough for retinal 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 is too small: darken the room and further dilate the pupil. Pupil diameter > φ4.0mm Pupil diameter = φ4.0mm Pupil diameter < φ4.0mm When the pupil diameter is small, press the on Area 4 of the monitor screen to set the small pupil diaphragm to "ON". SMALL PUPIL DIAPHRAGM SELECTOR BUTTON 60 BASIC OPERATIONS Small pupil diaphragm selector button

63 4 Bring the base slowly toward the patient side, and the fundus image appears on the fundus/anterior segment live image area. 5 Instruct the patient to look at the green light (internal fixation target). 6 While watching the image on the monitor, adjust the brightness of the image by touching the [Illumination level] display on the monitor. For details about the illumination level setting, see page 57. If the illumination level is too high, it is difficult to see the split lines or alignment bright spot. So, "Auto Focus", "Auto Z (Z Lock)" and "Auto Pola (Auto Polarization)" do not work smoothly. 7 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/anterior segment live image area. Alignment bright spot Split lines 8 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. Alignment bright spot Split lines 61 BASIC OPERATIONS

64 When the auto focus function does not work smoothly, set the illumination level as low as possible. When the auto focus does not work though the illumination level is decreased or 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 58. 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 monitor. The auto focus function is invalidated because the split lines are off. If the split lines are not easily visible, lower the illumination level, or lower the brightness of the monitor. For details about adjusting the brightness of the monitor, see "ADJUST- ING THE MONITOR" on page 98. If one of the split lines cannot be seen, check if dilation is sufficient or if the eye is obstructed by eyelashes or the eyelid, interrupting the light. 9 Move the control lever until the two bright spots are changed to one spot on the monitor. 10 Operate the control lever up and down, right and left to bring the alignment bright spot into the ( ) scale. 62 BASIC OPERATIONS

65 11 The "Auto Z (Z Lock)" and "Auto Polarization" functions work and the tomogram is automatically displayed on the tomogram live image area. The preparation for photography is finished. 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), press the Optimize button on the tomogram live image area to start the "Auto Z (Z Lock)" and "Auto Polarization" functions. You can change the Z lock position (tomogram display position) by touching the tomogram live image area if necessary. For details, refer to P.22. When the optic disc auto search function is ON in "Circle" scan of glaucoma mode, make sure that the optic disc is within the blue optic disc tracking frame. If the optic disc is not within the frame, operate as follows because the optic disc auto search function does not work: Operate the internal fixation target position move switch on the control panel to move the fixation position and put the optic disc of the patient into the optic disc tracking frame. If the orange line (warning line) is displayed at the top edge of the tomogram live image area, lower the Z lock position until this line disappears. For details, refer to P Right before taking a picture, tell to 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) without being misled by the scan line (red) during photography. 13 Make sure that the alignment bright spot and split line are correctly positioned on the monitor. Then, press the PHOTOGRAPHY SWITCH. By pressing the PHOTOGRAPHY SWITCH, tomography is done and then the color fundus photography is automatically done. Photography switch 63 BASIC OPERATIONS

66 When the xenon charging display flickers on the monitor, photography is not possible even if you press the PHOTOGRAPHY SWITCH. After charging is finished and the xenon charging display lights, take a picture. R L Xenon charging display If the patient blinks right before the color fundus photography, the automatic blink detection function stops the photography. In this case, make sure again that the alignment bright spot and split line are correctly positioned. Then, press the PHOTOGRAPHY SWITCH to repeat the procedure from the tomography. While you are taking a tomogram in the 3D scan photography of the glaucoma mode ("Scan Size" is 6.0mm 6.0mm, "Scan Resolution" is and "Fixation Position" is "Disc"), if the patient blinks or the fixation is moved, the tomogram may be deviated or missing. In this case, the "Distortion Adjust" function works. Consequently, after normal scan, the instrument scans again at the position of the deviated or missing data. However, when the optic disc is not clearly visible, this function does not work. 14 When photography is finished, the preview screen appears. If the light intensity of the photographed image is not correct, touch the Flash level display to adjust the light intensity. Then, repeat alignment and photography. Refer to "Setting the flash level" on page BASIC OPERATIONS

67 15 Press the Return button on the preview screen or the PHOTOGRAPHY SWITCH to access the Monitor screen again. Take a picture by repeating Procedure 1-14 if necessary. Refer to the instruction manual for software regarding the details about the operation on personal computer. In the "Circle scan" photography of the glaucoma mode (when the optic disc auto search function is ON), the optic disc auto search function works. Sometimes the optic disc cannot be automatically detected due to the optic disc shape of the patient's eye or the image contrast and, after photography, the message "Failed detection of the disc center" is displayed. In this case, press the Manual Set button or Search OFF button, which are displayed with the message, and take a picture again by the desired method. When the optic disc of the patient's eye moves sharply, when the optic disc is not within the optic disc tracking frame or when the optic disc position is not decided well, the message "Failed finding of the disc center" is sometimes displayed. In this case, press the Retry button or Auto Search OFF button, which are displayed with the message, and take a picture again by the desired method. After taking a picture again, the message "Failed finding of the disc center" may be displayed once more. If so, carry out one of the following two procedures. Press the Retry button to erase the message. Adjust the scan position by aligning the circle scan position with the optic disc center manually and take a picture. Press the Auto Search OFF button and take a picture manually. For the scan position adjustment, refer to the description about the scan position adjustment mode button on page 19. Search OFF Perform manual photography by the following procedure. 1 Press the Search OFF button on the displayed dialog box. 2 The optic disc auto search function is OFF. As watching the monitor, operate the internal fixation target position move switch on the control panel to move the optic disc center to the circle center. Then, take a picture. Manual Set Set the optic disc center manually by the following procedure. Then, take a picture again by using the optic disc auto search function. The following procedure is used to specify the optic disc position when the optic disc center is not found by the optic disc auto search function. This is different from the scan position adjustment procedure in which the operator adjusts the circle scan position to the optic disc center manually on condition that the optic disc center can be normally detected. For the scan position adjustment procedure, refer to the explanation about the scan position adjustment mode button on P Press the Manual Set button on the displayed dialog box. The optic disc specification mode is accessed and its screen is displayed. On the monitor, the reference image of fundus is displayed. Moreover, the circle and cross lines are displayed at the image center, and the fine adjustment buttons (up/down/right/left) and OK button are displayed around the reference image. 65 BASIC OPERATIONS

68 2 Touch directly the reference image on the monitor to align the circle center with the optic disc center approximately. Adjust the circle center finely with the fine adjustment buttons to decide the position. Finally, press the OK button to exit from the optic disc position specification mode. 3 In the condition that the optic disc auto search function is ON, operate the internal fixation target position move switch to move the optic disc into the optic disc tracking frame. Then, perform the normal circle scan photography. 66 BASIC OPERATIONS

69 ANTERIOR SEGMENT TOMOGRAPHY CAUTION 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. NOTE To ensure correct imaging, adjust the table height so the patient can relax with his/her chin placed centrally on the chin-rest. NOTE Mount the attachment for anterior segment on the forehead rest securely. If not, the anterior segment photography is not possible. NOTE Before taking a picture or tomogram of fundus, remove the attachment for anterior segment. If the attachment for anterior segment is mounted, you cannot take a picture or tomogram of fundus. NOTE Do not bend the attachment for anterior segment forcedly. It may be broken or deformed. NOTE Do not operate the focusing knob. You cannot take an optimal picture of anterior segment. NOTE Do not set the diopter compensation lens to others except "0". You cannot take an optimal picture of anterior segment. Mounting the attachment for anterior segment Mount the attachment for anterior segment onto the forehead rest base, as if the attachment covers the base as shown below. After mounting, make sure that the attachment for anterior segment is fixed on the forehead rest base. Then, take a picture of anterior segment. Attachment for anterior segment Forehead rest base 67 BASIC OPERATIONS

70 Setting the scan mode Press the Anterior Seg. button, which is one of the scan mode setting buttons, on Area 2 of monitor screen to access the scan mode for anterior segment. When the anterior segment photography mode is accessed, the buttons on Area 4 of the monitor screen are not displayed. After the anterior segment photography mode is accessed, the message to mount the attachment for anterior segment is displayed. If you change the anterior segment photography mode to the fundus photography mode ("Macula", "Glaucoma" and "Fundus Photo"), the message to remove the attachment for anterior segment is displayed. Check if the attachment for anterior segment is mounted or removed. Even if you select a scan mode which is not the same as the mode selected on the personal computer, the mode on the personal computer is automatically changed. It is not necessary to change the set mode again on the personal computer. Selecting the scan pattern In the anterior segment photography mode, the scan patterns shown below are set as default. For the details of the setting, refer to "List of initial values for scan setting items" on page 49. Touch the desired scan pattern icon on Area 3 of the monitor screen. Scan pattern: Line Scan pattern: Radial Scan pattern: 3D Setting the picture position Operate the arm of the external fixation target to guide the patient's eye to the correct position. When the anterior segment photography mode is accessed, the fixation target is automatically changed from "Internal" to "External" and you cannot change it. Setting the illumination level Set the illumination level by touching the [Illumination level] display on the fundus/anterior segment live image area. See "Setting the illumination level" on page 57. Setting the flash level In the anterior segment photography mode, the flash level is automatically set to "1.0W.s" (fixed), and the [Flash level] is not displayed on the fundus/anterior segment live image area. 68 BASIC OPERATIONS

71 Changing the diopter compensation lens Push in the diopter compensation lens selector and change the diopter compensation lens to (0). See "Changing the diopter compensation lens" on page 58. If the diopter compensation lens is set to others except "0", the following message is displayed. Change the diopter compensation lens to (0). Alignment and photography The alignment operation is done with the control lever. For details about movement/adjustment of the instrument body with the control lever, see "MEMO" on page Hold the control lever and pull the instrument fully toward the operator. 2 Using the control lever, move the instrument body right and left, up and down to display the patient's eye at the center of the fundus/anterior segment live image area. 3 Push in the instrument body slowly toward the patient side until the tomogram of the anterior segment is displayed on the OCT live image area of the monitor. In the scan mode for the anterior segment photography, the alignment bright spot and split lines are not displayed. In the scan mode for the anterior segment photography, all the auto functions are invalidated (OFF). So, the Optimize button is not displayed on the OCT live image area. Even if the tomogram is not displayed clearly, adjust the image quality not by operating the focusing knob but by moving the instrument body. 69 BASIC OPERATIONS

72 4 Move the instrument body back and forth and adjust its position finely so that the tomogram may be displayed within the optimal display position frame, which is displayed on the Z lock position display bar at the left end on the OCT live image area. Optimal display position frame 5 Make sure that the tomogram is clearly displayed. Then, ask the patient not to blink and press the PHOTOGRAPHY SWITCH. When taking a picture of cornea Select "Radial scan" and move the instrument body until the cornea tomogram is displayed near the optimal display position frame on the top of the screen. Take a picture of cornea where the signal of one vertical line displayed on the cornea tomogram is strong. This is the status where the scan center is fit to the cornea vertex. 70 BASIC OPERATIONS

73 When taking a picture of anterior chamber angle Select "Line scan". Push in the instrument body, which is in the pulled status. You will see the anterior chamber angle which is upside-down. Push in the instrument body until the tomogram of the anterior chamber angle is displayed near the optimal display position frame on the bottom of the screen. When moving the tomogram of the anterior chamber angle to the lower end of the screen, the tomogram has many folded parts. Move the instrument body to move the anterior chamber angle display position upward a little. Then, take a picture. When taking a picture of crystalline lens Change the setting to [Cornea] for "Reference Position" of the "Line scan" (Anterior Seg.1) by using the SETTING MENU BUTTON. Then, select "Line scan". Move the instrument body until the tomogram of crystalline lens is displayed near the optimal display position frame on the top of the screen. 71 BASIC OPERATIONS

74 6 When photography is finished, the preview screen appears. If the light intensity of the photographed image is not correct, touch the Flash level display to adjust the light intensity. Then, repeat alignment and photography. Refer to "Setting the flash level" on page Press the Return button on the preview screen or the PHOTOGRAPHY SWITCH to access the Monitor screen again. Take a picture by repeating Procedure 1-6 if necessary. Refer to the instruction manual for software regarding the details about the operation on personal computer. 72 BASIC OPERATIONS

75 COLOR FUNDUS PHOTOGRAPHY CAUTION 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. Setting the fundus photography mode Press the Fundus Photo button on Area 2 of the monitor screen to access the fundus photography mode. The tomogram live image disappears on the monitor and the fundus/anterior segment live image moves to the center of the screen. Setting the picture position Using the INTERNAL FIXATION TARGET POSITION SELECTOR BUTTON on Area 4 of the monitor screen, set the picture position. Each time you press the INTERNAL FIXATION TARGET POSITION SELECTOR BUTTON, the picture position is changed to "D" (optic disc center), "C" (the aged insurance law position), "M" (macula center), and "External fixation target" in this order. Set the picture position to "C" for the aged insurance law position, "M" for macula, "D" for optic disc, and "External fixation target" for anterior segment. Internal fixation target position selector button Setting the illumination level Set the illumination level by touching the [Illumination level] display on the fundus/anterior segment live image area. Refer to "Setting the illumination level" on page 57. Setting the flash level Set the flash level by touching the [Flash level] display on the fundus/anterior segment live image area. Refer to "Setting the flash level" on page BASIC OPERATIONS

76 Changing the diopter compensation lens Push in the diopter compensation lens selector to change the diopter compensation lens to "0". Refer to "Changing the diopter compensation lens" on page 58. Alignment and photography The alignment operation is done with the control lever. For details about movement/adjustment of the instrument body with the control lever, see the "MEMO" on page Hold the control lever and pull the instrument body to the utmost limit toward the patient. 2 Using the control lever, move the instrument body right and left, up and down to display the patient's eye at the center of the fundus/anterior segment live image area. 3 Align the ( ) scale with the patient's pupil on the monitor. Make sure that the patient's pupil is larger than the ( ) scale. Even if the pupil is smaller than the ( ) scale (pupil diameter is approx. 4.0mm or less), the automatic small pupil (diaphragm) function, which is usable only for the fundus photography mode, works. So, it is not necessary to set the SMALL PUPIL DIAPHRAGM SELECTOR BUTTON For dilation, refer to the "MEMO" on page 60. to "ON" on the monitor. If the pupil diameter is almost the same size of the ( ) scale, the automatic small pupil (diaphragm) function does not work and, under this condition, the instrument takes a picture. If you are not satisfied with the image in this case, set the SMALL PUPIL DIAPHRAGM SELECTOR BUTTON to "ON" on the monitor and take a picture again. Then, compare the image with the first one. 4 Push in the instrument body slowly toward the patient side, and the fundus image appears on the fundus/anterior segment live image area. 5 The ( ) scale on the monitor moves to the alignment position corresponding to the picture position. 6 Ask the patient to see the green light (internal fixation target). 7 As watching the image on the monitor, adjust its brightness by touching the [Illumination level] display on the monitor. For setting the illumination level, refer to "Setting the illumination level" on page Push in the instrument body straight. After the alignment bright spot and split lines appear, the auto focus function changes the split lines into one line automatically. 9 Using the control lever, change the alignment bright spots into one spot and put it into the ( ) scale. 74 BASIC OPERATIONS

77 10 When the positional relation between the instrument body and the patient's eye is proper for photography after putting the alignment bright spot into the ( ) scale, the color fundus photography is automatically done by the auto shoot function. Ask the patient not to blink and not to move his/her eyes during photography. If the patient blinks right before the color fundus photography, the automatic blink detection function stops the photography. Start the procedure again from alignment and take a picture. When the auto shoot function is OFF or when the diopter compensation lens is set to others except "0", the instrument does not take a picture automatically. Press the PHOTOGRAPHY SWITCH to take a color picture of fundus. 11 After taking a picture, the preview screen appears. If the light intensity of the photographed image is not correct, touch the FLASH LEVEL DISPLAY to adjust the light intensity. Then, repeat alignment and photography. Refer to "Setting the flash level" on page Press the RETURN button on the preview screen or the PHOTOGRAPHY SWITCH to access the Monitor screen again. Take a picture by repeating Procedure 1-11 if necessary. Refer to the instruction manual for software regarding the details about the operation on personal computer. 75 BASIC OPERATIONS

78 PREVIEW SCREEN After taking a picture, the preview screen appears. For the display on the personal computer, refer to the instruction manual (for software). Preview screen Function button Image display unit Scan position (Icon) Scan position (Numerical value) Function button Return: Cancels the preview mode and returns to the Monitor screen. 76 BASIC OPERATIONS

79 DISPLAY FORM OF PREVIEW SCREEN 3D/7Line Raster/7Line Raster (V) * Only the typical images (center, both ends) are displayed for tomogram. Radial/Cross * In radial scan, only the typical images (horizontal, vertical) are displayed for tomogram. 77 BASIC OPERATIONS

80 Line/Circle 78 BASIC OPERATIONS

81 Fundus photography mode 79 BASIC OPERATIONS

82 SAVING DATA Data are saved on the personal computer. For details, refer to the instruction manual (for software). PRINTING DATA Data are printed on the personal computer. For details, refer to the instruction manual (for software). HOW TO FINISH Finishing the personal computer 1 Finish this software. 2 Turn off the personal computer according to its regular finish method. Finishing the instrument 1 Turn OFF ( ) the POWER SWITCH of the instrument. 2 Using the control lever, move the instrument body to the position just above the base. 3 Turn the base brake knob clockwise and apply the brake to prevent the base from moving suddenly. To prepare for next photography, turn the control lever and move the instrument body to the center position. The vertical position mark indicates the standard for the instrument's vertical center position. When the instrument is not in use for a long time, unplug the power cords of the instrument, external recording device and others from the outlet and remove the cords from each device. This instrument adopts "Power save method" (P.50). If you use the instrument continually all day, it is recommended to use it without turning off the POWER SWITCH. 80 BASIC OPERATIONS

83 BEFORE REQUESTING SERVICE TROUBLESHOOTING Messages during operation Error message Memory error. Please turn the power switch OFF. Lamp house cover is off. Please turn the power switch OFF and close the cover. Hardware initial error 01 Please turn the power switch OFF. Reference motor error. Please turn the power switch OFF. Polarizer motor error. You may not get high-sensitive OCT image. Do you want to continue? Galvano error. Please turn the power switch OFF. Internal communication error 01. Please turn the power switch OFF. Y-Axis motor error. You may not get high-sensitive OCT image. Do you want to continue? Hardware initial error 02 Please turn the power switch OFF. Auto focus motor error. Please set focus manually. Internal communication error 02. You may not get high-sensitive OCT image. Do you want to continue? Internal communication error 03. The system sets Auto-functions disabled. Do you want to continue? Internal communication error 04. Please turn the power switch OFF. SLD light source error 01. Please turn the power switch OFF. SLD light source error 02. Please turn the power switch OFF. SLD light source error 03. Please turn the power switch OFF. SLD light source error 04. Please turn the power switch OFF. SLD light source error 05. Please turn the power switch OFF. Xenon light source error 01. Please turn the power switch OFF. Xenon light source error 02. Please turn the power switch OFF. Xenon light source error 03. Please turn the power switch OFF. Xenon light source error 04. Please turn the power switch OFF. Contents The EEPROM data error has occurred. The interlock error (front cover) has occurred. The FPGA error has occurred. In the light path length compensation motor, the original point sensor detection error has occurred. In the polarized beam shaft control motor, the original point sensor detection error has occurred. Galvano error has occurred. An error has occurred in the communication with the SLD control PCB. In the Y-axis control motor, the original point sensor detection error has occurred. The FPGA data error (configuration data) has occurred. In the auto focus motor, the original point sensor detection error has occurred. The I2C communication error (temperature sensor) has occurred. An error has occurred in the communication with DSP. An error has occurred in the communication with the xenon control PCB. The SLD temperature is not normal. The SLD pulse lighting is not normal. The SLD light intensity is not normal. The watchdog timer is not normal for the SLD control PCB. The SLD control PCB notifies that the Galvano error has occurred. The charge time is out. Overcharge has occurred. The discharge voltage is not normal. The discharge time is out. 81 BEFORE REQUESTING SERVICE

84 Error message Xenon light source error 05. Please turn the power switch OFF. Temperature error (Halogen lamp) Please turn the power switch OFF and cool down for a while. Temperature error (Line CCD) Please turn the power switch OFF and cool down for a while. Could not detect image. Please push [Optimize] button to try again. Detected blink while capturing fundus image. Please try again. Failed finding of the disc center. Retry Auto Search OFF Failed detection of the disc center. Manual Set Search OFF Camera is not connected. Please connect communication cable and turn the power switch ON on the camera. Out of disk space in the USB storage. Please change the one that has enough free space. PC is not connected. Please connect communication cable and turn the power switch ON on the PC. Capture software is not active. Please set the software active. Patient information is not inputted. Please input patient information and select capture mode. Printer is not ready. Please connect communication cable and turn the power switch ON on the printer. CCD power exceeds lower limit. Please turn the power switch OFF. CCD power exceeds upper limit. Please turn the power switch OFF. Could not detect the peak of CCD power. Please turn the power switch OFF. SLD light volume exceeds lower limit. You may not get high-sensitive OCT image. Do you want to continue? SLD light volume exceeds upper limit. Please turn the power switch OFF. Failed in auto shoot. Please shoot manually. Failed in auto focus. Please set focus manually. Temperature error (CPU) Please turn the power switch OFF and cool down for a while. Temperature error (Board) Please turn the power switch OFF and cool down for a while. Image board error (Error No.) Please turn the power switch OFF. The diopter compensation lens selector is pulled out. Push in the diopter compensation lens selector and change the diopter compensation lens to "0". Contents Charge and discharge is ON at the same time. The halogen lamp temperature is not normal. The line CCD temperature is not normal. Retrieval of the interference image has failed. Blink is detected. Search for optic disc has failed (when capturing). Search for optic disc has failed (when capturing). The digital camera is not connected. The USB storage cannot save the data. The external personal computer is not connected. The capture software in the external personal computer does not start. The patient information is not sent yet. The printer is not connected. Y-axis auto error (Lower Limit) has occurred. Y-axis auto error (Upper Limit) has occurred. Y-axis auto error (No Peak) has occurred. An error about the light intensity at the objective lens (Lower Limit) has occurred. An error about the light intensity at the objective lens (Upper Limit) has occurred. The auto shoot function cannot be used. The auto focus time is out. The SBC temperature is not normal. (CPU) The SBC temperature is not normal. (Board) The image board error has occurred. The diopter compensation lens is set to others except "0". 82 BEFORE REQUESTING SERVICE

85 Troubleshooting WARNING WARNING WARNING To avoid electric shock, do not attempt disassembling, rebuilding and/ or repairs on your own. Ask your dealer for repairs. Do not remove the covers from the main unit, chin-rest unit or power supply unit except for the lamp house cover. You may receive an electric shock. Do not remove the covers from the main unit except for the lamp house cover. Your eye or skin may be exposed to the laser radiation. When an error is encountered, review the Check List below. After following the instructions below, if you still have difficulty or if the problem does not fall into any of the categories listed below, contact your dealer or TOPCON (see the back cover). Check List Problem Condition Check Page Monitor does not work. Power cord is not connected to the outlet or instrument. Connect power cord. 31 Fuse has blown. Change fuse. 97 Monitor is not clear. Image is dark. Adjust brightness (brightness control). 98 Touch the [Illumination level] display on the 57 monitor to adjust the illumination level. Darken room and thoroughly dilate 60 patient's pupil. Periphery of captured image is dark. Captured image is flared all over. (The whole image is covered by light.) Captured image is whitened. Captured image has a dim white spot. Photographic image is dark all over. Illumination lamp does not turn on. Alignment is incorrect. Adjust alignment. 59 Patient s pupil is not large enough. Darken room and thoroughly dilate 60 patient's pupil. Alignment is incorrect. Adjust alignment. 59 Opacity in patient's eye. Flare cannot be removed Patient blinked at the moment the photograph was taken. Take another picture Objective lens is stained. Clean lens. 100 Eyelashes were in the patient's eye the moment the photograph was taken. (Dim light was seen at screen bottom the moment the alignment was done.) Let patient open eye wider and take the picture again. If not wide enough, open the eyelid (i.e., Take picture holding eyelid open). Flash level is insufficient. Touch the [Flash level] display on the monitor 57 to adjust the flash level. Xenon set screws are loose. Consult your dealer. 96 Xenon lamp has served its life. Consult your dealer. 96 Lamp terminal is loose. Consult your dealer. 96 Fuse has blown. Change fuse. 97 The lamp has burned out. Consult your dealer BEFORE REQUESTING SERVICE

86 Problem Condition Check Page Internal fixation target cannot be seen. ( ) scale is off monitor center. Split lines cannot be seen. Xenon lamp does not turn on. Cannot get patient's pupil center. Alignment is incorrect. Adjust alignment. 59 Fuse has blown. Change fuse. 97 Internal fixation target is set to the "D" or "M" side. External fixation target is set. Internal fixation target is set to periphery. Diopter compensation lens selector is not set to (0). Press the internal fixation target position selector switch to move it to the "C". Press the internal fixation target position selector switch to move it to the "D" or "C", "M". Change fixation position to center (Periphery fixation switch (Reset)). Return diopter compensation lens selector to (0). Patient's pupil is not large enough. Darken room and thoroughly dilate patient's eye. Xenon lamp has served its life. Consult your dealer. 96 Patient's face position is incorrect. (The chin and forehead are not correctly on the rests, or the patient faces sideways.) Have patient adjust his/her position accordingly. Patient's face height is incorrect. Adjust face height (Chin-rest handle). 53 Nothing is recorded Anomaly in external recording device. Check power supply, settings, etc on the external Cable connections are incorrect. Check and correct cable connections. recording device. 32 The color fundus image, which is not the same as the photographed one, is displayed on the preview screen. The shutter button of the digital camera is pressed. Turn off the digital camera, and then turn it on again BEFORE REQUESTING SERVICE

87 SPECIFICATIONS AND PERFORMANCE SYSTEM DIAGRAM This instrument is composed of the following three units. Main body unit Power supply unit Chin-rest unit 85 SPECIFICATIONS AND PERFORMANCE