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This document may only be used for your personal, non-commercial use. This document and all its contents (including without limitation, all text, formats, graphics and logos) are the property of Optos plc and are protected from unauthorized copying and dissemination by the Copyright, Designs and Patents Act 1988 (as amended), by various intellectual property laws and by international conventions.
Table of Contents What's New Introduction About the device Indications for use About images Image types Getting to know the device Understanding the equipment About the head rest Attaching and detaching the Patient Arm Support Attaching and detaching the Head Rest About the detector settings How to use the hand control About the software applications...
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Patient positioning About the Patient History view Using the Patient History window Opening images Selecting images from the Image Series view Opening images using alternative methods Discarding unwanted images Using the viewing options Color Channels Review Tools Recommended reading protocol Using the Automated view Using the Magnifier Using the 3D Wrap view...
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Archiving to a network Scheduling storage tasks Getting help Accessing help from the device Accessing help from the applications Optos on the Web Where to find features Capture application user reference Review application user reference Storage application user reference Scheduler application user reference...
Chapter 1 - What's New What's New This release supports the display of optomap® af images. Note: optomap® af images are captured using a green laser light for illumination. This contrasts with the traditional use of blue illumination or white light for autofluorescence imaging. Green light autofluorescence differs, and allows a different visualization of macular pathologies since macular pigment does not interfere.
The 200Tx uses red, green and blue lasers to produce a digital, high-resolution image, which is displayed on a PC monitor screen. This device can be used to capture angiography images. Red and green lasers are used for digital color imaging.
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Chapter 2 - Introduction Sample image from 200Tx device. The composite image supports analysis of the retinal image by allowing individual review of the green and red channel information. The Green Channel image contains information from the sensory retina through the pigment epithelium layers of the retina.
Chapter 2 - Introduction Image types There are different types of image for each type of procedure: optomap® – captures a retinal image. The standard optomap® procedure is a wellness exam. This procedure captures a standard optomap® retinal image. optomap® plus – captures a medical retinal image. The optomap® plus procedure is a medical retinal exam.
Chapter 3 - Getting to know the device Getting to know the device The device comprises the scan head module, Image Server PC, and Viewing PC. For more information, please refer to the Technical Data Specification supplied with the device. Images are captured on the scan head.
Chapter 3 - Getting to know the device Patient arm support and table wings (if supplied) – Devices used to capture optomap® fa images may be fitted with a patient arm support and table wings. They are used to support the patient when the injection is administered.
Chapter 3 - Getting to know the device Attaching and detaching the Patient Arm Support The patient arm support is fitted with a clamp and can be attached and removed from the table wings. Some devices are supplied with a patient arm support. The patient arm support supplied with the device is designed to support the weight of a resting arm.
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Chapter 3 - Getting to know the device The device requires low levels of room light to operate efficiently. Take care to Warning avoid accidents when working under low light conditions. Media opacities also absorb or scatter laser light and can block retinal structures. System response The device has a laser power of 4mW at the patient's eye and includes a laser safety system that would prevent the system being used if the lasers were operating at unsafe levels.
Chapter 3 - Getting to know the device How to use the hand control 200Tx Hand Control buttons Hand Control table height Use these buttons to adjust the table height. buttons Hand Control eye position Use these buttons to move the pupil circle to the center of the patient's eye.
Getting Help is easy, just press on your keyboard for help with your current task [F1] Admin application features application lets System Administrators and Optos Representatives configure the system. Admin application features include: Admin Application access control tools to let you create and manage user details.
Capture procedures. Access to these procedures depends on your system settings: ask your Optos representative for more information. These procedures let you capture different types of optomap® images, for example eye steered images and zoomed images. When an image has been captured using an optomap®...
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- At sites where the Image Everyone workflow is in place, this option displays the Confirm dialog box when a review session is recorded as billable. Contact Optos for more see Contact us on page 93. information on Image Everyone, tab - Set the view Options.
Storage Double-click the desktop icon - Start Menu – Start > All Programs > optos V2 Vantage Pro > Storage Scheduler application features application lets you manage patient records and appointments. You can create patient Scheduler records before the optomap®...
Double-click the desktop icon - Start Menu – Start > All Programs > optos V2 Vantage Pro > Scheduler Note application only connects to the Optos database and so should not interfere with other Scheduler applications. About software updates Push software is a feature where software updates are pushed out and are automatically downloaded by the system.
Chapter 5 - About capturing an image About capturing an image The following procedure explains how to capture an image using the application. The notes that Capture follow suggest techniques that can be used to deal with any changes that may be appropriate for an individual patient.
Chapter 5 - About capturing an image 6. Select the based on the patient’s eye color. The sets the system to expect a Iris Category Iris Category defined level of light returned from the retina. Lower light levels are returned when the patient's retina contains greater pigmentation levels.
Chapter 5 - About capturing an image The face pad and head rest must be cleaned with an individually sealed, 70% isopropyl alcohol wipe and allowed to air-dry between patients. The head rest can be removed for cleaning. The patient arm support should be cleaned with an individually sealed, 70% isopropyl alcohol wipe and allowed to air-dry between patients.
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Eye Camera image. Contact Optos if you think the limbus ring position needs to be altered, see Contact us on page 93. To help guide the patient to see the fixation light, the operator can view the patient's eye in the Capture dialog box, see Good Quality Image example on page 30.
Always use the dimmest Fixation Level Fixation Level setting the patient can see. 200Tx only - Click to re-centre the green ball if required. RESET POSITION If the alignment system does not turn green you should align the rings as accurately as you can.
Chapter 5 - About capturing an image Depending on the configuration of your device the following procedure types and options may be available: If following an optomap® plus procedure you can select the following: If required, capture an AF image, see How to capture Autofluorescence images on page 27. The Fixation Level controls the brightness of the green ball which helps the patient look in the correct direction.
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Chapter 5 - About capturing an image 2. Position the chair Explain to the patient what is about to happen, see Patient instructions on page 21. Ask the patient to sit in the chair. Move the chair forwards until the patient's face is approximately 15 cm (6 inches) from the front of the scan head.
Chapter 5 - About capturing an image displayed on the view. The center circle should remain inside the patient's External Eye Camera pupil. 8. If you are capturing eye steered images you will need to ask the patient to look in a particular direction, How to do eye steering on page 29.
Server PC. Multi-Frame Settings These settings define the number of images and the capture frequency applied when early-phase optomap® fa images are captured on a 200Tx device. You can also set whether optomap® fa procedures can be paused. Early-Phase Settings In the early-phase, the system will take multiple images when the capture button on the hand control is pressed, How to use the hand control on page 11.
Chapter 5 - About capturing an image Setting the Multi-Frame Setting to capture just one image. This setting will be applied to future sessions. Pressing the hand control capture button immediately after the first image has been taken. This method will only affect the current session. Note The early-phase is limited to capturing a maximum of 50 images.
Chapter 5 - About capturing an image 8. You can review all the images captured any time after the early-phase series has been completed. Click view to display the thumbnails of all the captured images. This will also enable Image Series [F10] the images to be saved to the Image Server PC.
Chapter 5 - About capturing an image Note Eye steering is not available for every procedure. Full user details can be found in the User Guide which is installed with the V2 Vantage Pro applications. View captured image The image is identified by the eye and timestamp details. You can: Check the quality of the full sized image.
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Chapter 5 - About capturing an image The thin green edge. Only a few eye lashes showing at the bottom of the image. Sample image from 200Tx device. Well aligned image External Eye Camera view Badly aligned images - examples These images show the results of various types of alignment problems.
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Chapter 5 - About capturing an image Patient too near Patient much too near Patient too far away Patient much too far away Patient too far left Patient too far right 32 of 100...
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Chapter 5 - About capturing an image Patient too high Patient too low Minimizing lids and lashes in images In some patients, images may be obscured by the patient's lids and lashes. You should follow your practice procedures to minimize lids and lashes in images. In some cases the amount of lid and lash can be minimized by gently lifting the patient's eyebrow.
Chapter 6 - About the Patient History view About the Patient History view view provides easy access to all the images for the selected patient. Select images from Patient History the image list and then choose option you want to use to open them. To select images Description from the...
Review Notes optomap® plus Review procedures are only available when the image was captured using an optomap® plus Capture procedure. Ask your Optos representative for more information about optomap® plus. These markers are also shown on the image thumbnails. If the secondary (compressed) image has been cleaned out, the label of the disk on which the image is sorted will be displayed.
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Chapter 6 - About the Patient History view Stacked images zoom, pan and move together. Color separations applied to one window are also applied in other linked windows. However, image adjustments such as Restore, Optimize, Gamma adjustment are only applied to the selected window. 1.
Chapter 6 - About the Patient History view 1. Select to display the dialog box. Tools menu > Preferences Preferences 2. Select the tab and confirm the selected options are correct for the viewing technique being Stereo used, see Setting User Preferences on page 15. 3.
Chapter 6 - About the Patient History view How to select images from the Image Series view All images are automatically selected when you open a series of optomap® fa images. Click an image to change the selection status. Selected images are shown with a blue border. Select to select all the images in the series.
Chapter 6 - About the Patient History view How to browse all the images from thumbnails You can open any image files on your network without selecting the images from a particular patient record. 1. Select to display the dialog box. File menu >...
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You should periodically empty the deleted folder to make space for new images The database records the location of the image files. It is important that any image deletions are performed using the Optos software and not directly through . This will ensure the Windows®...
Chapter 7 - Using the viewing options Using the viewing options When you review images it can be useful to use some of the viewing tools to look at the images in different ways. Some viewing tools let you change the color of the image, or help you concentrate on a particular area and use special tools to quickly change the review options for that area.
Chapter 7 - Using the viewing options Simulated BIO view simulates the retinal view as it would be seen via a Binocular Indirect Simulated BIO View Ophthalmoscope. The image is inverted and mirrored about the center of the image. This view allows you to target the relevant areas during a BIO examination.
Chapter 7 - Using the viewing options 4. Optional: Right click to change to an alternative view. If you select either view or Green Channel view you can then select one of the to change the contrast of the magnified Channel False Color Views area, see Using False Color views on page 48.
Chapter 7 - Using the viewing options You can control the view point using the mouse or buttons in the view. You can zoom in 3D Wrap or out and move around the image using the mouse or control buttons. The performance of the view will depend on the graphic capability of your PC.
Chapter 7 - Using the viewing options 1. Select the image you want to display using the view. Simulated BIO 2. Select to simulate the BIO view. "Simulated BIO View" will appear in the Image menu > Simulated BIO View image window title.
Chapter 7 - Using the viewing options Comparing with sample disease images You can discuss pathologies with a patient by comparing the patient's image and a sample disease image side by side. 1. Open the patient's image. 2. Select and select the sample image from the list. If the sample Image menu > ...
Diagnostic (pathology) codes and procedure codes can be added. The optomap® plus procedure code features can be made available by Optos. They can be used when the image was captured using one of the optomap® plus Capture procedures. Contact Optos for more information on using optomap® plus procedures, see Contact us on page 93.
Chapter 8 - Documenting your review About annotations, retinal drawings and measurements Annotations are graphical mark-ups drawn onto the image. Standard annotations are available for all image types. Retinal drawings and measurements are special annotations. Retinal drawings are used to indicate specific information, for example arteries, detached retinas and exudates.
Chapter 8 - Documenting your review How to delete an annotation You can delete annotations that have been added during the current session. You can either select and delete individual annotations or delete them all. Annotations cannot be changed after the image session has been closed.
Chapter 8 - Documenting your review How to add a retinal drawing You can add retinal drawings to open images. 1. Open the image you want to annotate and then select Annotation menu > Retinal Drawing 2. Select the retinal drawing type and draw the retinal drawing in the same way as annotations, see Annotations, retinal drawings and measurements on page 89.
Chapter 8 - Documenting your review – click each point around the area to be measured. Lines will be drawn between the Polygon points clicked. Double-click to complete the polygon. – hold down the left mouse button and stretch the circle around the area to be Ellipse measured.
Procedure codes cannot be edited or deleted after the image has been closed. These procedures may not be available on your system. Please contact Optos if you would like more information, see Contact us on page 93.
About Procedure Guidance Optos does not provide, and the optomap® plus guidelines do not constitute advice on making reimbursement claims. Diagnostic tests should be ordered by the treating physician and this physician is responsible for appropriate usage, adequate documentation and proper coding. It is the responsibility of the physician to comply with Medicare regulations, and check with the local insurance carrier for reimbursement information and instructions.
Chapter 8 - Documenting your review Depending on the type of image captured and the available review procedures you may also be able to add reimbursable procedure codes at the same time, see About review notes, diagnostic (pathology) codes and procedure codes on page 55. You can set User Preferences that will prompt for a Review Note if an image is opened but no details are added.
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Chapter 8 - Documenting your review 2. Repeat for terms you want to exclude by entering them in the box. Select to exclude Excluding Terms diagnoses that contain all of the terms or to exclude diagnoses that contain any of the One or more terms.
Medical Image Format (DICOM format) - Can be viewed only by Optos v2 and other medical imaging applications. Annotations and Review Notes are saved but do not obscure image details.
Distributing an image distributes a copy of the image. The original image file is not removed from the system. Annotations and Review Notes in distributed images can be viewed when using the Review application or Optos' optomap® image viewing application. See www.optos.com for download information.
Medical Image Format (DICOM format) - Can be viewed only by Optos v2 and other medical imaging applications. Annotations and Review Notes are saved but do not obscure image details.
Chapter 9 - Distributing images 1. Select to display the dialog box and select the patient record you Review Menu > Patient History Select Patient want to import the image into. 2. Select ) to display the dialog box. Tools menu > Import Image > Left Eye Right Eye Select Image to Import Selecting...
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Chapter 9 - Distributing images The print preview displays a preview of the current layout selections. Click an image in the print preview to select the image. The selected image will be displayed in the pane. Selected Image You can use the mouse to drag the image to display the required area. You can use the mouse scroll button to zoom in and out of the image.
Chapter 9 - Distributing images Note The header graphic will be placed along the top of the page. The aspect ratio of your graphic will be maintained. Your graphic will be scaled to fit the allocated space at the top of the page. The footer graphic will be scaled in the same way, but displayed at the bottom of the page.
Chapter 10 - Using the Image Library Using the Image Library contains images from patients who have had optomap® examinations. The images provide Image Library examples of pathology captured by the system and may be used for training purposes or patient education.
The primary files are used for reviewing. The secondary files are used in thumbnails and when primary images have been archived. Your Optos representative will configure the Task Settings when the device is installed. These settings should not be changed in the course of normal operation.
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Optos will configure the Task Settings when the device is installed. These settings should not be changed in the course of normal operation.
The length of time for which images can be retained will depend upon the volume of image data captured and the capacity of the hard disk. Your Optos Representative will help define the settings to be used.
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Chapter 11 - About archiving 3. Run any additional tasks. Insert a new recordable disk when prompted. - copies the database and all primary image files from the PC's hard disk to Archive and Verify the storage device. These original files are usually large, uncompressed files that fill the hard disk quickly.
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Task Settings performance is achieved, see Changing the Archive Task Settings on page 69. DVD disks (only if recommended by Optos): Always use DVD-R or DVD+R 4.7Gb single layer disks. Do not use DVD-RW, DVD+RW. Do not use double layer disks.
Chapter 11 - About archiving There are two types of DVD writer; + and -. You must ensure that you buy the correct type for your DVD writer. Archiving to a network When archiving to a network location or you need to setup the storage location, see Changing NAS device the Archive Task Settings on page 69.
Chapter 12 - Getting help Getting help If the help files do not answer your problem, please contact Optos, see Contact us on page 93. Additional material may be available on the Partner area of the Optos website. Accessing help from the device Help is available throughout the application.
Print Print Topic Optos on the Web The Optos web site contains a wide variety of information resources. Simply click the Partner Login link at www.optos.com to access the partner login area or to register for a username and password.
Opens the dialog box where you can change many of the system Settings settings. You should only change these settings when instructed by your Optos representative. You will need to login in before the settings options are available. button PATIENT LIST...
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Chapter 13 - Where to find features Image types Button/section Description opto button map® image Captures a retinal image. The standard optomap® procedure is a wellness exam. This procedure captures a standard optomap® retinal image. opto plus button map® image Captures a medical retinal image.
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Chapter 13 - Where to find features Button/section Description setting Eye Steering Controls the additional lights used to control the patient's gaze when the eye is being steered. Select the required direction (Nasal, Temporal, Inferior, or Superior) to switch on the appropriate red ball and switch off the Eye Steering green ball.
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Chapter 13 - Where to find features Image Quality Controls Button/section Description view button Composite Color Shows the default view used to display an image that has just been captured. This view mixes the red and green channels to present a color image.
Chapter 13 - Where to find features Button/section Description Functions in the same way as the slider. Red Contrast Settings button Discard Marks the image to be discarded at the end of the session. Click the image thumbnail to select it then click the button.
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Chapter 13 - Where to find features Review Tools Controls Button/section Description button Open Files(s) to View Opens the dialog box. Hold down and click each Select Image(s) to View [Ctrl] image filename or to select the first and last image filenames in a [Shift] group.
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Chapter 13 - Where to find features Image View Controls Button/section Description button Composite Color View Shows the view where you can use the zoom and pan Composite Color features to view the image in detail. This default view is used when an optomap® or optomap® plus image is opened.
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Chapter 13 - Where to find features Button/section Description button Select View Sets the zoom (in and out) to show the selected area of the image. Click the drop-down arrow button to display the view options: view - zooms to show the full image. Full Image - zooms to show an enhanced view of the optic disk and Central Pole...
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Lets you look at a locally optimized area of the image. You can also zoom in and out of the image in the usual way. may not be available on all systems. Please contact Optos for Magnifier more information, see Contact us on page 93.
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Chapter 13 - Where to find features Button/section Description Change the color view of the area to Comparison Overlay Composite Color view. Red Separation Green Separation button Show/Hide Image Adjustment Pane Toggles between hiding and showing the Image Adjustment pane is shown on the right of the image window and Image Adjustment pane contains the contrast, brightness and gamma settings.
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Chapter 13 - Where to find features Button/section Description pressing the left or right arrow on your keyboard to move the slider control. This control is not available when reviewing optomap® fa images. control Gamma The Gamma control will brighten or darken the image without saturating detail changing the exposure settings.
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Chapter 13 - Where to find features Method Description button Pause Pauses the view. You can stop the view by clicking the Automated Automated button and then moving on to another task. Pause button changes to the button when clicked. Pause Play You can also pause the...
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Chapter 13 - Where to find features Method Description Linked Images To review and compare several images while keeping the same area of each image in view, open the images using the button Open in Linked Windows in the window, see About the Patient History view on page 35. Patient History Linked windows zoom, pan and move together.
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Chapter 13 - Where to find features Button/Section Description Retinal drawings are not available when reviewing standard optomap® images. Undo annotation tool Removes the most recent annotations. Annotations cannot be removed or changed after an image has been closed. Cup to Disk Ratio measurement Click at least five points on the edge of the cup, then repeat around the disk.
Chapter 13 - Where to find features Storage application user reference Button/section Description button Archive and Verify Copies the database and all primary (uncompressed) image files from the PC's hard disk to the storage device. These original files are usually large, uncompressed files that fill the hard disk quickly.
Chapter 13 - Where to find features Scheduler application user reference Button/section Description button New Appointment Shows the dialog box and dialog box Select Patient Optomap Appointment Details where you can select the patient and then set the appointment details respectively.
Dunfermline, KY11 8GR Website: www.optos.com Scotland, UK Existing customers will need to provide their site number to allow Optos to access your details. You can find the Site Number on the documentation received from Optos. Alternatively, open the application Admin...
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Chapter 14 - Contact us Spain Telephone: +34 900 813015 All inquiries: esinfo@optos.com www.optos.com/es-es Website: Norway Telephone: +47 4691 2460 All inquiries: noinfo@optos.com www.optos.com/no Website: Sweden Telephone: +46 707 57 22 59 All inquiries: seinfo@optos.com www.optos.com Website: 94 of 100...
(installed on PCs) Introductory Handbook Medical safety, including Epilepsy warning. Cleaning and Biocompatibility Electrical safety Peripherals and Optos-supplied PCs About the system optomap® plus and optomap® image overview optomap® fa image overview optomap® af image overview Tour of the main component parts, including Image Server PC...
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Chapter 15 - Training Checklist Logging onto the device (with new username) System checks: using the hand control Setting options - optomap® fa automated capture System Navigation Set up System Administrator Stepping through the Capture procedures Terminology used Help sources Help on current task (F1) Application help (Help menu) Installed documentation (User Guide, Introductory Handbook...
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Chapter 15 - Training Checklist Patient angle to the device for successful imaging Table adjustments Head rest adjustments Explanation to patient External Camera feedback and XYZ adjustments Capturing images Image Acquisition Adjustments Fixation Pattern brightness Reviewing the image quality Good example images Bad example images Reviewing image quality and improving the next image optomap®...
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Chapter 15 - Training Checklist optomap® fa practice Eye Steering practice Reviewing Images Tour menu bar and tool bar Selecting and filtering patients Choosing images for review Discarding images in the application Review Reviewing Images: Color channels Zooming Dragging Review Notes Annotation Counting Annotations Procedure Codes (optomap®...
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Chapter 15 - Training Checklist Cleanup Scheduled archiving to network drive (or NAS device System Shut Down Shut down steps Power switches A Network Attached Storage device is a hard disk, or Solid State Drive, that is attached to the network. It has its own network address.
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