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User_Manual, 4, en_US - Bascom Palmer Eye Institute

1. 97 6 14 4 Deleting the Lightbox unsure nennen 97 Touch Ei 99 7 1 How to use the Touch Panel oenen eenen 99 7 2 Selecting Acquisition Modes une 100 7 3 Filter Wheel at Position A oons nnen ennen nnen 103 7 4 Filter Wheel at Position Roanne nennen 104 7 5 Selecting Acquisition Modalities 105 7 6 Selecting Acquisition Settings unne 106 7 7 Selecting a Fixation Light nanne 107 5 Table of contents 7 8 Activating the MultiColor Mode Option 107 Acquiring Images unnenvenen ennen ene enen ennen 108 8 1 Terms and Definitions Single Imaging Modes 109 8 2 Terms and Definitions Simultaneous Imaging Modes 110 8 3 Setting Default Acquisition Parameters 111 8 4 Unlocking Examinations unnnsens eneen eneen neen 112 8 5 Selecting a Fixation Light annae nnn 113 8 6 Selecting an Acquisition Mode enn 115 8 7 Graphical User Interface cSLO Acquisition Window 117 8 8 Acquiring CSLO Images nun aans nennen vennen 120 8 9 Graphical User Interface OCT Acquisition Window 124 8 10 Acquiring Simultaneous cSLO and OCT Images 128 8 11 Selecting Applications unne van ennen ennen eeen 135 8 11 1 Presets for Application Retina 137 8 11 2 Presets for Application Glaucoma 138 8 12 Selec
2. 69 6 5 4 Selecting All Patient Files ane van eneen nenn 70 6 6 Searching Patient Files sees 71 OOT QUICK SEAN eee 71 6 6 2 Searching Patient Files from Today 72 6 6 3 Advanced Search anneer enene nennen ereen enen 73 6 6 4 Loading Filters esee 15 6 7 Starting a New Examination u uuunn ennen enen 75 6 8 Continuing Examinations unne sanen eens nenn eneen 76 6 9 Deleting Patient Files and Examinations 77 610 Patent DAA nnen 19 6 10 1 Updating or Changing Patient Data 79 6 10 2 Updating or Changing Additional Patient Data 80 6 10 3 Updating or Changing Comments and Anamnesis 82 6 11 Examination Data unne snanen venen eenen nenennenen 83 6 11 1 Updating or Changing Examination Data 83 6 11 2 Updating or Changing Diagnosis 85 6 12 Entering Eye Data an sann eneen ennen eenenenenen 89 6 13 Moving Images between Patient Files 90 6 13 1 Merging Duplicate Patient Files ce eeeeeeeee ees 90 6 13 2 Moving Images Stored in the Wrong Patient File 92 6 14 Using the Lightbox rrrrrrrrrevnrrvnnrrnnrevnvennrrrvnrrnnnrnnernnne 94 6 14 1 Adding Images to the Lightbox 94 6 14 2 Saving the Lightbox rrrnnrrnarrnnnrrvnnrrvnrrnrnrrvvnrennnnnnnn 95 6 14 3 Removing Images from the Lightbox
3. Acquisition Module OCT Image cSLO Image Angiography Start a new examination Select an application Select a Create a preset scan pattern Align the camera Align the camera Switch on ART Mean Acquire images Set image intensity Switch off ART Mean to 7596 Inject the dye activate Switch on ART Mean injection timer amp for single scans Acquire a movie of dale ES Set image intensity Switch off ART Mean to 10096 Acquire images of late phase of dye Create Reports Perform Follow up examinations 58 O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Starting HEYEX 6 Heidelberg Eye Explorer HEYEX About this Chapter This chapter provides instructions on how to set up HEYEX before an examination and includes an in depth look at the functionality of the database window and image viewing window When starting HEYEX the database window is displayed This window provides all database functionalities and allows you to begin examina tions When opening a patient file the image viewing window is dis played This window provides all basic functions for working with patient files It shows all examinations that exist for the patient The examinations are organized in examination tabs by date Each dated examination tab contains image thumbnails for each examination on that date From here examinations can be c
4. 86 O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Examination Data Exarranaticn Data E Edi existing Diagnosia Insert new Diagnosis C Delete existing Diagnosis Check the Edit existing Diagnosis box and enter a new name gt Click OK to confirm The existing diagnosis is renamed but the original diagnosis is kept and must be deleted Deleting a Diagnosis Select the diagnosis to be deleted from the Diagnosis drop down list and click 1 Only a diagnosis that is not assigned to any examination can be deleted 1 Changes made to the diagnosis are made throughout the entire database not just that examination Examination Dats C Edi eating Diagnosis C ineen rev Disgnast Delete exiting Diagnos AMD gt Check the Delete existing Diagnosis box and click OK to confirm in the opening dialog box The diagnosis is deleted e Only 50 characters of the comment are displayed on I reports Longer texts are abbreviated and marked by 27 O Heidelberg Engineering GmbH Art Nr 97326 005 US 87 6 Heidelberg Eye Explorer HEYEX Examination Data 88 Overview Report BHEIDELBErG SPECTRALIS Tracking Laser Tomography ENGINEET INGE Patient Doe Jenna CSCR DOB 01 Jan 1947 Fax M n I Patient ID FA OCT DC c Comment Peripheral retinal changes in macular on both side Notes
5. I 3 Dos Jenna 107 181 C Doe John 01 021950 OD OD E of Herna AGM Pengsum 14 18 1333 kel oe Janny BP Progression 2 17 03 2008 EJ In order to search patient files by name type in the patient s last name e g Doe into the Name field Heidelberg Engineering GmbH Art Nr 97326 005 US 71 6 Heidelberg Eye Explorer HEYEX Searching Patient Files 6 6 2 12 gt Press or click Update Display All last names starting with Doe are displayed in the left part of the database window The last eight entries used for the query are saved and can be selected from the drop down list at a later time In order to improve search results type in the patient s last name fol lowed by the inital of their first name e g Doe J into the Name field All last names starting with Doe and first names starting with J are displayed in the left part of the database window The last eight entries used for the query are saved and can be selected from the drop down list at a later time r Heidelberg Eye Explorer pie Database Berord Setup Windew dige ee OO 7 D Die He an V WW Gl Fag cece Se S Hare ES k n dan he pto x Frank NY O Apjessfe O Cham H O Bleken C p sien EU Ge Tr Tue T i C Bott Shelame BF SD OCT Geographic Atrophy Ge 01 1831 Py E D Brodetien Horak Come with act CL 13 1
6. 15 of the month M is displayed On the 7 M is displayed On the 30 of the month fm is displayed reines eroi i Fie Database Record Setup Window Help Ien Tur aA see BC Almen Sebastian Serppnou Chorcdopathy 12011354 IR AF FAF FAMC Bl Ae Sebastian Sempgnroue Choroidapathy 1201 1954 IR AF FAF OG Aulaen Gregor HEP 60 degeer 61 01 1951 Bleken Ral Db 11 1974 GO B che Jens Macular Hole 1 01 1964 FA FAF STEREO OCT Bj ap Bol Seane BPSD OCT Geographic Atopy 02 01 1931 O Biskan Fal 06 11 1974 d Bleken Ral 06111974 EO Bolt Silane BP SD OCT Geographic Atiophy 02 01 1931 xo HC Broderzen Herak Comea with sch CL 11 11 1901 Chest Wem ASM lidotomy snd beth ACA OG 04 1852 jr Chan Kam ASM Filtering Bieb 19 06 1967 Dr Thesen B db Duae lestel Glaucoma Progression T 20 05 1564 TOS Boll Seene BP SD OCT Geographie Anon 12011931 EC Chee Yeng Cham ASM DUER pn Fuch Dysthe T0 01 1965 Frat Kan Br C Chis Were ASH duomi and bah ACA D2 04 18652 B Diela Isabel Glacoms Progressen 1 2005 1964 TCA GO Dem Simeon Ducos Podela 10 00 1992 Caucasian D O Doe John 01081950 E E C Bos Henna ASM Preigecm 14 08 1344 Prol Kiria D Toini i CO Dios dorma 11 07 1951 FG Doe denna BP Fingassan 1 2802 2008 jr Dos Jenny BP Progierson 2 17 03 2008 B Diceseher M ns HEP Sceerng 5 30 0 07 1986 W O Eger Marte Retnoschetie 03 06 1965 IR AF FAF FA ICG Vol Wy Frank Pad
7. February 2013 Heidelberg Engineering GmbH Art Nr 97326 005 US AE13 _HEIDELBENG SEE SSC Corporate Headquarters Heidelberg Engineering GmbH Tiergartenstr 15 69121 Heidelberg Germany Telephone 49 6221 6463 0 Fax 49 6221 6463 62 USA Heidelberg Engineering Inc 1808 Aston Avenue Suite 130 Carlsbad CA 92008 Telephone 1 760 536 3770 Fax 1 760 536 7100 US Service Center Heidelberg Engineering Inc 10 Reservoir Road Smithfield RI 002917 Telephone 1 401 349 0500 Fax 1 401 349 0504 email info HeidelbergEngineering com Internet http www HeidelbergEngineering com Heidelberg Engineering GmbH Supplemental instructions Please read this user manual and follow all precautions before using the device and the software Mind all safety advices on the device and in the manual while oper ating the SPECTRALIS Heidelberg Engineering hereby declares that this product conforms to C 0482 the requirements of Directive 93 42 EEC of the Council of the Euro pean Community dated 14 June 1993 regarding medical products MDD 93 42 EEC Warranty If the device is unauthorized reconstructed or opened by someone other than an authorized service personnel the warranty will be void Disclaimer HEYEX is a trademark of Heidelberg Engineering GmbH in the United States and other countries SPECTRALIS HRA OCT SPECTRALIS HRA SPECTRALIS FA OCT SPECTRALIS OCT SPECTRALIS OCT w
8. click Next to confirm The installation starts 48 O Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software Again select an installation language and click OK to confirm The HEYEX License Manager welcome screen is displayed Setup vil install Heidelberg E ye Explore Licence Manager in the boller folder Ta install bo this folder chek Med To well bo d lereni bokker chik Browse and select another foldet You can choose not to metall Heidelberg Eve Explore Licence Manager by choking Cancel to exit Setup Fig 35 Choose Destination Location dialog box Then the Choose Destination Location dialog box is displayed Select the destination folder for the Heidelberg Eye Explorer Licence Manager e g C HEYEX gt Click Next to confirm Setup has finished copying Mez bo your Computer Before vou can une the program uou most restart Windows or your computer 8 Yes wart to restart my computer now Ma d wil nest t my computer later Remove arg disks lom then dines and then click Finish to complete sabun Finith Fig 36 Setup Complete dialog box When the installation is completed the Setup Complete dialog box is displayed Before you can use the device and the software the PC must be restarted gt Select Yes I want to restart my computer now and click Finish 3 2 5 Installing a Soft
9. 13 1 5 1 Isolating Transformer uunnnans nennen venen eennen vens 13 1 9 2 FG Lure 13 1 5 9 External DEVCES sencsccdscrsaswevicenurdacesindeasereceasacdasnsanweuse 14 1 5 4 Antivirus Software aanneem neennenveneneensereen 14 1 6 Software Protection anna annn nennen en enen eneen sneven 14 1 7 Technical Description annae enen eneen seenen ennen 14 1 7 1 Confocal Laser Scanning unnenenen en ennseneen 14 1 7 2 Optical Coherence Tomography OCT 16 1 7 3 Heidelberg Engineering Technologies 16 1 7 4 MultiColor Scanning Laser Imaging Option 19 1 8 Precision of SPECTRALIS Measurement 19 1 9 Heidelberg Eye Explorer Software Platform 21 General Safety Messages rrrrrrrnnrarnnnnrrrnnnerrnnrrvrnnrrnnnnnennnn 24 2 1 Patent SafOlV norsmeessnsenntetdnen dritten dod n inb ead pua rd bd inui 24 22 Data SEM Leser 25 2 3 Equipment Reliability an enneneneneenn 25 2 4 Laser Safety aanne nenn enn nenen vennen enenrrennenr vens 29 Initial Operation annen een eneen erven en ennenen ennen 30 3 1 The SPECTRALIS Devic nan ennn eneen eneen 31 3 2 Installing the Software n uuunennenns eneen eneen 32 3 2 1 Local Installation with an HRA2 SPECTRALIS Device ciego EN 33 3 2 2 Local Installation with no HRA2 SPECTRALIS Device ires EE detentie 38 3 2 3 Network Installation nnen nennen nennen 43
10. All images are added to the lightbox As an alternative select one or multiple image thumbnails and drag and drop them to the lightbox 6 14 2 Saving the Lightbox gt Click amp to start HEYEX Add images to the lightbox amp Chapter 6 14 Using the Lightbox on page 94 Right click an image thumbnail in the lightbox The context menu opens Select Save Lightbox Heidelberg Eye Explorer Keep oignal lightbox Enter a name for the lightbox in the opening dialog box Heidelberg Engineering GmbH Art Nr 97326 005 US 95 6 Heidelberg Eye Explorer HEYEX Using the Lightbox gt Click OK to confirm Lighe 2204 2001 ry m Dil Press Fl fer help EE i L The lightbox is saved and will be displayed the next time the patient file is opened If several lightboxes have been saved they can be selected from the Lightbox drop down list If the lightbox has not been saved and the image viewing window is closed or another patient is called the message Do you want to save the current lightbox is displayed Click Yes to confirm or No to quit without changes Keeping the Original Lightbox If a lightbox has been saved under a file name e g 13 04 2011 and a new lightbox is saved with the same name it is possible to keep the original lightbox without overwriting the information So multiple light boxes can
11. Choose Destination Location dialog box is displayed 40 Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software Please erder lhe destinalon location hor the database and patierd data jeg D or CAHEYEX Fig 20 Choose destination folder for the database and patient data Select the destination folder for the database and patient data e g C HEYEX gt Click Next to confirm A dialog box is displayed asking whether an archive drive location shall be configured or not gt Click Yes to confirm or No to skip Please select the dive to use r mage dala archive meda e o enagnelba oplical dive extemnal hard desk Fig 21 Choose destination location for archive media If Yes has been selected the Choose Destination Location dialog box is displayed Enter a storage location that shall be used as image data archive media e g an external hard disk Heidelberg Engineering GmbH Art Nr 97326 005 US 41 3 Initial Operation Installing the Software gt Click Next to confirm Dick the type of Setup you prefer hen chk Nest Irish adis the Spectraks wering module only Choose this iristallati n for workstations eth no HAAZ or Specrlralis camera attached Fig 22 Select Type dialog box The Select Type dialog box is displayed Select No HRA2 SPECTRALIS system installed gt Click Next to confirm
12. Date 20 02 2012 Signature Fig 38 Report with abbreviated comment O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Entering Eye Data 6 12 Entering Eye Data The properties of patient files can be updated in case of incorrect or incomplete entries All entries serve documentation purposes only and are displayed on reports gt Click amp to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click amp to open the image viewing window FE ooo i SE 7973 Pe nm SA Patent Doe Jenna 11 07 1351 Paien Examinats Eye Data Curve reen Fialiaction dpt byrder dri oss deg Pupd size mm IDP mmHa Vraa The Eye Data dialog box is displayed gt Insert or change eye data in the following fields Parameter Unit Description C Curve mm Radius of curvature of the ante rior corneal surface Refraction D Spherical refraction of the exam ined eye Cylinder D Astigmatic refraction of the exam ined eye Axis deg Axis of astigmatism of the exam ined eye Heidelberg Engineering GmbH Art Nr 97326 005 US 89 6 Heidelberg Eye Explorer HEYEX Moving Images between Patient Files Pupil size mm IOP mmHg VFieldMean VFieldVar Corrective Lens Pupil diameter of the examined eye Intraocular pressure of the exam ined eye Visual field mea
13. Glaucoma Progression d 1505 1562 TOA All patient files containing the day s examinations are displayed gt In order to switch off the filter click i in the tool bar Advanced Search The advanced search allows users to search for patients using the examination data gt Click amp to start HEYEX In order to use the advanced search click 7 in the tool bar Database filter cmm rn Cd Nawapa FN tg Heleing physicum Sie be Examination Tee gree C wien he Laar p 4 days Dane Sud Dee D Show ork soamesbont phm the pateris that match to thir Mer The Database Filter dialog box is displayed Heidelberg Engineering GmbH Art Nr 97326 005 US 73 6 Heidelberg Eye Explorer HEYEX Searching Patient Files Applying a Database Filter Enter the patients name and or select the following search parame ters Referring physician Examination time Diagnosis Study Device Click OK to start the query The search results are displayed in the left part of the database window hd Saving a Database Filter Click Save as to save the database filter Save filter X m Save fer ae on Cancel The Save Filter dialog box is displayed Enter a name for the filter and click OK to confirm The filter is saved For further information on loading a
14. Patient Data Paliani Data More data Memo Commeri gt Click the Memo tab gt Insert or change comments and the anamnesis gt Click Insert time to add date and time stamp to the comment gt Click OK to confirm The warning message You are about to change the patient info is displayed gt Click OK to confirm or Cancel to quit without changes 6 11 Examination Data e It is possible to search patients using the examination data amp Chapter 6 6 3 Advanced Search on page 73 Insert the examination data and the diagnosis as detailed as possible 6 11 1 Updating or Changing Examination Data The properties of patient files can be updated in case of incorrect or incomplete entries Device type information however cannot be changed gt Click amp to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click 3 to open the image viewing window O Heidelberg Engineering GmbH Art Nr 97326 005 US 83 6 Heidelberg Examination Data 84 Eye Explorer HEYEX z a a r 4 p Eia HAH oz Em e AI prn Sep e EN Womed Te MAAND UPE REG SE en ahaha pa an ot Ti Bager A AT AT E p NEN Lu FAST dA AF F aim ar in 3 A B ras Aas ieee i anam 19 EE gt Click Examination Examination Data Diagnose Patient Doe Jenna 11 11 1851 Date Time 1402 2012 Th
15. 005 US General Safety Messages 2 Equipment Reliability NOTICE Do not install third party software and hardware that has not been approved by Heidelberg Engineering The operation of the device can be affected Incorrect measurement results can occur The system can be damaged NOTICE Electricity supply must comply with the required tol erances The wrong electrical supply can damage the device Make sure the local electrical supply meets the equip ment specifications CAUTION US Federal Law restricts this device to sale by or on the order of a physician or a practitioner Only distributors authorized by Heidelberg Engineering are allowed to sell Heidelberg Engineering devices WARNING Do not operate the device without power plugs marked hospitality grade which insecures the earthing reliability There is a risk of electric shock Always operate the system connected to power plugs marked hospitality grade or hospitality only These power plugs and receptacles meet the requirements of UL 498 WARNING The hardware component housing may not be opened by some other than trained qualified per sonnel authorized by Heidelberg Engineering There is a risk of electric shock Do not open the hardware component housing Heidelberg Engineering GmbH Art Nr 97326 005 US 27 2 General Safety Messages Equipment Reliability 28 WARNING Do not ope
16. 1 56 General HEYEX Settings Setting Display Options hd hd Before the first examination it is possible to set the general HEYEX settings At first the display options can be set it is possible to change the image thumbnail display and the look of the image viewing window Secondly the plug ins for the HEYEX can be loaded enabled or disa bled Please do not change the settings in the Disk Space tab Click to start HEYEX Select Setup Options in the menu bar T General Disk Space Plug ins lors Satings Large scon size ES i how confemation on exi Senall icon sine Horizontal spacing 20 Vetch piang Show mage numbers Default Split Moda Splt exam Lo oe x i The Options dialog box is displayed Click the General tab and set the following options Large icon size Small icon size Horizontal spacing Vertical spacing In order to display the image number of each image check the Show image number box In order to set the default split mode open the Default Split Mode drop down list and select one of the following options No split Split exam Split exam amp lightbox For further information on changing the layout of the image viewing window please refer to amp Chapter 6 3 2 Changing Display Options of Image Viewing Window on page 64 In order to get a notif
17. Bleken Raf 06111974 4 Disteile label Glaucoma Progreeson 1 20 05 1964 TCA ik Bot Stans BP SD OCT Ge odgispkec Alrophy O2 0 1931 Dor Jenna 11 07 1981 iC Biadeisen Herak Cosnea sah sci CL 11 11 1811 x 4 Creche Mara HEP Screening S30 01 011986 Fl Cham Kam ASM Filenng Bleb 19 06 1557 0 Theelen Chee reong Cham ASM DMEF in Fuchs Dystophke 1001355 fl Chasbol ea ASH lndoktorgy and biih ACA 07 04 1957 iod Distele leabel GlavoomsPuogessoni 2005 1354 TCA AG Dietele Seon Glaucoma Borders 1003 15827 Caucasian z fe D Dos John ie O Dae Herna Piengu 1400 0503 Prod Enee I Tomos ie Doe Jenna Laik Flap 5 02 1871 EO Dos Jenna BP Progeessson 1 25 02 3008 FO Dos denna COCR Di 1 5847 F OCT ie C Dos denna BCM Acquedion koder 1107 1951 2 1850 In order to open multiple patient files double click the patient files The circles next to the patient names turn black The patient files are displayed in the right part of the database window gt Click 3 to open the image viewing window All acquired images of the most recently selected patient file are dis played The acquired images are organized by examination date in individual examination tabs In order to display a specific patient file double click the patient file in the right part of the database window In order to quickly switch between the loaded patients open the Patient drop down list IR Heide Eye
18. Correction Line 257 11 8 3 Segmentation Tool nan rnnennenennnnnn 258 11 8 4 Graphical User Interface Layer RNFL 264 11 8 5 Normative Database sees 267 7 Table of contents 12 14 11 9 Thickness Map Tab unann vennen venen eneen 269 11 9 1 Graphical User Interface 269 11 10 Posterior Pole 8D ioo e retta ornnes 272 11 10 1 Graphical User Interface 272 11 10 2 Positioning the 8x8 Grid annen 274 Analyzing MultiColor Images Option 276 12 1 Identifying Image Thumbnails 276 12 2 Showing Selective Color Laser Images 276 12 3 Graphical User Interfac aanne enen 278 12 4 Color Balance PresetS noen nennen nennen 279 12 5 Analyzing Movies uns senenenen ene venen ene eenven 281 RODOS animeserie etende senteren 282 13 1 Customizing ReportS annae nennen ennn enen 282 13 2 Exporting Reports as Image Files 284 13 3 Printing ReportS ussen enervenrn ennen nnrnven 285 13 4 Overview Reports noen onee ennn enen enen eneen enn 289 13 5 OCT Overview Report aaneen ennen eneen eneen 290 13 6 Detailed Report aan vanen ene nenenenen nen ennnenn 291 13 7 Retina Single Exam Report aaneen een 292 13 8 Retina Change Report Recent Follow up 294 13 9 R
19. HRA Area 0 34 mm 0 24 0 58 1 7 1 2 2 9 mm OCT Mean 1 6 um 1 4 1 8 0 5 0 4 0 696 Retinal um Thickness volume scan OCT Cen 2 6 um 1 9 4 5 1 1 0 8 1 896 tral Foveal um Thickness volume scan OCT Cen 2 4 um 1 7 4 1 1 0 0 7 1 796 tral Foveal um Thickness B scan OCT RNFL 1 4 um 1 0 2 4 1 4 1 0 2 496 Thickness um global OCT RNFL 3 9 um 3 3 4 7 3 5 3 0 4 296 Thickness um in sectors Repeatability Data Summary Standard Deviation Coefficient of Variation Measure ment 95 Confi 95 Confi dence dence Interval Interval HRA Dis 0 02 mm 0 01 0 04 0 3 0 2 0 6 tance mm HRA Area 0 14 mm 0 09 0 26 0 7 0 5 1 396 mm OCT Mean 1 1 um 1 0 1 3 0 4 0 3 0 496 Retinal um Thickness volume scan 20 Heidelberg Engineering GmbH Art Nr 97326 005 US Preface 1 Heidelberg Eye Explorer Software Platform Measure Standard Deviation Coefficient of Variation ment z 95 Confi 95 Confi dence dence Interval Interval OCT Cen 1 8 um 1 2 3 4 0 7 0 5 1 4 tral Foveal um Thickness volume scan OCT Cen 1 7 um 1 2 3 3 0 7 0 5 1 4 tral Foveal um Thickness LE B scan OCT RNFL 0 7 um 0 5 1 4 0 7 0 5 1 396 Thickness um global OCT RNFL 1 1 um 0 9 1 4 1 0 0 8 1 296 Thickness um in sectors 1 9 Heidelberg Eye Explorer Software Platform Heidelberg Enginee
20. L u S on gt In order to display the image thumbnails as large icons click 4 gt In order to display the image thumbnails as small icons click gt In order to display the image thumbnails as a list click m FEEREAMOR M JEEP e setten 0 BREE BSR KETE BPR dt ie i i m a The window partitioning can be changed 64 O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Creating a New Patient File Hover with the mouse cursor over the separators of the lightbox and OD OS Drag and drop the separator to change the window partitioning For further information on changing these settings permanently please refer to amp Chapter 4 4 1 Setting Display Options on page 56 6 4 Creating a New Patient File gt Click amp to start HEYEX Click amp in the tool bar Patent Data ii we N Patiert Data More data Memo Paters DB ID 130 Lasi Doa Erst jenna Title Date of beth 11 07 1951 Sex if femme E Male Patiert ID 122256 frost Caucasian ra oK Cane Help I The Patient Data dialog box is displayed Insert the following patient data Last name mandatory First name mandatory Title Date of birth mandatory Sex m
21. Opening Patient Files on page 67 Click amp to open the image viewing window Eile View Record Image Setup Lightber Winden Help O00 goe porn SE tm FEE Patient Doe Jenna 1107151 ran Ea uox m AF po 3e er A Click Patient The Patient Data dialog box is displayed 80 O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Patient Data Click the More Data tab Enter or change the following data Insurance Additional insurance data Known allergies Country of birth Country of residence Region of residence Occupation Height Weight Smoking status Referring Physician Clinic The advanced search allows the search for patients using the informa tion entered in the Referring Physician Clinic field For further infor mation on the advanced search please refer to amp Chapter 6 6 Searching Patient Files on page 71 gt If there is no referring physician entered or in order to add a new refer ring physician click Patent Data An unkrisem phirscun vias elaied erii n r phoysiciar Hare Dj Cancel gt Enter name address and contact details in the opening dialog box gt Click OK to confirm The referring physician can now be selected from the drop down list O Heidelberg Engineering GmbH Art Nr 97326 005 US 81 Heidelberg Eye Ex
22. Setup has finished copying Mez bo your Computer Before vou can ute the program vou must restart Windows or pour computer 8 Yes wart to restart my computer now Ma will restart my computer later Remove ang disks lom Thes dives and then click Finish to complete sebup Fig 23 Setup Complete dialog box When the installation is completed the Setup Complete dialog box is displayed Before you can use the device and the software the PC must be restarted Select Yes I want to restart my computer now and click Finish 42 Heidelberg Engineering GmbH Art Nr 97326 005 US 3 2 3 Initial Operation 3 Installing the Software Network Installation Before starting the network installation please consider what kind of license you would like to install Fixed License If you have a fixed license you can use all functions offered by HEYEX acquire images and analyze images Fixed licenses are per manently associated with a single computer name With this type of license you can always access the system Floating License If you have a floating license you have the same privileges you have with the fixed license However floating licenses are not attached to a single computer name Only a certain number of license tokens are available for use If no license token is available when you try to access the system you receive the message LogOn of workstation failed because a sharin
23. be saved under the same name Right click an image thumbnail in the lightbox The context menu opens Select Save Lightbox Heidelberg Eye Explorer Name KEENE Iv Keep oignal lightbox The message Do you want to save the current lightbox is dis played gt Check the Keep original Lightbox box 1 Ifthe option Keep original Lightbox is not selected the original lightbox will be overwritten 96 Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Using the Lightbox gt Click OK to confirm EE E Deda a o Prest FI fer help Gm onn The lightbox is saved The lightboxes can now be selected from the Lightbox drop down list 6 14 3 Removing Images from the Lightbox gt Click amp to start HEYEX Add images to the lightbox amp Chapter 6 14 Using the Lightbox on page 94 In order to remove images from the lightbox right click an image thumbnail in the lightbox Display Print L l Scan Planning Tool RegionFimder Exchange 00 05 Export b Remove From lightbox Save lightbex X Delete lightbox Press Fl for help The context menu opens Select Remove from Lightbox The image thumbnail is no longer displayed in the lightbox 6 14 4 Deleting the Lightbox A lightbox that has already been save
24. database or remote compute Descuphion Installs single use version of the Soltwans Make sure that the beerse key is installed on this computer Fig 6 Select the setup type The Setup type dialog box is displayed Select the desired setup type Local installation database on this computer Installs a single user version of the software Make sure that the license key is installed on this computer Network installation database on remote computer In this example select Local installation gt Click Next to confirm Setup wall metal Heidelberg Eve Explorer in the laligeang holder Ta install la fa bolder chek Hest To install to a diferent folder chick Browse and select another You can choose nol Io install Hesdedberg E ve Explorer by checking Cancel to exi Setup Fig 7 Choose destination location for HEYEX The Choose Destination Location is displayed Select the destination folder for the Heidelberg Eye Explorer HEYEX e g C HEYEX 34 O Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software gt Click Next to confirm Setup val add program icons bo thes Program Folder ested below Vou may lype a new folder name or select one Irom lhe existing Feldeis list Click Next to continue ta me ces Fig 8 Select Program Folder dialog box The Select Program Folder dialog box is displayed gt C
25. liie Fed i OCT OCT ART Val Infra Red amp OCT B Scan Infra Red amp OCT B Scan Infra Red amp OCT OCT ART Volume B CO Frank Paul Glaucoma Frogeestion 3 15051362 TCA gt Click amp to start HEYEX gt Click H in front of the patient name All devices the patient was examined with are displayed gt Click in front of the device All examinations are displayed Double click the desired examination The examination is displayed in the right part of the database window Click amp to open the image viewing window The single examination is displayed In order to review the image double click the image thumbnail The analysis window opens In order to unload the single examination in the database window click oe in the tool bar O Heidelberg Engineering GmbH Art Nr 97326 005 US 6 5 3 Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Selecting and Opening Patient Files Selecting Multiple Patient Files gt Click amp to start HEYEX File Database Record Setup Window Help SR 7 UNS sacs Ham dl Update Dingler ELC Almer Sebastien Sempgnour Chaedopathy 12011354 IR RE FAFAC Aran Grego HEP ED degrees DUI 1955 EG Shu Gregor HEP EU degees Ut 01 1951 3 Bod Stefanie BP SD OCT Geographic Alrophy 0201 331 amp C Biche Jens Macular Hole 01 01 1584 F FAF STEREO OCT dB Cham Kan ASM Filtering Bleb 19 06 1967 Dy Theelen E C
26. saved filter please refer to amp Chapter 6 6 4 Loading Filters on page 75 Deleting a Database Filter gt In order to delete a filter click Load Laad Filter ipsi m AMD Dry DE 1 Comeal Dyatiogkhj CE alaucoma Cancel Egia The Load Filter dialog box is displayed gt Select a filter and click Delete to confirm The filter selected is deleted The Load Filter dialog box is closed The Database Filter dialog box is displayed gt In order to close the Database Filter dialog box click Cancel or E3 gt In order to switch off the filter and see the complete patient list click in the tool bar The complete patient list is displayed in the left part of the database window 74 O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Starting a New Examination 6 6 4 Loading Filters In order to use the function Load Filter a database filter must have previously been saved amp Chapter 6 6 3 Advanced Search on page 73 gt Click amp to start HEYEX Click in the tool bar Load Filter mn LAD Dry DE 1 Comeal Dyatnopk ar Glanacoena Cancel Karte Delete The Load Filter dialog box is displayed gt Select a filter Click OK to confirm The filter is applied The search results are displayed in the left part of the database window In order to swi
27. the touch panel and all its functions 7 1 How to use the Touch Panel Switch on the device Chapter 4 1 Switching the Device on and off on page 51 gt Click to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt In order to start a new examination click 2 in the tool bar amp Chapter 6 7 Starting a New Examination on page 75 The acquisition window opens After initializing turns to e If there is a safety interlock the message Safety interlock restart system is displayed on the touch I panel In the acquisition window the message Safety interlock Device must be restarted is displayed The patient sees four simultaneous blinking fixation lights Restart the system If the safety interlock persists stop using the system and call Heidelberg Engineering tech nical support On the touch panel press A high tone is audible when the scanners and the laser are switched on The camera starts and the cSLO image is displayed amp turns to W O Heidelberg Engineering GmbH Art Nr 97326 005 US 99 7 Touch Panel Selecting Acquisition Modes Use the touch panel to set the following settings Acquisition modes Laser intensity Scan angle Single acquisition or acquisition modalities Manual automatic image brightness control Internal external fixation light Injection timer OCT mode on off ACQ
28. wai OAH Pepai Aes 1 00 2007 OCT Val ogean brer ad eer 20 irl i MW Sod fl ACA V TT ATI pep SOP OOO Jer NRS I puter Jet LEE Der E y Iar fer fager blir dl ni Ui Eds iai 1004 1567 Ch aliis i Cisa dorp msn Mas D n en dF Heja Jepan igis Gei unes Pio DEO VET Cy Hem AMD OM DAL EI ENG C bag Wanda BE SD DCT Fascia api t DI 1957 7 himi T i Macdadionmd 213 G Miu Fl DP CALI e aL re ding IST 13 Cj dunk Prom Simi mg T2 TG AE Ti Bie PA WEE TRT Click amp in the Windows task bar HEYEX starts The database window is displayed Graphical User Interface Database Window Moker Ga Ur T i lid 5 d H r E d z 8 Dg 11 1374 Y BEET Gang gen iio ET OS TP Sad Hep Coraes 11 01 001 e t 3 B Dvs Wedge AIN eds iden dh GO jl E Deiri Ulmen Pagiras t ALS i TOR Oe dee P CH dogat hiia 11 Df 1960 a Miis 4 HEP Serg 53 Ol D VE B Epe leen Petter 10605 HRE FAF FAD wel fark Pai Carma Pepe 15 04 155 TC Wb Gerdt Ve Bac Biogen f 18 0 1 TA i Hidi Fmi Cleon ie FECI 1981 Cose B Hatten hike HAT REP Ot 021350 B blenderen John mage Daphne Laii nie TER VE Hach Deerns HIT ICA 188 Hm Eva ARED EFM 1104 2006 ARF FAF Fa ACT hed B Hopp iias HEP SON Comer PUT fl E Cars re S Spee bua 779 tari Hi VL ICT PR tet birder leues VG ES ities Ve Demel sig EN 198 Aer FAG LECT HE Gm e mm oW m E Bunt PE H Menu bar Tool bar Re 4 5
29. 02 1951 14 01 1 CJ aa The Change Patient dialog box is displayed Select the patient file to be kept Doe Jennifer gt Click OK to confirm The message Do you really want to change this examination from Doe Jenna to Doe Jennifer is displayed Heidelberg Engineering GmbH Art Nr 97326 005 US 91 6 Heidelberg Eye Explorer HEYEX Moving Images between Patient Files gt Click Yes to confirm The selected images are moved to the patient file to be kept Doe Jennifer and are no longer displayed in the patient file to be deleted Doe Jenna In order to move images from other examination tabs repeat the pre vious steps Select the patient file to be kept Doe Jennifer from the Patient drop down list and verify that this patient file contains all images that were moved from the patient file to be deleted Doe Jenna In order to return to the database window click amp in the tool bar gt In order to unload all patient files click 3 in the tool bar Delete the duplicate patient file of Doe Jenna that does not contain image thumbnails anymore For further information on deleting patient files please refer to amp Chapter 6 9 Deleting Patient Files and Examinations on page 77 6 13 2 Moving Images Stored in the Wrong Patient File For image acquisition the wrong patient file was accidentally selected As a result
30. 3 2 4 Installing the Licence Manager 48 3 2 5 Installing a Software Update 49 3 3 Accessing Software Information 50 Preparing for Examination eseeeeeeeseseesese 51 4 1 Switching the Device on and off nanne 51 4 2 Preparing the Device esses o3 4 3 Preparing the Patient unne nener eene nenenenennn o4 4 4 General HEYEX Settings an aanne nennen 56 4 4 1 Setting Display Options nun sauunn nennen ennen 56 142 Seting Plug ANS niro saninin a 57 W OFE OW EEE 58 Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Engineering GmbH Art Nr 97326 005 US Table of contents Heidelberg Eye Explorer HEYEX 59 Ol Stating HE YEN Vvs 59 6 2 Graphical User Interface Database Window 60 br TONN 61 6 2 2 Changing Display Options of Database Window 61 6 3 Graphical User Interface Image Viewing Window 62 EN FUP 63 6 3 2 Changing Display Options of Image Viewing Window 64 6 4 Creating a New Patient File nanne 65 6 5 Selecting and Opening Patient Files eee 67 6 5 1 Selecting a Patient File nnn aanneem nenn eneen 67 6 5 2 Selecting a Single Examination 67 6 5 3 Selecting Multiple Patient Files
31. 3 to open the image viewing window Select the examination tab of the current day gt Click 7a in the tool bar Continue Exsmination APG you punt you veni l bean palen Doe Jenna CSCR HD The Are you sure you want to re examine patient dialog box is dis played gt Click Yes to confirm The acquisition window opens gt Acquire images The acquired images are displayed in the examination tab of the cur rent day 6 9 Deleting Patient Files and Examinations i NOTICE Ensure that the local regulations retaining patient data eo are observed before deleting a patient file Deleting Patient Files in the Data gt Click amp to start HEYEX pase OM Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 O Heidelberg Engineering GmbH Art Nr 97326 005 US TT 6 Heidelberg Eye Explorer HEYEX Deleting Patient Files and Examinations Deleting Examinations in the Image Viewing Window 78 Bm Hame 3j C Brodersen Delete Database Record hum o mcm S Do uon really werd bo perisnentiy delete the followeng second Doe Jenna 11 11 1551 IV WES wani t permanently delete the database record The dara CANNOT be ietneved i an later me I Heidelberg Eye Explorer file Database Record Setup Window Help Lead b Che CHR Cek Coe Lead All 3 owe ow Unload n SS Uniead All Vims images E Propertie
32. 7 1511 a O Cham hrs ASM Fleng Bleh 1906 1567 0r Theelen EO Char Yeong Cham ASM DIMER Dn Fuchs Dystrapkst 1007 1965 Prot ki HO Chieti Wein ASH Inder and boh ADA a 4 1552 C Dneterla label Glaucoma Progiezsen 1 2005 1534 TCA Hi CO eale Simon Glsseoma bordene TU U3 5957 Caucasian Doe Jaden 00 1550 t CO Doe Henna ASM Frengssum 14 181932 Prol Kruse Dr Tomca IE EG Dos Jenna 11 07 1551 E C Dos Jenna HP Piogiecdon 1 22 02 2008 5 Das Jenny BP Popes 2 17032008 Fl EC Dipeschar blass HEP Scr ering 8 30 01 01 1398 m O Ege Metin Renoechens 10006195 IRI PF FAR FA IC Wol i C Frank Paul Glaucoma Frogrestion 3 1505 1962 TCA In order to recall queries open the drop down list gt Select a last name e g Doe gt Press or click Update Display All last names starting with Doe are displayed In order to switch off the filter delete the name and click Update Display Searching Patient Files from Today With the search functionality Today it is possible to filter for all patient files that were examined on the current day This feature could be useful in identifying examinations that require review or billing Heidelberg Engineering GmbH Art Nr 97326 005 US 6 6 3 Heidelberg Eye Explorer HEYEX 6 Searching Patient Files gt Click amp to start HEYEX gt Click f in the tool bar 1 The number on the icon varies depending on today s date On the
33. ALIS User Manual this document The HRA OCT is a non contact ophthalmic diagnostic imaging device It is intended for viewing the posterior segment of the eye including Two and three dimensional imaging Cross sectional imaging Fundus photography Fluorescence imaging including Fluorescein Indocyanine green Autofluorescence and to perform measurements of ocular anatomy and ocular lesions The device is indicated as an aid in the detection and management of various ocular diseases including Age related macular degeneration Macular edema Diabetic retinopathy Retinal and choroidal vascular diseases Heidelberg Engineering GmbH Art Nr 97326 005 US Preface 1 Third Party Hardware and Software Glaucoma and for viewing geographic atrophy as well as changes in the eye that result from neurodegenerative diseases The HRA OCT includes a retinal nerve fiber layer thickness normative database which is used to quantitatively compare the retinal nerve fiber layer in the human retina to a database of Caucasian normal sub jects the classification result is valid only for Caucasian subjects The optional SPECTRALIS Anterior Segment Module is an accessory to the SPECTRALIS HRA OCT and is indicated for imaging the ante rior segment of the eye 1 5 Third Party Hardware and Software i NOTICE Do not install third party software and hardware that eo has not been approved by Heidelberg Engineering The ope
34. Based on the core technologies of confocal scanning laser active live eye tracking and noise reduction technology MultiColor images dem onstrate high image contrast and resolution Without a flash light and no need for pupil dilation this entirely non invasive fundus imaging modality significantly improves patient comfort as compared to color fundus photography In addition simultaneous imaging with multiple laser colors selectively captures and portraits diagnostic information originating from different retinal structures within a single examination Blue reflectance highlights epiretinal membranes nerve fiber layer and macular pigment Green reflectance highlights blood blood vessels and exudates Infrared reflectance highlights drusen RPE abnormalities and changes in the choroid Along with the MultiColor image all three color laser images can be viewed and analyzed individually in the MultiColor viewing software 1 8 Precision of SPECTRALIS Measurement The reproducibility and repeatability of the various measurements pro vided by the SPECTRALIS were tested in a clinical study with the fol lowing results O Heidelberg Engineering GmbH Art Nr 97326 005 US 19 1 Preface Precision of SPECTRALIS Measurement Reproducibility Data Summary Measure Standard Deviation Coefficient of Variation ment 9595 Confi 95 Confi dence dence Interval Interval HRA Dis 0 05 mm 0 04 0 09 0 8 0 6 1 3 tance mm
35. Changing Display Options of Image Viewing Window on page 64 Small Icons amp Chapter 6 3 2 Changing Display Options of Image Viewing Window on page 64 List amp Chapter 6 3 2 Changing Display Options of Image Viewing Window on page 64 No split amp Chapter 6 3 2 Changing Display Options of Image Viewing Window on page 64 Split Exam amp Chapter 6 3 2 Changing Display Options of Image Viewing Window on page 64 Split Exam and Lightbox amp Chapter 6 3 2 Changing Display Options of Image Viewing Window on page 64 63 6 Heidelberg Eye Explorer HEYEX Graphical User Interface Image Viewing Window 6 3 2 Changing Display Options of Image Viewing Window The image thumbnail display and the look of the image viewing window can be changed E 3 0 BAG mn p am Luer Ce d jHw iE J os m m s j j m mE EE g E OL 2 u 3 gt In order to display the image thumbnails and the lightbox without split ting in OD and OS click 8 gt In order to display the image thumbnails split in OD and OS click 2 2 In order to display the image thumbnails and the lightbox split in OD and OS click 3 mn E m a us ma A cem em am E sl se p 5e BG E y na Z J ire RN nam oe n 7 LL m ja ug n3 E pomme 5 am p E
36. Class 3B may be accessible and can lead to injuries The power supply housing must only be opened by qualified service staff The warning label to this effect is located on the back side of the power supply i NOTICE Active eye tracking during OCT image acquisition is eo only possible for a certain maximum duration After that time the maximum permissible exposure can be reached In that case active eye tracking is switched off automatically and the message Tracking time limit for current eye reached OCT ART and Follow up disabled is displayed The laser on time during an OCT acquisition is limited by tracking time which is switched on with ART Mean The OCT image acquisition and follow up examinations with ART Mean are disabled when the time limit has been exceeded OCT image acquisition and follow up exami nations can be continued after a waiting time of approx 24 hours This way patient safety is ensured When ART Mean is disabled it is still possible to acquire OCT images without ART Mean Always switch off ART Mean after acquiring an OCT image to save tracking time WARNING Only use optical lenses provided by the manufac turer The incorrect use of lenses on the SPECTRALIS camera or the use of unauthorized lenses may result in the patient s retina being exposed to hazardous laser light O Heidelberg Engineering GmbH Art Nr 97326 005 US 29 3 Initial Operation 3 Initial Operation Abou
37. D Pi Perimeter if ELL The program files are copied to the destination folder Please browse for the n heotk database deecton this installation of the Heidelberg Eye Explorer e g ky Server hepen data Fig 29 Choose destination location In the opening dialog box Choose Destination Location browse the database network directory to use for this installation gt Click Next to confirm Fig 30 Browse patient image data folder Select the directory for the patient image data folders Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software gt Click Next to confirm Every Heidelberg Eve Explor vec station ID wahin ihe network For feed beerse shal ing the woik station ID vath 2 and increment thes value by 1 fer every new ebent matalstien For lasting licenses type m 0 Fig 31 Enter a workstation ID Enter a workstation ID For fixed licenses start numbering the workstation ID with 2 and increment this value by 1 for every new client installation For floating licenses type in O as workstation ID gt Click Next to confirm ou should d ine r unique workstation name for evens installation of the Heidelberg Eye Explorer Please enter the workstation name Fig 32 Enter a unique workstation name Enter a unique workstation name for every installation of the Heidelberg Eye Explorer gt Click Next to confirm
38. Data loss disables progression series and can lead to wrong diagnostic conclu sions Only allow authorized personnel to access the data Wilfull changes of data can lead to wrong diagnostic conclusions Implement measures to protect personal patient data from misuse Follow the instructions below to ensure equipment reliability Only certified staff of your local authorized distributor or Heidelberg Engineering staff should install the device Do not modify the device Modifying the device in any way will auto matically void the equipment warranty Heidelberg Engineering does not take responsibility for modified devices Do not attempt to repair the device if a problem occurs Only trained qualified personnel authorized by Heidelberg Engineering is allowed to do repairs For service requests contact your local distributor or Heidelberg Engineering Before using the device for the first time give it a visual review If there are any uncertainties optical mechanical or electrical defects contact your local distributor or Heidelberg Engineering Heidelberg Engineering GmbH Art Nr 97326 005 US 25 2 General Safety Messages Equipment Reliability Do not use the device if there is a technical defect unusual vibrations or an unusual sound If there are uncertainties contact your local dis tributor or Heidelberg Engineering Operate the system at an ambient temperature of about 18 25 C If the device is operate
39. F FAF FA TCU Wet EO Frank Paul Glaucoma Progarton 3 15 056 1862 TCA In order to open a patient file or to select a patient file for review double click a patient file The circle next to the patient name turns black The patient file is dis played in the right part of the database window gt Click 3 to open the image viewing window All acquired images of the selected patient can be reviewed The acquired images are organized by examination date in individual examination tabs In order to review an image double click an image thumbnail The analysis window opens gt In order to unload the patient file in the database window click ee in the tool bar 6 5 2 Selecting a Single Examination A single examination can be selected for review Heidelberg Engineering GmbH Art Nr 97326 005 US 67 6 Heidelberg Eye Explorer HEYEX Selecting and Opening Patient Files 68 Heideiberg Eye Epe kn File Database Record Setup Window Help EEKEREN gj Update Dispis b Dos Jenna Care 1 04 121263 Pj Sperian OCT 21 06 2010 Inis Fedt OCT OCT ART Volume E O Alme Sebastian Sempnou Chxrodopaihy 12 01 1554 IR AF FAF FANC l CC Aviles Gregory HEP BD degrees 01 01 1951 EO Bachie ders Macular Hole 01 01 1984 FA FAF STEREO OCT a 0 Bleken Fall 06111874 HE C Bolt Steane BP SO OCT Geographic Atrophy 02 01 1937 Sj Spectralis OCT 21 05 2010
40. How to use this User Manual e The symbol indicates helpful hints for using the device I and the software Safety messages answer the following questions What is the hazard What are possible consequences of not avoiding the hazard How is the hazard avoided Embedded Safety Messages Embedded safety messages are integrated into procedures or into other non safety information Integrating safety messages into proce dures can be particularly helpful as the safety message can be placed at the step in the procedure when it should be followed gt A CAUTION This is an embedded safety message of the type Cau tion The embedded safety message includes the use of a signal word the safety alert symbol and the message P 1 This is an embedded safety message of the type Note Procedures gt The procedure is used for supporting the reader in completing a task b Lists The list is used for structuring information 1 1 2 Explaining Identification Marks URL Information available on websites is identified by underlined text http www heidelbergengineering com Menu Path Menu paths of the software are identified by quoted italic font Each menu item is separated by a backslash File Save as Keys Keys are identified by their symbol en Examples Examples are identified by a gray background over the entire width of the page Cross References Cross references are identified by parentheses amp Chap
41. The message Would you like to configure an archive drive location is displayed Heidelberg Engineering GmbH Art Nr 97326 005 US 47 3 Initial Operation Installing the Software gt Click No to cancel Descnplion Instals the HAA 7 Specialis viewing and acquistion module Choose lis metalation Tor workstabone valha HRA or Specials camera altached mes Fig 33 Select Type dialog box The dialog box Setup Type is displayed Select one of the following setup types finish the installation and restart your computer HRA2 or SPECTRALIS system is attached to this PC amp Chapter 3 2 1 Local Installation with an HRA2 SPECTRALIS Device attached on page 33 No HRA2 SPECTRALIS system installed Chapter 3 2 2 Local Installation with no HRA2 SPECTRALIS Device attached on page 38 3 2 4 Installing the Licence Manager Plug the software dongle into the USB port Insert the software CD into the PC drive Wait for the automatic start of the installation program or manually run the program setup exe from the root directory Select an installation language and click OK to confirm Please select the program ba install Specials Pandy Soler instal Licence Manager only C Browse the CD ROM contents Back Met Cancel Fig 34 Select Installation dialog box The Select Installation dialog box is displayed Select Install License Manager only
42. UIRE Buttons with a yellow frame lead to submenus All selected options are highlighted blue 1 2 Selecting Acquisition Modes In order to access the different acquisition modes available on the 100 device turn the filter wheel to A or R 1 If the filter wheel is not correctly positioned at R or A it is not possible to select acquisition modes and acquire images In the status line of the acquisition window the message Invalid filter wheel position is displayed A covers the angiography and autofluorescence acquisition modes amp Chapter 7 3 Filter Wheel at Position A on page 103 R covers the reflection acquisition modes amp Chapter 7 4 Filter Wheel at Posi tion R on page 104 Infrared imaging is always available 8 The acquisition mode Red Free on the touch panel corresponds to the acquisition mode BR in the acquisi tion window Heidelberg Engineering GmbH Art Nr 97326 005 US
43. ake sure that the license key is installed on this computer For further information please refer to amp Chapter 3 2 1 Local Installa tion with an HRA2 SPECTRALIS Device attached on page 33 Local installation with no HRA2 or SPECTRALIS system attached to this PC This setup type installs a single user version of the SPECTRALIS viewing module only Choose this installation for workstations with no HRA2 or SPECTRALIS camera attached Make sure that the license key is installed on this computer For further information please refer to amp Chapter 3 2 2 Local Installa tion with no HRA2 SPECTRALIS Device attached on page 38 Network installation This setup type installs a network client For further information please refer to amp Chapter 3 2 3 Network Installation on page 43 Install the Heidelberg Eye Explorer Licence Manager only For further information please refer to amp Chapter 3 2 4 Installing the Licence Manager on page 48 Install a software update For further information please refer to amp Chapter 3 2 5 Installing a Software Update on page 49 Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software 3 2 1 Local Installation with an HRA2 SPECTRALIS Device attached e Installs the HRA SPECTRALIS viewing and acquisition module Choose this installation for workstations with a HRA2 or SPECTRALIS camera attached Plug the soft
44. amp Chapter 6 2 1 Tool Bar on page 61 Quick search 60 Heidelberg Engineering GmbH Art Nr 97326 005 US Selected patient files are displayed All patient files are displayed 6 2 1 Tool Bar ow Ore oe Ow One Ore Heidelberg Eye Explorer HEYEX 6 Graphical User Interface Database Window Database Window amp Chapter 6 2 Graphical User Interface Database Window on page 60 Image Viewing Window amp Chapter 6 3 Graphical User Interface Image Viewing Window on page 62 Filter amp Chapter 6 6 3 Advanced Search on page 73 Load Filter amp Chapter 6 6 4 Loading Filters on page 75 No Filter Today amp Chapter 6 6 2 Searching Patient Files from Today on page 72 Properties amp Chapter 6 10 1 Updating or Changing Patient Data on page 79 New Patient amp Chapter 6 4 Creating a New Patient File on page 65 New Examination amp Chapter 6 7 Starting a New Examination on page 75 Load amp on page 67 Unload amp on page 67 Load all amp Chapter 6 5 4 Selecting All Patient Files on page 70 Unload all amp Chapter 6 5 4 Selecting All Patient Files on page 70 6 2 2 Changing Display Options of Database Window The window partitioning can be changed Hover with the mouse cursor over the separator Drag and drop the separator to change the window partitioning O Heidelberg Enginee
45. an aR 223 10 8 4 Arrow Overlay ann sanen eneen en vener eenen ennen 224 10 8 5 Measuring Diameters aanneem ennen eneen 226 10 8 6 Setting an ETDRS Grid aaan aa enen 227 10 8 7 Copying Overlays naan enn vens enn enn enr ennen 229 10 9 Rotating IMAGES crises 233 10 10 Window Options aaneen enen en een enrene neen 233 10 11 Analyzing ART Composite Fundus Images 235 10 12 Analyzing Simultaneous Fundus Images 235 10 13 Analyzing Stereo Fundus lImagges 237 10 14 Analyzing Movies uus sennenennsenne eenen 239 Analyzing OCT Images nan nnen eneen 243 11 1 Identifying Image Thumbnails 243 11 2 Preprocessing Acquired Images 244 11 3 Extracting Fundus Images vennen 244 11 4 Expanding and Extracting Images and Movies 245 11 9 Display Turene 248 11 5 1 Graphical User Interface 248 11 5 2 Scrolling through OCT Images 250 11 6 Showing Position Markers and Segmentation Layers 251 11 7 SD VIeW TaD sirais anita metit mts matita out 252 11 7 1 Graphical User Interface 252 11 8 Thickness Profile Tab eese 255 11 8 1 Graphical User Interface Layer Retina 255 11 8 2 Editing the FoDi
46. andatory Male is set as default Patient ID Ancestry For further information on entering patient data please refer to amp Chapter 6 10 1 Updating or Changing Patient Data on page 79 Heidelberg Engineering GmbH Art Nr 97326 005 US 65 6 Heidelberg Eye Explorer HEYEX Creating a New Patient File gt Click OK to confirm xamenation Data Examen Dan Dura Caer Dee dama 11111381 Date Tenes 1022012 Deze Oee Shudy oK Cancel e The Examination Data dialog box is displayed In the Examination Data tab select the device type from the Device Type drop down list All other entries are optional For further information on entering exami nation data please refer to amp Chapter 6 11 1 Updating or Changing Examination Data on page 83 In the Diagnosis tab enter the patient s diagnosis For further infor mation on entering a diagnosis please refer to amp Chapter 6 11 2 Updating or Changing Diagnosis on page 85 gt Click OK to confirm Eye Data ee gt S i 00 os Curve rm riri fr Rekscen dpp 0 fo Cylinder dr I 0 done deg n D Pup size mm ye B o IDP eral N nm WF nekt aar n a Veha io B C vi cln Lene hoe el hoe el The Eye Data dialog box is displayed Insert the patient s eye data All entries are opt
47. annot be examined with conventional methods With the OCT examination we can exactly display the several layers of the retina which helps us to improve diagnosis and follow up examinations By means of the optical coherence tomography the examination of the posterior segment of the eye is possible The examination with the SPECTRALIS is completely safe without touching the eye and takes only a short examination time A light beam scans the retina and the optic nerve head No pupil dilation is necessary Please put your chin on the chin rest and your forehead against the forehead rest For best image quality please lean your forehead against the forehead rest for the duration of the examination I will move the device close to your eye but won t touch it Please look at the blue dot You are allowed to blink the examination results won t be affected The examination will take only a few seconds When the examination starts a red line or a red circle is visible If the red line or the red circle changes its position please do not follow it with the eyes constantly look at the blue dot I will let you know when the examina tion has finished e For further information please refer to the Heidelberg I Engineering Academy Quick Guides at http www heidelbergengineering com international education quick guides O Heidelberg Engineering GmbH Art Nr 97326 005 US 55 4 Preparing for Examination General HEYEX Settings 4 4 4 4
48. are the patient amp Chapter 4 3 Preparing the Patient on page 54 Prepare the device amp Chapter 4 2 Preparing the Device on page 53 Start an examination amp Chapter 6 7 Starting a New Examination on page 75 or a follow up examination amp Chapter 9 5 Acquiring Follow up OCT Images on page 199 52 O Heidelberg Engineering GmbH Art Nr 97326 005 US 4 2 Preparing for Examination 4 Preparing the Device NOTICE Shut down procedure neglected Data may be lost if shut down procedure is not per formed correctly Do not switch off the camera when the acquisition window is open Do not switch off the PC without closing HEYEX NOTICE Shut down procedure neglected Camera damage may occur if shut down procedure is not performed correctly Do not switch off the isolating transformer while the camera is acquiring images Switching off the Device Close all HEYEX dialog boxes and windows e g acquisition window or Preparing the Device analysis window gt Click E3 to close HEYEX The message Do you want to exit the program is displayed gt Click OK to confirm HEYEX is closed Select Start Turn off Computer The dialog box Turn off computer is displayed Select Turn off The PC turns off G Switch off the monitor 2 gt Switch off the power supply Switch off the isolating transformer 1 Ensure
49. d can be deleted amp Chapter 6 14 2 Saving the Lightbox on page 95 gt Click amp to start HEYEX gt Select a patient file that contains one or multiple lightboxes Heidelberg Engineering GmbH Art Nr 97326 005 US 97 6 Heidelberg Eye Explorer HEYEX Using the Lightbox 98 Click amp to open the image viewing window Open the Lightbox drop down list and select the lightbox to be deleted Right click an image thumbnail Display Print Scan Planning Tool RegionFinder Exchange OD O5 Export Remove from lightbox Save lightbox Delete lightbox l The context menu opens gt Select Delete Lightbox D Preus FI Tor help The Do you want to delete this lightbox dialog box is displayed gt Click Yes to confirm Heidelberg Engineering GmbH Art Nr 97326 005 US 7 Touch Panel About this Chapter Touch Panel 7 How to use the Touch Panel This chapter provides an introduction to the touch panel including Selecting acquisition modes e g infrared imaging IR or simultaneous IR OCT Selecting acquisition modalities e g movies tomographies composite images or stereopair images Selecting acquisition settings e g high speed or high resolution manual or automatic image brightness control Controlling manual image brightness control Acquiring images By the end of this chapter you should be able to confidently use
50. d in ambient temperatures which exceed the rec ommended operating environmental conditions this might lead to a longer start up time The device cannot be used during this period 26 NOTICE Do not expose the device to extreme temperature and or humidity changes High temperature variations can cause bad data quality Allow the instrument to adjust to room temperature for at least two hours prior to operation NOTICE Portable and mobile RF communications equipment can affect medical electrical equipment There is a risk of device malfunction when the device is operated close to electromagnetic interference fields Medical electrical equipment needs special precautions regarding electromagnetic compatibility Although the electromagnetic compatibility of the system has been tested in accordance with IEC 60601 1 2 Electromag netic Compliance EMC devices can nonetheless inter fere and cause bad data quality or electronic disruptions Always heed the EMC information provided in this manual when the the device is installed and put into service Avoid placing hand held high frequency devices next to the device NOTICE Do not operate the device in an environment with vibrations The proper operation of the device might be disturbed if the device is operated in an environment with vibrations Bad data quality and or incorrect measurements could result Heidelberg Engineering GmbH Art Nr 97326
51. d like to keep and the patient file you would like to delete 90 Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Moving Images between Patient Files gt Click amp to start HEYEX W Heidelberg Eye Explorer See e file Database Record Setup Window Help Em V vv Han 00033 cs Hane Update Display I 3 Doe Jenna 0202 1957 1401 e Dae Jenna 0202195 1407 3j 4 Des Jernder 02021951 14 01 cw W amp Doe Jenne 02021951 14 01 Double click the patient file to be kept Doe Jennifer The patient file is loaded in the right part of the database window gt Double click the duplicate patient file to be deleted Doe Jenna The patient file is loaded in the right part of the database window Make sure that only the relevant patient files are loaded in the right part of the database window gt Click 3 to open the image viewing window Select the patient file to be deleted Doe Jenna from the Patient drop down list gt If there are image thumbnails on both sides OD and OS click 88 to remove the split gt Press and hold lt and select all image thumbnails gt Release and right click a selected image thumbnail The context menu opens Select Change Patient Change Patient E ipn ii 3 Faase selec a nav patient from ihe Est Dos Jenaifer 02
52. e Examination Data dialog box is displayed Enter an operator name or select an operator from the Operator drop down list Select a study from the Study drop down list Entering a new Study If no study is entered or in order to add a new study click Enter a study name in the opening dialog box and click OK to con firm The study is saved and can now be selected from the Study drop down list Renaming a Study gt In order to rename an existing study click Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Examination Data Exarraristion Data fe Edi easing Study Insert reni Study C Delete ashing Shuck x Follow up gt Check the Edit existing study box and enter the new name in the opening dialog box gt Click OK to confirm The existing study is renamed but the original study is kept and must be deleted Deleting a Study Select the study to be deleted from the Study drop down list and Click g i Only a study that is not assigned to any examination can be deleted i Changes made to the study are made throughout the entire data base not just that examination Eamanation Data Ed exiting Stucky T nent news Study fe Delete cing Shuck LGA Followup OK Cancel lt gt Check the Delete existing study box and click OK to confirm in the opening dialog box The study
53. e dialog box The Select Type dialog box is displayed Select HRA2 or SPECTRALIS system is attached to this PC gt Click Next to confirm The T1394 bus driver installation box is displayed asking whether the driver shall be installed or not gt Click Next to confirm A message will be displayed explaining that a warning message might appear under Windows 7 asking whether the Thesycon IEEE T1394 bus host controller shall be installed or not If the warning message appears select Install this driver software anyway Setup has finished copying Mez bo your Computer Before vou can une the program uou most resta Windows or your compuler 8 Yes wart to restart my computer now C Ma d will pest my computer later Remove arg disks lom then dines and then click Finish to complete setup Firash Fig 13 Setup Complete dialog box When the installation is completed the Setup Complete dialog box is displayed Before you can use the device and the software the PC must be restarted gt Select Yes I want to restart my computer now and click Finish Heidelberg Engineering GmbH Art Nr 97326 005 US 37 3 Initial Operation Installing the Software 3 2 2 Local Installation with no HRA2 SPECTRALIS Device attached o Installs the SPECTRALIS viewing module only Choose this installation for workstations with no HRA2 or SPECTRALIS camera attached Plug the so
54. e TruTrack Active Eye Tracking technology allow the user to acquire follow up OCT scans using dif ferent devices within the SPECTRALIS product family The cSLO image acquired simultaneously with the OCT scan serves as the regis tration link for this purpose A unique algorithm enables automatic matching of cSLO images acquired with identical or different imaging modalities Heidelberg Noise Reduction TruTrack Active Eye Tracking enables the capture of multiple images in the exact same location The automatic real time ART mean func tion combines these images helping clinicians to discriminate between image noise and true signals from real tissue structures Noise is effectively eliminated and the result are images of high contrast with finer detail Heidelberg Engineering GmbH Art Nr 97326 005 US 17 1 Preface Technical Description AutoRescan AutoRescan HI FIOCT OCT SPECTrALIS SPECTrALIS Fig 3 Initial and follow up examination of one patient 18 Fovea to Disc FoDi Alignment Technology AutoRescan allows clinicians to track change over time Locating the initial scan is important locating the follow up scan is critical Using the fundus image like a fingerprint SPECTRALIS automatically places follow up scans in precisely the same location as the initial scan Elimi nating subjective placement of follow up scans is important for opti mizing patient flow and for confidently identifying small cha
55. e the selected images is displayed gt Click Yes to confirm The image is deleted Heidelberg Engineering GmbH Art Nr 97326 005 US 6 10 6 10 1 Heidelberg Eye Explorer HEYEX 6 Patient Data Updating or Changing Patient Data Patient Data The properties of patient files can be updated in case of false or incom plete entries gt Click amp to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click 3 to open the image viewing window e Heidenen Speler File Miu Record mage Setup Lighbexs Winden Help Don 2 Oen rr WEN A Womed PETN MN Patiert Data More data Memo Patiert DE 10 130 11 07 1551 Female Mak 122455 The Patient Data dialog box is displayed O Heidelberg Engineering GmbH Art Nr 97326 005 US 79 6 Heidelberg Eye Explorer HEYEX Patient Data Enter or change the following data Last name mandatory First name mandatory Title Date of birth mandatory Sex Patient ID Ancestry gt Click OK to confirm The warning message You are about to change the patient info is displayed Click OK to confirm or Cancel to quit without changes 6 10 2 Updating or Changing Additional Patient Data Click amp to start HEYEX Select a patient file amp Chapter 6 5 Selecting and
56. en ennrvenenvenen vene 330 Heidelberg Engineering GmbH Art Nr 97326 005 US 15 16 17 18 19 20 Heidelberg Engineering GmbH Art Nr 97326 005 US Table of contents 14 6 Exporting XML FileS unnnaen eneen een nen eenen 332 14 7 Exporting Movies saneren en enerennreenenenn 333 14 8 Burning Exported Data onto a CD 335 14 9 Computing Mean Images nnen nennen 336 14 10 Computing Composite Images 337 Data Backup aanne eneen eneen senen enenneneens 340 15 1 Archiving Images unne snnn ven enensr ennn eeneeenn 340 15 2 Retrieving Images unne nennen eneen eenen ennn 341 15 3 Compressing the Database nun nen 342 Troubleshooting an vann nennen evene venenenenen 344 Service and Cleaning nnn nennen ennen enen 348 17 1 Service and Maintenanc annua nanne nenenn 348 17 2 Saving the Log Information to the Archive File 348 17 3 Cleaning and Disinfection nnen veen 349 DENS SN 351 Technical Specifications nnen eneen een eenen 352 19 1 Electromagnetic Compatibility cc ceeeeeeeeeeeeeeeeeees 356 19 1 1 Guidance and Manufacturer s Declaration 356 19 1 2 Recommended Separation Distances 358 19 2 Regulatory Standards annees nennen 360 be AN enn 361 19 3 1 UL Classification Mark eneen 362 l
57. er Software Platform Images can be imported by Browsing to digital images e g JPEG TIF BMP Capturing screenshots Scanning in paper files For further information please refer to the Image Capture Module User Manual O Heidelberg Engineering GmbH Art Nr 97326 005 US 23 2 General Safety Messages Patient Safety 2 General Safety Messages A 2 1 Patient Safety 24 Review the following points before handling the device Carefully read the user manual Keep this user manual within easy access The inappropriate use of this device could damage the device and or Cause severe injuries Mind all safety advices on the device and in the user manual Follow all precautions listed in the user manual A thorough understanding of how to properly use the device will reduce examination time increase patient comfort and support best image quality Follow the instructions below to ensure the patient safety and the best examination results possible Never leave the patient alone in the examination room during the examination Clean and disinfect the head rest the chin rest and the lens in front of the patient Dirty device parts can transmit pathogenic germs causing infections Check that the scanners are working properly before starting an exami nation A high tone must be audible Never draw diagnostic conclusions based on a single examination Always heed past medical history i NOTICE Lack of
58. etina Change Report All Follow Ups 296 13 10 3D VIEW ISeDOLL ioie rien ette edo eroi eiae 298 13 11 Thickness Map Single Exam Report 299 13 12 Thickness Map Single Exam Report OU 300 13 13 Thickness Map Change Report Recent Follow up 301 13 14 Thickness Map Change Report All Follow ups 303 13 15 Thickness Map Change Report OU Recent Follow jj 305 13 16 Thickness Map Change Report OU All Follow ups 307 13 17 RNFL Single Exam Report OU with FoDi 309 13 18 RNFL Change Report with FoDi Recent Follow ups 310 13 19 RNFL Change Report with FoDi All Follow ups 312 13 20 RNFL Trend Report with FoDi 314 13 21 Asymmetry Analysis Single Exam Report OU 316 13 22 RNFL and Asymmetry Analysis Single Exam Report 317 13 23 Posterior Pole Assessment Report 319 13 24 Asymmetry Analysis Single Exam Report 321 13 25 MultiColor Reports Option aaneen 322 13 25 1 MultiColor Selective Color Laser Images 322 Processing DAS NN ERR m 324 14 1 Exchanging OD OS caserne aten 325 14 2 Exporting individual Examinations as E2E Files 325 14 3 Exporting Multiple Patient Files as E2E Files 327 14 4 Importing E2E FileS aanne nnen ene nen en neneneens 329 14 5 Exporting Pictures annen enn
59. ftware dongle into the USB port Insert the software CD into the CD drive Wait for the automatic start of the installation program or manually run the program setup exe from the root directory Select an installation language and click OK to confirm fv Spectrak Family Softwate inaa Licence Manager only Browse the CD ROM contents Fig 14 Select Installation dialog box The Select Installation dialog box is displayed Select SPECTRALIS Family Software and click Next to confirm Welcome bo the Heidelberg Eye Explorer Setup program Thi pogam vel instal Heidelberg Eye Explorer pn peas compute Le range tecommended jat vou sj l all windows programs baias runing thi Setup progr m Chek Cancel lo qui Setup and then close ary programs you have running Dick Hed lo continue veh Ihe Setup pogan WARNING The program m protected by copynghl baw and international heather Ursutlhonped reprodacbon or dilnbubon ol thes program or ary portion of ib may recul in severe cred and cnminal pensler and will be proseculed 1o the maeamum extent passible under law Fig 15 Welcome screen The installation starts and the welcome screen is displayed 38 O Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software gt Click Next to confirm Click the type of Setup you prefer then click Hest Description Installs smgle uzer version of the Soltwars Make
60. g Laser Imaging Option on page 19 Heidelberg Engineering GmbH Art Nr 97326 005 US Preface 1 Technical Description Getting the full picture of disease is critical to understanding complex pathologies Multi modality imaging offers deep insights into structure function and metabolic activity of the retina and consequently benefits patient flow detection and management of disease TruTrack Active Eye Tracking SPECTRALIS utilizes two separate beams of light to capture two images simultaneously One beam constantly tracks and images the fundus It also acts as a reference quiding the OCT beam Active eye tracking locks the OCT to the fundus providing precise alignment of blood vessels and fundus image Active eye tracking is of critical importance in 3D volume scans which are susceptible to eye motion artifact Fig 2 Image without and with active eye tracking The red dot indicates the OCT scan the blue dot indicates the IR laser All SD OCT devices operate with TruTrack Active Eye Tracking tech nology with dual beam scanning to produce OCT scans free of motion artifact Precise registration of OCT scan to fundus image Precise follow up examinations Wolf Schnurrbusch et al Macular Thickness Measurements in Healthy Eyes Using Six Different Optical Coherence Tomography Instruments Invest Ophthalmol Vis Sci July 2009 Vol 50 No 7 Pg 3432 3437 Image Registration The common HEYEX database and th
61. g violation occurred The software cannot be used until an other user logs off and a license token becomes avail able Insert the software CD into the PC drive Wait for the automatic start of the installation program or manually run the program setup exe from the root directory Select an installation language and click OK to confirm Select Installation Please select the program to metal f Spectral Famdy Solbeans ingal Licence Manager only Browse the CD ROM contents Back Hed Cancel Fig 24 Select Installation dialog box The Select Installation dialog box is displayed O Heidelberg Engineering GmbH Art Nr 97326 005 US 43 3 Initial Operation Installing the Software 44 Select SPECTRALIS Family Software and click Next to confirm og Welcome tothe Heidelberg Eye Explorer Setup program Thi program voll ndal Heidelberg Eye Explorer pn sous computes Li tronge tecommended tha vou sj l all windows programs before running tive Setup program Chek Cancel lo qui Setup and then close any programs you have munning Dick Next lo continue veh Ihe Setup program WARNING This program ex protected by copynghl law and international heater Ursuhonped reprodueb n or deinbubon ol the program or ary portion of ib map recul in severe cred and cnminad pensler and wil be preseculed bo ha pain eden nacshble under lav Fig 25 Welcome screen The i
62. ication when closing HEYEX check the Show information on exit box A dialog box will ask Do you want to exit the program each time HEYEX is closed gt Click OK to confirm Heidelberg Engineering GmbH Art Nr 97326 005 US Preparing for Examination 4 General HEYEX Settings 4 4 2 Setting Plug Ins gt Click amp to start HEYEX Select Setup Options in the menu bar Fite Time Comment 24 02 2005 11 56 Image Capture Modu 07 10 2011 1215 HEP Viewing Module hraviewer Vewer loaded 5460 07 09 2011 1529 HRA Spectraks Ve HRTC Viewer loaded 1300 151120051658 HRT Comea Viewing HATS Witwer loaded i200 30032010 14 01 HRT ONH Viewing amp HSFRegFnder Viewer loaded 2430 150320111207 HSF Region Finder The Options dialog box is displayed Click the Plug Ins tab gt Click an already installed plug in In order to unload the plug in click Unload In order to enable or disable the plug in click Enable or Disable In order to check or change the setup of the plug in click Setup gt Click OK to confirm e If there are uncertainties in adjusting these settings please ask your system administrator or contact your local distributor O Heidelberg Engineering GmbH Art Nr 97326 005 US 57 5 Workflow 5 Workflow Start HEYEX HEYEX Prepare the device Prepare the patient Create open a patient file
63. ilating the pupils might improve the image quality 54 O Heidelberg Engineering GmbH Art Nr 97326 005 US Preparing for Examination 4 Preparing the Patient e Make sure that the patient is not distracted during fixa I tion e g persons walking by The following explanations can help patients to understand the impor tance and purpose of the examination Explaining the Fundus Examination The structure of the multi layered retina in the posterior segment of the eye cannot be examined with conventional methods With the SPECTRALIS fundus examination we can exactly display the retina and provide unmatched detail and contrast in angiography and reflec tance images of both the retina and the choroid improving the diag nosis of pathologies The examination with the SPECTRALIS is com pletely safe without touching the eye A light beam scans the retina and the optic nerve head Please put your chin on the chin rest and your forehead against the forehead rest For best image quality please lean your forehead against the forehead rest for the duration of the examination will move the device close to your eye but won t touch it Please look at the blue dot You are allowed to blink the examination results won t be affected The examination will take only a few seconds will let you know when the examination has finished Explaining the OCT Examination The structure of the multi layered retina in the posterior segment of the eye c
64. ional For further information on entering eye data please refer to amp Chapter 6 12 Entering Eye Data on page 89 Click OK to confirm The acquisition window opens Acquire images 66 Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Selecting and Opening Patient Files 6 5 Selecting and Opening Patient Files 6 5 1 Selecting a Patient File gt Click to start HEYEX W Heidelberg Eye Explorer file Database Record Setup Windew Help ee T UL El A 72 22 Hae dl Update Display E o Ames Sebastien Sempre Choroidopak hy TENT 1954 IF AF FAP FAAC en Dou Jenna TIS fl C Alban Greer HEF ED degeer 1 01 1951 EO Bch Jern Macdar Hole 01 01 1984 FA FAF STEREO DICT m C Bleken Fal 65111874 tl C Boh Shela BP SD OCT Geographic Altophy 02 01 1331 EO Braderen Hark Comaa wh sc CL 1117 1911 E O Cham Kim ASM Fiering Bieb 1506 1567 Dr Thesen FO Chee song Cham ASM DME n Ficha Dystrophy 1001 1965 Pini Kui Ie Chamel Mener ASM Ipeetemo and bor ACA Ue Od 1552 EG Deele ba Glaucoma Progrersen 1 2005 1364 TCS Bi C Meale Sman Glaucoma Borde 10 DG 9982 Caucanan Cb Doe Jon MG 1550 I in Ls BA E Tara nn Cane 3 er gur Toce EF Doe Jenna 11 07 1951 E m 0 Doe deny Ha eernen2 17 03 3008 EO Dipeschar bass HEP Scrsening 8 30 01 01 1388 Em O Ege Malm Pl tn cclr esms 1006 1985 IRL FI
65. ip OE EN EE REN 363 9 1 Preface How to use this User Manual 1 1 1 1 1 1 10 Preface About this Chapter This chapter provides an introduction to this user manual the device the Heidelberg Engineering technologies and includes Explaining symbols and identification marks Qualification of personnel Scope of delivery Intended use Technical description Software configuration of Heidelberg Engineering products How to use this User Manual Explaining Symbols Safety Messages This user manual serves as a reference guide for the Heidelberg Engineering device Read the entire user manual to gain a full under standing of the device and the software It is not necessary to read all the chapters in chronological order Begin with a topic of interest Follow the links and references included in the text for guidance to other chapters Safety messages are indicated by symbols in this user manual They are marked by a signal word and a safety alert symbol indicating the category of hazard WARNING Warning indicates a hazardous situation which if not avoided could result in death or serious injury CAUTION Caution with the safety alert symbol indicates a haz ardous situation which if not avoided could result in minor or moderate injury A A NOTICE Notice is used to address practices not related to per sonal injury Heidelberg Engineering GmbH Art Nr 97326 005 US Preface 1
66. is played Click amp to open the image viewing window A random patient file is opened All acquired images of this patient can be reviewed The acquired images are organized by examination date in individual examination tabs In order to display a specific patient file double click the patient file in the right part of the database window O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Searching Patient Files Ee View Record Image Setup Lighthox Window Help jaaa r LI JR Pe m EERE Paent Droescher Mana HEP Steering 5 30 0101 Patierd Examination Eye Data Caters label Glaucoma Proguerin T 2005 nesesches Mais HEP Senseneng 5 30 01 01 1 In order to quickly switch between the loaded patients open the Patient drop down list All selected patient files are displayed Select a patient file All acquired images of the selected patient can be reviewed The acquired images are organized by examination date in individual examination tabs In order to review an image double click an image thumbnail The analysis window opens In order to unload all patient files in the database window click 3 in the tool bar 6 6 Searching Patient Files 6 6 1 Quick Search gt Click amp to start HEYEX M Heidelberg Eye Explorer Sr Ele Database Record Setup Window Help I Sm V V Gl Ham ov rane b Undone Dicis
67. is deleted 6 11 2 Updating or Changing Diagnosis 9 The comments entered in the Diagnosis tab will be displayed on reports In order to add comments that will I not be displayed on reports please refer to amp Chapter 6 10 3 Updating or Changing Comments and Anamnesis on page 82 gt Click to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click amp to open the image viewing window Heidelberg Engineering GmbH Art Nr 97326 005 US 85 6 Heidelberg Eye Explorer HEYEX Examination Data P H H WENGE MAT IP MAER SE em Maths pii omsl RAT D rarr SALAM aar le anassa fi WEIDE ECT AF TE Bl iaie PR T VUL A AT gt Click Examination The Examination Data dialog box is displayed Click the Diagnosis tab Select a number Enter or change the following data Diagnosis Diagn Ext Diagnosis Extension Comment Select a diagnosis from the Diagnosis drop down list gt Click Update to assign the diagnosis to the selected number Entering a new Diagnosis gt If no diagnosis is entered or in order to add a new diagnosis click Enter a diagnosis and click OK to confirm in the opening dialog box The diagnosis is saved and can now be selected from the Diagnosis drop down list Renaming a Diagnosis In order to rename an existing diagnosis click
68. ith BluePeak SPECTRALIS OCTPLUS SPECTRALIS OCTPYS with BluePeak BluePeak Blue Laser Autofluorescence TruTrack Active Eye Tracking AutoRescan Heidelberg Noise Reduction FoDi and Nsite are either registered trademarks or trademarks of Heidelberg Engineering GmbH in the United States and other countries Microsoft Windows Microsoft Windows XP Microsoft Excel and Microsoft Editor are either registered trademarks or trademarks of Microsoft Corporation in the United States and or other countries Intel Intel Core and Pentium are either registered trademarks or trademarks of Intel Corporation in the United States and or other coun tries FireWire and the FireWire Logo are registered trademarks or trade marks of Apple Computer Inc registered in the United States and other countries This product is manufactured under one or more of the following pat ents US 5 170 276 US 5 620 000 US 7 203 351 US 7 971 999 Heidelberg Engineering GmbH Art Nr 97326 005 US 3 Table of contents Table of contents Preac Lune 10 1 1 How to use this User Manual annen 10 1 1 1 Explaining Symbols ua aiaa 10 1 1 2 Explaining Identification MarkS 11 1 2 Qualification of Personnel annuus ennen serene ven 12 1 9 Scope of DEVON urriersnnennerentansddeerinerden dee dedanene 12 1 4 Intended Use suanersenereennere nerve nnnn eenen 12 1 5 Third Party Hardware and Software
69. lick Next to confirm Fig 9 Copying MFC Runtime files After the system files have been copied the Choose Destination Location dialog box is displayed Heidelberg Engineering GmbH Art Nr 97326 005 US 35 3 Initial Operation Installing the Software Please erder lhe destinalon location for the database and patient data jeg D or CAHEVEX E Browse Fig 10 Choose destination folder for the database and patient data gt Select the destination folder for the database and patient data e g C HEYEX gt Click Next to confirm A dialog box is displayed asking whether an archive drive location shall be configured or not gt Click Yes to confirm or No to skip PEEK ut f Please select the dive to use r mage dala archive meda e g magrelo oplcal dive extemnal hard dk Browse Fig 11 Choose destination location for archive media If Yes has been selected the Choose Destination Location dialog box is displayed gt Enter a storage location that shall be used as image data archive media e g an external hard disk 36 Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software gt Click Next to confirm Descnplion ingak the HRA Speciralis weing and acgusbon module this nstallation for wokstabons vatha HAAS cr Special camera allached t Back Mew Canc Fig 12 Select Typ
70. lick amp in the tool bar The lightbox is used to mark specific examinations for review at a later time and for printing reports o The lightbox can contain images from different examina I tion days 6 14 1 Adding Images to the Lightbox 94 La Heiden eng Eye Epio Eile View Becord Image Setup Lightber Window Help nog a n BEE E e x e 3 ME Pant Doe Jema T1 T5 9 Esten Examination EyeData HRA 13 01 2012 00 OG BS oe Display Prnt ferm ak m zm a AF ut A KP Scan Planning Toel ues r RegienFinder Exchange OD OS Change Patient Delete Export i Add to lightbox a ri pe Fa dt Sr H ean im EJ Ban Sn FA d 0 NF FA TLL Er la LB SE WT Hmm m Xm Dp al Ear map 17 Press Fl far help O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Using the Lightbox gt Click amp to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click 3 to open the image viewing window In order to add one image to the lightbox right click an image thumb nail The context menu opens gt In order to add multiple images to the lightbox press and hold and click the image thumbnails gt Release and right click a selected image thumbnail The context menu opens Select Add to lightbox
71. n deviation of the examined eye Visual field variation of the exam ined eye Select None Glasses Hard Contact Lenses or Soft Contact Lenses C Curve values are relevant to the SPECTRALIS device Keratom etry is required to get a proper transverse measurement parallel to the retinal surface in B scans and in HRA images Keratometry is not nec essary to obtain correct measurements perpendicular to the retinal sur face e g RNFL thickness measurements If no C Curve values have been entered the standard value is 7 7 This value is equal to the K value of Gullstrand s model eye The typ ical range of a K value is 7 2 8 4 mm If a K value is wrong by 0 1 mm the resulting error in a distance measurement parallel to the retinal surface is 0 8 96 gt Click OK to confirm 6 13 Moving Images between Patient Files It may be necessary to move images between patient files to address the following problems Duplicate patient files amp Chapter 6 13 1 Merging Duplicate Patient Files on page 90 Images stored in the wrong patient file amp Chapter 6 13 2 Moving Images Stored in the Wrong Patient File on page 92 6 13 1 Merging Duplicate Patient Files Duplicate patient files can be resolved by moving all images into a single patient file The duplicate patient file then needs to be deleted 8 Before merging two patient files identify the patient file you woul
72. n the right part of the database window E C Guy Landa Masula Hole 2302 1541 OCT Vol FADG i C Gurah Valens Glaucoma Progen 2 1507 18565 TCA E 2 Hari Fiu Glincoma Dubgde 15 12 1951 Laucanisn 3 C Haier Jul HAT HEP 01 02 1850 i C Herdenon John Ipae Lapse Module Samples Un OT 130 O Hermann Juha 11 07 1581 Ae Him Jessica HAT HEF 00 01198 m Hoch Barra HAT TCA Ot 14 E O Heppe Bend HRT HEP 01 01 1942 li D Hoen Areas Ange Sieaks 2406 1851 IR AF FAF F ICI OCT OQ Hoesa Eva ARMD ERM 11 04 2008 IR RF FAR FAACG Vol 4 Hopper Michael HEP 5 20 Screening DUT 3 Hors Rachel HEP Trend nli Noua 07 00 1585 E C kennel Daud FDFSAPHERT 00 01 1 55 I Ch Katmeais Ching Spaclralir Scans 11 07 1979 HAA Vol OCT PROG oO Keck Ehana Glaucoma 11 05 1964 Kahe ines OSCAR OLET 1978 FAF FA OCT STEREO 3i C koshe Tim Gieogisphic Alem 05 08 1980 AF FAR FAACG OCT E C koshin Jochen CSOR 03 0 1947 FA OCT ij C Koshn Johanna CHU DE 081991 FAF F Mrs PROG fl C Kebe Gered CECA 2303 1958 IF FF F Move FROG tij Kunkel Andes ASM Esnakocomas TOT 19983 Du Thesen E C Lesen Deere VT 1743 1555 Vol OCT le T0 02 1527 Vol OCT If HEYEX contains more than 1025 patient files scroll down and click More The further 1024 patient files are displayed Repeat this step until all patient files are displayed and the More button is no longer d
73. nd the Trend Micro antivirus soft ware When installing the antivirus software per the manufacturer s advice configure it so it does not scan automatically Otherwise it may inter rupt the operation of the device The software protector dongle must be connected to either the USB port of the PC the camera is connected with or to the PC that has access to the database On this PC the Heidelberg Engineering License Manager must be installed The software protector dongle must remain connected at all times while operating the device For further information please contact your local distributor or Heidelberg Engineering For acquiring digital confocal images a laser beam is focused on the retina The laser beam is deflected periodically by means of oscillating mirrors to sequentially scan a two dimensional section of the retina The intensity of the reflected light or of the emitted fluorescent light at each point is measured with a light sensitive detector In a confocal optical system light reflected or emitted outside of the adjusted focal plane is suppressed resulting in high contrast images Furthermore especially during indocyanine green angiographies ICGA the confocal optical system acquires a layer by layer three dimensional image This system allows clinicians to image patients with poorly or non dilated pupils which is especially important for dia betic patients who do not dilate well and make up a large proporti
74. nge The SPECTRALIS platform features a unique Fovea to Disc alignment technology that automatically tracks and anatomically aligns circle scans to match the alignment of the normative database improving accuracy and reproducibility of RNFL measurements and classifica tions FoDi alignment technology helps overcome measurement errors due to changing head and or eye position during scanning The patient position can influence the RNFL measurement Without FoDi alignment technology the head tilt and eye rotation affect the anatomical alignment of the scan With FoDi alignment technology unwanted rotations are corrected The exclusive SPECTRALIS FoDi alignment technology improves data integrity of the normative data base Using TruTrack Active Eye Tracking all scans in the SPECTRALIS database are aligned along the fovea to disc axis ensuring point to point thickness comparisons Heidelberg Engineering GmbH Art Nr 97326 005 US Preface 1 emmen 1 7 4 MultiColor Scanning Laser Imaging Option MultiColor image 2 Blue reflectance image G Green reflectance image 4 Infrared reflectance image MultiColor Scanning Laser Imaging is the latest addition to the SPECTRALIS multi modality imaging platform It is an optional retinal fundus imaging modality for all SPECTRALIS models MultiColor images are composed of three selective simultaneously acquired color laser images infrared green and blue reflectance
75. nstallation starts and the welcome screen is displayed gt Click Next to confirm Installs a single user version of the Solwa Make sure that the cerise key 15 installed on this computer Fig 26 Select the setup type The Setup type dialog box is displayed gt Select Network installation database on remote computer Heidelberg Engineering GmbH Art Nr 97326 005 US Initial Operation 3 Installing the Software gt Click Next to confirm Setup val install Heidelberg Eye Explorer in he lalong folder To install ba ther Folder click Hert Te install to a diferent folder cick Browse and select another Tou can choose nat lo indall Hexdeiberg Eye Explorer by chcking Cancel to ma Setup Fig 27 Choose destination Location for HEYEX The Choose Destination Location is displayed Select the destination folder for the Heidelberg Eye Explorer HEYEX e g C HEYEX gt Click Next to confirm Setup will add program icons to the Program Folder ited below Tou may lype a new folder name or select one thom lhe existing Folders fel Chek Med bo contre Progam Folder Existing Folders Fig 28 Select Program Folder dialog box The Select Program Folder dialog box is displayed O Heidelberg Engineering GmbH Art Nr 97326 005 US 45 3 Initial Operation Installing the Software 46 gt Click Next to confirm LE mn Frstaffatren af IBI
76. on of patients in a retina clinic Fluorescence dyes are excited in relatively narrow wavelength bands Using a laser is the most efficient way for excitation since all the energy is concentrated at one specific wavelength rather than in a broad continuum as with ordinary flash photography light Heidelberg Engineering GmbH Art Nr 97326 005 US Preface 1 Technical Description The SPECTRALIS requires considerably less retinal light exposure than photographic systems thus allowing for safer and more patient friendly examination The laser sources of the device emit laser light with four different wavelengths A blue all solid state laser with a wavelength 488 nm 2 nm or a blue laser diode with wavelength 486 3 nm is used to excite the fluores cein or the intrinsic autofluorescence A barrier filter at 500 nm sepa rates excitation and fluorescence light The same wavelength without the barrier filter is used to create red free images also called blue reflectance images The SPECTRALIS is also capable of high quality BluePeak autofluorescence imaging A diode laser at 786 nm wavelength is used with a barrier filter at 830 nm to separate excitation from fluorescence in the retina using indoc yanine green dye A diode laser at 815 nm wavelength produces infrared reflectance IR images A diode laser at 518 nm wavelength Option When using simultaneous imaging modes each image line is scanned individually by each la
77. ontinued and the analysis windows can be opened This chapter explains the simplest way to use HEYEX but do not be afraid to explore the software and develop a method that works best for you By the end of this chapter you should be able to confidently prepare HEYEX for an examination Chapter structure Starting the software The database window and all its functions The image viewing window and all its functions Creating editing and searching patient files Starting and continuing examinations Deleting patient files Updating or changing patient data Updating or changing examination data Updating or changing eye data Moving images between patient files Working with the lightbox 6 1 Starting HEYEX There are several ways to start HEYEX e Click the HEYEX desktop icon HEYEX starts The database window is displayed Select Windows Start Programs Heidelberg Eye Explorer Heidelberg Eye Explorer HEYEX starts The database window is displayed ESSEN ET ay eind O Heidelberg Engineering GmbH Art Nr 97326 005 US 59 6 Heidelberg Eye Explorer HEYEX Graphical User Interface Database Window 6 2 jg BE VUVYi TAA o ow Kamer Tam Burm Vister OG OM QUU B OC hme Geen penpan Cp TET 4944 Ui P F R FACIL Aaa Demum HER EO degrees Ui D unen Wdis jerm snis H MM 1504 FA FAF STEREO GCT Hieke Mal D 1884 Bok elg BE EO OCT epee kaker 6201 183 Beame
78. patient compliance Unprepared patients can cause poor examination results Carefully explain the examination procedure before the beginning of the examination so that patients suffering from a lack of concentration elderly people or patients who are afraid of the examination can achieve good examination results O Heidelberg Engineering GmbH Art Nr 97326 005 US 2 2 2 3 Data Security A Equipment Reliability A General Safety Messages 2 Equipment Reliability WARNING Incorrect patient data Incorrect data can lead to wrong diagnostic interpreta tion gt Confirm that the correct patient information is used when drawing diagnostic conclusions CAUTION Artifacts due to reflections from internal optics can be visible in reflectance images Residual reflections from optical surfaces may appear as bright spot artefacts in reflectance images Central arte facts are more likely for patients with lower fundus signal e g patients with cataract or small undilated pupils as well as for patients with strong negative refrac tion Do not mistake this artifact for a pathology Follow the instructions below to ensure data security If the software crashes during image acquisition repeat the examina tion Erroneous data can lead to wrong diagnostic conclusions Perform periodic data backup procedures Verify the integrity of the backup in order to avoid data loss caused by backup errors
79. plorer HEYEX Patient Data gt Click OK to confirm The warning message You are about to change the patient info is displayed Click OK to confirm or Cancel to quit without changes 6 10 3 Updating or Changing Comments and Anamnesis e The comments and the anamnesis entered in the Memo tab are not printed on reports For further infor mation on entering comments printed on reports please refer to amp Chapter 6 11 2 Updating or Changing Diag nosis on page 85 e Comments and anamnesis cannot be searched with the advanced search amp Chapter 6 6 Searching Patient I Files on page 71 Instead include information on the diagnosis which can be found with the advanced search amp Chapter 6 11 2 Updating or Changing Diagnosis on page 85 gt Click amp to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click aa to open the image viewing window Eie View ee Image Setup Lightber Window Help Bm wy La o5 i Boc HE EHE Patent pin oo sta bonc po em e AF Fr 38 xr AT YA as Deu iy Ll ie r Pa re VERE Je l E fd E Ga J E TA 25 49 EHan bg AJ Taman I TE IO OO ER ET Click Patient The Patient Data dialog box is displayed 82 O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Examination Data
80. r br k Cones VU VAN Cr Km AV eg Viet TANT Ee Tris Chee leor Cham did Dui R jp acus Iper TOUT 15873 fri jams Lin ren Dread uerum AG Edom anc Dom ACA DE DA 1952 Deini Inet Giro Papers d MEE Wd TOA se Samon hanens jodia VRON VER Casas Dos ep 107 1900 Dew Sem NG 19380 Dom H rs ACA emma TE OU 1910 Pd Hane Cy Torrea haima UR Lau Puig OG UG TFI Due esi BE Pigan ADL DOOR Dum Serra CSA E88 01 4947 FA DC bua bimi MH Angul lisis 11 PF VA Dum ep BP Pepe TPS EE Da ma HEP Serre 5 30 D O5 E Vom Mim Airoa WSE B RF KAF Fic Mel Frank Pd spes Froger VUA 19822 TEA Gip Linda Masis Hai TENTS OCT Vel PRT Guri Viele keri Fergie 1E PBE TLE id Pai marre Madrid 14 17 VEN man Han ja SAT MO NAG Hape Fori le Lassus Wiehie Spier 4 0I 1301 Hamsa Hin 7807 ir lon dame HT MR ri dri Heli Es HRT TEA DID PRS Hoste erd HAN EP f De qu lipsa eva rgoid sals 24 NER I R FAN TA KR OEF Hem sa APD ERE 1104 2008 EMD FAS FAADG Wd Mesos Hha HEP 5 iaro OLD 1586 moets Rahal HEP Tors run Nome li 1584 il Caa Aogas agder OO DR BRT Card Pastoe UIDI TIU Faser Deed AF SAP HRT OLD 1985 Fonts hemina Egmonds Scans H A ATA bol SOV PENG m Gama VI 164 GER OL 98 FAF EA DET STEREO Tea apres Gesta O04 1980 FF FAF Fi CUUUCT ken EROR ai iri Tha FACT wa CRAS DE GET TAE FAM PROG ate neen Eurial ASL Feigin WED Ten Laman D KHL 17 00 RE Wid D61 ken VET ula Hole TRE PEET ya DET Long
81. r to amp Chapter 6 11 1 Updating or Changing Examination Data on page 83 In the Diagnosis tab enter the patient s diagnosis For further infor mation on entering a diagnosis please refer to amp Chapter 6 11 2 Updating or Changing Diagnosis on page 85 gt Click OK to confirm Eye Data E op o C Curve men Ei mnm Reksin 0 lo Cylinder dpi ANN E Avie Ideal TG jo Pupil sce mm n 8D n IOP mH p n VWRekidaan n a Velda o B C rteclive Lene Hore Hone j o Jo The Eye Data dialog box is displayed Enter the patient s eye data All entries are optional and will be dis played on reports Click OK to confirm The acquisition window opens Acquire images The acquired images are displayed in the examination tab under today s date 6 8 Continuing Examinations If a patient is examined several times throughout a day all examina tions can be stored in the same examination tab in the image viewing window If the data have to be part of a new examination tab start a new examination Chapter 6 7 Starting a New Examination on page 75 76 O Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Deleting Patient Files and Examinations gt Click amp to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click
82. rate the device without an isolating trans former in accordance with IEC 60601 1 There is a risk of electric shock Always operate the device with an isolating transformer in accordance with IEC 60601 1 Connect all parts of the device the PC the monitor the table and the printer with the isolating transformer Do not put the isolating transformer on the floor Do not change the correctly installed device WARNING Do not operate the device in a network connection without an isolation in accordance with IEC 60601 1 There is a risk of electric shock WARNING Do not simultaneously touch electro conductive parts of connectors and a patient There is a risk of electric shock WARNING Do not operate the device without a grounded power supply There is a risk of electric shock Heidelberg Engineering GmbH Art Nr 97326 005 US General Safety Messages 2 Laser Safety 2 4 Laser Safety The SPECTRALIS instrument emits visible and invisible laser light through the objective lens on the front of the laser scanning camera The SPECTRALIS is a Class 1 laser product It does not pose any safety hazard whatsoever The laser class label is located on the rear panel of the camera housing However hazardous laser radiation may be accessible when the power supply is open WARNING Never open the power supply housing When the power supply housing is open visible and or invisible laser radiation of
83. ration of the device can be affected Incorrect measurement results can occur The system can be damaged 1 5 1 Isolating Transformer The device the TFT monitor and all other accessories need to be con nected to one of the following isolating transformers 230 50 60 DeMeTec GmbH IPS 1000R3 8K 1 000 120 60 TSI Power Corporation ILc 1000MED4 1 000 The isolating transformer must be certified in accordance to the stand ards IEC 60884 1 IEC 60601 1 and or UL 60601 1 Make sure that the total power consumption does not exceed the specified electrical power output for each individual isolating trans former as indicated above 1 5 2 Printers The device can be operated with any standard and Windows compat ible color laser printer In order to ensure safe operation please note that printers must have CE and or FCC approval O Heidelberg Engineering GmbH Art Nr 97326 005 US 13 1 Preface Technical Description 1 5 3 1 5 4 1 6 External Devices Antivirus Software Software Protection Fig 1 Software Protector Dongle 1 7 1 7 1 14 Technical Description Confocal Laser Scanning The device can be operated with the following external devices USB hub USB storage device External DVD drive In order to ensure safe operation please note USB hub and storage device must have CE and or FCC approval USB hub and storage device must be powered from USB port only The device can be used with AVG a
84. reparing Follow up Examinations 195 9 3 1 Defining a Reference Image in the Image Viewing AT SO e 195 9 3 2 Defining a Reference Image in the Analysis Window 195 9 3 3 Removing a Reference Examination in the Image Viewing Window eee 196 Heidelberg Engineering GmbH Art Nr 97326 005 US 10 11 Heidelberg Engineering GmbH Art Nr 97326 005 US Table of contents 9 3 4 Removing a Reference Examination in the Analysis limo M r 196 9 3 5 Excluding or Including an Image from a Progression gc 197 9 4 Closing and Opening a Progression Series 197 9 5 Acquiring Follow up OCT Imagges 199 Analyzing cSLO Images annae neen enen 204 10 1 Identifying Image Thumbnails 204 10 2 Graphical User Interface Analysis Window 205 19021 FOOD er 206 10 3 Adjusting Monitor Settings nanne 206 10 4 Setting Viewing Preferences aaneen en 207 10 5 Adjusting Image Settings unne eneen 211 10 6 Accessing Image Information 215 10 7 Zoom and Pan Mode unnvuans eenen 217 10 8 Adding Overlays rrrrrrnnnnnrnnnnnnennnnnenrnnrrnnnnnrennnnnennnsnenn 219 10 8 1 Measuring Distanc es aannemen nennen 219 10 8 2 Region Overlay nan snrenen venen eenner ennen 221 10 8 3 Text Overlay n
85. ring GmbH Art Nr 97326 005 US 61 6 Heidelberg Eye Explorer HEYEX Graphical User Interface Image Viewing Window 6 3 Graphical User Interface Image Viewing Window O EE JE Aad Fors 3 ART E aE m ART FALUDGA 0 45 04 3I ART FALDET 3 ART Ar ART guo i AE ANT aie Ut oer ended ar ade ET TIAN EG HAA OCT 11 08 2008 CD WIBDCT AT ART FAUDGA 39 88 IT ART FANT T 14 4E AT ART Examination data amp Chapter 6 11 1 Updating or Changing Examination Data on page 83 Examination tab Selected patient file Eye data Tool bar amp Chapter 6 3 1 Tool Bar on page 63 Acquired images OD OK Menu bar Acquired images OS Patient data amp Chapter 6 10 1 Lightbox amp Chapter 6 14 Using the Updating or Changing Patient Data Lightbox on page 94 on page 79 OR OR S 62 Heidelberg Engineering GmbH Art Nr 97326 005 US 6 3 1 Tool Bar Heidelberg Eye Explorer HEYEX 6 Graphical User Interface Image Viewing Window icon peseription me 4 om Bod 2p Heidelberg Engineering GmbH Art Nr 97326 005 US Database Window amp Chapter 6 2 Graphical User Interface Database Window on page 60 Image Viewing Window amp Chapter 6 3 Graphical User Interface Image Viewing Window on page 62 Lock Examination amp Chapter 8 4 Unlocking Examina tions on page 112 Large Icons amp Chapter 6 3 2
86. ring devices consist of the following software mod ules and plug ins Heidelberg Eye Explorer HEYEX Acquisition software Analysis software Network licenses Option Connection of practice management software Option Image Capture Module Heidelberg Engineering GmbH Art Nr 97326 005 US 21 1 Heidelberg Eye Explorer Software Platform Preface Heidelberg Eye Explorer HEYEX Acquisition and Analysis Software 22 Network Licenses External System Interface Optional Image Capture Module All Heidelberg Engineering devices operate on the Heidelberg Eye Explorer HEYEX platform HEYEX hosts the patient database from which the user manages patient files and performs examinations HEYEX also hosts the image acquisition and analysis applications for the different Heidelberg Engineering devices The following add on options are available for HEYEX Network Licenses External System Interface Option Additional analysis software In addition to the operating software including the acquisition and analysis software provided with each device additional optional viewing software is also available This viewing software enables full access to all images and patient data on PCs which are not connected to the device All Heidelberg Engineering devices can be used within a network envi ronment This allows users to review images from networked PCs often referred to as viewing stations using the same analysis
87. s Click OK to confirm 50 O Heidelberg Engineering GmbH Art Nr 97326 005 US Preparing for Examination 4 Switching the Device on and off 4 Preparing for Examination About this Chapter This chapter provides instructions on preparing the device and the patient for the examination A well prepared patient provides better examination results This chapter will also address general HEYEX settings for examinations By the end of this chapter you should be able to confidently prepare the device and the patient for an examination 4 1 Switching the Device on and off e It is not recommended to frequently turn the device on and off Instead switch on the device in the morning and 1 off in the evening even if the device is not in constant use throughout the day Heidelberg Engineering GmbH Art Nr 97326 005 US 51 4 Preparing for Examination Switching the Device on and off Switching on the Device gt Switch on the isolating transformer gt Switch on the power supply gt Switch on the PC 3 and the monitor The PC will start its boot sequence The Windows start screen is dis played until the login screen is displayed gt Click a user name and enter password if necessary The message Loading your personal settings is displayed If the login sequence has finished the Microsoft desktop is displayed gt Start HEYEX amp Chapter 6 1 Starting HEYEX on page 59 Prep
88. s LOT 1854 AP FAP PARC s Doe Jenna 10715 Delete F STEREO OCT New patient Ke i02 01 1931 New exarninatian 81 H O Cham Kam mr ewenng men eroe pe ut heslan E Chee Yeong Cham ASM MEK n Fuchs Dysgl 10071 1965 Prod Ki Cima Weiner ASH Indtomy and both ACA 2 4 1562 E C Maele label Glaucoma Progression 2005 1365 TCA D Dietele Simon Glaucoma Bordene 1003 1992 Caucasian ir CQ Dos John Ot 02 1550 fl 0 Doe Hima ASM Flengsgum 14 8 1333 Prol Kruse Dr I ceno Bik Dee derma 11 07 1351 CO Doe Jenna BP Progression 1 25 02 Z008 EG Doe Jenny BP Pigeon 17032008 IO Dapeschar Masia HEP Scoenng 530 01 01 1388 ED Ege Halm A mosch ss 03 06 1965 FIL RF FAF FA ICG Vet EO Frank Pad Glaucoma Progression 3 15 05 1362 TCA Select Record Delete in the menu bar The Delete Database Record dialog box is displayed gt Check the Yes I want to permanently delete this database record box Data permanently deleted from the database cannot be retrieved Click OK to confirm The patient file is deleted Images of bad quality or those which are unsuitable for use while affected by artifacts may be deleted Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 gt Click amp to open the image viewing window Select one or several image thumbnails gt Press The message Do you really want to delet
89. ser For example during simultaneous fluores cein and indocyanine green angiography only the 488 486 nm laser is switched on for the first scan of a line while during the second scan only the 786 nm laser is switched on In every acquisition mode indi vidual images temporal image sequences or a focal series of images layered three dimensional images can be acquired Heidelberg Engineering GmbH Art Nr 97326 005 US 15 1 Preface Technical Description 1 7 2 1 7 3 16 Optical Coherence Tomography OCT 1 A Scan 2 B Scan 3 Volume The device uses spectral domain optical coherence tomography SD OCT technology also referred to as Fourier domain OCT FD OCT The beam of a super luminescence diode SLD scans across the retina to produce a cross sectional B scan image In order to create high spatial resolution three dimensional images of the retina B scans as close as 11 microns to each other can be acquired The infrared beam of the SLD has a central wavelength of 870 nm Heidelberg Engineering Technologies Multi modality Imaging The HRA OCT is a multi modality imaging device It combines SD OCT with five fundus imaging modalities Blue reflectance imaging BR Infrared imaging IR amp BluePeak blue laser autofluorescence imaging AF Fluorescein angiography FA 4 Indocyanine green angiography ICGA MultiColor imaging Option X Chapter 1 7 4 MultiColor Scannin
90. software that is used on the instrument PC In a network environment the common HEYEX database containing all patient data is located on a network server Images acquired with the device are saved to this database Viewing and analyzing these images is possible at any computer that meets the viewing station requirements viewing station receives access to the database through a network license The network license can be fixed perma nently assigned to a computer or floating many viewing stations share a defined number of licenses Each device includes at least two floating network licenses If viewing access for more concurrent users is required additional network licenses can be purchased HEYEX can exchange patient data and images with other compatible systems in the department e g Electronic Medical Record systems Image Management Systems PACS etc The interface is deployed via the DICOM standard or via a proprietary interface The following features are included Import of patient demographics DICOM Modality Worklist into HEYEX Export of images and reports from HEYEX For further information please refer to the DICOM Interface User Manual The Image Capture Module software enables the import of external images or documents e g from other devices or Windows screen shots and adds them to the patient file in HEYEX O Heidelberg Engineering GmbH Art Nr 97326 005 US Preface 1 Heidelberg Eye Explor
91. t examination data Doe Jenna from the Patient drop down list Select the examination tab that contains the incorrect examination data gt If there are image thumbnails on both sides OD and OS click 88 to remove the split gt Press and hold and click the incorrect image thumbnails gt Release and right click an incorrect image thumbnail The context menu opens Select Change Patient Change Patient E Il V Please selec navy patient from ihe Eat Dot Jennifer 02 02 1951 14 01 The Change Patient dialog box is displayed If multiple patient files are loaded select the correct patient file Doe Jennifer gt Click OK to confirm The message Do you really want to change this examination from Doe Jenna to Doe Jennifer is displayed Heidelberg Engineering GmbH Art Nr 97326 005 US 93 6 Heidelberg Eye Explorer HEYEX Using the Lightbox 6 14 Using the Lightbox gt Click Yes to confirm The selected image thumbnails are no longer displayed in the incorrect patient file of Doe Jenna In order to move images from other examination tabs repeat the pre vious steps Select the patient file Doe Jennifer from the Patient drop down list and verify that this patient file contains the image thumbnails that were moved from the patient file Doe Jenna In order to return to the database window c
92. t this Chapter This chapter provides an introduction on the initial operation of the device and includes The SPECTRALIS device Installing software updates 30 Heidelberg Engineering GmbH Art Nr 97326 005 US 3 1 The SPECTRALIS Device Initial Operation 3 The SPECTRALIS Device External Fixation Light Forehead Rest Head Rest Column with Red Marks Chin Rest Touch Panel with ART Sensitivity Knob Camera Head o Fo 0 f9 RENO Heidelberg Engineering GmbH Art Nr 97326 005 US QO amp eoooc Objective Lens Filter Wheel Focus Knob gt not shown Adjustment Screw for Chin Rest Joystick Setscrew not shown 31 3 Initial Operation Installing the Software 3 2 32 Installing the Software Setup Types Please check the operating system If the operating system is not Windows XP or Windows 7 32 bit update the operating system before installing the software or software update mel e Switch off the power supply of the SPECTRALIS device before starting a software installation or update p Close HEYEX before starting a software installation or e I update The following setup types are available Local installation with an HRA2 or SPECTRALIS system attached to this PC This setup type installs a single user version of the HRA SPECTRALIS viewing and acquisition module Choose this installation for workstations with an HRA2 or SPECTRALIS camera attached M
93. tarer EE is Eile Mew Record Image Setup Ligeiber Window Help emsa 85 s qg 895 AR HE ee Patient Examination Eye Data Auth Grego HEP ED degeees I OM 1551 SHAT i OG iaiia pA in ST TELE ta hon e poc em e AF prn Se ver side EAN VA UTE PEA ME Ar Bil TE ET C UE F x E NEVNE Vx H Fa 82 4e E ao p F E75 49 C ue ge AF TE Haan mcs 8 All selected patient files are displayed Select a patient file All acquired images of the selected patient can be reviewed The acquired images are organized by examination date in individual examination tabs In order to review an image double click an image thumbnail The analysis window opens 69 6 Heidelberg Eye Explorer HEYEX Selecting and Opening Patient Files 6 5 4 Selecting All Patient Files 70 In order to unload a patient file in the database window right click the patient file The context menu opens Select Unload The patient file will no longer be displayed in the right part of the data base window gt In order to unload all patient files click in the tool bar Click to start HEYEX gt In order to select all patients click 33 in the tool bar If more than 20 patient files are selected e g 146 patient files the message Do you really want to load 146 patients is displayed gt Click Yes to confirm All patient files are displayed i
94. tch off the filter click in the tool bar 6 7 Starting a New Examination e It is not possible to start a new examination in the image viewing window if the examination is not on the current day The message Examination is not of the current day is displayed Open the database window and re start the examination If a new examination is started a new examination tab is created If the data have to be part of the same examination tab continue the exami nation amp Chapter 6 8 Continuing Examinations on page 76 gt Click to start HEYEX Select a patient file amp Chapter 6 5 Selecting and Opening Patient Files on page 67 In order to start a new examination click 2 in the tool bar Continue Exsmination Are pou punt you wan bg enne paler Doe Jenna CSCR YES NO L The message Are you sure you want to re examine patient is dis played Heidelberg Engineering GmbH Art Nr 97326 005 US 15 6 Heidelberg Eye Explorer HEYEX Continuing Examinations gt Click Yes to confirm xamenation Data Deuce pene Braen Hais Daya Doe dama 11111381 14 2 2012 Study The Examination Data dialog box is displayed In the Examination Data tab select the device type from the Device Type drop down list All other entries are optional For further informa tion on entering examination data please refe
95. ter number Title p number e g amp Chapter 1 1 2 Explaining Identification Marks on page 11 Heidelberg Engineering GmbH Art Nr 97326 005 US 11 1 Preface Intended Use 1 2 1 3 1 4 12 Qualification of Personnel Scope of Delivery Intended Use This user manual is intended for persons who are experienced in the operation of ophthalmic imaging and diagnostic equipment in accord ance with 82 of the Medical Devices Operator Ordinance The operator must have access to the user manual the enclosed relevant security information and maintenance details comprising proper handling uti lization and the operation of the medical device To support continuing education on their equipment Heidelberg Engineering offers regular live and online training courses for clini cians researchers photographers technicians and office staff For fur ther information view the Heidelberg Engineering Academy program at http www heidelbergengineering com The following components are included with the purchase of a SPECTRALIS instrument Laser scanning camera Camera mount with integrated head rest Isolating transformer Power supply Software protector CD containing operation software Heidelberg Eye Explorer HEYEX Acquisition Module and Viewing Module 2 IEEE 1394 cables to PC Touch panel incl cable connection and power supply Foot switch The following manuals are included with the purchase SPECTR
96. that head rest and camera lens are clean gt Clean and disinfect the head rest the chin rest and the lens before the examination Adjust the height of table for the patient O Heidelberg Engineering GmbH Art Nr 97326 005 US 53 4 Preparing for Examination Preparing the Patient Adjust the chin rest for the patient using the black adjustment screw 1 The patient s eyes must be level with the red marks on the head rest column Ask the patient to put their forehead against the forehead rest If the patient s forehead is not against the forehead rest there will be problems during image acquisition as there is too much distance between the camera and the patient s eye 4 3 Preparing the Patient NOTICE Lack of patient compliance Unprepared patients can cause poor examination results Carefully explain the examination procedure before the beginning of the examination so that patients suffering from a lack of concentration elderly people or patients who are afraid of the examination can achieve good examination results e Perform the SPECTRALIS scan before other diagnostic studies that may irritate or dry the cornea For patients I with dry eyes and contact lens wearers apply artificial tear fluid shortly before the examination For best image quality OCT scanning and fundus imaging using the acquisition mode FAF should be done with dilated pupils When examining a patient with cata ract d
97. the patient s images are stored in the wrong patient file Images may be moved from the wrong patient file to the correct patient file NOTICE Images moved to the wrong patient file Moving images to the wrong patient file may lead to a loss of data integrity If undetected this may result in erroneous diagnostic conclusions and or erroneous treatment Make sure to move images to the correct patient file 92 Heidelberg Engineering GmbH Art Nr 97326 005 US Heidelberg Eye Explorer HEYEX 6 Moving Images between Patient Files gt Click amp to start HEYEX We Heidelberg Eye Explorer el t Ee Database Record Setup Window Help mise amp i e o mu v WV Es HI mR oe oe ch oe Hane Update Display s as Jenna 0202 1851 1401 0 E Dae Jenna 02 02 1551 10 4 Des Jernder 02021951 14 401 Doe Jenndes 02021951 14 01 Fig 39 Example of mixed up patient files Incorrect file Doe Jenna Correct file Doe Jennifer gt Double click the correct patient file Doe Jennifer The patient file is loaded in the right part of the database window Double click the incorrect patient file Doe Jenna The patient file is loaded in the right part of the database window Make sure that only the correct and the incorrect patient files are loaded gt Click 3 to open the image viewing window Select the patient file that contains the incorrec
98. ting Scan Patterns aaan ennen eneen 138 S PME EIL E 138 8 12 2 Circle SCSFDIS uic bono nu nra Debate btn a Pak otav aor Lanta d ie 139 91259 Star Ne 140 8 12 4 Volume SCANS arersaaroennee to denen Da aio nant Pagus ius 141 8 13 Creating Acquisition Presets susssse 142 8 14 Changing the OCT Color Scale 143 8 15 Enhanced Depth Imaging EDI 144 8 16 Performing an Angiography eeseeeeesss 146 8 17 Injection Timers eeeeeeeeereeen n 152 8 18 High Magnification Images nun nnnenen 154 8 19 Acquiring a BluePeak Blue Laser Autofluorescence Ee C 155 8 20 Acquiring a Movie annua venne nene nennen ennen 160 8 21 Acquiring a Composite Fundus lImage 163 8 22 Acquiring a Composite 3x3 Fundus Image 169 8 23 Acquiring a Stereo Fundus Imagge 170 8 24 Performing a Tomography aaneen nennen een 175 8 25 Acquiring MultiColor Images Option 179 8 25 1 Acquiring MultiColor cSLO Images 180 8 25 2 Acquiring MultiColor OCT Images 185 Acquiring Follow up Examinations 193 9 1 Terms and Definitions sees 194 SPAM Ivo onteerd eenn senen E 194 9 3 P
99. ware Update gt Insert the software CD into the PC drive Wait for the automatic start of the installation program or manually run the program setup exe from the root directory Select an installation language and click OK to confirm A message will be displayed asking whether the older version of the installed software shall be updated or not O Heidelberg Engineering GmbH Art Nr 97326 005 US 49 3 Initial Operation Accessing Software Information gt Click Yes to confirm Click Finish to complete Setup Fig 37 Setup Complete dialog box When the installation is completed the Setup Complete dialog box is displayed HEYEX can now be launched Check the Yes I want to launch Heidelberg Eye Explorer box and click Finish 3 3 Accessing Software Information Verify the installed version of HEYEX the acquisition module and the viewing module Soc GL BHEIDELEE amp EracG ENGINEETNTTG Hesdeiberg Eve Explorer Weimar 1 700 Installed Module Version HRA Spectralis HRA Spechalii Visvng Module EEMS B HRA Specteke Fame Acguisitinn Module 54 Print Edi Sendlosunpart Sarl Ma H2E 12 4 00 Con f WprkslabonID feed icena 23011 H idsbeng Engreeimg Gb h g Ayan Heidelberg ngneeing com gt Click amp to start HEYEX Select Help About in the menu bar The About Heidelberg Eye Explorer dialog box is displayed Check the installed module
100. ware dongle into the USB port Insert the software CD into the CD drive Wait for the automatic start of the installation program or manually run the program setup exe from the root directory Select an installation language and click OK to confirm Plaaze select the program to install Specials Family Software ingal Licence Manager oniy Browse the CD ROM contents Fig 4 Select Installation dialog box The Select Installation dialog box is displayed Select SPECTRALIS Family Software and click Next to confirm Welcome bo Has Eye Explorer Setup pogar This pog stal Heidelberg E ye Explorer pn peas Er K eke ed pend all Windows programs beton running thi Setup progi Chek Cancel la quii Setup and then close ary programs you have running Dick Hed lo continue wah Ihe Setup pogam WARNING The progam rs protected by copynghl baw nd i ical hest Unauthorized reproducti n or distnbubion of the progim or ary portion of ib may recul in severe cred and cnminal pensler and wil be prosecuted bo the maman extent posable under lav ee rem Fig 5 Welcome screen The installation starts and the welcome screen is displayed O Heidelberg Engineering GmbH Art Nr 97326 005 US 33 3 Initial Operation Installing the Software gt Click Next to confirm Click the type of Setup you prefer then click Next LL asini Deal Ires iri dateen on lw compuler Hebwcek henk
101. zee that the cerise key is nstalled on thes computer Fig 16 Select the setup type The Setup type dialog box is displayed Select the desired setup type Local installation database on this computer Installs a single user version of the software Make sure that the license key is installed on this computer Network installation database on remote computer In this example select Local installation gt Click Next to confirm Setup vill retell Heidelberg Eve Explorer n the lalioeang folder To install to Wher Feldes click Hest Ta metal to a dlferent folder cick Browse and select another folder You can choose nol lo incisl Hesieiberg Eve Explorer by cicking Cancel to ext Setup Fig 17 Choose destination location for HEYEX The Choose Destination Location is displayed Select the destination folder for the Heidelberg Eye Explorer HEYEX e g C HEYEX O Heidelberg Engineering GmbH Art Nr 97326 005 US 39 3 Initial Operation Installing the Software gt Click Next to confirm Setup val add program icons bo the Program Folder ksted below You may lype a new folder name or select one from Ihe existing Feldes Bel Dik Med to continue Fig 18 Select Program Folder dialog box The Select Program Folder dialog box is displayed gt Click Next to confirm Fig 19 Copying MFC Runtime files After the system files have been copied the

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