English manual - augenarztbedarf.de & ophthalworld.de
Contents
1. www bon de PHOENIX User s Manual Cobra Op UOg MMM 8UJOJU 01 006 08 LS70 0 006 08 LS70 l l l y qn 9SGEZ FL aggisieuggulaie Hau eu sil s bsq lm udo u o q Internet www bon de Telefon 0451 80 900 0 Telefax 0451 80 900 10 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de Contents SES Il 1 INSTALLATION AND START UP 5 ki WSU ANSON ON 5 1 U IUTU s n 8 15 Phoenix Program Dart 10 14 Ya rara 12 2 Ii ollELLUDALAB Ey aaa aaa sus adajat 14 21 PANENtS LISE E EEE A 15 22 koti ni NEE 16 e YUM Patient RE 16 27 SCLC CUMIN A PU Ysni 17 Z AUVanced Se rch nie 18 26 1ICcoEtitce 19 3 EXAMINATIONS DATABASE ica ise ke a a a a a bl 20 57 AV 11 n Uu 20 32 Selecime an EE Te n n li 20 5 gu Examination DICA si 21 3 4 lectucunli E TO ula 21 Jo TE b ay q 22 3 6 LDU ii c 22 57 Miele 23 il Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de A DEL een 25 4 1 Luna un i R K 25 4 2 26 4 3 Miscellaneous Other cr iii iaia 272. Header1 Header 2 Header 3 Address City Country State Phone Mobile E mail gt iz amp b LIPE m Fax Figure 9 2 Company Data Click the sje button to insert a logo Type the other company data in the empty fields shown in the window Click OK to confirm Exits the Printing window Esc 60 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH 10 Meibography Meibography is an examination in which the health of meibomian glands is evaluated Such examination can be performed by Sirius Modi or by Cobra using the instruments IR illumination source since meibomian glands cannot be spotted using standard visible light illumination Once the IR images of meibomian glands have been acquired using the Live acquisition software they can be manually processed inside Phoenix in order to calculate the gland health score and save it for further patient evaluation Basically the glands health tends to decrease as its area becomes smaller inside the eye lid while a healthy eye presents the inside of upper and lower eye lids completely filled with meibomian glands a suffering dry eye presents a surface of eroded meibomian glands So the main idea is to calculate the ratio between the area covered with glands and the tot
3. The host computer will be configured on your 1Pad as the router Following the button in the upper right corner of the main screen the address of the host computer and port it listens to are to be configured Online NI gt The default configuration is IP 192 168 10 10 port 5100 75 76 L I ui A Configure 2 ka st 192 168 10 10 Op UOq MMAM Jeulalul 01 006 08 970 0 006 08 970 UOJSJOL yOEGN 9GGEZ FL OgeJISISUJBUIJOIS HqUI Jeyssjesa sgeunen 0100 U oq bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Create an ad hoc wireless connection For indications on how to create an ad hoc wireless connection on Windows XP see below You can create an ad hoc wireless connection on the host computer to access through wifi the web service In order to create the adhoc connection follow these steps wy af Connetti manualmente a una rete wireless Specificare la modalit con cui si desidera aggiungere la rete ka Creare manualmente un profilo di rete Consente di creare un nuovo profilo di rete oppure di individuare una rete esistente e salvarne il profilo sul computer in uso necessario conoscere il nome SSID e la chiave di sicurezza se applicabile della rete Crea una
4. 3 4 Deleting an Examination To eliminate a patient examination from the database select the examination to be deleted by right clicking then clicking en and confirming the deletion request warning message Warning deleting an examination also deletes all the images associated with it 21 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 L beck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH 3 5 Refraction ke ve ia When an exam is selected the G Refraction icon goes active Selecting the Refraction icon opens a window from which to enter the patient refraction data COD gs ph D GADI RU 0 50 075 amp 15 E KE b r 1 22 105 L BCVA Figure 3 2 Entering Refraction Data Two labels permit opening the right eye OD or left eye OS chart If the refraction value entered is the value measured on eyeglasses and the corneal apex to lens distance is entered in the box for that purpose the system calculates the refraction at the corneal vertex Enter the values of the sphere in diopters Sph the cylinder in diopters Cyl the cylinder axis in degrees Ax and the distance to test eyeglass in mm in the relative fields If the data is incomplete the warning icon will appear If the data are correctly entered the icon will be displayed The patient s natural visual acuity is entered in the UCVA U
5. MICROSOFT SOFTWARE SUPPLEMENTAL LICENSE TERMS MICROSOFT NET FRAMEWORK 4 FOR MICROSOFT WINDOWS OPERATING SYSTEM Ver ERA k r primu Do you accept the terms of the pending License Agreement If you choose Dont Accept install will close To install you must accept this Figure 1 1 Accept installation of framework Wait until the component is installed bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 2 Microsoft NET Framework 4 Setup xx x Installation Progress Please wait while the NET Framework is being installed File security verification All files were verified successfully Installation progress Installing NET Framework 4 Client Profile Figure 1 2 Framework install Upon completion of the procedure outlined below or if Framework is already installed click Next to begin installing Phoenix il Phoenix Welcome to the Phoenix Setup Wizard The installer wall guide you through the steps required to install Phoenix on your computer WARNING This computer program is protected by copyright law and intemational treaties Unauthorized duplication or distribution of this program or any portion of it may result in severe civil or criminal penalties and wall be prosecuted to the maximum extent possible under the law Figure 1 3 Phoenix install Select the
6. 80 900 10 Internet www bon de 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de 4 4 DICOM Digital Imaging and Communication in Medicine DICOM is a medical computer standard adopted by many health agencies and hospitals in all parts of the world which permits medical operators to exchange images and other information via computer systems adopting this standard Deselect the Suppress DICOM messages box to show any errors that do not interfere with image capture Settings V Suppress DICOM warnings MOD_CSO Storage commitment Auto Send Uncompressed Java Home C Program Files x86 CSO Phoenix java Figure 4 4 DICOM If DICOM is instead selected the remaining menus must be used Configuration AE PACS PMS C50 10 10 10 108 104 Figure 4 5 29 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 L beck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH Click the m Configuration ii Configuration AE EyeCare Title PMS Host 10 10 10 108 Timeout s Port Timeout s Limit 104 Reset P ng Reset Ping Ok Cancel Cancel Figure 4 6 PACS and PMS Configuration This window allows the user to identify the PACS system that will receive his information or t
7. TCP IP Protocollo predefinito per le WAN che permette la Server DNS preferito comunicazione tra diverse reti interconnesse Server DNS alt tivo Conyaida mpostazon alfusota Avanzate le m Finally in order to make sure the ad hoc connection 1s started automatically on computer startup save the Tollowing command netsh wlan connect name Cobra In a file in automatic execution on the start menu 79 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Ad hoc connections on windows XP From the network connections panel Choose the properties for the wireless connection adapter Reti disponbi Per connettersi disconnettersi o ottenere ultenon informazioni sulla reti senza f rilevate lara clic sul pulsante qui sotto Visualizza reti senza fi Hei preferite La connessione automabca ale reti disponibili veni effettusta nell ordine indicato di seguito ete Broadcom 802 11n Choose add under preferred networks t Connessione rete senza fili X m Sirius Propriet 2 Generale Bet senza Avanzate Connessione automatica Assocanone hutertrazore Corressone Nome amp sete SSIO na Quando la rete viene rilevata il computer vi si connette automaticamente Connetti anche n a
8. 2011 r Ip Figure 9 1 Selecting Images for Printing Select the images to print up to 4 images by double clicking in the gallery on the right of the screen The selected images will be shown in the bottom right hand box The image s may be printed on paper Print button or converted to PDF format PDF button In the first case the PC must be connected to a printer In the second the user may choose the file destination desktop or gallery 42 Do you want to archive this report Click Yes to archive no to save to desktop Click Yes or No 59 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 80 900 10 Internet www bon de 80 900 0 Telefax 0451 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH 9 1 1 Printing Toolbar o gt Refreshes the print preview image show modifications Update m t Permits changing the print settings Options Prints the page shown in the Preview Print a o Enlarge Reduce Preview of the image u 8 8 Enlarge Reduce Preview x Displays or hides the heading if inserted and relative logo Show Hide Heading Permits changing the text of the head ng and the logo click the button Edit Heading to shovv the head ng data entry change form Figure 9 2 Edit
9. 4 4 DICOM Digital Imaging and Communication in Medicine 29 25 DOE aa EE E EEEE EE EEA 32 6 e e E ge ii n bi A4 S ElIkkbsssescsrr r r r s da o lado 35 5 1 onur iii ii 36 5 VICIVIIO i iii i i iin 38 5 3 SULU 39 5 4 Mosaic preview ModE csie 40 6 VIEWING AND MANAGEMENT OF SINGLE IMAGES 43 SS DN WR E ET 44 6 ibrlu 44 AA EE ERA RR 45 CMN Kr e E 45 07 Meli 46 SoA TE WE 47 07077 M s RO een E E 48 ASS OR TE Bee lte E 48 Mem weg Ke eg E a 49 650 IL l n ti ro 49 2 WAVELENGTH DIVISION ee ae 51 5 SECONDARY TUNETIONS eiserne anne ne a a nee nen En nu D S 52 8 1 KEE 52 NR SCV ro PR o b ina 52 8 1 2 COPA or Vy DON nee euer 53 iii Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de S2 TAS aaa nosa jadi abs e ab si 53 8 3 Stereo Imaging Overlay of Fundus 5 222222 2 54 BE Nodi 54 59 Il lin WOO o a e re ee da 60 10 MELDOORUET tte ann ast onodi oda o See ee i o o aan 61 10 1 Acquiring E E EE 61 10 2 Processing the CX AIIM Ri aiar 62 10 7177107 Ee EE 62 107 Tracing ee 63 10 Tracing sland lili aaa 04 10 24 Zooming ANA
10. 4 Settings o O gt Q o The Settings menu may be accessed only if the Patients List is not displayed on the main screen d r Click the button to empty the patients list Then click select Settings 4 1 Language lor open the File menu and After selecting Settings the menu for setting the system language will open Settings si die 4 gt z Deutsch English UK English US English AU Espanol MX 6 Fran ais taliano Language Instruments Groups Miscellaneous DICOM v Figure 4 1 Settings Select the language to be used by the software and click OK 23 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 4 2 Groups For creating editing or deleting groups of examinations Cataloguing the examinations by homogeneous type groups for example keratoconus PRK myopia PPK hypermetrophy trauma etc is useful as a search aid Settings Language Instruments Miscellaneous DICOM Zeile Keratoconus Myopic Postop Normal Pellucida Suspect K Transplantation Figure 4 2 Groups Menu Click the D button to insert a new group The button can be used to edit pre existing groups Th
11. You will see the next window with the instruments installed Press the Configure button to modify the settings You will see the Figure 4 11 SP The button permits inserting manually a new instrument for use The instruments must be inserted using the wizard 32 80 900 10 Internet www bon de 80 900 0 Telefax 0451 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH lt lt o Q o 7 Instruments Device class Model name Executable ma 7 Figure 4 11 Inserting a New Instrument Seria Enter the model name reported alongside the exam and an Executable File select the SCLive executable file then select the class from the pull down window shown in Figure 4 11 When done click OK After the system has automatically installed the instruments Scheimpflug camera and topographer it will start the first calibration see the next paragraph The button permits editing an existing instrument To eliminate an instrument from the list select it and click Click the button to calibrate the instrument For calibrating see next paragraph In the following setting you can choose whether to set a timeout in choosing the instrument 5 seconds after which the instrument s live application will be launched automatically When not checked the acquisition ch
12. examined in a yet to be defined group select lt new group gt to open a box in which to enter the name of the new group 23 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de Select a group The buttons permit associating the right eye group with the left and vice versa Clicking an image displays a preview of the summary of the selected examination in the lower portion of the screen Double clicking an image opens the processed image summary Chapter 5 Right click a gallery image and select Z Addcapton Fe to add a brief description mj x Delete acquisition To eliminate an image click b To open an image double click vvith the left mouse key or press Enter e If the selected image is a previously processed map the topographic maps viewing environment will open If the selected image is a still to be processed Scheimpflug capture the image is first processed and the summary environment is then opened If the selected image is pupillographic the pupillography examination will open e If the selected image is an image acquired with the slit lamp the image viewing environment will open 24 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH
13. file path for software installation and click Next We recommend not changing the default file path displayed bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de il A ss s Select Installation Folder Confirm Installation The installer wall install Phoenix to the following folder The installer is ready to install Phoenix on your computer To install in thes folder click Next To install to a different folder enter it below or click Browse Click Next to start the installation Folder C Program Files CSO Phoenix Browse Disk Cost Install Phoenix for yourself or for anyone who uses this computer Everyone dk ew i Figure 1 5 Confirmation install Figure 1 4 Installation directory Click Next to complete installation Click Close at the end of installation The following screen appears Click OK to confirm and proceed installation of a demo database Cancel in case of an upgrade 2 Proceed installation of DBPhoemx ex CADBPhoenix m Figure 1 6 Install DB Installation Complete Phoenix has been successfully installed Click Close to exit Please use Windows Update to check for any critical updates to the NET Framework Cancel bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 90
14. in a long time consuming routine which obviously will not produce any result From the Analysis menu or toolbar click the button to access the Mosaic mode This mode can be accessed from any acquisition in the study then all other study acquisitions will be automatically added to the mosaic up to a total of 7 acquisitions If the study contains more than 7 acquisitions the Image Selection window 8 1 1 1s presented to select the desired acquisitions until the maximum allowed number is reached Creating mosaic please wait Cancel Figure 1 Progress window 54 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 www bon de The above image indicates that the mosaic is being generated this process requires a certain amount of time depending on the number of acquisitions and their complexity In case the process takes too long more than a minute it can be stopped anytime by pressing the Cancel button on the window The reconstructed mosaic is then displayed on screen Three modalities are available in the mosaic window and they provide the functionalities that lead to the creation of the final mosaic image This button activates global view mode which is activated by default just after the mosaic is reconstructed as displayed in the next screenshot The mosaic is shown as a set of fix
15. in the database press Enter to open the window for entering a new patient Click the button and use the 7 keyboard keys to scroll the patients list or select a patient directly from the list With the Patient Box empty press Enter or double click the highlighted patient name A patient archive may be opened by clicking the button to the left of the name Type in a portion of the Last Name First Name string to display a list of patient names meeting the criteria To select a particular patient proceed as described in the previous point For instance you may display all the patients whose names begin with a given letter or who have the same last name or who have the same last name and the same first name initial etc When a patient is selected the list of associated examinations opens automatically see Chapter 3 Examinations Database 17 2 5 Advanced Search Ei Click the button to access the advanced search function Instrument Instrument Exam date dd MM yyyy Groups 171 Birthdate dd MM yyyy El Keratoconus DC Accession Number E Myopic Postop 7 Identification code O Normal F Gender 17 Pellucida Patient s age m PRK E Refening Physician s Nam 17 Suspect K S ming ysician s Name insana El Caption Exam date dd MM yyyy 171020115 17 10 2011 Birthdate dd MMfyyyy 17710201155 17 10 2011 O Accession Number O Identification code Gender Male M 2 Female Pati
16. patient entry press the Enter key or click the OK button To cancel click Cancel Whenever a new patient is created an examination associated with that patient is also created A window for selecting the examination type then opens See New Exam below 2 1 Patients List Any new patient entered is displayed in the patients list window on the left hand side of the screen To view the list of all the patients entered click the 9 button To empty the contents of the patients list from the main screen click the J button 15 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 2 2 Patient Data When a patient 1s selected the entered data will be displayed on the main screen red rectangle Phoenix File Settings ey Info A Quit Lastname Name 2 Example Sirius Normal 0000032773 Identification code P 30 09 1975 19 OD TE OD Group Normal v Group Normal K OS 5 Example Cobra Miscellanea P0084948745 I Example Densitometry Cataract 0000851983 Example Densitometry Cataract 0003964930 amp Example Densitometry Trauma 0000524295 Example Densitometry IOL 0000262152 Add caption Add caption Example Modi Progressive K 0003375104 Example Modi Progressive K 0002195456 amp Example Modi Miscellanea 00000011
17. see Paragraph 4 2 3 2 Selecting an Examination Once a patient has been selected click the button or press Enter or double click with the mouse to access the Examinations Database Clicking the symbol to the left of the patient name opens the list of examinations associated with that patient The symbol becomes a Click the symbol to close the list Alternatively open the list by pressing the gt arrow key on the keyboard and close it by pressing the arrow key To select a previously stored examination use the mouse or scroll with the 11 keyboard arrows to highlight one examination after another and for each view the relative images in the window on the right hand side of the screen 20 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 L beck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH 3 3 Editing Examination Data To edit the data for an examination select the exam right click and select the command Edit Exam Data Edit exam data Monday September 22 201 3 24 51 Referring Physician s Name Accession Number 08122215245 Identification code 061222152451 Figure 3 1 Editing Exam Data This action opens a window in which the user may edit the date and time of the exam and enter the name of a referring physician Click OK to confirm the changes otherwise click Cancel
18. the search functions The selected images will be shown in the column on the right Click the Ok button to confirm click the Cancel button to cancel and return to the previous window Example Cobra Miscellanea P0084948745 OD 4 5 2011 8 00 Patient Management OD 4 5 2011 8 00 0D 4 5 2011 8 00 0D 4 5 2011 8 00 0D 4 5 2011 8 00 Figure 8 1 Selecting Images for Comparison 52 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de ss na IMI Gi O a 2 D 8 1 2 Comparison Window The selected fundus images will now be displayed in the comparison window as shown in Figure 8 2 The zoom and panning functions on the various fundus images are linked in order to permi observing all the images in the same position at the same enlargement Figure 8 2 Fundus Image Comparison 8 2 Full Screen The Analysis menu or toolbar allows the user to access the full screen view by clicking the button In this mode the image occupies the entire monitor screen area Analogously to the x functions explained in Section 0 the and buttons allow the user to scroll the images pa captured during a single exam The button instead starts automatic scrolling of the images at constant time intervals t 53 80 900 10
19. the mouse button clicked then moving the mouse to draw the glands bound green points will be automatically set Avoid crossing lines or creating loops or complex paths It is not possible to create gland points outside of the red bounds a mouse click outside the red borders will result in the adding of a gland point on the nearest red bound MIX Delete this control point Delete all control points Figure 10 5 Edit points Defined points can be removed by left clicking the mouse a white cross appears on the point when the mouse passes over the point Right click on a single point pops up a context menu which allows removing the single point or all the gland points defined so far 64 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH O Q D New points can also be set between existing ones in order to refine the green line shape Just move the mouse between points to obtain a preview of the new point s influence then left click to add it to the points set definitively 10 2 4 Zooming and tracing This is an advanced editing option Keep clicked to switch to between edit mode movement mode Figure 10 6 Switch edit zoom mode Sometimes it is necessary to zoom in the image to obtain more precision in tracing gland points While tracing points on a zoomed meibo
20. to select the instrument with which to capture the examination and to access the capture environment Capture Window Toolbar BUTTON SHORTCUT ICON FUNCTION Settings Opens the panel for setting general capture parameters Mosaic amp Activates mosaic preview mode 1f available Autogain Displayed when auto gain function is active active by default Focus Indicator ES Reactivates the focusing support window 1f deactivated Exit Exits the Capture window Figure 5 1 Toolbar Buttons Summary The window shown below will open Figure 5 2 Capture Window 35 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de If the software 1s set for operation in the one shot single capture mode a message will request that the user press the joystick button to start capture The previous window will be shown after the button is pressed 5 1 Centering The first step in running an exam is to center the patient s retina using the infrared LED Move in slowly toward the pupil which will appear as a brighter region in the image shown on the screen brightness is increased when the auto gain function is active Center this region on the screen raise or lower the instrument using the appropriate joystick knob Invite the patient to look directly and steadi
21. uc laya osa 65 10 2 5 Finalizing meibography examination o 06 10 3 Meibography thumbnails and gallery 2222 68 APPENDIX A IMPORT EXPORT EXAMS rire 69 di Exporiino an RN ET o ei ai ii ad a S e 69 b Imporane anexam natlon b l l at 70 APPENDIX B SAFETY AND INDICATIONS FOR USE 11 APPENDIX C CONFIGURE PVIEWER IPAD 72 HOW CON MGMT MT ranio ova E eta dia ki 72 HOW 10 CONMGUTE yonr IP AG a a ya 74 Create an ad hoc wireless connection sauna dadda yd Eege 77 Ad hoc connections on windows RP een a a aaa aad aqa adna q a aaa 80 IN 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH O 1 Installation and Start up 1 1 First installation Pass to chapter 1 3 if the Phoenix software has just been installed Insert the CD and wait for the installation procedure to start If Framework 4 0 1s not installed on the PC the next screen will be displayed Accept the licensing conditions and click Accept For the following components Microsoft NET Framework 4 x86 and x64 Please read the following license agreement Press the page down key to see the rest of the agreement
22. 0 0 Telefax 0451 80 900 10 Internet www bon de The Phoenix icon will appear on the desktop 1 2 Upgrade In case of an upgrade of the Phoenix software 1 e an installation of the Phoenix software on a system where an older version already was installed the following message might appear upon uninstalling the old version Phoenix The following applications should be closed before continuing the install PSearch Service 9 Automatically close applications and attempt to restart them after setup is complete Do not close applications A Reboot may be required Figure 1 7 Service active bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de www bon de This means the WCF service menu has been used to install the Web Service interface for Phoenix Please make sure to uninstall the service following Start Menu gt All Programs gt CSO gt Phoenix gt WCF Service gt Uninstall PSvcHost Wi cso PDF Printer A Phoenix Phoenix A Lenses WCF Service a Configure PSvcHost 63 Install PSvcHost 2 Start PSvcHost Stop PSvcHost Uninstall PSvcHost 4 Indietro Cerca programmi e file P LI After this the uninstall will correctly complete See the appendix for more information on the installation of the WCF Sercvice bon Op
23. 22 Example Pupillography Miscellanea 000026 Example Sirius Myopic Postop 0001638406 Example Sirius Transplantation 0005046272 Example Sirius Keratoconus 0000688134 Example Sirius Pellucida P1936942796 amp Example Sirius Normal 0000032773 16 04 2010 11 42 Scheimpflug Camera amp Example Sirius Marfan syndrome 000075366 Example Slitlamp Miscellanea 0000655360 amp Example Specular Miscellanea 0000524288 E Example VideoK CL P0642214157 ERE PD e g Figure 2 3 Patient Data 2 3 Editing Patient Data To edit the patient data move the mouse pointer to the patient name and right click Select 2 Edit patient data Which reopens the patient data window for editing the last name first name date of birth and or gender Click OK after having made all required changes 16 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH o O gt Q o 2 4 Selecting a Patient A patient already listed in the database can be selected in a number of different ways Type a last name and first name in the Patient Box n order to insert the last name and name correctly you must type Last Name comma First Name without spaces If the typed name does not correspond to any patient already present
24. Click Yes to exit or No to continue using the program 13 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH Oo O Q D 2 Patients Database Surname Mame Identification code Figure 2 1 Search Panel Each patient is identified by Last Name First Name and an Identification Code that is automatically generated by the program To locate a patient in the Database type the Last Name and First Name in the Patient Box or type the Identification Code To select a search criterion click the button alongside Last Name First Name or alongside the Identification Code To view a patient type his her Last Name First Name or Identification Code in the Patient Box As the letters or numbers are typed the pull down list will display patients meeting the criteria If the typed characters do not yield any results a warning icon will appear The warning icon 1s also displayed in the case an excessive number of results 1s returned Once a patient 1s selected his her Last Name First Name with Identification Code and date of birth will be displayed in large type in the top portion of the screen Fill Patient List Displays all the patients entered in the database Empty Patient List Empties the contents of the window in which the patient list is displayed but does n
25. Internet www bon de 80 900 0 Telefax 0451 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH Oo O Q D 8 3 Stereo Imaging Overlay of Fundus Images Click the button on Analysis menu or toolbar to access fundus image stereo imaging overlay window The user will be requested to select a second image of the same eye captured in such a position as to permit evaluating a disparity use the Image Selection window 8 1 1 to select When the selection is confirmed the program accesses the fundus image superimposition window in this window the user may e enlarge or reduce the sizes of the two fundus images using the mouse wheel e move the first image hold down the left mouse button and drag the image to the desired position e move the second image hold down the right mouse button and drag the image to the desired position e change the relative percentages of transparency hold down the Shift key and rotate the mouse wheel 8 4 Mosaic This feature is available only on multi core processor PCs since real time mosaic building is a very time consuming process Please use the mosaic mode only if the currently selected acquisition belongs to a study containing at least one more image acquired satisfying mosaic criteria 1 e one central retina image followed by one or more peripheral images Otherwise starting mosaic mode may result
26. Single image D Accesses the full screen mode Full screen borca Accesses window for viewing the image at different wavelengths Wavelength Divider Coi Accesses the window for comparing different fundus images from the Comparison gallery Accesses the Stereo imaging window superimposition Stereo Imaging Accesses the Mosaic window Mosaic Table 3 Analysis Menu 6 3 3 Menu Options Menu AS Displays general information about the patient and the current exam Show Information Toggle Smoothing Using interpolation smoothes out the image to eliminate the pixelating effect that appears when the image 1s greatly enlarged Overlay gt Font Allows the user to change the font character used for the overlay text Allows the user to change color of overlay text line Overlay Color for Measurement Overlay Line Width Allows the user to change the width thickness of the overlay line Table 4 Options Menu 48 80 900 10 Internet www bon de 80 900 0 Telefax 0451 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de 6 3 4 Menu Tools Menu KI Allows the user to activate the zoom function with the mouse wheel Zo sn and the panning function drag Cp Measurement of distances on the retina in degrees Distance e Calculates the ratio between two circular areas defined by the user in Cup to Disc Ratio surfac
27. al eye lid area A low ratio determines a high probability of suffering dry eye 10 1 Acquiring meibography images Meibography images can be acquired by Sirius Modi and Cobra even though there could be some major differences in images acquired with the instruments due to the different optical engineering N B When acquiring with Sirius it is highly advisable to place a 4x Lens in front of the instrument optic otherwise the image cannot cover the whole glands area due to a reduced field of view The procedure explained here is very simple and is replicable using Cobra and Sirius live acquisition e Start the live acquisition and prepare the patient by exposing the upper lid and lower lid meibomian glands in any order e Center the glands on screen and focus the image moving the instrument forwards or backwards or using the focus handle in case of Cobra e Take the picture using joystick button Acquired picture will be showed on screen as a thumbnail Acquire at least one image for the upper lid and one for the lower lid e When a satisfactory amount of images has been acquired exit Live acquisition 61 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Gi O 2 Q D 10 2Processing the examination Enter the meibography examination gallery and double click on the desired image to start
28. ation then you will configure the 1Pad to discover that information through a wireless connection How to configure Phoenix From the WCE Service menu in your start menu choose Install PSvcHost The following screen might appear Choose no since your Phoenix CD already contains the framework Net 4 0 installation Available on https itunes apple com it app pviewer id57 1848602 72 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Pivettout ewe NET Framework nmalestbon Ener o To run thus application you fest must install one of the following verica of Bhe NET Framework 7 NE Framework Veruona v4 0 Would you be to doverdoed nd instab HIET remercat Verpons vi D ran vos No g ped Computer Removable Disk CSO share wth cider Documents Music te Pictures EI Videos T Computer Networt Release notes Phoena pal k setup After the framework is installed try again to install the PSvcHost 73 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de How to configure your iPad Select the wireless network available for interaction with Phoenix Settings Airplane Mode Wi Fi Ka Blue
29. ble 1 Toolbar Buttons Summary 6 3 Menu Bar The bar at the top of the screen contains the menus shown below File Analysis Options Tools Filters Figure 6 3 Fundus Image Management Menu 46 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de 6 3 1 File Menu Save a screenshot print screen in a user selected format JPEG Gage geg ag BITMAP GIF PNG or TIFF image Save image Saves the image in a user selected format JPEG BITMAP GIF PNG or TIFF ig Closes and returns to the main window Close E Prints the screen containing the image A Preview window is shown Dan before printing Print Screen Prints the screen containing the image without showing the Preview Immediate Print Allows the user to print up to 4 selected fundus images on a single page cfr Section 9 Printing A Preview window is shown before printing Print Immediate Allows the user to print up to 4 selected fundus images on a single page without showing the Preview 4 Exits the program Exit Table 2 File Menu 47 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de 6 3 2 Analysis Menu e Accesses the single image display window
30. ck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de Image format Selects the format for saving the captured images visible spectrum and IR The user may specify the quality in the case of Jpeg compression default setting Acquisition mode Selects the working mode In the One shot mode the instrument takes one shot and the image 1s automatically displayed on the screen After capture the instrument immediately enters the stand by mode With the instrument in stand by every time the capture software is launched the user must press the joystick button to wake the instrument In the Non stop mode the instrument does not go to standby except after the elapsed preset stand by time and images may be captured one after the other in this case the images are not displayed immediately after capture The instrument starts up automatically each time with no need to press the Joystick button Autogain enabled Enables the auto gain function If activated the instrument continually adjusts image brightness for optimal values this feature facilitates centering especially in cases of patients with very small pupil diameters This function also permits the operator to view the patient s face clearly before beginnin
31. e and area F Draws an arrow on the image Draw Arrow 21 Draws a rectangle on the image Draw Rectangle Abc Allows the user to insert a line of text in the image Add Text Table 5 Tools Menu 6 3 5 Filters Menu Allows the user to activate the zoom function with the mouse wheel Canis and the panning function drag Returns to the default Gamma Restore g gt Returns to the three color view of the image Barrier filters Unfiltered w gt h Shows only the IR component Barrier filters gt Infrared Image d gt Shows only the choroid component Barrier filters Choroid 0 Shows only the vascular component 49 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Barrier filters Vascular Cd gt Shows only the red free component Barrier filters gt Red free d gt U Shows only the nerve fiber component Barrier filters gt Nerve Fibers Table 6 Filters Menu 50 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Gi O 2 2 D 7 Wavelength Division Click the ch button in the Analysis menu or on the toolbar to access the wavelength divider window The window shown in Figure 7 1 displays
32. ed overlapping pictures and the global image can be moved and zoomed in or out using mouse and mouse wheel Single mosaic pictures cannot be moved or rotated here Figure 8 3 Mosaic assembly 55 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 1 www bon de This button activates manual edit mode Every single mosaic picture is now selectable circled in red and can be dragged using the left mouse button or rotated using the mouse wheel While being dragged the mosaic picture becomes transparent to make manual linking easier This way any issue due to the automatic reconstruction can be fixed manually Figure 8 4 Rotate a single acquisition Right clicking on a single picture brings up a pop up menu that allows to remove that picture from the mosaic Removed pictures are placed in a gallery on the bottom of the screen All images that were not selected for the automatic reconstruction process are also placed in this gallery They can be re inserted manually in the mosaic by double clicking them from the gallery 56 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Gi O 2 Q D Figure 8 5 Gallery of discarded acquisitions This button finalizes m
33. ent s age Referring Physician s Name DeNiro Robert Caption Exam search Exam search Figure 2 4 Advanced Search For each of these categories clicking the button so as to check select it visualizes the boxes for entering search criteria e by gender male or female e by date of birth start and end dates of the interval to be searched e by check in number a box for entering the number this field features the automatic completion function e by examination date start and end dates of the interval to be searched e by patient age minimum and maximum age 18 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH o O gt Q o e by referring physician a box in which to type the physician s name e by instrument a list of possible examination capture instruments for example Fundus camera keratoscope pupillographer Scheimpflug camera slit lamp biomicroscope e by group a list of the groups created via the Settings function see Chapter 19 by caption the caption added to a single acquisition 15 used as a search parameter Select the boxes that permit establishing the search criteria Click Search to display
34. eters Cup Disc is based on evaluation of the circles passing through the three points That is it considers the cup and the disc as two circles and then calculates an approximate evaluation of the ratio The system will then ask if the user wants to refine the evaluation of the cup to disc ratio with advanced measurement Do you wantto perform an advanced Cup ta Disc ratio measurement Click Yes to enter an editing environment in which the cup and the disc are not considered simply as circles but as 16 endpoint polylines in this environment the user can manually adjust the cup and disc through many degrees and thus with great precision 44 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 L beck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH 6 1 3 Overlay For overlaying arrows rectangles and text on the image use the toolbar buttons Click x to delete the last overlay Toolbar and Menus 6 2 Toolbar BUTTON Single Image Wavelength Divider Comparison Full Screen Stereo Imaging Mosaic Unfiltered Infrared Image Choroid Vascular Red free Nerve Fibers Delete Close SHORTCUT F11 Del ICON 0 U m s 4 Dl and S menu or FUNCTION Accesses the window for displaying the images as single fundus images Accesses the window for displaying the images a
35. g the approach to the pupil which 1s thus facilitated Stand by time Time out for stand by mode From stand by press the joystick button to wake the instrument 5 4 Mosaic preview mode This feature is available only on multi core processor PCs since real time mosaic building is a very time consuming process Please note that this function only enables the mosaic preview mode which purpose is to provide a real time feedback of how the acquired images are merging correctly together The final mosaic can be built later and can also be edited manually using Phoenix software as explained in 8 4 Therefore the final mosaic picture will not be available after closing the Live acquisition software only a preview of it will be available in order to understand if mosaic pieces have been captured with sufficient quality Press to start mosaic preview mode mosaic mode on label is shown on the screen top right corner This mode exits automatically when laterality 1s changed or manually when the toolbar button 1s pressed again 40 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de Pictures can be acquired normally in any order although it is advisable to start from the central retina image to shorten computation time Immediately after every acquisition a background process e
36. ge Management Window This window displays the fundus images captured in the Live mode Click the and buttons to scroll all the images captured during the same exam To browse the various displays available in the fundus imaging module use the options available in the menu at the top of the screen or the toolbar Depending on the position in the program some items may not be displayed and or may be disabled For a detailed description of the functions of each menu or button see 6 3 To use the measurement or overlay functions click the appropriate buttons on the toolbar to the left of the image 43 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 6 1 1 Linear Measurements AA To make linear measurements click the Fi button on the toolbar or in the menu Measurements are made in degrees Since the retina image is enlarged by an unknown power the measurements supplied by this function are purely indicative Figure 6 2 Linear Measurement on the Retina 6 1 2 Cup to Disc Ratio Click the D button on the toolbar or menu to measure the cup to disc ratio After this measurement mode is selected the user is requested to indicate three points on the disc and three points on the cup The first system calculation of the ratios to calculate the ratios between the areas Cup Disc A and between the diam
37. graphy image it is no longer possible to move the zoomed image as usual since a left click on the image would produce a new gland point not a moving grip as it would in normal image viewing To by pass this behavior click and keep clicked the right mouse button an alert appears as shown in the screenshot to switch between points tracing mode and standard Zoom mode which allows moving the image The same switching function can be obtained by clicking the button which appears only when image is zoomed in 65 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Gi O 2 Q D 10 2 5 Finalizing meibography examination alla AR i Once all gland points have been placed cl ck the button to end the editing phase Healthy gland area will be drawn in green while loss area will be red Area of loss score is calculated together with a pre established degree in the meibomian scale Score and degree are printed and visible directly on the image while a detailed review of the attributed score is available in a separate window which appears on the top left corner of the main form Meibography score is automatically calculated even if the flag button is not pressed and edit mode is closed by clicking the quit button The updated image can now be printed alone or compared wit
38. h other processed or unprocessed meibographies saved in pdf format etc It 1s possible to return to the editing mode by clicking the button which becomes visible after the meibography has been validated with the flag button This way the examination is always editable after re entering it in the future 66 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de na Gi 2 o D NI Meiboscale Area of loss Figure 10 8 Meibo scale The meibo scale window in the top left corner of the screen can be expanded and then collapsed again for further reviewing of the attributed score Here 5 scale samples are available for consulting and visual comparison with the current examination image Those samples may help to understand if the whole process has been completed correctly so that the sample image reflects the health state of the processed image with a coherent area of loss score 67 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 10 3 Meibography thumbnails and gallery preview OD Group mb Group OS d am ae E z gt s lt Add caption gt lt Add caption gt lt Add capton gt caption gt lt Add captio
39. he PMS system from which information may be requested In the relative fields enter Title PACS PMS ID Host PACS PMS IP address Port PC port to which PACS PMS is referred Timeout s maximum waiting time before disconnecting a call received If the field is left blank any number of exams may be received Click OK to save the settings as entered otherwise click Cancel Click Ping to initiate a call to the PACS PMS system Click Reset to remove PACS PMS Setting Under local you can configure the local Application Entity name and port Limit for PMS configuration only identifies the maximum number of exams that may be 30 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH o O gt Q o Storage parameters Storage commitment Lossless b l Figure 4 7 Save Parameters The Save Parameters allow the user to specify several data storage options e Storage commitment select to receive a computer receipt for the data sent Fill in the Port and Receiving PC fields e Lossless select this box to select the type of compression used for sending in a 5 to 100 ratio in 5 steps in jpeg format Otherwise the files are sent in the original uncompressed format Note that this principal is based on a best first algorithm when images are originally acquired
40. is button goes active when a group 1s selected for editing The LE deletion button is instead used to delete a group It goes active when a group is selected for 26 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH Oo O Q D 4 3 Miscellaneous Other Clicking Other accesses the window shown below Settings Database Image root CADBPhoenix lmages Database C DBPhoenix phoenix mdb Backup in C DBPhoenix lmages cso Maximum number ofbackups Patient Management V External Patient ID Issuer Modality PMS Reminder on application closing v on deletion V on series error ly assign group Performance Max exams returned Figure 4 3 Other Information Menu Database Click the unlock button to change image root and Database Image root Clicking the Li button in this section selects the image management file called root cso Database Using the button to select a file from the database phoenix mdb Backup in Using the m button you can choose the destination folder fo backup files You can choose the maximum number of backups to perform Patient Management Deselecting Patient ID external option box also deselects the other two options mode and PMS and it will be possible to insert the ID code at the moment a
41. ken place Database type ACCESS b Database location CADBFhoeniphoenimdb Figure 1 9 Database connection Confirm pressing OK The main screen will open t 11 80 900 10 Internet www bon de 80 900 0 Telefax 0451 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH Oo O Q D Figure 1 10 Main Screen of the Phoenix Program This first screen allows the user to manage the database of patients and the examinations associated with each It is made up of various sections and menus When the program 1s launched all the windows are empty 1 4 File Menu Settings Allows the user to select the software language manage groups and instruments and make other settings see Chapter 4 This menu may be accessed only if the patient list is not displayed If patients are displayed in the list click Clear Patient List to enable the Settings function Esc Exits and closes the program 12 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Phoenix 1 Are you sure you want to exit Show this message again Figure 1 11 Confirm Exit from Program Selecting the suitable box on the Settings Other menu see Chapter 4 displays a request for confirmation of exit from program
42. ly at the orange fixation point generated by the instrument Once the pupil is centered continue to move in very slowly until the patient s retina becomes visible If necessary focus the image by turning the upper knob If enabled the focusing support window will provide visual feedback showing improvement worsening of the focus Turn the focus knob in the same direction as long as the lighted indicator continues to rise stop turning the moment it begins to descend Generally speaking an ascending path indicates that image focus 1S improving while a descending line indicates a worsening of the focus The focus indicator should nevertheless be considered significant only when the retina image is stable and correctly illuminated Figure 5 3 Focus Indicator Stabilize the image as much as possible wait until the patient 1s immobile and check that the light does not flicker The image must be uniformly illuminated see example image Do not move in further when the image is clear too close a proximity could generate undesired reflections 36 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Gi O 2 2 D Press the joystick button to capture the image The captured image will be saved in the OD right eye or OS left eye gallery depending on the eye to which the captured i
43. mage refers Figure 5 4 Example of Optimal Centering 37 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de e 1 Gi a 2 D 5 2 Viewing The instrument performs simultaneous capture of two images of the central portion of the retina one obtained with visible spectrum illumination white light and one obtained with infrared spectrum illumination The visible light image is available in the gallery immediately after capture left click the thumbnail to display a full screen view Figure 5 5 Visible light Capture To view the infrared spectrum image right click the thumbnail and select Show IR from the pull down menu select Delete to delete the selected image The infrared spectrum image provides a different diagnostic picture since the infrared light penetrates the tissues to a greater degree this mode permits capturing the structure of the choroid and so facilitates diagnosis of nevi and other pathologies of the retina Figure 5 6 Gallery Menu 38 Figure 5 7 Infrared Capture 5 3 Settings The e icon displays the current application settings o Acquisition mode One shot Non stop Autogain enabled Figure 5 8 General Settings 39 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L be
44. meibomian glands evaluation The procedure is computer assisted but requires manual tracing of glands points After evaluation is completed a gland health score will be saved and will be available for further patient consulting Y Phoenix lt Aggiungi dcrizione gt o 56 Chiudi Figure 10 1 Image capture 10 2 1 Starting evaluation These buttons start the evaluation for upper lid and lower lid respectively in the above case the lower lid evaluation is selected The same buttons can be used to delete the evaluation measure and restart Deletion is preceded by a confirmation message Deleting the measurement means that all control points displayed will be lost 62 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de e 1 e Gi 2 o D 10 2 2 Tracing eye lid bounds Figure 10 2 Define boundaries Four 4 control points must be set in order to define a very raw bound of the eye lid s area of interest Place the blue points in order to build a trapezoidal shape Exclude lid areas that are not completely reverted since they are not useful for the computation One point in the example case the left most one should be placed near the tear punctum while the opposite side points the right most ones should be placed on the end f
45. n gt lt Add caption gt Figure 10 9 Gallery meibography acquisitions After closing the examination the image thumbnail is updated with the area of loss score and degree and areas of interest healthy vs unhealthy are drawn in different colors The gallery preview also contains all needed information so it is not strictly necessary to re open the examination for future patient evaluations 68 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 5 Oo O Q D Appendix A Import Export exams a Exporting an examination Exporting an examination or a patient select with right button of the mouse on the examination and click export Edi exam data x Delete exam Figure 8 1 Export examination You will see the editing screen of the anagrafic data to be exported Edit the data f you want and select OK It will be exported the file zcs My computer My network Figure 8 2 File esportato 69 b Importing an examination To import a previously exported file zcs you must open the archive containing the file and drag the column occupied by the patient list as shown in the next window File 7 Settings info EI out Surname Name Mr J O Identification code el S rire m OD Export file I E
46. ncorrected Visual Acuity box the maximum visual acuity attainable with correction is entered in the BCVA Best Corrected Visual Acuity box The Cancel button closes the window without saving the changes To save the entered data click the OK button or press Enter 3 6 Capture The CH Capture icon goes active when a new exam is created or when an empty exam is selected It permits selecting the instrument with which to capture the exam and accessing the capture environment 22 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 3 7 Image Gallery When an exam previously stored as described above 1s called up the Gallery window on the right hand side of the main screen will show the images relative to each exam as it 1s selected The images are subdivided by OD right eye and OS left eye Phoenix File iz Query MWL Settings Info a Quit Surname Name b 0000000 Example Cobra P0947809186 5 9 1973 2 SSS Example Cobra P0947809186 6 3 2011 10 32 Fundus Camera Figure 3 3 Image Gallery A type group may be defined for each eye in order to facilitate future searches Figure 3 4 Groups Click the button to open the pull down menu of the groups entered in the Settings Groups menu see Chapter 19 To enter the eye being
47. oice screen will be shown until the user makes his choice Acquisition setting start acquisition after timeout Figure 4 12 Choice time out 33 4 6 Activations In this section it is possible to upgrade the license of the software In the section Export it is possible to enable the data export to external applications Settings License Type Li Ka Upgrade license Export 177 CT View Calco Datagraph 7 EasyFit F Assort W EyeLite V Raw File 7 Focus l SCHWIND interfaces Focal Point L Set default Exportv 2 v Remind to select other eye for multiselect Figure 4 13 Activation settings For a number of external applications it is possible to configure the export on the main gallery The default can be chosen from the combo box Check the reminder if you want a reminder message for exporting both eyes contemporarily to the external application 34 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Gi O 2 Q D 5 Capture The x Capture icon goes active when a new exam is created or when an empty exam is selected This function allows the user
48. old of the eye lid or as stated before where the eye lid is not completely reverted anymore All the control points that have already been set can still be canceled until the last point is set by hovering the mouse on them and left clicking when the white cross appears The bounds red lines do not need to be very precise in this phase since they will be adjusted automatically in the next phase Figure 10 3 Adjust boundaries by moving the blue and yellow control points Use the all yellow points to adjust the red shape Try to move the points including the 4 manually set points and see how their movement affects the global shape The yellow points at the end of the yellow lines can be stretched such as to modify the curvature of the red shape 63 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de e 1 www bon de The mechanism is very intuitive anyway try to approximate the eye lid shape but remember that there is no need to be too strict in this approximation 10 2 3 Tracing gland points Figure 10 4 Trace gland points Highlight the glands area by left clicking on the upper glands bounds or lower bounds in case of upper eye lid meibography Every click adds a green gland point the more points are set the more accurate the gland area 15 It is also possible to keep
49. osaic creation as it merges all overlapping pictures together in a single image excluding of course all the pictures that have been placed in the discarded gallery All pictures edges are smoothed and image transitions combined in a more uniform image If you are satisfied with the final mosaic image you can print or save the diagnostic report choosing File gt Print screen capture If the mosaic has been finalized using the currently described procedure then all pictures are merged together and mosaic image 15 optimized for printing Ge black background is turned to white Otherwise a normal screenshot is proposed 57 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Figure 8 6 Finalize mosaic Example Cobra Miscellanea OD Ernie YI SSC d rinin code 0083943743 San dara ant time CA 200 Zeien date QA SESS 16 3 3 PDF Print Cancel Figure 8 7 Print preview 58 9 Printing The user may print a single image or several images selected for comparison Select Print from the File menu 6 3 1 the Preview Image Selection window will open 2 Patient Management Example Cobra Miscellanea OD Example Cobra Example Cobra Miscellanea OD Miscellanea OD Gitte 10 10 1660 ker dik coco POOR Dan cima sra tem 4 5 2011 ROD Again cime 4 5
50. ot delete the patients from the database E Search Permits searching patients in the database by gender date of birth check in number examination date patient age referring physician instrument or group see Paragraph BA To enter a nevv pattent in the database click the icon on the main screen to open a new window Enter the patient data in the window last name first name date of birth and gender Typing a Last Name First Name pair in the Patient Box automatically opens the window for entering the data for the new patient 14 80 900 10 Internet www bon de 80 900 0 Telefax 0451 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH o Q o Create a new patient Surname Name Birthdate Gender Identification code 0003604480 Cancel Figure 2 2 New Patient Data Window Date of birth must be entered in the form two digits for the day two digits for the month and four digits for the year Entering an invalid datum will cause a warning icon to be displayed Entering a patient whose data are identical to those of a patient already contained in the database will likewise open a window containing a warning message The identification code is automatically entered by the system unless a different option is selected from the DICOM Settings menu See Chapter 4 3 To confirm new
51. patient is created If this option box is instead selected it will not be possible to enter the ID code manually Select one of the following two options e Modality the ID code is automatically assigned by Phoenix when a patient is created e PMS The ID code and relative personal data will be crossloaded to Phoenix from an external database The ID of the agency or institution providing the data must be entered in the field alongside the PMS item 27 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de o O gt Q o tE Note that in the latter case the patient entry icon is not active Reminder The user may select among the following options e Close application displays the message requesting confirmation to close the application e Delete displays the message requesting confirmation to delete an image from the gallery e Series error this warning is given when traces of images erroneously moved to other folders or files remain in the examination in question e Assign group after performing an acquisition a reminder is presented for classification group assignment of the assigned series Performance Max exams returned sets a limit to the maximum number of examinations upon database queries Might be set in case of network environment to tune performance 28 80 900 0 Telefax 0451
52. rete ad hoc kA Consente di creare una rete temporanea per la condivisione di file o di una connessione Internet Annulla m gt The new network will be created starting from the network connections on the control panel The limitations of the ad hoc network are illustrated below for instance maximum distance between client and host should be 10 meters therefore the configuration of an ad hoc wireless connection is only for demonstration purposes 77 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de nualmente a una rete wireless Configurazione di una rete wireless ad hoc Una rete ad hoc talvolta denominata rete da computer a computer una rete temporanea utilizzata per la condivisione di file presentazioni o una connessione Internet tra pi computer e dispositivi I computer e i dispositivi di una rete ad hoc devono trovarsi a non pi di 10 metri circa N uno dall altro Se il computer connesso a una rete wireless possibile che durante la configurazione di questa rete venga disconnesso Define the network Cobra without authentication and make sure to save the connection indicated by the checkbox as shown below onnetti manualmente a una rete wireless Assegnare un nome alla rete e scegliere le opzioni di sicurezza Nome di rete Cobra Tipo di sicurezza Ness
53. ssenca di broadcast di rete Charre rete enge w Stabilisci una connessione quando questa rete La rete ncheede una chiave per le seguenti cperamore a distanza di rilevamento fufertcazmore di rete Aperta xara And set the P settings as described above 80 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH DISCLAIMER Always create a BACKUP of the database before updating the application or archive and or before conducting any maintenance operations We also recommend backing up the archive on a support different from that normally used for example CD ROM or DVD at regular intervals at least once weekly bon optic srl declines all responsibility for loss of data caused by improper manipulation of the archive Manufacturer b on Optic VertriebsGmbH Stellmacherstrasse 14 D 23556 L beck Rev 0 3 Phoenix Ver 2 6 18042013 M l
54. t different wavelengths Accesses the environment for comparing various fundus images from the gallery Accesses the full screen mode Accesses the stereo imaging window superimposition Accesses the Mosaic window Returns to the three color view of the image Displays only the IR component Displays only the choroid component Displays only the vascular component Displays only the red free component Displays only the nerve fiber component Deletes the display image Closes the fundus image management window and returns to the gallery 45 80 900 10 Internet www bon de 80 900 0 Telefax 0451 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de Scroll back PgDn Scrolls back through the gallery images Scroll forward PgUp o Scrolls forward through the gallery images Zoom Enables activation of the zoom function with the mouse wheel or the panning function drag View measurements Displays or hides the measurement buttons toolbar Distance Measures distances on the retina in degrees Cup to Disc ratio e Calculates the ratio between two circular areas defined by the user in surface and area Line Draws a straight line on the image Rectangle Draws a rectangle on the image image Delete Deletes drawings and text overlaid on the image Text Abe Allows the user to type a line of text on the Ta
55. the original image top left To insert this filter on the single screened image click the button the infrared image top center To insert this filter on the single screened image click the button the red free image top right To insert this filter on the single screened image click the vd button the choroid image bottom left obtained by considering only the red component To insert this filter on the single screened image click the button the vascular image bottom center obtained by considering only the green component To insert this filter on the single screened image click button the image of the nerve fibers bottom right obtained by considering only the blue button component To insert this filter on the single screened image click the Figure 7 1 Wavelength Division SI bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 8 Secondary functions 8 1 Comparison LE Click the button in the Analysis menu or in the toolbar to access the comparison function 8 1 1 Image Selection The capture image selection window will be displayed From this window the user may select up to six images by double clicking the gallery images Should the images to be compared belong to a different exam or patient click the W button on the Patient Management bar to access
56. the search results 2 6 Delete Patient To delete a patient name right click the patient select a and then confirm the deletion request warning message Warning deleting a patient also deletes all the examinations associated with that patient and the relative Images 19 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH o O gt Q o 3 Examinations Database An unlimited number of examinations may be associated with each patient the examinations are defined on the basis of the instrument used and the date of creation 3 1 New Exam After a new patient is created an examination will also be created ar To create a new examination for an existing patient click the button If working with a single instrument the image capture mode will be automatically accessed Otherwise if at least two instruments are used the window shown below will open Select the instrument to be associated with the current examination After selection the capture mode is accessed 3 seconds until Ime Figure 3 1 Instrument Selection Each examination is filed by date of creation and instrument type It is also possible to attribute a pathology group Group Classifying the examinations by codified groups is useful for conducting searches The groups list may be edited from the Settings menu
57. tic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 1 3 Phoenix Program Start up Click the Phoenix icon on the desktop The screen shown below will appear asking the user to send an e mail containing the code for unlocking the software Send the email to support bon de 1 Insert your serial number On the CD P o 2 Copy following code and send it to support bon de Copy 3 y Past here the activation Key Faste B Register You have 30 logins remaining Demo Phoenix Figure 1 8 Registration Screen You need to connect the database when you open the first time the software Press OK if the database has been created during the installation and Phoenix 1s ready to use 10 80 900 0 Telefax 0451 80 900 10 Internet www bon de 23556 L beck Telefon 0451 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 www bon de If the database is just present press browse button and select phoenix mdb You need to connec the root cso file contents in the same database folder Open the Miscellaneous menu in the settings and check if the Image root field is complete Otherwise search the root cso that will be in the database phoenix mdb folder see 4 3 Reconfigure Database Either you have decided to change Database ora maintenance operation has ta
58. tooth Choose a Network v Cobra gt VM Cellular Data Yi nr Fe Do Not Disturb OFF Other gt Notifications Ask to Join Networks OFF General Known networks will be joined automatically no known networks are available you Sounds will have to manually select a network kod Brightness amp Wallpaper KA Picture Frame Privacy iCloud Mail Contacts Calendars Reminders i This network by default will be configured as follows 10 33 AM Not Settings CI Cobra Airplane Mode OFF SO WiFi i Forget this Network n EZ Bluetooth On Autovoin CX ww Cellular Data IP Address Z Notifications IP Address 192 168 10 100 Pata s General Subnet Mask 255 255 255 0 Sounds Router 192 168 10 10 Auf Brightness amp Wallpaper k l Picture Frame Privacy na HTTP Proxy Mail Contacts Calendars mn Notes DNS Search Domains 74 Internet www bon de 80 900 0 Telefax 0451 80 900 10 Telefon 0451 23556 Lubeck StellmacherstraBe 14 bon Optic Vertriebsgesellschaft mbH www bon de Make sure the address is configured as static and the IP address is on the same netmask as the host computer Since typically the host computer will be configured as having address 192 168 10 10 this means that the iPad must have an address similar to 192 168 10
59. una autenticazione ape v Suggerimenti per la scelta Chiave di sicurezza Nascondi caratteri V Salva questa rete Next configure the network s IP settings The IP Address assigned will be the router on client computers 78 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de i iopriet Connessione rete wireless Propriet Protocollo Internet versione 4 4 5 Rete Condivisione wen i Connetti tramte E possible ottenere l assegnazione automatca delle impostazioni IP se ia rete supporta tale caratteristica In caso contrario sar necessario amp Atheros AR338x Wireless Network Adapter richiedere amministratore di rete le impostazioni IP corrette Contgura _ 5 Den automaticamente un ndrazo IP La connessione utilizza gli elementi seguenti i Ut zza i seguente indrizzo IP a Protocollo intemet versione 6 TCP IPv6 D indirizzo IP 192 168 10 10 CT Mini i Armi ia E Subnet mask 255 255 255 0 Driver di LO del mapping di individuazione topologia kee a Risoonditore individuazione topologia di collecame Gateway predefinito 192 168 10 10 i m i gt thers ndrizzo server DNS automaticamente installa Disinstalla Propnet Utilizza seguenti indirizzi server Descrizione os
60. uncompressed all compression options can be performed when the image is acquired lossless it can be forwarded also lossy but not uncompressed finally when the image is acquired lossy it can t be forwarded other than lossy Java Home CAProgrammiColFhoenk java Figure 4 8 Java Runtime Environment This parameter defining the environment required for using the functions offered by DICOM is configured at end of software installation 31 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 4 5 Instruments Clicking the Instruments label accesses the section for managing the instruments to be used Settings 2 V dil External Camera Acquisition setting V Start acquisition after timeout Figure 4 9 Instruments Management Connect all the instruments to use and press the Instruments wizard button Instrument wizard The following procedure automatically detects the presence of instruments connected to the PC and allows the user to perform configuration and calibration Connectto the PC all the instruments which are going to be used and press the button Configure to start the procedure Detected devices SlitLamp Digital Vision Installed jee Specular Microscope Capture Installed Slit lamp Capture Figure 4 10 Installed instruments
61. valuates the acquired images and a pop up window asserts whether the last acquired image merges with the previous ones If this is not the case the picture can still be merged with other future acquisitions so you should not delete it unless it is clearly a bad quality image R 1 Te Tal A21 7 34411 e1 HI a VINA IE tI Ee 2197211911 5 Figure 5 9 Mosaic preview After exiting mosaic preview mode a summary window pops up and displays a bigger preview of the valid mosaic pictures merged together This is how the mosaic pictures will be automatically merged together later in Phoenix without any manual editing If mosaic preview is not satisfactory you can manually edit the produced mosaic for example 1n case of bad quality images or in presence of retina diseases anomalies that interfere with automatic mosaic reconstruction 4 42 www bon de Figure 5 10 Preview mosaic Op UOg MMM 8UJOJU 01 006 08 LS70 0 006 08 SYO l l l y qn 99962 FL aggisieuggulaie Hqu eu sil s bsq lm udo u o q bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de 6 Viewing and management of single images Double click any image in the gallery to open the window for displaying and managing the single fundus images Figure 6 1 Fundus Ima
62. xample Slitlamp 0000655360 zcs File ZCS Altre risorse Dettagli Risorse del computer Se Phoenix v 1 1 0 22 3 User Cristian Figure 8 3 Import file Wait a few seconds and the patient will appear in the list 70 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Appendix B Safety and Indications for use Safety For data security please refer to the management of Windows security It is recommended to enter a password to access the account used Indications for use Pictures of the fundus can be acquired with the nonmydriatic fundus camera This enables detection and monitoring of eye diseases Furthermore pictures of the anterior eye surface and meibomian glands can be acquired This is used in the detection and monitoring of dry eye 71 bon Optic Vertriebsgesellschaft mbH StellmacherstraBe 14 23556 L beck Telefon 0451 80 900 0 Telefax 0451 80 900 10 Internet www bon de Gi O Q D Appendix C Configure PViewer iPad In order to use Phoenix with Pviewer follow these instructions First you will install the service host that exposes Phoenix Patient inform
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