Quick Reference Guide - topcon-medical.co.uk...3 Topcon (Great Britain) Medical Limited 3 DRI OCT...

Quick ReferenceGuide

DRI OCT TritonOptical Coherence Tomography

61647 Topcon quick start guide Triton.indd 1 27/03/2019 09:56

Select Patient Capturing OCT Scan Types Anterior Segment Scanning Fundus Photography - Colour orAuto Fluorescence Peripheral Fundus Photography

OCT Angiography

Fluorescein Angiography

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Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Index2

Index

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Select Patient

In the case of a New Patient – Click [New Patient] and access the register Patient panel. Input the necessary items and click [Register].

Input your Login details.

Double click the Imagenet 6 icon on Desktop.1

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Entering name, DOB, sex and ethnicity is recommended to ensure the patient is compared to the correct Normative Database.

Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Select Patient3

Select Patient




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Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Select Patient3 3


Click [Acquisition] at top of screen or to the right of screen.

In the case of an Existing Patient – Select a Patient in [Patient List] or search for a Patientby using [Advance] tab. Highlight the Patient.4

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In [Patient List] field, all patients are displayed.It will be more ecientto sort and to search in [Advance] by ID/name/last test date.

4 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Select Patient

Select Patient




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Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Select Patient3 4


Position the Patient.

Choose Scan Type.

Place the Patient's chin on the chinrest. Keep their chin and forehead stable. Be sure to adjust the chinrest height to align the eye marker and thecorner of the eye.

Adjust the Patient’s height using the [Up] and [Down] chinrest buttons found next to the joystick on the machine.

Once Scan Type is selected, the machinewill automatically go into capture mode.

You may need to use the[Small Pupil] setting for Patientswith small pupils or turn the

require the fundus photo.

Capturing OCT

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[Small Pupil] button

5 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Capturing OCT

[On]/[Off]


Choose Scan Type.






Capturing OCT

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[On]/[Off]

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Instruct the Patient to look straight ahead and find the Fixation Targetand to blink as normal until you are ready to press the trigger to capture.

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1. Move the machineforwards until yousee the pupil align.

3. Make sure the optic disc is centrally in thebox – Move the fixationtarget if required.

Live Fundus View is alive view of the OCT, it will also enhance contrast to distinguishretinal structures.

4. If the B-Scan image quality is poor and in the red in the bar above, press [Optimize] to enhance signal strength.

IR Illumination

If IR fundus image is noisyor dark, please turn up the illumination level.

Flash Intensity

Increase if Patient is poorly dilated or has small pupils.

[Live Fundus View]

2) Ensure distance indicator circles are green and overlapping and in the brackets. Yellow = too closeOrange = too far away

Green line = Scan positionBlue cross = Fixation target

position



Choose Scan Type.






Capturing OCT

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[On]/[Off]

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Once the Patient is reminded to fixate on the target and not to blink, press the trigger on thejoystick to capture.

3. Once the Patient is fixated correctly, you can adjust the OCT scan toensure it is appearing centrally in the box bymoving this Z Tab.

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Images will then automatically be saved for you to view in the Imagenet 6 software.6

Check OCT quality after capture. 5

2. Patient Fixation

Use the arrow keys on the base of the machine to move the Patient’s Fixation in the direction required.

1. If the Patient Fixation needs adjusting, this little blue cross is thegreen internal fixation cross.

Immediately after capture, the Shadowgram will appear to ensure there are no fixation losses or blinks.

If poor quality, press [Delete] and repeat capture process.



Choose Scan Type.






Capturing OCT

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[On]/[Off]

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Scan Types

Macula3D Macula – Scans the macula area 7 x 7 mm cube scan

3D Wide – Scans macula and disc combined 12 x 9 mm scan

FGA Mode – Allows precise follow up scans of Naevi and areas of interest

Dynamic Focus – Line scan allowing enhanced view of vitreous, retina and choroid in one

Radial / 5 Line Cross – Overlapping scan that penetrates cataracts or media opacities

Macula Fundus Photo – Colour, Red Free, Autofluorescence, Fluorescein Angiography

Glaucoma3D Disc – Analysis of Retinal Nerve Fibre Layer 6 x 6 mm cube scan

3D Macula V – Analysis of Ganglion Cell Layer 7 x 7 mm cube scan

3D Wide Scans macula and disc combined 12 x 9 mm scan

Stereo Fundus – Stereo photo of optic disc

Disc Fundus Photo – Colour, Red Free, Autofluorescence, Fluorescein Angiography

Anterior Radial Anterior 6 mm – Central Corneal Thickness measurement

Radial Anterior 16 mm – Assess larger surface area of corneal e.g scleral lens fitting

Line Anterior H or V 3 mm or 6 mm – Single Angle measurement

Line Anterior H or V 16 mm – Angle to Angle measurement

3D Anterior – 3D view of anterior angle

OCT Angiography3 x 3, 4.5 x 4.5, 6 x 6, 9 x 9, 12 x 12 mm cube OCTA – Dye-less angiogram of structure and flow of retinal circulation.

8 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Scan Types

Scan Types

Macula3D Macula – Scans the macula area 7 x 7 mm cube scan

3D Wide – Scans macula and disc combined 12 x 9 mm scan

FGA Mode – Allows precise follow up scans of Naevi and areas of interest

Dynamic Focus – Line scan allowing enhanced view of vitreous, retina and choroid in one

Radial / 5 Line Cross – Overlapping scan that penetrates cataracts or media opacities

Macula Fundus Photo – Colour, Red Free, Autofluorescence, Fluorescein Angiography

Glaucoma3D Disc – Analysis of Retinal Nerve Fibre Layer 6 x 6 mm cube scan

3D Macula V – Analysis of Ganglion Cell Layer 7 x 7 mm cube scan

3D Wide Scans macula and disc combined 12 x 9 mm scan

Stereo Fundus – Stereo photo of optic disc

Disc Fundus Photo – Colour, Red Free, Autofluorescence, Fluorescein Angiography

Anterior Radial Anterior 6 mm – Central Corneal Thickness measurement

Radial Anterior 16 mm – Assess larger surface area of corneal e.g scleral lens fitting

Line Anterior H or V 3 mm or 6 mm – Single Angle measurement

Line Anterior H or V 16 mm – Angle to Angle measurement

3D Anterior – 3D view of anterior angle

OCT Angiography3 x 3, 4.5 x 4.5, 6 x 6, 9 x 9, 12 x 12 mm cube OCTA – Dye-less angiogram of structure and flow of retinal circulation.

8 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Scan Types8


To capture an Anterior Scan, instruct the Patient to look straight ahead andensure they are aligned with the callipers on the side of the headrest. Attach the AnteriorLens and the Anterior Headrest.

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Select 16 mm or 6 mm Line Anterior to assess the Patient’s angles.There is no internal fixation, however just instruct Patient to lookstraight ahead or turn the External Fixator on.

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Anterior Segment Scanning

Anterior Headrest

2. Once you see the cornea, drive the machine further forward until the iris is satin between the blue lines and press the trigger on the joystick to capture.

1. Align the line scan through the centre of the pupil and drive the machine slowly forward until you see the cornea in the left hand box.

Anterior Lens

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Anterior Headrest

Anterior Lens


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Anterior Headrest



Anterior Lens


Anterior Headrest

Anterior Lens

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Select 6 mm Anterior Radial Scan to assess corneal thicknessand instruct the Patient to look straight ahead at the little reddot in the camera lens.

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To capture, press the trigger on the joystick.4

Images will be saved automatically onto Imagenet 6.5

2. Once the cornea has come into view, ensure it is sat in the yellow box by pushing the machine forwards and by twisting the joystick up or down to make sure the Corneal Reflex line is visible.

1. Align the radial scan with the centre of the pupil and drive the machine slowly forward until you see the cornea in the left hand box


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Anterior Headrest



Anterior Lens


Anterior Headrest

Anterior Lens

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11 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Fundus Photography

Fundus Photography – Colour or Auto Fluorescence

1 Position the Patient - Set the Patient's chin on chinrest. Keep their chin and forehead stable. Be sure to adjust the chinrest height to align the eye marker and the corner of the eye.

2 Instruct the Patient to look straight ahead and find the internalfixation target.

3 Select [Fundus Photo] on main menu.

4 Press the relevant [Fundus Photo] button – [Colour] or [Auto Fluorescence] -change fixation position from Macula, Centre or Disc.

5 Move the machine in until the two circles are green and together within the brackets.Adjust IR brightness or flash power if required and also the fixation target to adjustPatient fixation.

Adjust the Patient’s height using the [Up]and [Down] chinrest buttons found next tothe joystick on the machine.









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6 Once aligned and evenly illuminated, instruct the Patient not to blink andpress the trigger on the joystick to capture.

7 Press the button on the PC to save your images to Imagenet 6.

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4. Ensure distance indicator circles are green and overlapping and in the brackets.

Yellow = too close

Orange = too far away

1. Select [Colour] or [Auto Fluo] depending on the Fundus Photo required.

2. Change fixation position if required from Macula, Centre or Disc.

3. If the Patient’s fixation needs adjusting, this little blue cross is the green internal fixation cross.

5. Flash Intensity

Increase if the Patientis poorly dilated orhas small pupils.

IR Illumination

If IR fundus imageis noisy or dark, please turn up the illumination level.

[Save]









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13 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Peripheral Fundus Photography

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Peripheral Fundus Photography

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2 Select Fundus Photo on main menu.

3 Move the machine forwards until the two circles are green and overlapping togetherin the brackets and press [Peri] button. Instruct the Patient to look at the fixation target.


Yellow = too close


1. Press [Peripheral Photo]

Position the Patient - Set the Patient's chin on chinrest. Keep their chin and forehead stable. Be sure to adjust the chinrest height to align the eye marker and the corner of the eye.



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Yellow = too close





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4 Move the Patient’s fixation by pressing the preset buttons on the bottom left.Once aligned and illuminated perfectly, press the trigger on the joystick to capture.

5 Once aligned and all illuminated evenly, instruct the Patient not to blink and pressthe trigger of the joystick to capture.

6 Press the [Save] button on the PC to save your images to Imagenet 6.

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1. Move fixation target easily using this preset fixation positions to capture peripheral photos.

2. This little blue cross is the Patient’s green internal fixation cross. This will move when the fixation presets are selected on the left.

3. Flash Intensity

Increase if the Patientis poorly dilated or has small pupils.

IR Illumination

If IR fundus image is noisy or dark, please turn up illumination level.


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Yellow = too close





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4. When B scan image quality is poor and in the red in the bar above, press Optimize to enhance signal strength.

15 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | OCT Angiography

3. Once the Patient is fixated correctly, you can adjust the OCT scan to ensure it is centrally in the box by moving this Z Tab up and down.

2"I%M&4. Press [Optimize] to obtain best quality.

1. Move the machine forwards until you seethe pupil align.

2. Ensure distance indicator circles aregreen and overlappingand in the brackets.

Yellow = too close


IR Illumination

If IR fundus image is noisy or dark, please turn up the illumination level.

OCT Angiography

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2 Select OCTA size from main menu.

3 Push the machine forwards until the pupil aligns, ensure the OCT B-Scan is central to the boxby adjusting the Z tab and then press [Optimize] to obtain the best quality OCTA.

Position the Patient - Set the Patient’s chin on the chinrest. Keep their chin and foreheadstable. Be sure to adjust the chinrest height to align the eye marker and the corner of the eye.








Yellow = too close


IR Illumination


OCT Angiography

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4 After pressing [Optimize], press the trigger on the joystick to capture the OCTA. Remind the Patient they can blink as normal as there is an Auto Tracker, but to keep fixatedon the fixation target. You will see the Scan Position move down as it scans.

5 If scanning takes too long, press the trigger on the joystick again to cancel Auto Tracking. This will complete the scanning without tracking. The Patient must then be asked not to blinkto avoid artefact.

6 Images will be saved automatically onto Imagenet 6 software.

Scan Position

Blinking or eye movement prevents scanning. When scanning stops, a red arrow shows, but Auto Tracking restarts when the alignment position is OK. It completes the scan until the end.








Yellow = too close


IR Illumination


OCT Angiography

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1 Your hospital will have its own protocol on administering fluorescein and timingsof the procedure.

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3 Move the machine in until the two circles are green and together within the brackets. Adjust IR brightness or flash power if required and also the fixation target to adjust thePatient fixation. When ready, press [Start] to start timer.

17 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Fluorescein Angiography





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4 Press the trigger on the joystick to capture FFA images.

5 When finished, press [Save] on the PC to save all images to Imagenet 6.

18 Topcon (Great Britain) Medical Limited | DRI OCT Triton | Quick Reference Guide | Fluorescien Angiography

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IR Illumination

If IR fundus imageis noisy or dark, please turn up the illumination level.


Yellow = too close


1. Select [Colour] or [Auto Fluo] depending on Fundus Photo required.

2. Change fixation position if required from Macula, Centre or Disc.

3. If Patient fixation needs adjusting, this little blue cross is their green internal fixation cross.

5. Flash Intensity

Increase if the Patientis poorly dilated or has small pupils.



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Topcon (Great Britain) Medical Limited t: 01635 551120 e: [email protected] w: topcon-medical.co.uk

Topcon Irelandt: +353 1 223 3280 e: [email protected] w: topcon-medical.ie

Topcon (Great Britain) Medical LimitedTopcon House, Kennetside, Bone Lane, Newbury, Berkshire, RG14 5PX


Quick Reference Guide - topcon-medical.co.uk...3 Topcon (Great Britain) Medical Limited 3 DRI OCT...

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