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AP-7000 Instruction Manual

1. po Stimulus 2 R o e 30 20 10 0 10 20 30 40 Visual angle degrees Intensity of the Presented Stimulus in Screening Examination Zones 4 Reference value 5dB Mariotte blind spot Omitted Intensity of the Presented Stimulus in Screening Examination For the point where the patient could not see the stimulus the mark is given 2 Parameter setting 4 Common parameter You can set the following parameters Presentation time presentation interval stimulus size blind spot size fixation loss false positive reaction false negative reaction stimulus color background color fixation gaze monitor pupil diameter measurement and AP 340 2 Screening parameter You can set the following parameters Intensity Zone Reference value Quantify scotoma 4 8 2 Supra There are 6 kinds of examination programs Standard Macula Mariotte Optional e D Test Esterman Both Supra Examination Program Program Examination Area and Points SCONE MELE Summary Time min Standard Within 60 83 points 3 to 5 General Group examination Glaucoma exam etc Macula Within 10 21 points 1 to 2 Abnormal visual field in the macular area Optic nerve disease Mariotte Within 10 around the blind spot 1 to 2 To grasp the tendency of Mariotte s 21 points blind spot to enlarge in the early stage glaucoma Optional Within 80 select from 331 points 1 to 18 An exami
2. cccccccccsssssrscccesessseeccccssssseecccessssseesecesessseeececesesseeeceeesesseeeeeeseeses 144 9 10 R pair OF the TMS TUN CINE ssns 144 10 Troubleshooting i e ecccccccetssssssccccceeeesssscccccceesssseccccceeeees 146 T1 SDECITICAUION ecrane eerie 150 12 Technical information cc cc cecceccsccsccsccsccsccsccsscsseees 152 12 1 Examination points of each examination Prograim ccccssscccccssscccssssrecessssecessssescesesseceesessneeessseeseeeees 152 12 2 Stimulus Intensity and SIZE oss ces scsi case schaccesdeckadenas aguas thas densideceussacesdensideduuetiaesnuadidacnuaeisesaeedesadnuadeaesanedseasereetavens 156 12 3 Spectrum distribution Of IUMINOUS SOUICE ccssccccsssrcccssssccccssscccessscecessssneccesssesecssseseesssseseessseseseees 157 13 Electromagnetic compatibility IEC 60601 1 2 159 1 System description 1 1 Intended use KOWAAP 7000 is an automatic perimeter to perform perimetry examinations and to display examination results Static quantitative perimetry examinations and kinetic perimetry examinations are available 1 2 Principle of measurement and System overview When the power switch is turned on setup items required for examinations appear on the touch panel The examiner selects a program and sets parameters on the touch panel according to the specified procedure When an examination begins stimuli are sequentially projected acc
3. 1 Test Auto Examination is automatically performed according to the other set parameters Manual The location and direction of moving the stimulus can be set manually Auto Manual Examination is performed automatically first and then manually When you select Manual the examination can be conducted on up to five isopters and up to 36 directions for each isopter You cannot select Manual for lsopter Screening 1 Isopter Screening 2 or Ilsopter Threshold 2 Start 1 When you select Periphery 80 or Center 30 the movement of the stimulus is centripetal moving from the periphery toward the center Periphery 80 Examination starts from the outermost angle in each direction Center 30 Examination starts from 30 in each direction You cannot select Center 30 for lsopter Screening 1 lsopter Screening 2 or Isopter Threshold G Goal Center When there is no response from the patient the examination in the current direction finishes at the center Center Goal When you select Manual or Auto Manual Center switches to Center Goal When there is no response from the patient the examination in the current direction finishes at the center or goal depending on whether the direction toward the center has been selected with Start Direction or Start Goal respectively Maximum When there is no response from the patient the stimulus passes through the cen
4. 730 W x430 D x700 H mm Operating Environmental Conditions Compliance standard IEC 60601 1 2005 IEC 60601 1 2 2007 Environmental temperature 10 to 35 C Relative humidity 30 to 90 1 012866 1999 Amd 1 2008 1 015004 1 2006 Safety standard and classification According to the type of protection against electric shock Class device According to the degree of protection against electric shock Type B applied part According to the type of protection against ingress of water as detailed in the current edition of IEC 60529 IPX0 According to the degree of safety of application in the presence of a flammable anaesthetic mixture with air or with oxygen or nitrous oxide Equipment not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide According to the mode of operation continuous operation 11 Specification Examination Screening Program Standard Precision Center Periphery Glaucoma V Meridian Center 1 Center 2 Method 2zone 3zone 4zone Quantify Scotoma Intensity step 5dB provability variable p value Quick mode is available Optional threshold Optional thresholdO Screening ScreeningO Perimetry on fundus on fundus Perimetry combined fundus image It is available in the Threshold Center examination Threshold Center 1 Center 2 Isopter Threshold Analysis Analysis for Each G
5. ON the number of digits for IDs can be fixed to a specified value 0 is added on the left of IDs You can select Alignment to unify the number of digits of the IDs which are already registered For Input you can specify whether to open the ID input dialog available for numeric value or for input of both numbers and characters 24 Sa A list of devices connected to the USB connector is shown Press Refresh to update the device list When you press the row of the device you wish to remove the row is selected and shown in orange Then you can press Stop to safely remove the selected device Press Close to finish safe removal of hardware 4 Preparation for examinations 4 11 Preparation for patients and alignment of examined eyes After entering the patient information setting the examination program and parameters and positioning the corrective lens in the holder if needed prepare the patient for the examination 4 11 1 Setting a corrective lens Set a corrective lens adjusted for the eye to be examined 1 Setup the corrective lens holder near the chin rest in the dome 2 Insert an astigmatic lens to the dome side of the corrective lens holder and adjust the axis degree a 3 Insert a spherical lens to the chin rest side of the corrective lens holder A 4 11 2 Explanation for patients First provide a relevant explanation about the examination to a patient T
6. The following is a list of consumables used on this instrument Please contact Kowa or your Kowa dealer for purchase or any inquiry It is recommended that you always stock the Projection lamp and the fuse for replacement Part name Purchase order number Projection lamp OSRAM 64602 Fuse 0218005 MXP T5A L250V 9 9 Backup of examination result data Data backup is automatically carried out when the power is turned off See 4 10 Configuration settings For the backup destination select a drive other than C drive and different from the data drive If C drive or data drive is specified as the backup destination no data backup is performed 9 10 Repair of the instrument lf there is a need to return your KOWA AP 7000 to the manufacturer for repair or maintenance please contact Kowa or your Kowa dealer 9 Maintenance and inspection 10 Troubleshooting Start up exit Message Cause and Remedies No Database file e Leave the message on the left being displayed First confirm that Please confirm the data drive and the the network components LAN cable hubs etc are surely network etc connected and normally operating to establish a healthy network Next confirm that a personal computer hard disk drive USB flash drive etc specified as the data save destination are surely connected and operating normally If any of these components are not correctly connected or operating normally return to the normal s
7. is ON P 60 the position of the examination points is corrected after the actual blind spot position is detected 5 4 Manual examination 5 4 1 1 point threshold examination Point being examined Intensity gt adjustment 2012 12 13 16 28 buttons Point i examined already e i _ i ea p gt Bs pena Fix Loss c f False Po tes pills SAREE Al Points Rest Points Gute AP 7OOO 2012 12 13 1 point threshold examination The examination is executed in the following procedure 1 Press the button of a point to be examined 2 The examination point enters the selected state In the dome a stimulus with an intensity of 50 dB is presented at the point 3 When you press any of the intensity adjustment buttons on the right side the numeric value of the examination point is changed In the dome a stimulus with an intensity of the displayed value dB is presented During the examination change the stimulus intensity with the intensity adjustment buttons and have a dialog with the patient for example asking Can you see this or How about this to proceed with the examination to determine the threshold of the point 4 Upon determination of the threshold press Set The point is recorded as an already examined point with its threshold value 5 Repeat the steps through to determine the threshold of each point E gt A gt gt E gt Before exam Se
8. Each time you press Switch eye the examined eye to display changes in the order of Both eyes L R The Supra Esterman Both examination result is shown for all examined eyes displayed When you press Analysis during multi display mode the display of the result for which the analysis result can be shown is switched See 6 6 Analysis of Threshold Examination Result You can select the examination results and press Multi during multi display mode to perform multi display of the selected results only To return to the previous multi display mode press Multi again to Result Pesce Chart Date 2010 06 15 17 17 8 MS Date 2010 06 15 17 18 ChaT hresholdCenter1 wis uperQuick All Chart T hresholdCenterl SuperQuick MS Date 2010 09 151719 amp EJ Date 2010 09 15 17 20 Chart ThresholdCenter1 ianiai Chart ThresholdCenter1 a uperQuick Ga AP 7FOOO 2012 12 14 Multi display 6 Display Print and Analysis of Examination Results 6 5 1 Comparing examination results The multi display screen allows you to compare 2 examination results of the same program for the same eye a Ei Result fl Result Sinu Date 2010 06 1517 17 8 Date 2010 091517 19 i8 ia akon a Combi Chart T hresholdCenter1 SuperQuick All Chant T hresholdCenter1 SuperQuick All sA sajes 3 a egjs 29 is 2s 13 aa sa salaa se s aa sa salsa se lt 6 gt 29 29TH 22 19 23 29 29430 26 aa aa sA 4 lt 145 sa se sa aa asa sa 4 lt 1
9. Electromagnetic environment guidance KOWA AP 7000 uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic instrument KOWA AP 7000 is acceptable in all types of facilities without any limitation to the electrical supply network connected to KOWA AP 7000 Guidance and manufacturer s declaration electromagnetic immunity KOWA AP 7000 is intended for use in the electromagnetic environment specified below The customer or the user of KOWA AP 7000 should assure that it is used in such an environment Immunity test IEC 60601 test level Compliance level Electromagnetic environment guidance Electrostatic discharge ESD IEC 61000 4 2 Electrical fast transient burst IEC 61000 4 4 Surge IEC 61000 4 5 Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 1 1 Power frequency 50 60HZ magnetic field IEC 61000 4 8 6kV contact 8kV air 2kV for power supply lines 1kV for input output lines 1kV differential mode 2kV common mode lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles lt 5 UT gt 95 dip in UT for 5 sec 6kV contact 8kV air 2kV for power supply lines 1kV differential mode 2kV common mode lt 5 UT gt 95 dip in UT for 0 5 cycl
10. ID in the Configuration dialog and set Input to Value the ID input dialog appears when you select the ID text box on the input screen You can input an ID using up to 32 characters Use the keyboard in the dialog to input the ID Pe moa ete inad naad ated iasad inead azad aad aed pas BS Deletes the preceding character ID input dialog After entering the ID press OK To cancel the input operation press Cancel When you input an ID of a patient who has been examined before the name birth date sex correction and visual acuity in the most recent examination associated with the ID are automatically input If you input the ID of a patient who has not been examined before but information other than the ID of the patient has already been entered a confirmation message appears to clear the patient information When you press OK the input ID is entered and the patient information is cleared When you press Cancel the input ID is entered without clearing the patient information 4 4 2 ID Name If you select ID in the Configuration dialog and set Input to Character the name input dialog appears when you select the ID or Name text box on the input screen You can input characters in the same way as in the ID input dialog Up to 32 characters can be entered for an ID The available number of characters for each name is as shown below depending on the number of displayed names P 59 of display
11. To grasp the shape of a visual Within 30 76 points field as an isopter equal sensitivity curve Super quick X Examination Time applies to the case in which there are two isopters when an examination is performed automatically X Isopter Screening 1 lsopter Screening 2 and lsopter Threshold are available only when the isopter examination is performed automatically X The Fovea examination can be performed in the Isopter Threshold 0001 Name kowa 4 Date of Birth 1943 02 20 Age 69 None 2012 12 03 16 21 J 05 41 Center i False Pos False Neg Fae AP 7OOO 2012 12 11 Example of isopter examination result screen 4 Preparation for examinations 1 Examination method A stimulus with the single intensity is moved along the meridian The points with responses from the patient are connected to grasp the shape of the patient s visual field as an isopter 2 Parameter setting You can set the following parameters False positive reaction False negative reaction Stimulus color Background color Fixation Target AP 340 3 lsopter setting ProgramSetting When you select Isopter in the Program Change dialog lsopter in the lower left becomes selectable When you press lsopter the Isopter dialog appears to allow you to change the parameter values dedicated to the isopter examination program The values provided with the asterisk mark are set by default for T screening i
12. Cancel not to delete Axis is not input OK has been pressed with Cyl Cylindrical diopter power input and while Axis Axis degree was not entered in the Correction value input dialog for the patient information Enter a value in the Axis input box or clear the value in the Cyl input box and press OK Cyl is not input OK has been pressed with Axis Axis power input while Cyl Cylindrical diopter degree was not entered in the Correction value input dialog for the patient information Enter a value in the Cyl input box or clear the value in the Axis input box and press OK e The image is broken Cannot display The image file selected to set a fundus image on the input screen e There is insufficient memory for cannot be read Select another image file displaying the image e This is not displayable bmp format e Cannot assign the bitmap memory Reactivate the application to set it Settings have been made to link up with a card reader or filing effectively system KOWA VK Series Restart the instrument to allow the changed settings to take effect Examination screen Message Cause and Remedies Darken the room Cannot recognize the patient s eye Please make sure that the chin is placed correctly on the chin rest Do you want to manually select the patient s eye Failed to acquire the pupil position Do you wish to proceed with acquisition from the beginning The fovea is examined first The fixation target
13. Chart Graph 10 on A Name Chart MD 1 29 dB Year p lt 1 0 59 95 Date of Birth 1973 05 04 VFI 3 93 Year p41 1 93 95 Bis R MD 184 4B Year p lt I 0 71 95 VFI 4 90 Year p lt 1 2 10 95 MD Forecast 2010 09 38 2 BS 2f 5 2008 06 2008 11 2009 04 2009 09 2010 02 2010 07 2010 12 a VFI Forecast 2010 09 38 2008 09 2010 02 2010 07 2010 12 12345678901 2345678901 23456789012 2011 10 09 09 39 Example of printout 7 Chronological change 7 3 Graph displays The chronological change screen displays two different graphs with the following 12 analysis indexes per screen at the same time You can select which graphs to display by pressing Setting and Chart P 62 When Graph3 4 is set to ON in the Chart dialog two other graphs can be added to display chronological changes Graph3 and Graph4 are shown when you press Switch graph during display of Graph1 and Graph2 MD Center PSD Macula Quadrant TD Macula PSD Center AGIS Classification a VFI CIGTS Anderson a MD Macula Quadrant TD Macula Boxplot All graphs have the date and time of examination on the horizontal axis Thus the rightmost plot is the newest result The distance between plots on the horizontal axis is relatively determined from the date and time of examination An item assigned to the vertical axis varies with the graph However in any gr
14. Operating environment 1 Be sure to prevent the instrument from being operated by anyone other than the following certified personnel e MD Ophthalmologist ophthalmology resident e Nurse vocational nurse e Orthoptist Optometrist 2 Handle the instrument with care and do not apply strong shock to the instrument Avoid placing any object on the instrument 3 Avoid high temperature and humidity direct sunlight and dust when installing and storing the instrument Strictly observe the following environmental conditions po Operating Transporting and storing Environmental temperature 10 to 35 C 15 to 60 C Relative humidit 30 to 90 10 to 95 4 Avoid condensation when using transporting or storing the instrument 5 Place this instrument in a darkroom or a room of which luminance can be reduced as low as a darkroom 6 7 When operating the touch panel be sure to use the input pen included with this instrument When housing the lens holder fold it backward and then to the left side If you fold the lens holder to the left without folding backward it may come into contact with the exterior of the instrument Use great care 8 When cleaning the head rest chin rest response button and head band wipe with rubbing alcohol Do not sterilize them 9 Do not install any software other than the KOWA AP 7000 accessory software in this instrument Otherwise the instrument may be caused to malfunction Kowa will not be liab
15. Same arrangement 5 Examination You can make selections by a rectangular tool or lariat tool The rectangular tool is effective to select all the stimuli in a certain area The lariat tool is effective to finely select the stimulus Both can choose two or more areas Rectangular tool procedure TA T m wy 1 Select Rectangle z a ie Po 2 Touch the start point 3 While touching move the input pen Release the input pen O Press OK Dja 6 The selected points are shown as ALAA seth sts hihthitttithtitttttttttthtthtttttttttttttitttttttttittittttttttttttttthtithttttitttttttttttshtissthsthtithtttitttttthhttttithsthtttittitshhittttithttthhitttitits Gee AP 7OOO 2012 12 13 16 23 lariat tool procedure 7 input Examination x Result je 1 Select Lariat 2 Touch the start point G While touching move the input pen Release the input pen Press OK Use the same procedure to select the already selected points press Delete in the dialog and press OK and the already selected examination points are deselected X You can use the rectangular tool and lariat tool in combination X In the optional examination Save appears If you register a program with this button the selected examination point positions are also saved 5 Examination 5 3 5 Fundus perimetry When you press Test after selecting the fundus image on the input screen P 57 the operation pr
16. This message appears when the lens holder is set for the periphery examination more than 30 or upon completion of center examination with the lens holder set in the program consisting of both center within 30 and periphery examinations Thus be sure to fold the lens holder backward In the program consisting of both center and periphery examinations the stimulus is normally presented in random order However when the lens holder is set the periphery examination is carried out upon completion of the center examination Therefore this message appears after the center examination is completed e An attempt has been made to re test an eye other than the one examined previously Check the eye to be examined left or right Select the point examined again e OK has been pressed without examined points selected for re testing Select the points to be re tested Next the screening examination starts Next the threshold examination starts The examined eye is incompatible with the fundus image Maximum number of isopters reached e lsopter examination has been completed during the Ilsopter Screening threshold examination program Press OK to start the screening threshold examination e During the perimetry coordinate setting on a fundus image for fundus perimetry the positions of the fovea and opti disc have been reversed in comparison to the actual examined eye Check whether the examined eye matches the fun
17. for connecting the instrument to a personal computer contact Kowa or your Kowa dealer as well v Do not connect or disconnect any external device during examination Otherwise it may cause data to be lost v When you use a peripheral device and or other external device connected to the peripheral device it must meet all applicable EN IEC standards v Data processing devices must meet IEC 60601 1 or IEC 60950 Systems that use such data processing devices must meet IEC 60601 1 1 The system administrator who builds such a system bears all responsibility to have the system comply with the requirements of IEC 60601 1 1 Should you have any questions contact Kowa or your Kowa dealer 3 Flow of operations 7 Startup P 24 e Darken the room for examination e Set the power switch to ON side e Press the sub power switch 2 Patient information input and examination program setup p27 e Enter patient information ID name date of birth etc e Set the examination program and parameters e Mount the corrective lens on the corrective lens holder according to the examined eye Program selection dialog 3 Preparation for patients and alignment of examined eyes en e Explain the instrument and examination to the patient e Cover the eye not to be examined e If the eyelid of the examined eye partially covers the pupil lift the eyelid and keep it up with tape or the like e Seat the patient and
18. 1 4 Anynon medical electrical equipment connected to this system to compose a medical system must comply with safety standards of IEC or ISO provisions applicable to such non medical electrical equipment 5 Do not use any additional multi tap or extension power supply cable other than those Kowa specified to this system 6 Power supply to this system or Multi tap with Isolation Transformer must be provided individually Do not route the power supply through other multi tap to the system or Multi tap with Isolation Transformer 7 The power supply cable for electrical equipment composing a medical system must have durability that meets IEC 60245 IEC 60227 or higher standards 8 Assure that the power supply is turned OFF when connecting other devices to the system 9 Do not turn ON the power supply until all devices are completely connected 10 Do not place or install the devices and the system components on an unstable or inclined table Precautions for use of Multi tap with Isolation Transformer 1 Do not place Multi tap with Isolation Transformer directly on the floor Water droplets during room cleaning may enter the multi tap resulting in the component s failure 2 The power supply cable to Multi tap with Isolation Transformer must be connected to a power receptacle with a protective ground terminal equipotential to the protective ground of this instrument 3 When
19. 40 50 p aia izis ini iris abel 29 30 27 Sl 2 25 30 25 19 54 TotalDeviation ME 3 53 POS FSD are Pez GHT Outside Normal Limits FI 59 z Anderson s Criteria do da M ae ai mo 5 o feo ee ot tt Se mid oo oo fe New owl Od h A aS h ay 4 dolce do Po cn do mod ce mips om A cn A moo 4 py Defect rank Bebe Curve dB lt 0 5 1075 20 25 30 35 40 50 Eel ell Kowa pack 2 Color Total value of Mariotte blind spot Program name each quadrant Analyze method Initial Progream ThresholdCenter1 All 22 16 18 26 Sil 22 23 26422 2722 SE Bebie curve Scale Defect rank Bebie Curve Threshold 29 26 25 29 33 23 476 321 507 386 23 23 23 26 Total 1965 1425 PatternDeviation MD 1 97 P lt 5 2 10 P lt 5 5 4 oe PSD 3 18 P lt 5 2 57 P lt 5 Total value of whole TotalDeviation GHT Outside Normal Limits VFI 94 Anderson s Criteria PSD GH PD Anderson Early AGIS 0 CIGTS 0 Stage Nfl Mm Ono Yio d wm NR No do i i A 1 Analysis Reliability honn Ono I I n ao w Total deviatio Total deviation p value Meaning of __ p value mark dB lt 0 5 10 15 30 m 40 50 Gaze monitom TEER All Gray Pattern deviation Pattern deviation p value Correspondence of color gray of Scale to Threshold Value Each analysis
20. Export ID Date _Time_Directions Type SER EXT ftom Deserton th YYYYMMDD 8 characters Y Year M Month D Date Year Month and Day are shown in the order as specified HHMMSS H Hour M Minute S Second i Format 3 MDR a Same as Format 2 excluding that Direction and Type are placed in reverse order and SER is specified as 01 Ki The selectable output contents are as follows Grayscale a DP value p value map of total deviation a PDP value p value map of pattern deviation aa Print Same as the print format X For the threshold examinations the item names are shown For other examinations only the examination result part is shown You can change the screening mark and grayscale mark Screening 1 Kowa automatic perimeter KOWA AP 3000 and KOWA AP 5000 earlier version 2 Standard setting Scale 1 Kowa automatic perimeter KOWA AP 5000 later version and KOWA AP 6000 earlier version 2 Kowa automatic perimeter KOWA AP 3000 and KOWA AP 5000 earlier version 3 standards setting Luminance Print You can adjust the grayscale brightness for printing 12 E Print Size Single eye Ad i 5 Header OH cis You can make setting for printout Size Set the print size of the examination result for a single eye or both eyes Regardless of a single eye or both eyes select one from A4 A5 and A6 T
21. Link with KOWA VK Series a Link To link up with KOWA VK Series select ON Drive Specify the data drive Database Select the database type When the KOWA VK database is MSDE you need to set an SQL server If you select MSDE set the server name and server type Press VK Write to execute data write to KOWA VK Date format Export Destination P 61 4 Preparation for examinations 15 EMMARCAT Ea Link to other products Destination Select OF Cancel You can make settings for a link with other manufacturer s equipment e Link To link up with other manufacturer s equipment select ON Destination Specify the destination This dialog allows you to perform the following 2 types of operations 1 Browsing the results of examinations executed on KOWA AP 7000 from another manufacturer s filing system KOWA AP 7000 outputs an examination result file images and text to the link destination upon completion of the examination Reading the output file from the other manufacturer s filing system enables the examination results of KOWA AP 7000 to be browsed in that filing system 2 Transferring patient information from other manufacturer s filing system to KOWA AP 7000 When a patient information file test is output from another manufacturer s filing system to the link destination KOWA AP 7000 the patient information is transferred If KOWA AP 7000 has an exami
22. Manual see 5 3 5 Fundus perimetry 5 2 1 Practice When you press Practice a stimulus is presented in the dome so that you can show how the stimulus is presented to the patient before the actual examination The practice takes about 30 seconds To cancel the practice press Practice again When there is a response from the response button the response mark 63 appears in the upper left of the screen You can move the chin rest during the practice If two or more stimuli are selected for an isopter examination pressing Practice will open the stimulus selection dialog box Select the stimulus to use press OK and the practice starts 7 input Examination Practice on E E PE Sandan Standard II I White White False Pos False Neg All Points Rest Points Practice lsopter stimulus selection 5 Examination 5 2 2 Examination Start When you press Start after the patient adapts to the luminance in the dome guideline 1 to 2 min after the patient is seated in front of the dome the pre exam setting is performed as described below and then the examination starts 1 Gaze monitor setting If the gaze monitor function P 95 is set to ON by the applicable parameter setting the operation of acquiring the pupil position of the examined eye is performed before the examination This operation is not executed if fixation is set to AUX or the current examination program is Thr
23. O OIIO O OO QOG ocoooocolboooo O O O O lO O O amp coMo colo ooo o 6 5 2 Combine the examination results For the examination results of the same eye with the same ID you can combine the central visual field examination result and peripheral visual field examination result or the central visual field examination result and isopter examination result to grasp the whole visual field Re Test ena Edit Data BPA otom BAL narge R e gt 5s op Review View Name TestDatel F cl MOO T hresholdCenterl SuperQuick TestDatell 2011 06 01 23 39 4 M i tiO MET hresholdPenpher Combine the examination results The following examination programs are available for combination Screening Center and Screening Periphery Threshold Center1 and Threshold Periphery L Isopter and Screening Center Isopter Screening1 L Isopter and Screening Center 1 Isopter Screening2 a lsopter and Threshold Center 1 Combination cannot be performed with the result of the examination which was not completed The combination procedure is the same as 6 5 1 Comparing examination results When you press Save the combination result is saved If you try to execute another operation without saving the combination result the following message appears Combination The combined data is not saved Continue operation When you press OK the combination result is not saved and the operation you would like to ex
24. Patient information input P 30 Make necessary settings P 59 4 10 Configuration settings 6 Display Print and Analysis of Examination Results 6 2 Examination result switchover and list display The Examination result switchover button and Result count button Order of displayed results Total of results are displayed above the patient information on the right of the examination result screen Press Review to display the previous examination result of the patient with the same ID or press View to display the next examination result When you press the Result count button the examinations performed with the same ID are listed You can select and display an arbitrary examination result from this list The operation method is the same as described in 4 3 Loading patient information by Open List These operations are common to the examination result screens Examination result j changeover buttons 25 22 25 24 con 28 29 30429 29 29 eae 29 30 31 31131 30 29 26 29 31 32 30 31 32 Date of Batt 27 26 20 29 25 25 27 22 13 19 22 25 28 451 26 16 20719 21 30 487 26 23 23 23 Total 2033 TotalDeviation 2 si 3 PattemDeviation MD 259 P lt 2 PSD 515 P lt 05 P Tin i tandard Standard lt GHT Outsce Normal Lets Size Co 1 1 White White VFI 92 OFF Anderson s Criteria Anderson Moderate AGIS CIGTS Stage False Neg Al Points Rest Points ue AP 7OOO 2012 12 13 Patient ID List Result coun
25. These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Technology for Life Science Kowa Company Ltd World Sales Headquarters Kowa Optimed Inc 4 14 Nihonbashi honcho 3 chome Chuo ku Tokyo 103 8433 Japan 20001 So Vermont Ave Phone 81 3 3279 7639 Torrance CA 90502 U S A Facsimile 81 3 3279 7541 Phone 1 310 327 1913 URL http www kowa co jp e life Facsimile 1 310 327 4177 URL http www kowa usa com Hamamatsu Factory 3 1 Shinmiyakoda 1 chome kitaku Hamamatsu city Shizuoka Pref 431 2103 Japan 2011 Kowa Company Ltd All rights reserved FT10 V1 2K 111121 Printed in Japan
26. and press Delete a confirmation message 1 4 Hemianopiah d a p pea rs oo a Cranium elete Glaucoma suspected Hemianopia Heteronymous Hemianopia Homonymous Hemianopia Normal Tension Glaucoma Normal T ension Glaucoma suspected ucoma egistrationlistDele Primary Open Angle Glaucoma suspecte M k ene oo 72 2 OL 8 1 Entry list deletion dialog When you press OK the selected item is deleted When you press Cancel the confirmation message d ialog is closed 1 4 Hemianopiah Delete the selected data Diagnosis When you press OK upon completion of the deletion operation the entry list deletion dialog is closed Input Data The ID and the date of birth are not entered Input again It is not necessary to input all the patient information items However ID and Date of birth are required and Se must be entered The ID is required for identifying examination result data The date of birth is an important parameter for examinations When you press Examination without the ID and date of birth input a message dialog appears as shown below If Prohibit No ID is set to OFF in the Configuration dialog P Error Bookmark not defined you can press Cancel to proceed with the examination without entering an ID If the Date of birth is not entered the quality of the examination will be reduced and some analysis functions will be unavailable 4 4 1 ID Value If you select
27. applicable RF compliance level above KOWA AP 7000 should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as reconfiguring or relocating KOWA AP 7000 Over the frequency range 150kHz to 80MHzZ field strengths should be less than 3 V m Recommended separation distances between portable and mobile RF communications instrument and KOWA AP 7000 KOWA AP 7000 is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of KOWA AP 7000 can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications instrument transmitters and KOWA AP 7000 as recommended below according to the maximum output power of the communications instrument Rated maximum output power of transmitter W Separation distance according to frequency of transmitter m 150kHz 80MHz 80MHz 800MHz 800MHz 2 5GHz d 1 2 V P d 1 2 V P d 2 3 VP 100 12 For transmitters rated at a maximum output power not listed above the recommended separation distance d in metres m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE1 80MHz and 800MHz the separation distance for the higher frequency range applies NOTE2
28. at unstable location such as on a shaky base or a tilting surface Doing so may cause the instrument do to drop or fall over and result in a bodily injury A N Do not replace the projection lamp immediately after turning OFF the main power You could be burned by a lamp heated to a high temperature Caution Wait for more than about 30 minutes to cool the lamp down before replacing High temperature Do not touch the projection lamp bulbs with your bare hand Otherwise the lamp may reduce the light intensity or operating life Keep your fingers off the location of the chin rest and the under the chin rest s cover When the chin rest moving the fingers may be pinched and injured Do not wipe the outer surface of the instrument with solvents such as benzene organic solvent and ether Doing so may cause discoloration or degradation For the operator do not touch the following connectors and patient simultaneously e Response button jack e USB connecter e Ethernet connecter Do not use a sharp object to perform touch operation on the touch panel Otherwise It may cause instrument malfunctioning Do not apply excessive force to the touch panel Otherwise It may cause a failure or an injury Meanings of symbols Caution Turn off the power Wait until the lamp switch when the or flash lamp has BE War NIN lamp or flash lamp Caution cooled when the l TERRES High voltage
29. daily inspection table Inspection items Procedure Acceptability criteria Plates and labels Visually verify that plates and labels are readily readable Plates and labels are and not contaminated readable Exterior Dome Visually verify that exterior components have no flaw crack There is no flaw crack deformation or rust deformation or rust Power supply cable Visually verify that there is no flaw or damage There is no flaw or damage Connecting power Visually verify that the power supply cable is directly and Power supply cable is supply independently connected to the commercial power supply directly and independently connected to the commercial power supply Touch panel Verify that the patient information input dialog appears when Patient information input you start the instrument and press Edit Data on the input dialog appears screen using the input pen Stimulus presentation Verify that a stimulus is presented in the dome when you Stimulus is presented start the instrument and press Practice on the examination screen Response button Verify that the response mark appears in the upper left of Response mark appears in the examination screen when you start the instrument and the upper left of the screen push the response button in the state where the examination screen is open Chin rest Verify that the chin rest moves up down left or right when Chin rest smoothly moves to you press the
30. is shown below It is explained with the result of All gray 6 Display Print and Analysis of Examination Results 6 6 1 Threshold The measured sensitivity dB of each point is displayed The higher the value the higher the sensitivity which means the patient can see a stimulus of lower intensity For example the patient was able to see the stimulus of 28dB at the point of of the upper center and 30dB at of the upper center Therefore the sensitivity in is higher than that in The total of each quadrant and the total of the whole are also displayed P 117 6 6 2 Scale Scale shows the distribution of thresholds visually The correspondence between the threshold and the scale is shown in the lower right In gray scale the darker point means the sensitivity is low and the brighter point means the sensitivity is high In color scale the point in warm colors means the sensitivity is low and the point in cold colors means the sensitivity is high For example it is found that the sensitivity is exceptionally reduced near the Mariotte blind spot Point of 15 0n the ear side and 3 on the lower side The value at this point is O in the example However the position and the size of the blind spot may vary by individuals so the sensitivity at this point may not be low or the sensitivity of the point X 15 Y 3 above this point may be also low 6 6 3 3D 3D analysis can be displayed and printed fo
31. less for One or more criteria for 27 points or less for Threshold Center 2 early defect are Threshold Center 2 No of points with total deviation p value lt 5 No of points with total satisfied and any criteria deviation p value lt 1 lt 10 points for severe defect are gt 20 points not satisfied One or more points have 0 dB or there are points All points gt 15dB with less than 15 dB in sectors above and below the horizontal meridian Sensitivity within central 5 6 6 12 AGIS The Advanced Glaucoma Intervention Study The AGIS score is a visual field assessment method used in clinical trial AGIS The degree of abnormality in the nasal side visual field upper half visual field and lower half visual field is scored with use of the total deviation and calculated into a total value which is referred to as the AGIS score 0 to 20 As the score is larger the sensitivity is lower Symptom progression judgment with AGIS is defined to check whether the results of three consecutive visual field examinations show a score increase by 4 or more points 6 6 13 CIGTS The Collaborative Initial Glaucoma Treatment study The CIGTS score is a visual field assessment method used in clinical trial CIGTS Taking continuity of scotoma into consideration the degree of abnormality in the visual field is scored into a value with use of the total deviation p value which is referred to as the CIGTS score 0
32. life Do not touch any unit other than the lamp unit when replacing the projection lamp bulb Otherwise there is a risk of bodily injury or Prohibitory malfunction 9 7 Fuse Replacement Before checking the blowout of a fuse make sure to check the following 1 The power supply cable is properly connected 2 Confirm that the power lamp is lit in orange STANDBY when the power switch is turned to on lf the power is not turned on even if the items above are checked check the fuse When you inspect or replace a fuse be sure to wear anti static gloves or the like Do not use bare hands Otherwise the fuse life may be shortened 4 Turn OFF the power switch and unplug the instrument from the power outlet Turn the fuse holder at the power supply counterclockwise with a flat head screwdriver Pull the fuse and check whether the fuse has blown If the fuse has blown replace it with a new one Make sure that the fuse type and rating are correct Place the fuse holder Connect the power supply cable to the power outlet OO DO O When replacing the fuse make sure the main power is turned OFF and the instrument is unplugged from the power outlet If the fuse holder cover is removed without unplugging the instrument electrical shock or burn may occur Ww e Q Use a designated fuse only Using an undesignated fuse may cause the J arming instrument to malfunction or cause a fire Obligatory 9 8 List of consumables
33. medical electrical system ccssscccsssecccssssrccesssseccesssecesssseeecsssseeeesssesecsesesesseseseessseesens 7 Operational considerations for hospital grade electrical instrument safety and accident POF GUO BN PARE A TA E E A E E A A E A EN A cere sere ees 10 Components and supplies soooeeeesssseeeeesssseeeesssseeeeesssseeeeesssseceessssseeeesssseeeeessssoeeeesssseeeeessseeeeesssseeeeesssseeeeessseeeeesssseeeee 11 Contents esseseseseosesesessososesessoscseseseososeseoeososeseseososeseseosesesesesseseseseee IZ 1 System description ee ccccssssseccecccccccccccceeeeeesessssssssees 14 tih Niended MSS euicssogssonieriiie ri rn RAR SA h 14 1 2 Principle of measurement and System OVErVvieW ssccccssssccccsssrcccssssecccsssseccsssseeseessseesesssseesesssseeeesssaees 14 Lo FEINES eann R E E E eee ER EE ee eee 14 1 4 Name and function of each component 15 2 Installation 000eeoeoeoesesesesesososcsossesssesesososososososoesesesosososososoeoesee 20 21 Installati n ennio an EAEE EENT EEAS EEEE EEEE RES 20 22 CONNGCtING an external GOVICC s sssse a E 21 3 Flow of operations sseessesssessesessesecessssecossesscoesessecesseseesssesse 22 4 Preparation for examinations sessseseeeessseescecsssseseeeeee 24 4 1 Switching on and off the instrument seseeseesseessseessoessseesseesssessseesssessseesssoesseesssessseesssessseessseesseessseesseessses 2
34. mode It is effective for patients who cannot stand the Normal mode The Bracketing strategy is used in principle though the intensity is not increased or decreased by 2 dB The intensity is changed by 3 dB 2dB in part not 4 dB If it is found that the examination result of a point is exceptionally different from that of other points upon completion of examination on all points re examination may be performed on the point only 3 Quick 2 The examination time is reduced to about 40 of that of Normal mode It is effective for screening The method is the same as the Quick 1 in principle though the points of high sensitivity will be examined roughly The stimulus to be presented is changed during the examination depending on the response from a patient to reduce the examination time Super quick The examination time is reduced to about 25 of that of Normal mode It is effective for screening The method is the same as the Quick 2 in principle though it is more specialized in detecting glaucomatous visual field defect This mode examines around the Bjerrum area nasal step fovea and the blind spot especially It is effective for early detection of the early to middle stage glaucoma at short times However the areas other than those above are examined roughly so a very small scotoma may not be detected 2 The Fovea examination can be performed in the Center 1 2 and Isopter Threshold If you set the Fovea examination to ON the thre
35. observe or pay close attention to during operation of this instrument x1 A bodily injury means an injury burn electrical shock and so forth that will not necessitate hospitalization or long term outpatient treatment x2 Damage to property means an extensive damage to a house and or household goods as well as a domestic animal and pet Meanings of symbols Graphical indication of any danger including warning and caution What is warned is explicitly and pictorially indicated by a picture or its associated message on or near a pictorial symbol Graphical indication of prohibited operation prohibitive item What is prohibited is explicitly and pictorially indicated by a picture or its associated message on or near a pictorial symbol Graphical indication of any mandatory action obligatory item What must always be done is explicitly and pictorially indicated by a picture or its associated message on or near a pictorial symbol Disclaimer Kowa is not responsible for Any damage caused by fire earthquake third party s action any other accident or user s intentional or unintentional error abuse or use under abnormal conditions Any damage resulting from use of the product or its malfunction e g operating loss shutdown change loss of stored data and so forth Any damage resulting from disregarding what is described in this manual Any damage resulting from for instance malfunctioning of ins
36. party other than an agent authorized by Kowa 5 Kowa is not liable for malfunctions and or damages resulting from maintenance and or repairs using parts other than repair parts specified by Kowa 6 Be sure to connect the instrument to the specified power source AC100 230V 50 60Hz 7 The input voltage should always be maintained within 10 of the rated voltage 8 This instrument is floor standing type not intended for moving When it is necessary to move the instrument contact Kowa or your Kowa dealer 9 Turn off the power switch before connecting the instrument to an external device or connecting disconnecting the power plug to from the outlet 10 Before turning off the power switch be sure to follow this document Do not turn off the power switch when the touch panel is showing a black screen without any data shown or with It is now safe to turn off your computer shown otherwise it may cause a failure or data loss 3 Precautions for instrument 1 Always cover this instrument with dust cover when not in use in order to protect them 2 This instrument is floor standing type not intended for moving When it is necessary to move the instrument contact Kowa or your Kowa dealer 4 Disposal precautions Disposal of this instrument is subject to local waste management and public safety laws and regulations When you need to dispose the instrument comply with the ordinances and regulations of the applicable local gover
37. program is deleted Program list allows you to change the settings of each program and save the changed settings When you select Program list and press Add the program dialog appears allowing you to make program settings and parameter settings 4 Preparation for examinations 4 17 2 Examination parameter setting Common parameters In the description below the values provided with the asterisk mark are set by default You can change those parameter values using the parameter value change dialog when necessary x x Presentation time Standard 0 2 sec Optional You can set a value in the range from 0 1 to 1 2 sec When you press Optional the change button in the upper right of the dialog becomes effective Press this button to open the numeric value input dialog and input a new value for the presentation time Presentation interval Standard Max 1 5 sec Min 0 6 sec Long Max 3 3 sec Min 0 6 sec Auto The maximum interval is automatically set according to the response time of the patient during an examination When you press Auto Standard and Long appear below it Then you can select either one for the initial value Stimulus size III Select from through V which correspond to the Goldmann s stimulus sizes through V Blind spot size II Select from through V which correspond to the Goldmann s stimulus sizes through V Fixation loss ON Select ON to stop the curre
38. recommended to replace the lamp as soon as possible If the background lamp is off contact Kowa or your Kowa dealer Cannot set the stimulus intensity A head band may be obstructing the sensor in the dome Take the head band out of the dome and restart the instrument If nothing is obstructing the sensor the intensity of the projection lamp is reduced If the lamp is lit it is not necessary to replace it immediately However it is recommended to replace the lamp as soon as possible If the projection lamp is off immediately replace it with a new one If the same message still appears after lamp replacement the possible causes include dirt on the sensor and or lens and disconnected lines Contact Kowa or your Kowa dealer Darken the room e Luminance in the dome cannot be set The room is deemed to be too bright to use the instrument Darken the room and press OK Confirm the date e Check the current date and time being displayed Date OOOO Xx AA A e lf the current date and time are incorrect press Date to open the A date setting dialog and then set the correct date and time P 68 When the date is not correct e Even if the current date and time are correct this message may appear when the power is turned on immediately after it is turned off 10 Troubleshooting Message Cause and Remedies Cannot run camera viewer e The camera for eye fixation monitoring has an error Restart the instrument If the same me
39. the examination is finished The results of a manual examination are automatically connected but can also be manually connected Upon completion of the examination the following confirmation message appears lsopter lsopter for manual examination results have been connected automatically Reconnect lsopter manually 0001 Name KOWA Date of Birth 1943 02 20 Age 69 None 2012 12 13 16 58 01 20 Center A Confirmation message for manually connecting examination results When you press OK the lines connected automatically are erased to open a screen for manually connecting the lines When you press Cancel the lines connected automatically become the final examination result However if some points that are not automatically connected are still remaining the display transitions to a screen for manually connecting the lines Lines which are connected as an isopter are only for stimuli with which a manual examination has been executed Select the specified stimulus points in order of connection When a connected line becomes a closed curve it is fixed as the examination result If you press OK according to the number of unconnected point the line is fixed as the examination result When you press Cancel the connected lines are erased in sequence ae Oe ll PO me De ny Pe ou lsopterStandard connected points C the pointin order of drawing in Isoptar Manual connection selection screen for manual e
40. the fixation loss function and then proceed with the examination by checking the fixation loss through the eye fixation monitor only For the evaluation of the fixation loss fixation monitoring by the examiner through the eye fixation monitor and the result of the gaze monitor function can also be used as reference 0 8 2 False positive Reaction The motor to change a stimulus is moved at a fixed interval and not to present a stimulus If a patient responds to the movement or sound of the motor and pushes the button even though he she does not see a stimulus the number of responses increases When the false positive reaction examination is in progress the characters of False positive reaction are shown in orange in the lower right of the examination screen The progress status and result of the false positive reaction examination are shown in units of percentage and in the format of Number of responses Number of examinations in the lower right of the screen As the value of Number of responses Number of examinations increases the reliability of the examination result is reduced If the value reaches 33 or more the false positive reaction value is shown in orange and XX appears on the left In addition XX also appears on the left of the percentage indication when printed 0 8 3 False negative Reaction A stimulus may be presented in brighter intensity at a point the patient has already responded If a patient
41. threshold center 1 examination is carried out during interactive dialog with a patient in the same way as an examination with the Goldmann perimeter If after completing the examination the result of a point is exceptionally different from that of other points re examination may only be performed on that point 2 Parameter setting You can set the following parameters Presentation time presentation interval stimulus size blind spot size fixation loss false positive reaction false negative reaction stimulus color background color fixation gaze monitor pupil diameter measurement and AP 340 However the presentation time and presentation interval are not available for the 1 point threshold examination For optional screening O and optional screening the following parameters are also available in addition to the above ones Intensity Zone Reference value Quantify Scotoma 4 Preparation for examinations 4 9 Perimetry examination with fundus images In perimetry examination with fundus images the visual field is examined with a fundus image displayed on the screen By overlapping the fundus image and the perimetry result you can grasp the correspondence between the two The understanding of whether the abnormal development of the two corresponds with each other or the abnormality of which one precedes the other will help to make the diagnosis CustomOptionalThreshold Threshold 23 9 0001 Name KOWA Date of Bir
42. to 20 As the score is larger the sensitivity is lower Symptom progression judgment with CIGTS is defined to check whether the score is worsened by 3 or more in comparison with the score on the base line 6 Display Print and Analysis of Examination Results 6 6 14 VFI Visual Field Index The VFI is an index which is conscious of patient s QOV Quality of Vision and shown in units of percentage It is 100 when the visual field is normal it is 0 when the visual field is completely lost The pattern deviation p value total deviation p value when MD is 20dB or less is used to show the result of each examination point in the range of 0 to 100 weight for each examination point and then calculate the score into a VFI value 6 6 15 Classification From the examination result of the center threshold the degree of glaucomatous visual field disorder is classified into the following 8 levels N M a IIb IVa IVb IVc V As the level goes from the left to the right the visual field disorder is more advanced When Artifact of setting is ON the value with Artifact considered is shown in P 60 6 6 16 Total of Quadrant Whole For 4 quadrants of upper nasal side lower nasal side upper ear side and lower ear side the total value of thresholds of each quadrant and the total value of whole thresholds are displayed Even if no error is found in p value of the total deviation or pattern deviation carefully watch
43. using a Multi tap with Isolation Transformer receptacle with a protective ground terminal read the instructions attached to the receptacle to familiarize yourself with the correct use Daily maintenance and cleaning 1 System components e Wipe the soiled outer surface with a firmly squeezed dampened soft cloth Use mild detergent to remove excessive dirt Do not use chemicals or solvents such as thinner and benzene As the touch panel cover easily gets scratched lightly wipe it with a soft cloth such as gauze e Refer to the instructions provided with each device for details of device maintenance and cleaning 2 Power supply cables connecting cables and connectors e Visually inspect that all cables have no flaw or damage e Visually verify that earth leads of all components and protective ground terminals are securely connected e Disconnect the power supply cables from the power outlet when you do not use the system for a long period of time 3 Others e When you add a personal computer to the system for filing purposes captured images are stored in the hard disk drive of the personal computer Back up the data stored in the hard disk drive regularly since hard disk drives may have a mechanical or electrical failure Combinations of medical electrical equipment and non medical electrical equipment 1 Precautions for system IEC 60601 1 1 Safety requirements for medical electrical systems describes the components combina
44. 00 1500 1600 1700 nm Spectrum distribution of background light s luminous source yellow 300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700 nm 13 Electromagnetic compatibility IEC 60601 1 2 13 Electromagnetic compatibility IEC 60601 1 2 This instrument is a medical electrical instrument Medical electrical instruments require special care and are subject to electromagnetic compatibility EMC standards The following section describes the EMC and precautions regarding this instrument When installing or using this instrument read the description carefully and follow the directions described The EMC of this instrument was tested based on IEC 60601 1 2 1 Please note that portable or mobile type radio frequency communication devices RF communications instrument may adversely affect this instrument resulting in malfunctioning 2 The electromagnetic compatibility EMC of this instrument was tested with the options and accessories shown below Since using an option or accessory other than those specified may cause malfunctioning of this instrument due to interferences of external device or cause malfunctioning of external device use only the options or accessories specified for this instrument v 100V power supply cable KP300VCTF3X1 25SQKS16A 3m v Personal computer CE Marking and VCCI approved personal computer v USB cable Type A B 2m 3 This instrument is not designed to be used adja
45. 012 12 13 16 08 Duration 02 07 Target Center P Time Interval Standard Standard Size Color II White White Fix Loss False Pos False Neg All Points Rest Points Gime AP 7000 2012 12 13 16 10 After Threshold Meridian examination 5 3 2 Custom Circle Threshold examination The examination point selection screen for the Custom Circle threshold examination is as follows Select the circle to examine and press Start During the examination the examination result screen graphically shows a distribution of the threshold values on the selected circumference of circle f input Examination ez Result e a imma CustomCircleThreshold Center tandard Standard I1 Whte White Rest Points D AP 7000 2012 12 13 16 11 Custom Circle Threshold examination CustomCircleThreshold All 15 Degree R nia gt ID 0001 Name KOWA Date of Birth 1943 02 20 Age 69 Correction None Date 2012 12 13 16 13 Duration 02 25 Target Center P Time Interval Standard Standard Size Color IIZI White White Fix Loss False Pos False Neg All Points Rest Points Fe AP 7OOO 2012 12 13 16 16 After Circle Threshold examination 5 Examination 5 3 3 Quadrant Threshold examination The examination point selection screen for the quadrant threshold examination is as shown below Select the quadrant to examine and press Start You cannot select two or more quadrants If you select the second quadrant the
46. 1 Center 2 Supra Threshol lsopter Program lsopter Standard Screening1 Screening2 Threshold Kinetic Method Auto Manual Isopter other examinations are automatically tested Summary ee to grasp the shape of a visual field as an isopter equal sensitivity curve Custom Program Circle threshold 1 point threshold Quadrant threshold Optional thresholdO Optional threshold ScreeningO Screening a in which you can set the stimulus positions at your option manual an which is performed through a dialog with a patient PenmEIy On Perimetry combined fundus image fundus Fovea _ er It is available in the Threshold Center examination Fovea Examination examination For details on each examination program see 4 8 Each Examination Program 4 7 1 Examination program setting 4 Preparation for examinations The program selection dialog allows you to change the settings for examination programs The examination points right eye and parameters for the selected program are shown on the right side of the dialog When you press OK after completing the program setting through Registration list or Program list the new settings are shown on the input screen When you press Cancel no change is applied Registration list allows you to select a registered examination program from the list It will be more convenient if you register frequently used examination programs The sele
47. 201007 207003 207005 201007 201008 2010 17 Peds ave e eye Right Eees 2008 05 200811 200501 200 03 200505 200507 200509 200511 201001 201003 211005 2010 07 2010 09 2010 11 Ge AP 7000 2012 12 13 Changing over the examined eye display of left eye only 7 Chronological change 7 6 Graph emphasizing In the graph display mode data in a specified period of time can be emphasized In particular the MD Center MD Macula and VFI graphs allow you to specify a period of time and highlight the linear regression in the specified period This function is useful for example when checking whether the changed treatment is effective or not The content and display conditions of the linear regression to be emphasized are the same as for MD Center MD Macula and VFI The MD forecast is calculated from the MD and VFI linear regressions in the last period of the VFI forecast You can make settings for emphasizing in the upper graph only When you set emphasizing in the upper graph emphasizing is also executed in the lower graph in the same way Use the following procedure to set emphasizing Q Press Emphasize to turn it ON 7 Touch the start point of the period to be emphasized in the upper graph Touch the end point of the period to be emphasized in the upper graph fp gt Examnation Result Chart BGs i E ERT 5010 08 2008 09 2009 02 2009 07 200912 201005 2010 10 D AP 7000 2011 10 24 Graph emp
48. 3 14 18 Screening Standard Reference value P value 1 Examination method The Screening examination adopts the method of dividing the sensitivity of a patient at each point into two or more steps zones The number of zones can be selected from 2 3 and 4 The presented stimulus intensity for dividing the sensitivity into zones varies with the setting of the reference value 5 dB or p value See the table below The reference value p is available only for Center 1 and Center 2 examinations All the screening examination programs use the same examination method except for the examination points The examination points are arranged differently between the normal mode and the quick mode The quick mode provides a rougher point arrangement but the examination time is shorter Stimulus intensity by setting of number of zones and reference value dB Stimulus Reference intensity value Standard Normal values for each age 5dB the intensity that total deviation becomes p 5 Stimulation 1 SdB The normal values for each age 10dB yale the intensity that total deviation becomes p 1 Stimulation 2 10000asb 0dB 1 Incase of examination with 4 zones and reference value 5 dB The first stimulus is presented with the intensity 5 dB lower than the normal sensitivity curve value at each examination point Standard The stimulus is presented twice at the points without any response from the patient Next for the points
49. 4 4 2 Operations available with the input screen eesssseessseessssoessssoessssoessssoesssseessseeessseeessseeessseeesssoeessseeesssees 27 4 3 Loading patient information by Open List 00oooooeossseeesssoeesssoessssoessssoesssseesssseesssseesssoeessseeesssoesssseeesssees 28 4 4 Patient information input eeeeeeeseeeeessseeeeesssseeeessssseeeesssseeeeesssseceeessseeeeesssseeeeesssseeeesssseeeeesssseeeeesssseeeeessseeeeessssee 30 4 5 Loading patient information from the advance entry liSt ccsssscccessssccssssrccessssecccsssseceessseseessseecens 38 4 6 Clearing the patient information ccsssscccsssscccsssscccsssseccssssescessssesecsesseeecssseseesesaescesssecesssseeseesenseeens 39 4 7 Setting of Examination Program and Examination Parameter csscccsssccsssccesssccesssecesssecesseecessees 40 4 8 Each Examination Program seeeessssseeesssssoseesssssocesssssooeeessssoceesssssoeesssssoeeeesssseeesssssoossssssoeeesssssoceessssseeesssssoe 45 4 9 Perimetry examination fundus images sseessssoessseeesssoessssoessssoessssoessssoesssseesssseesssoeessseeesssoeessseeessseeesssees 57 4 10 CONTIG AR OMS TEIN GS saccente eN EEEN E 59 4 11 Preparation for patients and alignment of Examined eyes cccsssccsessccesssseccessseeccessseecesssneeeees 71 5 Examination sesesesesosossssesssesesesosososososossesososososososossssesesososo
50. 56 sa sa sa S S c3 gt 23 29 30 31 23 29 2 2 sA th on as 2994 s4 s sa sa 3A sA on t pfas s4 se sd so J we v S J we a oS Sele 9 aaas gt sA an 95 25 salos se sa sa sA on 25 25 gajes se o s sa oe Fe S gt gt 2 Fo J Oe we FAS gt 3A on 22 sdlas 72 sa 44 e A SA 22 salaa so 9a sa 7 lt we we amp wo SIS 25 2e 4 r r Date of Birth on a 5 28 24 26 2 se s 30 28 23 26 33431 28 24 26 o sa 3 olen so 32 ea a 494 o J 29 24 17 9 20 18 23 29 an so syfoz sa so an so otter gt f 30 19 27 25 24 28 ma 4 aa a S sir gt sr iS ee ovr ee bb Be _ av tig F o TAY Ga AP 7000 2012 12 14 Comparing examination results display The comparison result and 2 examination results to be compared are chronologically displayed on the left and right sides of the comparison screen respectively Press Print to print the comparison result Press OK to close the comparison result display Note that you cannot save any comparison result Comparison appears only when it is possible to compare the examination results Otherwise it is not displayed The following examination programs are available for the comparison Screening Standard Intensity Center Periphery Glaucoma V Meridian Center 1 Center 2 Supra Standard Macula Mariotte Threshold Center 1 Center 2 Macula 1
51. 8 2008 10 2005 02 20008 2005710 201002 201006 2010 10 Fae AP F7OOO 2012 12 13 18 19 Chronological change display 7 Chronological change The chronological change screen allows you to perform the following operations Setrig I Print the chronological change in graph form P 128 7 2 Print Toggle between graphic display and data display P 133 7 4 Data display Change the eye of which data is displayed P 134 7 5 Changing over the examined eye for display Emphasize an arbitrary period of time P 135 7 6 Graph emphasizing Toggle between single page display and scrollable display P 136 7 7 Scrollable display Toggle between grayscale mode and color mode for data display P 133 7 4 Data display Display selected data as base data at the leftmost position P 133 Make various settings P 59 4 10 Configuration settings 7 2 Print When a printer Separately available is currently connected the chronological change being displayed can be printed For the connection with a printer see 2 2 connecting an external device When you press Print in the upper left of the screen the chronological change being displayed is printed The printout is as shown in the diagram below The patient information ID Name and Date of birth is shown in the upper portion and the chronological change is shown in the lower portion 123456789012245678901 23456789012 KOWA AP 7000Ver 0 0 5 0 Norm Ver 0 0 0 1
52. D input dialog enter the patient ID which does not exist in KOWA AP 7000 but exists in KOWA VK Series Press OK and then the patient information ID name date of birth and sex corresponding to the input ID is read and enters the input state If any examination result of near or distant correction exists under the same ID as above in numeric processing software the most recent result is also read and input If an ID with any examination result is input the most recent examination result corresponding to the ID is displayed 2 Patient information input If you enter an ID in the patient information input dialog which exists in VK the patient information ID name date of birth and sex corresponding to the input ID is read and enters the input state If any examination result of near or distant correction exists under the same ID as above in numeric processing software the most recent result is also read and input 3 Advance entry list When you press Registration List an advance entry list in the KOWA VK equipment is displayed Select the patient to examine press OK and the patient information ID name date of birth and sex is read and enters the input state If any examination result of near or distant correction exists under the same ID as above in numeric processing software the most recent result is also read and input If an ID with any examination result is available is input the most recent examination result corres
53. GE CURRENT Earth conductor of the MULTIPLE SOCKET OUTLET is broken Due to high TOUCH CURRENT of B See rationale for 16 5 The earth conductor of the MULTIPLE SOCKET OUTLET is broken No causes of exceeding LEAKAGE CURRENT Due to high TOUCH CURRENT of B See rationale for 16 5 a Potential difference between PROTECTIVE EARTH CONNECTION S of A and B b Due to high TOUCH CURRENT of B See rationale for 16 5 No causes of TOUCH CURRENT or EARTH LEAKAGE CURRENT exceeding limits IEC 60601 MEDICAL ELECTRICAL EQUIPMENT in compliance with IEC 60601 IEC xxxxx Non medical equipment in compliance with relevant IEC safety standards Separating transformer see 16 9 2 1 Introduction Practical means of compliance Apply 16 5 in all situations No further measures are necessary Additional PROTECTIVE EARTH CONNECTION for A or B or Separating transformer Do not use metal connector housing or SEPARATION DEVICE Additional PROTECTIVE EARTH CONNECTION for A or B or Separating transformer No further measures are necessary Do not use metal connector housing for SIGNAL INPUT OUTPU T PART or SEPARATION DEVICE Additional PROTECTIVE EARTH CONNECTION for A or SEPARATION DEVICE or Do not use metal connector housing in the PATIENT ENVIRONMEN T If equipment B is outside the PATIENT ENVIRONMENT and if equipment A is a CLASS
54. II equipment and has accessible conductive parts connected to the PROTECTIVE EARTH CONNECTON of equipment B then additional safety measures could be necessary for example additional protective earth for B or separating transformer or SEPARATION DEVICE Operational considerations for a hospital grade electrical instrument safety and accident prevention 1 Only qualified personnel should operate this instrument 2 The following items shall be considered when installing the instrument 1 2 O oO A OQ Install at a location away from water or accidental splashing Install at a location which will not be adversely affected by atmospheric pressure temperature humidity ventilation sunlight dust air containing salt sulfur and other substances Take care to guard against tilt vibration and strong impacts e g during transportation Instrument must not be installed at locations where chemicals are stored or gasses are generated Be careful with the radio frequencies voltages and allowable amperes power consumption of the power supply Properly connect ground wires 3 The following items shall be considered before using the instrument Make sure that the instrument activates properly after checking switch contact polarity dial setting and so forth Make sure that the instrument is properly grounded Make sure that all cables are properly connected and secured Use of other instruments and app
55. Macula 2 Periphery lsopter Isopter Screening 1 Screening 2 Threshold except isopter A comparison cannot be performed with the result of an examination that was not completed Use the following procedure to compare the examination results 1 Press Comparison 2 The examination result numbers available for the comparison are shown in green Those unavailable for the comparison are grayed out Select the first examination result The color of the selected examination result number turns orange To cancel the selected examination result select it again estDate 2010 09 17 19 52 E estDate 2010 09 17 20 07 E hart T he sholdCentert fouperduick T hreshold art T hysholdCenter1 puperQuick Threshold Comparable AN 2011 10 13 21 49 ii estDate 2011 10 13 21 49 hrashrellGenterl SuperQuick T hreshold ThregaldCenterl Sypertuick Threshold Cannot be compared The examination results which can be compared with the one selected in step are shown in green Select the second examination result fOO N fH TestDate 2010 03 17 19 35 8 sstDate 2010 03 17 19 39 iy Chart T hresholdCenter1 SuperQuick T hreshold hart T hre holdCenter1 super uick T hreshold Selected Comparable with selected result TestDate 2010 06 17 19 44 15 L Chart T hresholdCenter1 SuperQuick T hreshold 20 The comparison screen appears The comparison results of the examinations are displayed as shown on the next page 6 D
56. Program T hresholdCenter1 B oth All Initial Program T hresholdCenter Both All Ge om op View aview Ga AP 7OOO 2012 12 13 Combination of both eyes result display screen Combine the examination results of both eyes If the examination parameters for both eyes to be displayed are the same you can combine the examination results of both eyes BothCombination Example of the combined result Press Combination to display the combined result as shown above Press Print to print the combined result Press OK to close the combined result display Note that you cannot save any combined result Combination appears only when it is possible to combine the examination results Otherwise it is not displayed The combination conditions are as follows Program Screening Supra Threshold Isopter X Threshold Meridian and Supra Optional are excluded Parameter The following parameters shall have the same values 1 2 3 O of _ N Stimulus Size Stimulus Presentation Time Background Intensity Stimulus Color Fixation target Threshold Macula 1 only Screening Intensity Pre Test is not available Zone Reference value Quantify Scotoma Quick Supra Intensity Threshold Fovea Isopter Auto Manual not available Start 2 OFF only Interval Standard 12 lines and 45 8 lines only No of isopters 6 Display Print and Analysis of Examination Results The examinati
57. RENT Additional PROTECTIVE EARTH CONNECTION for A or B or Separating transformer Additional PROTECTIVE EARTH CONNECTION for B or Separating transformer for B Additional PROTECTIVE EARTH CONNECTION for A or B or Separating transformer Additional PROTECTIVE EARTH CONNECTION for B or Separating transformer for B Situation No 2a Items A and B are ME EQUIPMENT 2b Items A and Item B are ME EQUIPMENT powered via a MULTIPLE SOCKET OUTLET Item A is ME EQUIPMENT and Item B is non ME EQUIPMENT Item Ais ME EQUIPMENT and item B is non ME EQUIPMENT powered via a MULTIPLE SOCKET OUTLET Items Aand B are ME EQUIPMENT 3b Item A is ME EQUIPMENT and item B is non ME EQUIPMENT Item Ais ME EQUIPMENT and item B in is ME EQUIPMENT or non ME EQUIPMENT Medically used room Inside the PATIENT ENVIRONMENT A IEC 60601 Outside the PATIENT ENVIRONMENT B IEC 60601 MULTIPLE SOCKET OUTLET Mains Mains Plug A B Plug IEC 60601 IEC xxxxx A IEC 60601 IEC xxxxx MULTIPLE SOCKET OUTLET IEC ne IEC ae IEC site IEC oe Common protective earth B e 60601 Common L Common protestiveearth earth Common protective earth Non medically used room IEC ee B IEC 60601 or IEC xxxxx Protective earth with potential difference Examples of possible causes for exceeding LEAKAGE CURRENT limits No causes of exceeding LEAKA
58. Select Start 2 Select e for the intermediate file 3 for the intensity and I for the size Press Register I 3e is added to the registered stimulus Stimulus deletion method Example To delete I 2e for Start 1 in the above settings i ii iii Select the type of the start point to delete Start 1 or Start 2 Start 2 can be selected only if Blind spot is set in Start 2 Select the stimulus to delete from the Stimulus area Press Delete and the selected stimulus is deleted Select Start 1 Select I 2e Press Delete and the selected stimulus is deleted 2e is deleted from the registered stimulus When there is no response from the patient up to the end of the examination X is displayed When Test is set to Auto and there are multiple isopters the examination is performed beginning with the stimulus which is easily visible to the patient a When Test is set to Auto and there are multiple isopters the examination start position is determined based on the examination result if the isopter is the second or subsequent one and there is an examination result in the same examination direction 4 8 4 Custom There are 7 kinds of examination programs Circle threshold 1 point Threshold Quadrant threshold Optional threshold O Optional threshold Optional Screening O Optional Screening The programs provided with
59. TT 1 7 000 INSTRUCTION MANUAL US Introduction Congratulations on your purchase of KOWA AP 7000 KOWA AP 7000 is an automatic perimeter intended for measurement of the visual field This manual provides a description of the operating procedures of the KOWA AP 7000 and the precautions to be observed during its use Please read this manual carefully to assure that the instrument can demonstrate its full capabilities and work safely After you have finished reading keep this manual in an easily accessible location near the instrument for future reference Safety precautions This manual describes important precautions to be observed when you use this system to assure that the system is used safely without causing any damage to the human body or property of the purchaser and other persons The designations and pictorial symbols used in this manual are described in the table below These should be fully comprehended before reading the text of this manual This document does not include any information about replacement or repair of parts other than consumables For details about the replacement or repair of parts see the Service Manual Meanings of designations Improper operation of this instrument may incur a risk of causing death or serious injury Improper operation of this instrument may result in bodily injury or damage to property Descriptions you must read Describes items you should
60. When you press Cancel the gaze monitor function for this examination is deactivated Pupil Acquisition Failed to acquire the pupil position Do you wish to proceed with acquisition from the beginning 2 Diameter measurement setting If the pupil diameter measurement function is set to ON in the applicable parameter setting the operation of measuring the pupil diameter of the examined eye is performed before the examination Operate according to the given messages and voices The measurement result is automatically input as patient information You can check it in patient input dialog 2 of the input screen P 36 Ne ued j The pupil diameter measurement result is a reference value 3 Blind spot position setting If the fixation loss is set to ON in the applicable parameter setting setting the blind spot for the patient can be performed The blind spot position setting will be required to confirm the fixation loss P 96 The blind spot position setting is not executed in the 1 point threshold examination and isopter examination The blind spot position setting operation determines the position of the blind spot based on the response from the patient to the stimulation at a position adjacent to the blind spot You can change the blind spot size through parameter setting The operation from the blind spot setting to examination start is automatically executed as a series of steps 4 Other pre exam setting If the patie
61. adjust the height of the chair e Adjust the height of the top panel of the motor operated optical table Alignment of examined eyes e Place the chin of the patient on the chin rest and place the forehead of the patient against the head rest setting the face in the stable position e Align the eye of the patient to the center of the dome e Adjust the distance between the examined eye and the corrective lens 3 Flow of operations A Practice pz e Explain how to use the response button to the patient e Ask the patient to practice using the response button so that the patient will understand the examination lt 5 Examination r7 e Start the examination e Pay attention to the condition of the patient during examination and check the position and fixation of the examined eye lt 6 Result display ess e Upon completion of the examination the examination result display is displayed e Tell the patient that the examination is finished and release the patient e The eye not to be examined is not covered Examination f Ending P 24 e Press the sub power switch e When the message Do you wish to exit the KOWA AP 7000 appears select OK e Confirm that the power lamp is lit in orange STANDBY and then set the power switch to OFF When ending the examination be sure to follow the procedure described in 4 1 Switching on and off the instrument Do not tur
62. ale Color t Kowa pack 1 Gray Threshold The analysis items to be displayed vary depending on the analysis method as shown in the table below O Displayed Not displayed Total Pattern i analysis SUN Analysis Method Threshold Scale 3D a ie y Quadrant deviation deviation indexes Whole Threshold Kowa pack 1 Kowa pack 2 For Threshold Macula 1 and Threshold Periphery Kowa pack 1 the threshold scale total deviation and Bebie curve are displayed Lf a E ee ee eee ee ee Mie EE po oO fF oO Oo o o pO O fF O O DO O PO o o Of o o You can press Print to print the currently displayed examination result For analysis of the result of an interrupted examination only Value and Scale are available X When the date of birth of a patient is not entered the result analysis of the patient can only be displayed in Value and Scale To display other analysis methods touch the Input Data to enter the date of birth Then display the examination result again and press the Analysis you want X In fundus perimetry it is possible to display only numeric values for a threshold examination while it is also possible to display the total deviation for Custom Optional thresholdO and Custom Optional threshold examinations only The list of Threshold Center1 examination results is shown below Value Scale is Threshold Periphery examination resu
63. already selected quadrant is deselected aie Soe a CustomQuadrantThreshold Center andar Standard l l White White Rest Points i Gee AP 7000 2012 12 13 16 17 Before Quadrant Threshold examination 5 3 4 Optional examination The following examinations allow you to arbitrarily select examination points Supra Optional Custom Optional thresholdO Custom Optional threshold Custom Optional screeningO Custom Optional screening l input 3 Examination ez Result ae SupraDiagnostic False Neg All Points Rest Points Ge AP 7OOO 2012 12 13 16 20 zaak oe i ee Se ae ia 2 CustomOptionalThreshold eer eet fe ee ee ee eee e ee a IAI White White eee eee ee eo o ee o ee oe tee ett eleaoee eee ee ee ee ee ee ee ee eeereoevteeoereoev eee eee eee eeeeoevre eee ee ee amp eer eet eoeveienee eee eee eee ee ee eeeiegee ee ee eee eee eet eevee eetreieeeoeoeeeovneo 6 eee e e fee ee eeeeeveieeoeoeoreeeeeee eo eee eee eeeeveeieoeoerrerm e ee eeeee amp eo 7 ee eee r r a a eee eeoeoeoeo eee ee ee eee eee eee eeeveieeoeoeoreoreeneeeee ee eee R ee e RRR RRR RRR ee RRR eee r r a a a O E a a a a ee eee eet tet eeoeeteeiegeeevenev eee ee ee RRR eee eet eoev eeoeonee eee eee 1 eo r a o ee ojo ototo Rest Points d AP 7000 2012 12 13 16 21 Custom Optional threshold Custom Optional screening
64. ame When you press Register the input diagnosis is registered in the list Then when you press on the right of the text box the list is displayed in the drop down menu allowing you to select the input diagnosis Regarding diagnosis four items can be selected for each eye 4 4 8 Pupil Diameter When you press the Pupil Diameter text box in patient information input dialog 2 the pupil diameter input dialog appears The input range is from 1 0 to 15 0 mm If an examination has been conducted with the pupil diameter measurement function set to ON the most recent measurement is input Nea noes v The pupil diameter measurement is a reference value 4 4 9 Eye Pressure When you press the Eye Pressure text box in patient information input dialog 2 the eye pressure input dialog appears The input range is from 1 to 40 mmHg 4 Preparation for examinations 4 4 10 Comment When you press the Comment text box in patient information input 2dialog the comment input dialog appears You can enter a comment using up to 128 characters The input method is the same as that of the name When you press Register the comment is registered in the comment list Then when you press on the right of the text box the list is shown in the drop down menu allowing you to select the comment 4 4 11 Drug Administration When you press the Drug Administration text box in patient information input 2 dialog the drug administrat
65. aph the analysis result is better for a plot in the upper position When you touch a plot in a graph the information of the corresponding examination is shown as in the diagram below When you consecutively touch a plot the display switches over to the result screen which displays the examination result 1 MD Forecast 2010 09 38 Aa 16 c i lla tac a O ie 2 3 i ai E aaaea vy at F aeeeee tances es 2 3 2009 03 15 16 56 L ThresholdCenter 1 SuperQuick MD 2 38 P lt 2 3 0 a ri 20209 0Ps 4 2008 06 2008 11 2009 04 2009 09 2010 02 2010 07 2010 12 Information of the corresponding examination 1 MD Center and MD Macula MO Forecast 2010 09 38 20790 208 20609 5 2008 06 2008 11 2003 04 2009 09 2010 02 2010 07 2010 12 The MD Center and MD Macula graphs show the chronological change graph and MD forecast as illustrated in the diagram above The chronological change graph shows the MD value p 5 and p 1 by using a dashed line The area below Caution MD is shown in yellow The Caution MD value can be changed with Setting P 63 linear regression For MD PSD and VFI graphs if the regression of the examination result is statistically significant a linear approximation is shown by use of a dashed line The linear regression dB year its statistical significance and 95 confidence interval are shown below the patient information on the right side of the screen The statistical si
66. ata of the selected ID You can press List All Examinations to delete one selected examination result When you press Safety Remove Hardware in the patient ID list dialog a list of devices connected to the USB connector is shown Select devices to remove and press Stop The selected devices are safely removed P 69 4 4 Patient information input Input information of patients The input information consists of the following items Patient information ID Name Correction Sex Doctor Visual Acuity Diagnosis Pupil Diameter Eye pressure Comment Drug Administration Program Parameter When you select a text box on the input screen the corresponding input dialog appears For details on the input method see the subsequent sections When you press Input Data in the upper left of the input screen the patient information input dialog appears It allows you to input the ID name Date of birth and correction of each patient When you select a text box the corresponding input dialog appears For details on the input method see the subsequent sections When you press OK with necessary items input the patient information is transferred to the input screen When you press Cancel the dialog is closed and the input screen returns without any input information When you press Registration List the input information gets registered in the advance entry list When you press Clear in the u
67. ay method allows you to easily grasp the change of each information item The rightmost examination result is the newest You can slide the scroll bar in the lower portion of the screen to change the display range Alternatively you can change the display area by sliding the scroll bar while touching the examination result display area In addition when you consecutively touch a single examination result the screen switches over to the result screen for displaying the examination result a eae O E oon A DAs Sy n 2 Dosane Sy Dosen SLY Of ST rrashsisreter i S p9 Suck aaee D LOA Si reshsctete Supra aLOAaDTmendsete Supra 012 Chart Rapid Date of Birth 1973 09 16 2 32 17 14 2i22 21 lt 0 20 14 yf 87 7000 sonia eal Data display When you press Color during data display the scale indication of the examination result is changed over between grayscale mode and color mode lf you press Base and select the examination result while data is being displayed the selected result is fixed at the leftmost position 7 5 Changing over the examined eye for display You can press Switch eye to change over the examined eye for displaying the graphs and data Each time you press Switch eye the examined eye for display is changed in the order of By eotn eyes L R f input 2 Examination e3 Result Chart Name Chart Rapid Date of Birth 1973 09 16 2008 05 200871 200607 200803 200805 200507 200805 200611
68. cent to an external instrument or placing one on top of another Therefore do not apply such use Nevertheless if such use is inevitable it is necessary to monitor constantly to make sure the instrument is functioning normally after such use has been adopted 4 Accessories and options used with this instrument are tested for EMC when combined with instrument below Since usage with an instrument other than that specified may cause malfunctioning of this instrument due to interferences of other devices or cause malfunctioning of other devices do not use any instrument other than specified below Option 1 Personal computer CE Marking and VCCI approved personal computer 5 We specified the functions listed in the table blow as the basic performance of this instrument to determine EMC of this instrument Function Essential performance Stimulus presentation Instrument operation functions Camera image display Touch panel functions Display without disturbance Guidance and manufacturer s declaration electromagnetic emissions KOWA AP 7000 is intended for use in the electromagnetic environment specified below The customer or the user of KOWA AP 7000 should assure that it is used in such an environment Emissions test Compliance RF emissions CISPR 11 RF emissions CISPR 11 Harmonic emissions IEC 61000 3 2 Voltage fluctuations flicker emissions IEC 61000 3 3 Class B Class A Complies
69. cted examination program is shown in Orange Program list does not save any changes to the program settings Program Register New Program selection dialog Use it when performing an examination not to be registered in the registration list or a one time examination When you select Registration list or Program list and press Setting the program dialog appears allowing you to change the program settings and parameter settings The registration list and program list can be used in the same way to select an examination program or change settings When you press Setting the program change dialog appears Registration list allows you to make changes to the selected program while Program list allows you to make changes to an examination program to be performed this time This dialog allows you to change the selected program to another Depending on the program it is also possible to make ON OFF settings for the quick mode time reduction mode and fovea threshold examination fovea When you press OK the change is applied and the program name change dialog appears Program change dialog When you press Cancel the program change dialog is closed without making any changes When you press Parameter in the lower left of the program change dialog the parameter value change dialog appears This dialog allows you to give changes to the parameters in accordance with the selected program When you pr
70. ction is shown in the following graphic form during examination and in the examination result 0 cette nen aes een ses setts lt Fixation check fails Time In the examination with the gaze monitor function set to ON the graph showing the evaluation result of the gaze monitor function extends to the right each time the stimulus is presented The fixation misalignment is shown up to 10 on the scale in the upward direction The fixation misalignment of more than 10 is shown as 10 The red line below the graph indicates that the fixation check has failed The fixation check failure can be caused by blinking eyelashes eyelid ptosis examined eye s misalignment dirt on the corrective lens reflection of the corrective lens and the like To set the gaze monitor function to OFF press Stop to interrupt the examination and then press Parameter to change the gaze monitor function setting You cannot set the gaze monitor function to ON during an examination 5 8 Examination Reliability The reliability of an examination can be tested by 3 indices below 5 8 1 Fixation Loss Heijl Krakau Method H K Method When the blind spot is being stimulated the characters of Fixation loss are shown in orange in the lower right of the examination screen If a fixation loss occurs the fixation target flashes twice and a voice message for alerting is given In the lower right of the screen the fixation loss status and result a
71. d the wall Insert the plug of the response button to the response button jack and insert the protruding portion of the response button to a hole in the left side of the touch panel Attach the headband to the left and right of the head rest respectively Attach the input pen strap to the hole in the lower left of the touch panel Confirm that the power switch is OFF O side and connect the power supply cable to the AC inlet Insert the power supply cable to the power outlet This instrument is floor standing type not intended for moving When it is necessary to move the instrument contact Kowa or your Kowa dealer Example of installation Q Make sure the instrument is properly grounded to prevent bodily injuries Connect the plug into the three Warning Warning wire grounding type outlet with ground wire Otherwise Obligatory High Voltage electrical shock may occur Do not place the instrument close to the wall because it is too difficult N Warning S to remove the power supply cable from AC inlet Prohibitory 2 Installation 2 2 connecting an external device This instrument is provided with 2 USB connectors and an Ethernet connector as the external interface connector allowing data output to a printer media and a personal computer When it is necessary to install printer drivers for connecting a printer to the instrument contact Kowa or your Kowa dealer where you purchased the instrument In addition
72. d upon stabilization of the lamp intensity In this case a bright room disables light adjustment Be sure to operate the instrument in a darkroom In case of a failure in light adjustment an initialization error message appears as shown below InitialError Darken the room When the input screen appears the light adjustment is complete The cursor on the touch panel is shown in the hourglass shape when the motor initialization is started and it is shown in the original shape when the light adjustment is started 4 Preparation for examinations Since the chin rest automatically operates for initialization do not touch A N Caution N eal the chin rest or the exterior on the front Otherwise it may cause injury Prohibitory How to stop the instrument 1 Press the sub power switch which does not respond on the examination screen 2 When the finish message Do you wish to exit the KOWA AP 7000 appears select OK MAP 7000 Finish Do you wish to exit the KOWA AP 70007 Parameter b V W A Sub power switch d 3 Approximately 20 seconds later the screen enters the state without any data displayed black screen AP 7000 D E Pong ISTAND eS ao d 4 Confirm that the power lamp is lit in orange STANDBY and then set the power switch to OFF O side When terminating the instrument always use this procedure Do not turn off the power switch when the pow
73. do not worry but surely press the button when you see a light again a YOU may feel like the fixation target has moved or the background light intensity is changed If you do so it is not unusual Even if you feel the background is dark press the response button when you recognize the light a he examination time may take long depending on the examination program and patient s response Please encourage the patient by for example talk about the progress status of the current examination a Since any examination can be interrupted tell the patient what to do if the patient wants to stop the examination If the patient keeps pressing the button the current examination is interrupted 4 11 3 Preparation for patients Following the explanation to the patient prepare the patient for the examination Cover the patient s eye not to be examined Insufficient covering will adversely affect the reliability of the examination results Completely cover the eye and confirm it with the patient If you use an eye patch tape it onto the eyebrow to prevent a string of the eye patch from entering the visual field of the examined eye lf the eyelid of the examined eye partially covers the pupil lift the eyelid and keep it up with tape Use care not to lift the eyelid too much to blink If the eyelid covers a part of the pupil the upper visual field may occasionally be unable to be examined correctly Upon completion of covering the unexamined eye s
74. dus image In addition check whether the examined eye is left or right e An attempt has been made to start the Isopter Manual examination with 6 types of stimulus Up to 5 types of stimuli can be selected for an isopter examination To perform an examination with 6 or more types of stimuli complete one examination with some types of stimuli once and then perform another examination with the other types of stimuli 10 Troubleshooting Result screen Message Cause and Remedies The combined data is not saved Continue e An attempt has been made to change over the screen to another operation without saving the result of data combination To save the combined data press Cancel and Save in this order To not save press OK and proceed with the operation The data has been properly copied e Data read has been normally completed from Kowa automatic perimeter AP 6000 AP 5000 or AP 3000 to AP 7000 The remained memory of the drive is less e This message appears when the remaining free space of the data than 5 save drive is less than 5 at the time of software startup or examination result save Database Network error Message Cause and Remedies e Network connection error e The database or network is abnormal in some way Select OK e Network drive has been shut down to save the data locally If the database or network is restored e Could not connect to the network when the instrument i
75. e 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles lt 5 UT gt 95 dip in UT for 5 sec Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be at least 30 Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment If the user of KOWA AP 7000 requires continued operation during power mains interruptions it is recommended that KOWA AP 7000 be powered from an uninterruptible power supply Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment NOTE UT is the a c mains voltage prior to application of the test level 13 Electromagnetic compatibility IEC 60601 1 2 Guidance and manufacturer s declaration electromagnetic immunity KOWA AP 7000 is intended for use in the electromagnetic environment specified below The customer or the user of KOWA AP 7000 should assure that it is used in such an environment Immunity test IEC 60601 test level Compliance level Electromagnetic environment guidance Conducted RF 3 Vrms IEC 61000 4 6 150 kHz to 80 MHz d EN 61000 4 6 Radiated RF 3 V m Portable and mobile RF communications in
76. e curve of p value 5 red curve do not correspond with each other because they are arranged in descending order Therefore if the p value of total deviation at all the points is not less than 5 the Bebie curve and the curve of p value 5 red curve may cross with each other 6 Display Print and Analysis of Examination Results 6 6 7 MD Mean Deviation MD refers to an average value of the total deviation Overall average visual field defect is displayed When the value is negative or the value is less the visual field is lower than the normal sensitivity curve The p value is the provability variable showing the degree of abnormality of MD There are 5 kinds of p values 10 5 2 1 and 0 5 For example in All gray MD is 1 97dB marked by p lt 5 This means that the measured sensitivity curve is 1 97dB lower in average than the normal sensitivity curve of normal 68 years old people and less than 5 of normal 68 years old people have such value When Artifact of Setting is ON the value with Artifact considered is shown in P 60 6 6 8 PSD Pattern Standard Deviation PSD refers to a standard deviation of the total deviation however with weighting given for each examination point The deviation of the measured sensitivity curve from the normal visual field pattern is displayed The larger the value the larger the deviation The p value is the provability variable showing the degree o
77. e examination date of the previous examination result differs from the date of re test this day the following message appears Press OK to proceed to the examination screen Press Cancel to return to the re test selection Examination The date of the original examination result is not today Would you like to proceed 9 cone 6 Display Print and Analysis of Examination Results For the isopter examination re test of each point is available for the examination of which result was obtained automatically Regardless of the Auto Manual and Auto examinations re test of each point is carried out with the Auto Manual examination program Upon completion of automatic examination the display changes to the manual examination screen so that you can additionally execute a manual examination When re test of each point is executed with the Auto Manual examination program the examination results results of the manual examination which are not available for re test are grayed out For example in the diagram shown below assume that you are trying to perform re test of each point for the results of the examination which was executed with the conditions of Auto Start 1 Periphery 80 I 4e and 2e and with the conditions of Manual 3e and 6 points The points examined manually are grayed out and cannot be selected e a G TY input amp Exarmnaton r aaeei L J Run same test s Example of tryi
78. eat the patient to face this instrument When the instrument is normally used the correct relative position of the patient operator and instrument is as shown in the diagram below That is the patient confronts the dome s opening while the operator confronts the touch panel Remove the headbands from the instrument when not used When the instrument is normally used the correct relative position of the patient operator and instrument 4 Preparation for examinations 4 11 4 Alignment of an Eye to be examined After preparing the patient for the examination align the position of the examined eye Make sure that the chin rest and head rest are cleaned If a corrective lens is required be sure to set it in the corrective lens holder before the patient places his her chin on the chin rest When examining the left eye instruct the patient to place the chin on the right side chin rest When examining the right eye instruct the patient to place the chin on the left side chin rest Next confirm that the patient s head is in the stable state with the chin on the chin rest and the forehead placed against the head rest At that time adjust the height of patient s chair and motor operated optical bench s top panel so that the patient can be examined in a comfortable position After confirming that the patient is in the stable position use left and right head bands to keep the head position stable For right eye examination For l
79. ecute can be performed When you press Cancel the message box is closed and the display returns to the combination result screen 6 Display Print and Analysis of Examination Results 6 6 Analysis of Threshold Examination Result You can analyze the examination results of Threshold Center 1 Center 2 Macula 1 Macula 2 Periphery and Isopter Threshold examinations Total deviation pattern deviation and analysis indexes are displayed when the following examination conditions are satisfied Date of birth is input Presentation time Standard 0 2 sec Examination was performed to Background color White the end Stimulus color White Program threshold Stimulus size Ill Only when the stimulus size is different the total deviation and pattern deviation are displayed as a reference value When you press Analysis during display of the examination result the method of analyzing the results changes in the order shown below You can press Setting to set the initial value in The early stage Threshold P 67 For Threshold Center 1 Threshold Center 2 Threshold Macula 2 and Isopter Threshold Threshold lt All Color lt Kowa pack 2 Color i Scale Gray Kowa pack 1 Color 1 t 3D Gray 3D Color f Kowa pack 1 Gray Scale Color 1 Kowa pack 2 Gray All Gray Threshold For Threshold Macula Periphery Threshold Kowa pack 1 Color t Scale Gray Sc
80. ed names is 1 32 characters No of displayed names is 2 15 characters for each input box No of displayed names is 3 10 characters for each input box S mid mial mia mid ta nta a nid te a mas nad a msa nad ta tel a miad maa mea maa pad maal mta miad tat miad ta a mis pad maal maa mad ta a a ia ts Name input dialog 4 Preparation for examinations 4 4 3 Date of birth When you press the Day Month or Year input box for Date of Birth the corresponding input dialog appears The selected item Day Month and or Year is shown in Orange You can input a value using the numeric keys in the dialog To delete the entered value or selected value press Clear in the lower right To delete all values press All Clear in the lower left Month input box mian mie mim mini nel min miin s n lal men n n mins Clear A S a Day input box After entering the date of birth press OK To cancel the operation press Cancel X The available date of birth begins with 1 January 1895 4 4 4 Correction When you press the Correction text box the correction input dialog appears An examination at a point within central 30 requires near correction at a distance of dome diameter 30 cm This input dialog allows you to input a near correction value for performing the examination at a point within central 30 You can directly input a numeric value However the instrument is provided with a fu
81. eft eye examination Use the chin rest move buttons in the lower left of the touch panel to move the chin rest up down left or right and adjust the pupil s center of the examined eye with the center of the white cross hairs on the eye fixation monitor Be careful not to catch the patient s hand or finger between the chin rest and the main body of the instrument A caution message appears during operation with the chin placed on the chin rest Tell the patient to look at the orange light at the center of the dome In the case the fixation light is at the center For the patient who needs a corrective lens adjust the lens holder to provide a distance of about 12 mm between the top of the lens and the top of the cornea When adjusting the corrective lens holder use care to prevent the lens from coming into contact with the patient s eye and eyelashes 5 Examination 5 1 Operations available with the examination screen When you press Test in the menu button area after completion of settings and preparations the examination screen appears The examination screen allows you to perform the operation from the examination start to the examination completion 7 input 3 Examination ez Result n InitialProgram ThresholdCenter1 Quick1 30 tandard Standard WAI Whte White 30 Center tandard Standard IAI Whte White False Pos False Neg All Points Rest Points Ge AP 7000 2012 12 13 Examination screen d
82. er lamp is not in orange STANDBY Otherwise it may cause a failure or data loss 4 Preparation for examinations 4 2 Operations available with the input screen Upon startup of the instrument the input screen is automatically opened The input screen also appears when the menu button Input is pressed on another screen The input screen allows you to make preparations for an examination including eee information input and examination EE E selection Correction Program InitialProgram ThresholdCenter1 Quick1 Parameter Common Screening lsopter Gee AP 7OOO 2012 12 07 Input screen The input screen allows you to perform the following operations Open a patient ID list and load patient information P 28 4 3 Loading patient information by Open List Input information about a patient P 30 4 4 Patient information input Load patient information from an advance entry list P 38 4 5 Loading patient information from the advance entry list Clear patient information P 39 4 6 Clearing the patient information Select and register examination programs and parameters P 40 4 7 Setting of Examination Program and Examination Parameter Make settings for perimetry on fundus images P 57 4 9 Perimetry examination with fundus images Make various settings P 59 4 10 Configuration settings 4 3 Loading patient information by Open List When you press Open on the input screen the patient ID list dial
83. escessseeeeessseeceeseseesens 109 6 7 Fundus perimetry examination result display ccsssscsccccsssssseccccsssssssecccesssssceseesssssseeeceesssssseeeeeees 118 6 8 lIsopter examination result display ccsssssseecccsssssssecccessssssecccesssssneeceesssssseeeccesesssneeseessssssneeeeeesseses 119 SF RETES Ene ee ee er ee eee ee T ne ne ee eee eee ee eee 121 7 Chronological change 2 0 0 0 eeseeessssssccccccccceeeessssssseeeceee 126 7 1 Operations available with the chronological Change SCreen cccsssccccsssecccssssecccsssseccessseceessseeeees 126 faz PAN een encase EEE allen cat oie lee ian Wiens poet seiaadu ete a tise ncadlcts gel pian etn 128 WO Graph displays oneen arrar ENISA AENEA ANENA cevatens cecaseussacadeoscecaseustacadeoscssaseeacecaseescneek 129 fe Meme Dr Bo C7 9 Fc Cee ee a E OA E A EA ee ree eee eee 133 7 5 Changing over the examined eye for display cccssscccssssssccssssccessssescesssseceesssecesssseeeeessseseesssseeeees 134 1 0 Graph EMP NASIZUNG meme orriari cadens Sue Cea lee ccna ENE EENEN sce canta ce ATRE OAE TA ei 135 7 7 Scrollable display sosicccovesseccosssseccasesce cease seecadessce cease sce vadessceceusessevadeesce causensevadesscecausussevaaeos ceseusussaradeoscsseusucsecaseeserses 136 7 8 Sorting the examination results ccccssscccsssssccssssecccsssseccessssescesssseccessssescesssseecessseesesssseeseessseesesseseeeens 137 8 Link
84. eshold Macula 1 or Supra Macula Perform the pupil position acquiring operation according to the given messages and voices When the pupil position acquisition start message appears ask the patient to look at the fixation target at the center of the dome confirm the eye fixation on the eye fixation monitor and press OK Pupil Acquisition Please look at the orange light in the center After confirming the fixation please select OK Next instruct the patient to gaze at the fixation target which will be lit in the lower left from the center of the dome Confirm the fixation on the eye fixation monitor a aaa sack a the Aa lagi ot ues ra ih and press OK Pupil Acquisition After confirming the fixation please select OK Again ask the patient to look at the fixation target at the center of the dome confirm the fixation on the eye fixation monitor and press OK Upon acquisition of the pupil position of the examined eye the examination is started If the operation fails in pupil position acquisition a message appears as shown on the right The pupil position acquisition failure can be caused by fixation loss eyelashes eyelid ptosis opacity of the middle translucency body small pupil dirt on the corrective lens reflection of the corrective lens and the like Le ST To retry the acquisition confirm the eye fixation and then press OK Not to retry the acquisition press Cancel
85. ess OK the changes you have made are applied and the parameter value change dialog is closed When you press Cancel the parameter value change dialog is closed without making any changes STP eTING sUprey Intensity Lone Beterence value Wiantty scotone I l aE FE Ha FE EE Reset bind spot 1E E even Parameter change dialog When you press OK in the program change dialog the program name change dialog appears This dialog allows you to change the program name You can enter a new program name using up to 16 characters pried ined badadi badadi bated baagi badadi baled batad batad bree i O tl al ta ad md md nia md ud ma en you press OK the program name change is reflected in moet oad adad Inia nad babad iiad babad baled innad the program selection dialog When you press Cancel the screen goes back to the program selection dialog without changing the program name The changes made to the program are reflected S R Program name change dialog nad maal mad ma mid nad a a ts When you press Add in the program selection dialog the program addition dialog appears When you press OK after selecting or changing the program in the same way as in the program change dialog a new program is added to Registration list You can register up to eight programs When you press Delete the confirmation message dialog appears for program deletion When you press OK the selected
86. examination Do not sterilize 9 5 Cleaning the exterior and the touch panel When the exterior of this instrument other than described above is dirty follow the steps below to clean it 1 Wipe the surface with firmly squeezed dampened soft cloth 2 Wipe off the obstinate dirt with soft cloth after dampening it in water or lukewarm water with diluted small amount of neutral detergent and firmly squeezing it Do not use solvents such as thinner and benzene for cleaning the exterior When the touch panel is dirty clean according to the following steps 1 Wipe the touch panel with a soft cloth after dampening in water and firmly squeezing it 2 Lightly wipe the touch panel with a dry and soft cloth before the surface becomes completely dry Do not wipe the entire surface at once Finish area by area Water drops leave spots when they are dried Use only a wet cloth for cleaning the exterior Do not wipe with solvents N Caution such as benzene thinner or ether Otherwise it may cause discoloration Prohibitory and or deterioration 9 6 Projection lamp replacement Be sure to wear anti static gloves or the like when replacing lamps 1 Turn off the power switch and remove the power supply cable from the outlet 2 Rotate the stud counterclockwise using a flathead screwdriver or equivalent and remove the projection lamp cover G Confirm that the lamp unit has no heat and disconnect the connector 9 Mainte
87. f abnormality of PSD The same kind of p value as MD is used For example in All gray 3 18 marked by p lt 5 This means the deviation of the measured threshold from the normal value of 68 years old people is 3 18 and less than 5 of normal 68 years old people have such value When Artifact of Setting is ON the value with Artifact considered is shown in P 60 6 6 9 GHT Glaucoma Hemifield Test GHT detects a pattern of a local visual field defect typical to glaucoma and evaluates the significance of a glaucomatous visual field defect As shown in the diagram the examination points for Threshold Center 1 examination are classified into 10 sectors and a pattern deviation is scored and compared in the corresponding sector above and below the horizontal meridian The scores are evaluated as one of the following 6 types 4 Out of normal range e ejo Blind spot e Sore difference of at least one pair of corresponding Ea Ka sectors is p lt 1 e Total score of at least one pair of corresponding sectors e is p lt 0 5 e e d e 2 Boundary zone e Score difference of at least one pair of corresponding sectors is p lt 3 3 Boundary zone amp overall sensitivity reduction e Judgment is Boundary zone and sensitivity is p lt 0 5 4 Overall sensitivity reduction e Sensitivity is p lt 0 5 e wene S 5 Exceptionally
88. formation is extracted and shown in a list Press Reset search to go back to the original patient ID list When you press Today only the patients that had examinations on that day are extracted and shown 4 Preparation for examinations You can press Export in the patient ID list dialog to export all examination results of the selected patient or selected examination results You can set the export destination file format file name and content of the examination result using the procedures in 4 10 Configuration settings When the selected export destination has data with the same file name as the selected file name a confirmation message appears The file of a same name exists File name F FTOOO0003 jpg O Save as F FTO000003 1 jpg Overwrite When you select Same as the selected file is saved as file name O O stands for a number When you select Overwrite the selected file overwrites the existing file After selecting either one press OK and the file is saved in the selected save mode When you press All OK the selected items are applied to all examination results of the selected patient When you press Delete in the patient ID list dialog a confirmation message appears DataDelete Delete all data of the selected ID Selected ID 0001 ae ee Press Cancel to close the confirmation message dialog without deleting the data Press OK to delete the d
89. ft eye place the forehead against the right dent Lens holder Set a corrective lens in Move back and forth to adjust the distance between the examined eye and the lens House it when not used USB connector Ethernet connector Dome Describe inside the main body A 7000 Chin rest lt Applied part gt Place the patien s chin on the chin rest and put it into the stable state to prevent the face from moving To examine the right eye place the chin in the left dent To examine the left eye place the chin in the right dent Headband lt Applied part gt Stabilizes the head position of the patient Touch panel Allows you to perform operation and data display of this instrument Data is input by an accessory input pen Sub power switch Toggles the operating state of the instrument between Active and Standby Response button lt Applied part gt Used while being held by the patient s hand The patient pushes the button upon confirmation of the stimulus Projection lamp cover Remove this cover to replace the projection lamp Power switch Switches the power ON or OFF ON OFF O AC inlet with fuse holder Insert the power supply cable A fuse is contained Display section Input screen Menu buttons Setting Sub menu input O Examination pe Oe s TEN lt lt buttons EE o Eye fixation Patient Program InitialProgram ThresholdCenter1 Quick1 Chin res
90. ge appears during operation of the buttons Examination screen Corrective lens holder mark oe lh ae Response button mark Gaze monitor result display Stimulus presentation point Response button mark Appears while the response button is being pushed Corrective lens holder mark Appears while the corrective lens holder is standing Gaze monitor result display Appears when the gaze monitor function is active Examination program Examination program name program content is shown Examination point pattern display area Examination point pattern appears according to the selected examination program Examination points Points where a stimulus is presented Upon completion of examination the examination result for the point is shown according to the examination type Examination program 1 System description Examination point pattern display area Examined eye Patient information Examination information Examination status Gee AP 7OOO 2012 12 07 Examination point Stimulus presentation point Point where a stimulus is currently presented Examined eye Eye being examined is indicated as Left or Right Patient information Patient information entered from the input screen is shown Examination information Examination information is shown including examination date time and parameters Examination status Examination status is shown includi
91. gnificance p lt O indicates whether the regression is significant or not If the regression is zero that is there is no change in a series of visual fields of the concerned patient the statistical significance is not shown If the regression is significant that is a series of visual fields of the concerned patient change significantly from the viewpoint of statistics the statistical significance o lt O is shown This indicates that the visual field change is significant with a probability of 100 O O is 5or 1 1 The MD of the left eye in the diagram on the right shows a significant IZAT decrease with a probability of 99 and its decreasing rate of 1 88 to 0 70 m dB Year p13 0 59 95 dB year 1 29 0 59 with 95 certainty 2 The VFI of the right eye in the diagram on the right shows a significant wel i Right decrease with a probability of 99 and its decreasing rate of 7 00 to 2 8 MBF EAEE dB year 4 90 2 10 with 95 certainty VFI 4 90 2AYear pels 210 95 v The linear regression dB year is shown when the number of examination results of the eye is 5 or more v The MD linear regression is known as MD slope which is one of the indexes of the visual field change The regression caused by aging is about 0 1 dB year If the MD exceptionally decreases from this value it may be recognized to have a critical change v Significance of the linear regression indicates whether a ser
92. hasizing When you press Cancel emphasizing is cancelled 7 Scrollable display You can press Scroll to toggle between single page display mode and scrollable display mode The scrollable display mode allows you to change the display range by sliding the scroll bar in the lower portion of the screen Chart Rapid Date of Birth 1973 09 16 2008 09 209811 20501 2008 03 2005 05 2008 07 2008 09 00 11 20100 21003 20005 201007 20009 2010 11 Patient s e ent s eye oon Patient s eye Beak eeu wD dRG Reb BEREA 2008 08 200811 200507 2005 03 200505 200807 200805 20011 2010 01 2010 03 201005 201007 20009 2010 11 Fee AP 7000 2012 12 13 1 page display 012 Name Chart Rapid Date of Birth 1973 09 16 Patient s eye pi 222 AP 7000 2012 12 13 18 29 Scrollable display When you press 1 page the scrollable display mode is cancelled and the single page display mode becomes active 7 Chronological change 7 8 Sorting the examination results You can sort the results based on the artifact and reliability index during the graphic display of the chronological change When you press Artifact it turns on and the graph of the examination result analysis index with the artifact is taken into consideration Each time you press Artifact it is toggled between ON and OFF When you press Reliability it turns on and a graph is displayed excluding the examination results in which any of the reliability
93. he number of points to be examined In the case of the initial examination the initial intensity at each point is determined based on the age of the patient For the second and subsequent examinations it is determined based on the previous examination result It is also determined based on the previous examination result when the current examination is Threshold Center 1 2 and the examination of Screening Center 1 2 with p value as the reference value has been carried out in the past G Normal Quick OFF All Thresholds Examination The threshold is determined by 4dB 2dB Bracketing strategy First a stimulus with an intensity assumed to be visible to the patient is selected from the normal sensitivity curve and presented When the patient makes a response the stimulus is decreased by 4 dB If the patient responds the intensity is decreased by 4 dB until the patient cannot see it Then the intensity is increased by 2 dB until the patient responds which will be the threshold If the patient cannot see the stimulus at first the intensity is increased by 4 dB until the patient responds If the stimulus is seen the intensity is decreased by 2 dB until the patient cannot see it When the patient cannot see it the intensity is increased by 2 dB until the patient responds which will be the threshold 2 Center 1 Center 2 gt Quick 1 Macula 1 Macula 2 Periphery Quick The examination time is reduced to about 60 of that of Normal
94. he patient s comprehension of the examination influences the reliability of the examination result Tell the patients the following matters especially An examination is performed in a dark room one eye is examined at a time The eye not to be examined is covered The patient is seated puts the chin on the chin rest place the forehead against the head rest to prevent the face from moving during an examination and have an examination a Adjust the height of patient s chair and motor operated optical bench s top panel while confirming with the patient so that the patient can be examined in a comfortable position a The patient takes the examination with the response button in hand Tell the patient not to touch any devices other than the response button aa While looking at the orange light fixation target at the center of the dome press the button each time you see a round white light stimulus around the center Demonstrate the examination by practice aa Keep looking at the orange light at the center during the examination If you do not keep looking at the orange light the buzzer may sound and the orange light may blink In the case the fixation light is at the center a Your may blink your eyes during the examination However do not close your eyes for long aa Even a person with good eyesight may sometimes be unable to see the round white lights If you cannot see any lights for a long time during the examination
95. he print size set here applies to printing of the examination result for each eye Therefore for example if A5 is set to print the examination result of both eyes the examination result of both eyes is printed in A4 size A5 x 2 The default is A5 for both Single eye and Both The print size setting is not applied to other printing styles described later Chronological change Multi display and the like a Header Footer You can set whether or not to add a header and or footer to the printout The default is OFF To set the header or footer select ON and touch the corresponding text input box to open the input dialog an as Date Set whether or not to print the date The default is OFF 4 Preparation for examinations 13 BACKES MD Center PSD Macula Quadrant TD Macula PSD Center as AGIS Classification aa VFI a CIGTS Anderson MD Macula Quadrant TD Center Boxplot With Graph3 4 set to ON you can add other two graphs to display chronological changes You can select the items from the 12 items above Graph 3 and Graph 4 are shown when you press Switch graph during display of Graph 1 and Graph 2 on the chronological change screen You cannot set the same item for Graph 1 and Graph 2 and for Graph 3 and Graph 4 respectively SPE name L ASU Ee Serena Su Serene Ler ji Bees UT You can link settings to Kowa filing system KOWA VK Series See 8
96. high sensitivity e Sensitivity is p299 5 6 Within normal range ele e e Not applicable to any of the above cases gt e kd a Sector of GHT Do not use GHT for assessment of any disease other than glaucoma 6 6 10 Anderson s Criteria When one or more of the three criteria in the table below are satisfied the symptom is judged as an early glaucomatous visual field defect On the screen a satisfying item is shown on an orange background while an unsatisfying item is shown on a white background PSD Pattern Standard Deviation p lt 5 GHT Glaucoma Hemifield Test Out of normal range Each of consecutive 3 points has p lt 5 and one of them is lower by p lt 1 or more 3 points needed to coincide with travel of NFL and be judged by a doctor For possible consecutive 3 points a symbol at pattern deviation p value is displayed in an enclosure of an orange color In Threshold Center 1 and Isopter Threshold examinations the target is the examination points excluding those on the outer most circumference PD Pattern Deviation 6 6 11 Anderson With reference to MD total deviation p value and center sensitivity the severity of glaucoma is classified into 3 levels of early moderate and severe es ee e MD Mean Deviation gt 6dB lt 12dB lt 25 gt 50 18 points or less for 38 points or less for Threshold Center 1 Threshold Center 1 12 points or
97. holder is shown and printed in parentheses beside the conventional values In order to reduce the influence of the artifact the values are calculated from the examination points indicated in the diagram on the right excluding the points for one complete circumference The points on the nasal side are not excluded because they are important points for diagnosing glaucomatous visual field changes The default is OFF 8 Adapt position to fundus Select ON to correct the examination points set prior to the examination according to the blind spot position which was detected in the fundus perimetry The default is ON 9 You can select the vision display mode from the decimal visual acuity logMAR visual acuity and fraction visual acuity 20ft 60ft The default is Decimal LE E E E DE SE E E 4 Preparation for examinations For the items shown below when you press the applicable button the corresponding dialog appears When you press OK upon completion of the item setting the dialog is closed Then press OK in the Configuration dialog and the new setting is reflected When you press Cancel the dialog is closed with the setting unchanged 10 ESLER Select Formati D ataFile ha Pint Select the export destination file format file name and content of the examination result The selectable file name formats are as follows Format Data File FT serial number jpg or pdf Format2 VK
98. hreshold Center 1 76 points Center 2 54 points Meridian 14 points Periphery 68 points Macula 2 68 points P X Macula1 is same as Supra Macula 12 Technical information 12 1 4 Isopter Start Periphery lsopter Interval Standard 12 directions lsopter Interval 45 8 directions lsopter Interval 20 18 directions lsopter Interval 30 12 directions X Examination point of lsopter Screening 1 Screening 1 Threshold is add to placed examination point of Screening Center Center 1 Threshold Center 1 each other 12 1 5 Custom Circle threshold 20 points Optional threshold 568 points X 1 point threshold Quadrant threshold is same as Threshold Center 1 X Optional thresholdO Optional ScreeningO is same as Supra Optional X Optional screening is same as Optional threshold 12 2 Stimulus Intensity and Size 12 2 1 Stimulus Intensity table i l i Intensity dB peer Goldmann MENSUB Tar Goldmann 12 2 2 Stimulus Size Goldmann Area mm2 Diameter mm Visual angle degrees Ooa f a f e f o 1 Oo m f a f os f o 12 Technical information 12 3 Spectrum distribution of luminous source Spectrum distribution of stimulus luminous source 300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700 nm Spectrum distribution of background light s luminous source white 300 400 900 600 700 800 900 1000 1100 1200 1300 14
99. ical shock bodily injury or instrument malfunctioning Refer all servicing to Kowa or your Kowa dealer The instrument modified or repaired by anyone other than a Kowa designated repair facility will void the warranty Obligatory Introduction N Caution The power supply must be provided for the sole use of this instrument Sharing the same power supply with other external devices may cause instrument malfunctioning Be sure to prevent the instrument from being operated by anyone other than the following certified personnel e MD Ophthalmologist ophthalmology resident e Nurse vocational nurse e Orthoptist Optometrist When operating the instrument use caution so that the patient s face or hand does not come in contact with the parts of the instrument Otherwise it may cause a bodily injury When operating the instrument use caution so that the patient s face does not touch the end of the instrument Otherwise it may cause a bodily injury A patient with the smaller head may get his or her head caught between the components Handle the projection lamp and the fuse with caution Otherwise glass components may be damaged resulting in a bodily injury 9 Prohibitory Do not pull the power supply cable when unplugging the instrument from the power outlet Doing so may damage the cable and cause a fire or electrical shock Be sure to hold the plug when unplugging Do not install the instrument
100. icates each score Quadrant TD Center Quadrant TD Macula rs 2008 05 2006 12 2009 03 2009 06 2009 09 2009 142 2010 03 2010 06 2010 09 2010 12 The graphs of quadrant TD Center and quadrant TD Macula are as shown above 6 Stage Anderson MH R a SS Z 2008 03 2008 12 2009 05 2009 06 2009 09 2009712 2010 03 2010 06 2010 09 2010 12 The Stage and Anderson graph are as shown above The vertical axis indicates each score The Anderson graph is classified into three stages of Early Moderate and Severe from the top in this order 10 40 0 0 E a E A E E E a Peinlomein dea weiss cele raielpsiveelomalstieeieaceint s 5 s s Maximum value 10 a222 85th percentile 15 assa Median value 20 EEEE 15th percentile 25 assa MINIMUM value 30 Boxplot 35 40 2008 09 2008 12 2009 03 2009 06 2009 09 2009712 2010 03 2010 06 2010 095 2010 12 A boxplot graph is as shown above In this graph five values of the total deviation in each examination result are represented by a single plot as shown in the diagram on the right 7 Chronological change 7 4 Data display You can press Switch graph to toggle between graph display mode and data display mode In the data display mode the examination information scale threshold total deviation p value pattern deviation p value and Bebie curve of each examination result are arranged in a vertical row and displayed in chronological order This displ
101. ies of visual field changes are Statistically significant or not but does not show that the concerned patient has some disease with significance MD forecast When the linear regression of MD is displayed an MD forecast graph calculated from the linear regression is shown The value in brackets on the horizontal axis indicates the age of the concerned patient This graph can be used to forecast the MD value for a specified age in the case where the MD will change along with the current regression The area below the Caution MD value set in 4 10 Configuration settings is shown in yellow For the VFI a forecast graph is also displayed in the same way 7 Chronological change 2 PSD Center and PSD Macula 2008 06 2008 05 2008 12 2009 03 2009 06 2009 09 2009 12 2010 03 2010 06 2010 09 2010 12 The PSD Center and PSD Macula graphs are as shown above In the graphs the PSD value 0 p 5 and p 1 are shown by dashed lines 3 VFI Forecast 2010 03 38 10 2013 09 2033 09 2053 09 lath fai 2008 06 2008 11 2009 04 2009 09 2010 02 2010 07 2010 12 In the VFI graph the chronological change and VFI forecast are shown as in the diagram above In addition the linear regression and VFI forecast are also shown in the same way as MD 4 CINAMA CR o 2008 05 2008 12 2009 05 2009 06 200909 200912 2010 03 2010 06 2010 09 2010 12 In the AGIS and CIGTS graphs are as shown above The vertical axis ind
102. indexes fixation loss false positive reaction and false negative reaction is equal to or more than the reference value 20 or 33 Each time you press Reliability it is toggled between ON and OFF You can operate Artifact and Reliability individually and also set both to ON at the same time Artifact OFF Reliability OFF Artifact ON Reliability ON While an MD or VFI graph is being displayed you can select Exception When you press Exception and specify an examination point which you wish to exclude the excluded point is reflected in the MD and VFI linear regressions Chart Exception OFF Exception ON 8 Link with KOWA VK Series This instrument can perform the following functions by linking up with KOWA filing system VK Series For changing the settings to link up with KOWA VK Series contact Kowa or your Kowa dealer 8 1 Automatic saving of perimetry results into Kowa VK Series As well as being automatically saved to the database of this instrument upon completion of an examination the examination result is also automatically saved to KOWA VK Series In this case the examination result images are saved to the VK system while the MD and PSD values are saved to the applicable numeric processing software only when the performed examination is Threshold Center 1 Threshold Center 2 or lsopter Threshold This allows you to compare the perimetry result with other e
103. ined counterclockwise Random Examination is performed in a random order for each meridian Manual The stimulus presenting order can be set arbitrarily You cannot select Manual for lsopter Screening 1 lsopter Screening 2 or lsopter Threshold Stimulus speed The default is 5 3 Select one from 3 sec 5 sec and 5 3 When you select 5 3 the stimulus moves at a speed of 3 sec within 30 from the center and of 5 sec in the rage of 30 or more from the center Stimulus Size Intensity l 4e I 2e All types of stimulus size intensity registered for Start 1 and Start 2 only with Blind spot set are shown in the Stimulus area If you select Blind spot for Start 2 I 4e and I 2e are registered for Start 1 and no value is registered for Start 2 by default Eein eeanigndardl inos TY E a a 2s annainn t S amn Start 1 initial settings Start 2 initial settings 4 Preparation for examinations Stimulus registration method Select the type of the start point to register Start 1 or Start 2 Start 2 can be selected only if Blind spot is set in Start 2 ii Select the intermediate filter a b c d or e intensity 1 2 3 or 4 and size I Il IV or V of the stimulus to be registered Press Register and the stimulus is registered at the selected start point Example To register I 3e for Start 2 I ii iii
104. ing the thresholds allows you for example to compare the quadrants of the upper and lower nasal sides to find a difference which may imply an early symptom of glaucoma and the like When Artifact of setting is ON the value with Artifact considered is shown in P 60 The point with threshold lt 0 is calculated as 2 Reference book e Ophthalmology practice 15 perimeters bunko do e A Visual Field Index for Calculation of Glaucoma Rate of Progression Am J Ophthalmol 145 343 353 2008 e Advanced Glaucoma Intervention Study 2 Visual field test scoring and reliability Ophthalmology 101 1445 1455 1994 e Gillespie BW et al The Collaborative Initial Glaucoma Treatment Study Baseline Visual Field and Test Retest Variability Invest Ophthalmol Vis Sci 44 2613 2620 2003 e Asman P et al Glaucoma Hemifield Test Automated Visual Field Evaluation Arch Ophthalmol 110 812 819 1992 6 Fundus perimetry examination result display An enlargement function is provided for displaying fundus perimetry examination results It allows a section of the examination result image to be enlarged Use the following procedure 1 Press Enlarge 2 While keeping it in contact with the screen move the input pen to specify the range of enlargement 7 input lh Secuieni When you release the input pen the selected area is enlarged Press Enlarge again to return to the previous display 7
105. input Examinator 6 Display Print and Analysis of Examination Results 6 8 lsopter examination result display The result display of the Isopter Standard examination is provided with the Paint out Scotoma function and the Enlarge function 6 8 1 Paint out Scotoma This function allows you to paint out the closed curve of the examination results using the color of the stimulus The procedure is as follows 3 Press Scotoma to activate this function 4 Touch the inside of the closed curve to be painted out If you touch the common area priority is given to the area lower than the touched position To erase the paint activate the function and touch the painted area The information of the painted area is saved T di st et ea Result car TEENE y l EXIS NON Result co AE IsopterStandard lsopterStandard 80 Paint out Scotoma 6 8 2 Enlarge You can press Enlarge to enlarge the central area up to the displayed visual angle of 30 When you press Enlarge during enlarged display the screen returns to the previous display mode II _ f input E Se iliciiley O Result lsopterStandard 30 c KOWA 1943 02 20 69 None 2012 12 05 20 30 10 22 Center False Pos 0 0 5 False Neg 0 0 2 Gee AP 7OOO 2012 12 13 Enlarge of the Isopter examination 6 Display Print and Analysis of Examination Results 6 9 Re Test You can perform the same examina
106. ion input dialog appears You can enter a drug name using up to 32 characters The input method is the same as that of the name When you press Register the entered drug name is registered in the drug administration list Then when you press on the right of the text box the list is shown in the pull down menu allowing you to select the drug administration Regarding drug administration three items can be selected for each eye 4 5 Loading patient information from the advance entry list If any information registered through the patient information input dialog is available you can load patient information from the advance entry list For how to register information through the patient information input dialog see P 30 Press Registration List on the input screen and the advance entry list appears The advance entry list is a list of information registered through the patient information input dialog The list consists of the following items a D Name Date of birth Fundus images You can load patient information from this list When you press a line of the patient information that you wish to load the line is selected and its background color turns Orange When you press OK in this state the selected patient information is loaded and shown on the input screen When you press Cancel the advance entry list is closed to go back to the input screen RegistrationList IDO Name Datecof Birth Fundus __
107. ion programs include Standard Precision Center Periphery Glaucoma Hemianopia Center 1 and Center 2 Since each program is provided with the quick mode except for Center 1 and Center 2 programs 14 programs are available for screening examinations Screening examination Program Examination Area and Points mammann Summary Time min Within 60 83 points General screening at the first exam Glaucoma and Within 40 64 points Hemianopsia Within 70 140 points Middle to end stage glaucoma Within 60 93 points Hemianopsia Within 30 82 points Glaucoma Within 30 69 points Retinal disease 30 to 70 58 points To grasp the progression of the 30 to 60 24 points middle stage glaucoma etc Bjerrum area contain nasal step l Within 50 117 points Early detection of glaucoma Early to middle stage glaucoma Within 30 72 points Within 60 53 points Hemianopia Quick Within 50 31 points Center 1 Within 30 76 points 3 t05 Normal Glaucoma Regional disease Brain disorder Center 2 Within 30 54 points 2 to 3 Normal Glaucoma Regional disease Brain disorder Examination Time applies to the examination conducted with four zones When the examination is conducted in two or three zones the examination time is shortened However it may be long if Quantify scotoma is executed OT II III III III II II II III III II III III I ScreeningStandard ate OF Geir Rest Points Gm AP 7OOO 2012 12 1
108. is asleep or lazy the percentage increases and this cannot be checked by the other reliability tests When the false negative reaction examination is in progress the characters of False negative reaction are shown in orange in the lower right of the examination screen The progress status and result of the false negative reaction examination are shown in units of percentage and in the format of Number of nonresponses Number of examinations in the lower right of the screen As the value of Number of nonresponses Number of examinations is increased the reliability of the examination result is reduced If the value reaches 33 or more the false negative reaction value is shown in orange and XX appears on the left In addition XX also appears on the left of the percentage indication when printed 6 Display Print and Analysis of Examination Results 6 Display Print and Analysis of Examination Results 6 1 Operation available with the result screen Upon completion of the examination the display automatically switches to the examination result display screen If you use Open to load a past examination result or if you press the menu button Result when entering the patient information containing the saved examination result the display is switched to the examination result display screen and the most recent examination result is shown on the screen The result screen can provide various methods of display anal
109. is replaced High temperature lamp is replaced T5A L250Vx2 INPUT AC100 230V 50 60Hz Pull the plug of power cable from Warning wall socket when High voltage fuses are replaced USB USB Ethernet p AP 7000 Introduction CIN LA POWER STANDBY DS MN _ id VY s k Kowd mover KOWA AP 7000 AC100V 200VA POWER Ac230v 200VA A cass 1 4 14 Nihonbashi honcho 3 chome Chuo ku Tokyo 103 8433 Japan MADE IN JAPAN Symbol mark Symbol for Type B applied part Symbol for Power ON Symbol for Power OFF Symbol for instrument status Power ON or Standby Symbol for Response button jack Symbol for Reference the instruction manual Symbol for Pushing prohibited Symbol for Warning or Caution Symbol for Warning High voltage Symbol for Caution High temperature Operating precautions 1
110. is the 4 points at the lower center Next the threshold examination starts Next the Isopter examination starts The fixation target is the selected one Put back the lens frame Please switch eyes e The room is deemed to be too bright to perform an examination Adjust the luminance of the room to be the same as that when the instrument is started Start has been pressed when the patient s chin does not yet come into contact with the chin rest Confirm that the patient s chin is surely placed on the chin rest Press OK to manually specify the eye to be examined Press Cancel to close the message box There is a failure in the gaze monitor setting Pupil position acquisition failure can be caused by eyelashes eyelid ptosis opacity of the middle translucency body and small pupil To retry the acquisition confirm the eye fixation and then press OK To not to retry press Cancel If you press Cancel the gaze monitor function will be deactivated for this examination Start has been pressed on the examination screen at the time of the examination startup with the fovea examination set to ON The fixation target is automatically moved to 4 points at the lower center Press OK to start the fovea examination Fovea examination has been completed with the fovea examination set to ON The fixation target is automatically returned to the original location Press OK to start the threshold isopter examination
111. isplay Print and Analysis of Examination Results Comparing Screening examination and Supra examination results The description of the marks displayed at each point on the comparison display is as follows O The sensitivity is better than the previous examination results e The sensitivity has not changed compared to the previous examination results The Sus a is lower than the previous examination results luput L Hxarmnaton E e es Result N Chan Ghart yaar EAI Re S Edit Examination Data Date 2012 12 07 19 11 ml Date 2012 12 07 19 19 imi Ea Q akn a j ScreeningCenter41 ScreeningCenter41 30 30 R om Review ID 0001 Name KOWA Date of Birth 1943 02 20 Comparison oO Oje et coce e s s e OTO O88 Dee coo CO 0 e Otje 0 t OJOO O e e e gt 0 H Gm AP 7000 2012 12 13 17 25 9 Comparing Threshold examination results On the comparison display the difference of the sensitivity dB will be displayed in a value If the sensitivity point has decreased the value showing difference of the sensitivity dB will be shown in white 7 mpat Examination me Oz Result EN eia ye TET rs eer a e e WS TestDate 2010 06 1517 18 i EJ TestDate 2010 09 1517 20 E Chart T hresholdCenter SuperQuick T hreshold Chart T hresholdCenterl SuperQuick T hreshold R Ge 1720 20 T Revie Comparison 0 0 0 0 0 0 E 0 E 0 oM co ole co co O O O
112. ive reaction blind spot resetting or fixation target type during the examination press stop to interrupt the examination and press Parameter to make the desired changes If fixation loss is OFF Fixation loss is not ON during the examination Note that you cannot change the examined eye during the examination J EE Es Zimm 30 d AP 7000 2012 12 07 During threshold examination When using a corrective lens and the examination point is within central 30 and more than 30 from the center the area within central 30 is examined first After finishing the area within 30 the examination stops and a dialog stating Put back the lens frame appears When you press OK the current examination is temporarily stopped After confirmation of fixation it resumes when you press Start Even if the stimulus is moved in both ranges within 30 from the center and more than 30 during the isopter examination with for example Start 1 set to Periphery 80 no message will appear concerning the corrective lens A meridian is shown at every 10 in the background of the perimetry coordinates and the meridian at 30 from the center is shown in pink circle Use this line as a guide and set a corrective lens when necessary Center 30 f G AP 7000 2012 12 13 During Isopter examination start1 Periphery80 5 2 4 Completion of an Examination Upon completion of the examination the screen switches to the exa
113. le for malfunction of the instrument caused by installation or execution of such extra software 10 Be sure to follow the procedure when terminating the instrument See 4 1 Switching on and off the instrument Do not turn off the power switch when the touch panel is showing a black screen without any data shown or with It is now safe to turn off your computer appearing otherwise it may cause a failure or data loss In this case Kowa will not be liable for any failure or data loss 11 In part of the image display area of the KOWA AP 7000 software ifjpeg spi in the NiftyServeF GALAV library is used as a jpeg plug in with permission from Mr Yoshihito Takemura 2 Precautions for electric system 1 The power supply must be provided for the sole use of this instrument Sharing the same power supply with other external devices may cause the instrument to malfunction 2 When the instrument will not be used for a long period of time turn off the power switch and disconnect the power plug from the outlet Otherwise a fire may start 3 Use great care to select an installation location of the instrument so that the power plug will not be disconnected during operation of the instrument In the event the plug is disconnected during operation be sure to turn off the power switch and then insert the plug to the outlet 4 Kowa is not liable for malfunctions and or damages resulting from maintenance and or repairs performed by the third
114. lect stimulus Adjust intensity Determine and record threshold 5 Examination 9 4 2 Ilsopter examination Manual 1 Examination Manual The manual examination of the isopter examination is executed as described below Prior to specifying the examination point select the intensity size and speed of the stimulus f input 9 Examination ez Result j Ajma IsopterStandard Delete button Specify the measurement start point Intensity Size selection Stimulus speed selection Stimulus moving method selection lsopter examination Manual If you select Enlarge before selecting the start position the screen display range is enlarged by 30 toward the center The button cannot be selected while the stimulus is moving lsopterStandard Specify the measurement start point Up to 5 isopters can be examined including the automatic examination If you try to perform the examination with the 6th stimulus the following message appears disabling the examination lsopterStandard Specify the measurement start point lsopter Maximum number of isopters reachedLimit 5 4 2012 12 13 16 39 i 11 04 4 1 Max Number of isopters 1 Moving method Start Direction Press Start Direction to set the stimulus moving method Touch the examination start position It should be within the examination available range in the range where the meridian is shown on the perimetry axis Upon dete
115. liances on the same power circuit is liable to cause errors and incorrect flash output resulting in incorrect diagnosis or hazards External circuits and connectors that may come in direct contact with the patient must be checked frequently for signs of wear 4 The following items shall be considered when using the instrument 1 Be sure to minimize the time and quantity required for diagnosis and treatment 2 Always assure that the instrument and patient are in good condition 3 When an abnormality is found on the instrument take proper measures for instance stopping the operation of the instrument to assure the patient s safety 4 Do not allow the patient to touch any of the instrument controls 5 The following items shall be considered after using the instrument 1 Turn OFF the instrument after setting control switches dials and so forth to their initial statuses by the specified procedure 2 Do not pull on cables for removal because an excessive force is exerted on them 3 Clean and rearrange accessories cables etc 4 The instrument must be cleaned prior to use 6 In case of a problem or malfunction stop the operation and contact Kowa or your Kowa dealer for repair 7 Instrument shall not be modified 8 Maintenance 1 Periodically check the instrument and its components for any abnormality 2 When using the instrument after it has not been used for a while please check beforehand to assure tha
116. lt 1 1 74 95 2008 058 2008 10 20502 20503 200 10 201002 2010 08 201010 Gee AP 7000 2012 12 11 Chronological change graph and data display area Shows a chronological change graph and data Examined eye information Shows examined eye information for chronological change Artifact button Press to show a graph of examination result analysis indexes with artifacts considered Reliability button Shows a graph excluding the examination results in which any of examination reliability Fixation Loss False positive Reaction and False negative Reaction exceeds the reference value 20 33 or 33 Exception button Selectable when an MD or VFI graph is displayed Allows you to specify and exclude examination results from calculation of the MD and VFI linear regressions 2 Installation 2 1 Installation This instrument must be installed by personnel familiar with handling of the instrument according to the installation instructions See the Service Manual AOO N Mount this instrument on a motor operated optical table available separately lt Installation location gt e Place on a horizontal surface in a robust location e Avoid hot air and moisture e Avoid exposure to direct sunlight e Place in a darkroom or a room where luminance can be reduced as low as a darkroom X When installing the instrument against the wall provide a distance of approximately 15 cm between each side of the instrument an
117. lts Initial Program ThresholdCenter1 Threshold Initial Program ThresholdPeriphery K pack1 lt 0 lt O lt 0 lt 0 151 lt 0 5 9 6 lt 0 7 5 O 199 9 13 11 23 20 14 26 18 34 20 13 23 25 18 17 20 16 21 19 17 ais Total 838 Defect rank nat ge HE 73 idia Bebie Curve Total 1940 E Pos Kowa pack 1 Gray XThreshold Periphery Initial Program ThresholdCenter1 Scale Po ae ee ae ol I I Scale Color d lt 0 5 10 15 20 25 30 35 40 50 Initial Program ThresholdCenter1 3D Initial Program ThresholdCenter1 3D d lt 0 5 10 15 20 25 30 35 40 50 Ee 3D Color 6 Display Print and Analysis of Examination Results Initial Program ThresholdCenter1 K pack1 42 359 an a 461 225 ef 25 z5 20 26 25 26 30 20 18 23 30 21 29 26 25 od 24 lt 0 30 ed 30 30 27 30 25 oi 31 27 25 25 30 25 453370 27 27 13 aan 399 otal MaR PatternDewiation MD 3 53 P lt O 5 3 41 P lt 0 5 PSD 3 76 Pe2e 3 67 Pees GHT Outside Normal Lirnts VFI 89g Anderson s Criteria PSD E PD Anderson Moderate AGIS 1 CIGTS 5 Stage IIL TotalDeviation Co co noon cn cn 1 L L fe fe a a CI co oo D h om fe fe M an do co O h m Zi mm hob dot dole 4 CT fe fe coo 4 Gi mn amp co do Soe smo do fda do do om oo nok oof oe oe oy Pa l m 2 A coms dw je co dco om oo ee w Mjo nAn h EN i P moti 2 E 10 15 20 25 30 35
118. mination result display The examination result is automatically saved Tell the patient that the examination is finished remove the head bands and let the patient relax The examination result screen allows you to display and print the examination results and change the examination result display See 6 Display Print and Analysis of Examination Results Upon completion of the isopter examination the isopter is automatically plotted When it is difficult to automatically plot the isopter during auto manual examination the screen goes to the one that allows you to manually plot the isopter Select the points to plot one by one in order To perform an examination on another patient press Input to return to the base menu 5 Examination 5 3 Programs requiring examination point selection The following examination programs require examination points to be selected before the examination starts 5 3 1 Threshold Meridian examination The examination point selection screen for the Threshold Meridian examination is as follows Select the meridian to examine and press Start During the examination the examination result screen graphically shows a distribution of the threshold values on the selected meridian ime ee mie ee ThresholdMeridian Center tandard Standard I Whtte White ThresholdMeridian All Meridian 45 225 ID 0001 Name KOWA Date of Birth 1943 02 20 Age 69 Correction None Date 2
119. minations the instrument allows you to carry out dynamic examinations time reduced examinations in time reduction mode and manually operated examinations It is also available with Kowa s original examination program that allows you to conduct perimetry in combination with a fundus image and check the correspondence between the perimetry result and the fundus image An examination result is automatically saved upon completion of the exanimation The threshold program is provided with many functions for displaying and evaluating examination results The isopter program is provided with a visual field defect grade determination support function Examination results of both eyes can be displayed and printed facilitating comprehension of the perimetry of both eyes It is possible to conduct multiple examinations The results of these examinations can be displayed and printed These records make chronological changes easy to observe Examination results can be printed printer available separately In addition a USB or Ethernet connector can be used to transfer the examination results to external media and personal computers 1 System description 1 4 Name and function of each component Main body Head rest lt Applied part gt Place the patient s forehead against the head support and ensure stability to prevent the face from moving To examine the right eye place the forehead against the left dent To examine the le
120. n X Performing perimetry at the points corresponding to the fundus image will cause the point correspondence to be clearer Therefore for the fundus image perimetry it is recommended to use either program of Custom Optional thresholdO and Custom Optional screeningO which allow you to arbitrarily choose examination points and provide a shorter stimulus presentation interval X The fundus image is automatically displayed upside down to fit to the perimetry X The selectable fundus image file formats are BMP bmp and JPEG jpg of VGA 640 x 480 or higher resolution When you press Test after selecting the fundus image file you will proceed with the coordinate setting and examination point selection on the examination screen in this order P 87 When you press Safety Remove Hardware a list of devices connected to the USB connector is shown Select the devices and press Stop to safely remove the devices P 69 4 Preparation for examinations 4 10 Configuration settings When you press Setting the Configuration dialog appears You can make various settings in this dialog Setting is not available during examination Setting Adapt position to fundus Vision chart nl onto Configuration dialog When you press OK in the Configuration dialog upon completion of settings the new settings are reflected When you press Cancel the dialog is closed without any settings changed 1 Version of the software Sh
121. n an examination starts if Quick2 or Super quick is selected for the second or subsequent threshold center examination 18 Keir Jorr a fo i a po po cuit Ns You can make settings for a card reader 19 PANWEWWAIR Meisel You can specify whether or not to display the analysis result for each item when the threshold examination result is displayed For details about the format see 6 6 Analysis of Threshold Examination Result 20 PES Year Month D ay 24H oe You can set the date and specify the display format of the date and time 21 Combination with database You can combine a database stored on another Kowa automatic perimeter Select the file folder of the database to be combined 4 Preparation for examinations 22 OANCEA You can specify whether to enable or disable the intensity check on the examination screen and the yellow background intensity check during startup If you set Background Yellow to OFF you cannot set the background for examinations to Yellow 23 by You can make settings for ID input When Prohibit No ID is ON no patient information is registered and no examination can be performed if no ID is entered When Prohibit No ID is OFF patient information can be registered as No ID if no ID is entered If fixed number of digits 0 padding is set to
122. n off the power switch when the power lamp is not lit in orange STANDBY Otherwise it may cause a failure or data loss 4 Preparation for examinations 4 1 Switching on and off the instrument How to start the instrument 1 Confirm that the surrounding area of the instrument is dark enough to perform an exanimation 2 If any peripheral device such as a printer is connected to the instrument set its power to ON 3 Set the power switch to ON side and confirm that the power lamp is lit in orange 4 When the sub power switch is pressed the orange power lamp goes off and then the green power lamp is lit 5 The touch panel shows the messages as shown on the right The chin rest will move for initialization and the following confirmation message appears Select OK The instrument will start the initialization 1 7000 Kowa AP 7000 Initializing KOWA AP 7000 Wait for a while with a cup of coffee Chin rest will move for the initialization Be careful NOT to get your finger etc caught in moving parts POWER s noay Caution Sub power switch Chin rest will move for the initialization Be careful NOT to get your finger etc caught in moving parts 6 Approximately one minute later the input screen appears on the touch panel and the startup operation is complete X During the initialization of this instrument motor initialization and light adjustment are starte
123. nance and inspection 5 Pull out the projection lamp and attach a new lamp If you touch the bulb of the projection lamp with your bare hand when pulling out the lamp the oil of your hand will adhere to the bulb and may cause it to burn and blacken the surface which will reduce the light quality Be sure to wear gloves or the like when replacing the lamp 6 Return and firmly screw the projection lamp unit to the original position 7 Reconnect the connector Reattach the projection lamp cover and rotate the stud clockwise to firmly fix the cover Upon completion of replacement turn on the power and perform an examination to confirm that the stimulus is correctly projected If the luminance is uneven in a stimulus it may become even when the projection lamp is pulled out by 1 to 2 mm from the position where the lamp is fully inserted turn OFF the power switch before unplugging from Warning the power outlet Otherwise there is a risk of High Voltage electrical shock When replacing a new projection lamp be sure to after use When replacing the flash tube or projection light bulb be sure to turn OFF the power Warning switch and unplug it from the power outlet and wait High Voltage for 30 minutes or more Do not replace the projection light bulb immediately Do not touch the projection lamp bulb or the flash lamp bulb with your bare hand Otherwise the lamp may have reduced light intensity or Prohibitory Operating
124. nation result of the patient corresponding to the transferred information the Result screen appears to show the latest examination result If KOWA AP 7000 has no examination result of the patient the Input screen appears However the above linked operations are not available when an examination is in progress on KOWAAP 7000 X Examination result file in 1 above 1 Image file The content and file name are the same as those in 13 Export Destination described above However the file type is fixed to JPG format You can change the settings for the file from the External output dialog 2 Text file The file name is the same as 1 above and is given txt as the extension The content is as follows 37 tt 33 te 37 t Distant correction value Near correction method Near correction Examination program name em es ription erate ID Character string consisting of no more than 32alphanumeric characters Character string consisting of no more than 32alphanumeric characters Date of birth Ch Era Fg b 19430220 aracter string of 8 numbers February 20 1943 Examination eye 01 0 L1 R Correction method Numeric of 0 to 5 0 Lens 1 Glasses 2 Contact lens 3 IOL 4 Non ID Name Date of birth Examined eye value Naked vision Corrected vision 33 tt 33 tt Correction value Sph Cyl Axis sign or Sph sign Numeric value Numeric value 0 to 20 Cyl sign N
125. nction of enabling a distance correction value input to automatically calculate a near correction value when a corrective lens is used Near correction value calculation requires the date of birth to be input in advance L distant gt gt near E E ee eee Ee a SS wat aid pena nd Dadada at md td afoot aad aa 1 For the near correction input you can press on the right of the Method text box to open the drop down list and select the method from the list If correction values are entered with Method set to None in 2 ASren VEINES and subsequent steps Method is automatically set to Lens 2 Inputting correction values You can input both distant and near correction information for each eye The selected item is shown in Orange You can input a value using the numeric keys in the dialog Press Clear in the lower right to delete the selected value and All Clear in the lower left to delete all values Upon completion of correction value input press OK To cancel the value input operation press Cancel 1 Sph Spherical diopter power Cyl Cylindrical diopter power Select a value in the tens place a value in the ones place a value after the decimal point and a sign in this order The range of available values is as follows Sph 25 to 25 Cyl 10 to 10 2 Axis Axis degree Input a value using the numeric keys in the dialog in the range of 10 to 180 wei ta tn
126. ner selects the quadrant Regional disease brain disorder eel See eee Esterman Within 80 120 points General Both Group examination roe e 6 oge Mp 4 6 sgGTAM IM o AP 7000 2012 12 11 Example of supra examination result screen 1 Examination method The Supra examination adopts the 2 zone method dividing the sensitivity of each point into 2 steps 3 zone method for D Test only Unlike the Screening examination the normal sensitivity curve is not used and all the points are examined at the same intensity The intensity is set during the parameter setting When you select Macula the fixation target is automatically set to the 4 points at the lower center In the Optional site examination the examination point is selected before an examination 2 EEGEN Common parameter You can set the following parameters Presentation time Presentation interval Stimulus Size Blind spot size Fixation Loss False positive reaction False negative reaction Stimulus color Background color Fixation Target Gaze monitor Pupil diameter measurement AP 340 However if you select Macula the fixation target is automatically set to the 4 points at the lower center disabling gaze monitoring and pupil diameter measurement Supra parameter Intensity Optional 31dB When you press Change the numeric value in put dialog appears to allow you to input the intensity value 4 Preparation for examinations 3 Ab
127. ng examination reliability and remaining examination points Result display screen Examination program Examination result change buttons f Te ey re OD cco ee ae SS a ae Initial Program ThresholdCenter1 All Result count button Examination E result display dajes 4 aja MD 1 94 P lt 5 area 5 ete PSD 3 72 P lt 2 j tandard Standard GHT Outside Norma Limts IL Whitte White VFI 92 Sasza FF Anderson s Criteria Anderson Early AGIS 0 CIGTS Stage Gee AP 7OOO 2012 12 11 14 31 Examination program Shows the name of the examination program to be displayed Examination result display area Shows the examination result and analysis result Examination result change buttons Sequentially change the display of the examination result Result count button Sequential No of displayed result Total results is shown Press to show a list of examinations conducted with the same ID 1 System description Chronological change screen Artifact button Reliability button S Recueil oe Dem en ee eS ee a ee Name Chart 4 Date of Birth 1973 05 04 4 Chronological E 2008 08 2008 10 20502 205053 20510 200 02 St 2010 10 Patient s eye change graph or eae Sa MD 1 29 dB Year p lt 1 0 59 95 3 and data a SALE Ess ae _ ee VFI 3 42 Year p lt 1 1 47 95 Examined eye display area Patient s eye Right information i 75 MD 1 78 dB Year p lt 1 0 69 95 VFI 4 20 Year p
128. ng to select re test points for re test with Auto Manual examination program 6 10 Editing of patient information When you press Edit Date the patient information editing dialog appears as shown in the diagram below This dialog allows you to edit the patient information for the examination result currently displayed on the screen The updated name date of birth and sex are applied to all examination results with the same ID Other updated items in the patient information are applied to the currently displayed examination result The procedure is the same as that described in 4 4 Patient information input P 30 r input 2 Exarmnator 4 Result S PEO s gt i Edit eee Sern ere ee Clee ee sopterStandar me ROAA ae a ey Edit Data 0001 KOWA 1943 02 20 69 None 2012 12 13 16 58 Date of Birth 1943 02 20 69 01 20 Center Correction False Pos False Neg Fur AP 7000 2012 12 13 Patient information editing dialog If the ID to which you will change is already registered for another patient the following message appears Edit Data To specified ID another patient information is registered Edit Threshold 1943 02 20 A present setting Screening 1989 01 08 The result is moved after changing the name of specified ID date of birth and sex The result is moved without changing the name of specified ID date of birth and sex Repeated ID message Select whe
129. nment and ask an authorized industrial waste management contractor for disposal 5 Prescription Device Caution A N Caution Federal law restricts this device to sale by or on the order of a Physician or Practitioner For US market Introduction Precautions use of medical electrical system 1 Precautions for use of medical electrical system 1 All components of this medical electrical system may be installed within a limited patient environment a radius of 1 5m around a patient when all components are installed in accordance with the installation instructions using Multi tap with Isolation Transformer which is one of the system components 2 As a prerequisite for installing this system other components a personal computer printer video capture printer video monitor or other devices which do not comply with IEC 60601 1 must be powered from Multi tap with Isolation Transformer The electric power to these components supplied from an electric source other than Multi tap with Isolation Transformer e g power outlets may cause increased enclosure leakage current or potential difference between protective grounds resulting in the injury to the patient or operator Use Multi tap with Isolation Transformer only for supplying the power to components other than system components 3 Any medical electrical equipment connected to this system to compose a medical system must comply with IEC 60601
130. nt examination when a fixation loss takes place during the examination Select OFF to perform no fixation loss examination with blind spot stimulation You can re set the blind spot during an examination only P 79 False positive reaction ON To perform the false positive reaction examination ON Not to perform OFF False negative reaction ON To perform the false positive reaction examination ON Not to perform OFF Stimulus color White You can select one from four colors of white blue green and red Background color White You can select one from two colors of white and yellow When the background color is set to yellow the background intensity becomes 100 cd m Fixation Center Only one point at the center of the dome is set as the fixation target Aux 4 points at a position of 8 75 degrees from the center of the dome are set as the fixation target When a patient has a visual field defect in the macular area and cannot see the target at the center select Aux and tell the patient to see the center of the 4 points You can set the intensity of the fixation target by moving the slider on the right upward or downward G1 Gaze monitor x ON Activate or deactivate the gaze monitor function P 95 2 Pupil diameter ON Activate or deactivate the pupil diameter measurement function X The pupil diameter measurement result is a reference value 43 AP 340 When you press this button the size prese
131. nt s chin is not firmly placed on the chin rest when Start is pressed the examined eye confirmation message appears as shown on the Can not recognize the patient s eye Please make sure that the chin is placed correctly on the chin rest right Confirm that the patient s chin is surely on the chin rest and the examined eye is displayed above the patient data on the right side of the examination pa pinion screen and then press Cancel Patient s eye Do you want to manually select the patient s eye To manually set the examined eye press OK select the examined eye and then Eye press OK med i OK If the examination is executed only in the range where the examination points are at a position of 30 or more any examination with a corrective lens is not required In this case if the lens holder is set the message Put back the lens frame appears When you put the lens holder back and press OK the examination is started r4 A est ep Lamination Examination a e N 7 IsopterStandard i 7 0001 KOWA PenpheryExamination 1943 02 20 69 Put back the lens frame 4e speed False Pos False Neg Fae AP 7000 2012 12 13 At the start of Eonar examination with Start 1 Penher 80 5 Examination 9 2 3 During Examination After the examination has started occasionally check the eye fixation monitor to see whether the patient is gazing at the center of the dome If the examined eye becomes ou
132. ntation time and color of the stimulus are set to those which most closely approximate the settings in automatic perimeters KOWA AP 340 and AP 125 Screening Supra Parameter The values provided with the asterisk mark are set by default for screening Intensity Set the method of determining the level of the normal sensitivity curve which is used as the standard for intensity of the stimulus By Age The values of the normal sensitivity curve for each age are automatically set based on the input date of birth Pre Test The thresholds of the 4 points that are at a position of about 12 7 degrees from the center of the dome are checked at the beginning of an examination The normal sensitivity curve is determined by the response result Optional You can set a value in the range of O through 50 dB When you press Optional Change below it becomes effective When you press Change the numeric value input dialog appears Then you can input a value The normal sensitivity curve is determined with the set value as a reference 2 Zone x 4 Select from 2 3 and 4 3 Reference value P value Select p value or 5 dB P value can be selected only for Center 1 or Center 2 examination 4 Quantify Scotoma OFF Select ON OFF If you select ON be sure to make Quick ON OFF P 40 setting as well 4 Preparation for examinations 4 8 Each Examination Program 4 8 1 Screening The screening examinat
133. o5 Kowalc iro 1988 11 08 1989 11 05 Advance entry list 4 Preparation for examinations 4 6 Clearing the patient information Pressing Clear Data with patient information input allows you to clear the patient information When you press Clear Data the clear confirmation message appears When you press OK the patient information on the input screen is cleared When you press Cancel the confirmation message dialog closes to return to the input screen Baii pO Resi jenar tay put i a Clear t ns Clear Data Do you want to clear the patient information displayed Parameter Screening Isopter i Intensity by Age Zone 4 Reference value P Value olor White White Quantify Scotoma OFF arget Center End AP 7000 2012 12 11 4 7 Setting of Examination Program and Examination Parameter Use the input screen to set an examination program and examination parameters You can select any of the examination programs shown in the table below You can change the parameter values for each examination program When you press Program the program selection diagram appears Input screen Examination program Group Program Method Summary Screening Program Standard Precision Center Periphery Glaucoma V Meridian Center 1 Center 2 Method 2zone 3zone 4zone Quantify Scotoma Intensity step 5dB provability variable p value Quick mode is available except Center
134. oceeds to the coordinate setting on the fundus image and the examination point selection in this order The coordinate setting and examination point selection are performed in the following procedure input E Examination Dg ES Se s Custom 1 Practice l Finish x Parameter nt j PIFI IIIIIIIIIIIIIIIIIIIIIIIIIIITIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIS IIIIIIII7III7IIIIIIITIITITITA 4 y CustomOptionalScreening 1 Touch the fovea 2 Touch the blind spot G Fine tune the fovea and blink spot positions respectively 4 Press OK Press Cancel to return ld input Examination f mae am CustomOptionalScreening 23 8 Select rectangle or lariat tool 6 Select the examination points in the same way as in the optional examination 7 Press Save to save the Center J examination points in the es advance entry list size Color IAI White White intialintensty Zone Intional 31dB 4 oS p 1 OdB Reference value Quantify Scotoma P Value OFF lt False Neg Al Points Rest Points fee AP 7OOO 2012 12 13 X If the fovea and blind spot positions are set in Threshold Macula 2 the examination points are automatically determined X If the perimetry coordinates are determined on the fundus image the display range of the fundus image becomes the maximum examination range X When Change fundus perimetry presentation position
135. og appears In the patient ID list dialog Patient ID list is selected as the default The patient ID list shows a list of ID information of the patients that have been examined so far The list consists of the following information items ID Name First Last a N You can load patient information from this patient ID list When you press a line of the patient information that you wish to load the line is selected and its background color turns Orange When you press OK the selected patient information is loaded to show the result of the most recent examination that this patient had When you press Cancel the patient ID list dialog is closed to go back to the input screen When you press List All Examinations a list of all examinations that have been conducted so far is shown The list consists of the following information items ID L Name Examination Date Examination program Examination eye Right or Left m No Examination serial number Patient ID List 2012 10 18 2012 12 10 2011 06 02 2012 10 21 2010 09 15 2012 10 30 2011 08 24 2011 08 24 Patient ID list dialog When you load information from this list the result of the selected examination is shown The patient ID list allows you to search for data through extraction with the ID name and date When you input multiple IDs names and dates See P 31 and P 33 for the input method and press Start search the applicable in
136. on visual acuity and the like press Input to return to the input screen and press Edit Data to update the patient information 6 9 2 Re test of each point When you press an examination point displayed in the re test selection dialog box the point is selected and enclosed by an orange circle To deselect the selected point press the point again The point is deselected and the red circuit disappears When you press Remove selection all the selected points are deselected at one time When you select a re test point and press OK the display goes to the screen for performing examination only at the selected points with the same examination conditions as those for the examination result shown on the previous screen Run same tesi s 22 18 22 26 30 23 22422 17 22 27 25 20 27 25 21 25 20 26 25 26 30 28 36 27 30 20 18 23 30 21 29 30 30 20 29 26 25 17 30 22 29 30 38 29 lt 0 30 29 26 29 27 30 30 29 30 27 30 28 25 26 27 23 27 31 27 25 23 25 25 29 30 25 Retest all 70 rT 1s If the examination selected for re test is actually incomplete the selected points and previously unexamined points are subject to re test When you press OK without selecting any examination point only the previously unexamined points are subject to re test X Re test of each point is not available for the Threshold Meridian examination Custom Circle threshold examination and Custom 1 point threshold examination If th
137. on results are combined in the following method Threshold For the examination points common to both eyes the examination results of the more sensitive eye are adopted Left Right Combined result 10 20 35 15 35 20 mhas 40 30 35 25 40 30 For the examination points available only for either one eye the examination results with those points available are adopted Left Right Combined result vie elv 9I Viv ska e v e v SY elv In the isopter examination the examination points of the same stimulus which are not the actual examination results are connected by a black line for convenience sake Left Right Combined result TESS 6 5 Multi You can press Multi to divide the screen into a maximum of 4 display areas and show a different examination result of the same ID in each display area The examination results are chronologically displayed in the upper left upper right lower left and lower right in this order You can press Multi again to return to the normal display mode In this case the examination result displayed immediately before the multi display was performed is shown on the screen To display a specific examination result touch once the display area of the concerned examination result to select it and press Multi or consecutively touch it twice If the specific examination result is selected the examination result number above the examination result is shown in orange usually in green
138. ording to the parameters specified by the control program A stimulus generated by the projection lamp used as a luminous source is projected in the dome evenly illuminated by the background lamp controlled by the dimming circuit The size of the stimulus is determined by the dimensions of the hole in the turret The color and luminance of the stimulus are determined with the color filter and ND filter in the turret Focusing is carried out by moving the focus lens The stimulus presentation time is determined by the period of time when the shutter is providing the light path The stimulus projection position is controlled by horizontally or vertically rotating the projector mirror and projector lens The stimulus projection order is determined by the control program A patient makes a response by pushing the response button upon confirmation of the projected stimulus during eye fixation targeted to the LED at the center of the dome The control program checks for any response and record the check result After completion of the specified examinations the results are shown on the touch panel and stored in the instrument The results can be sent to a printer available separately 1 3 Features This instrument is operated through the touch panel The instrument is provided with various examination programs including the central view program all view program screening program threshold program and isopter program In addition to many static exa
139. out Esterman Both When the Esterman Both examination program is used examinations are performed with the chin rest moved fully to the right and the face placed on the left portion of the chin rest Any corrective lens is not used If a patient wears glasses daily perform examinations with the glasses on In Esterman Both the examination parameters are set as shown in the table below Parameter Setting Stimulus ize whi wn You cannot change the examination parameters other than the presentation time presentation interval false positive reaction false negative reaction and fixation Esterman Both displays Esterman score No of responses Total of points in the lower right of the result screen eee SupraEstermanBoth 80 The Esterman score is calculated by the following equation Esterman score No of responses Total of points x 100 4 8 3 Threshold There are 6 kinds of examination programs Center 1 Center 2 Meridian Macula 1 Macula 2 and Periphery Threshold Examination Program Program Within 30 Within 30 Examination Time min Examination Area and Points 76 points 54 points Meridian Within 50 14 points Within 5 Within 10 30 to 60 Periphery i TotalDeviation 21 points 68 points 68 points Pattem Deviation MD PSD GHT VFI Anderson s Criteria 1 94 P lt 5 3 72 P lt 2 Outside Norma Limits 92 Ander
140. ows the version of the software 2 Destination to save data Shows the destination to save data 3 Backup data Shows the destination to save backup data Data backup is automatically executed upon power shut down When you press Setting you can change the destination to save backup data Select a drive other than C drive and data drives If C drive or a data drive is specified as the backup destination no data backup is performed 4 Display of both eyes When displaying the examination results of both eyes side by side P 101 you can select the sides to display the results of the right eye and left eye The default is Left Right 5 No of displayed names You can select the number of names to be displayed The default is 1 6 I olaaakclsaemercltclerebis Select the normal eye database to be used for analyzing and displaying the measurement results on other perimeter such as KOWA AP 6000 The default is AP 7000 AP 7000 Regardless of the model on which measurement was made analysis is executed with the normal eye database of KOWA AP 7000 Each model Analysis is executed with the normal eye database implemented in the model on which measurement was made 7 Artifact When the Threshold Center 1 or Isopter Threshold examination is performed with this parameter set to ON the MD PSD and Classification is calculated in consideration of artifacts such as eyelids and a corrective lens
141. ponding to the ID is displayed 8 3 Selecting perimetry examination fundus images Fundus images saved in VK equipment can be used for fundus perimetry on KOWA AP 7000 Use the following procedure 1 Input the applicable ID which exists in KOWA VK Series 2 When you press Fundus the fundus images saved with the input patient ID in VK equipment are displayed 3 Select the fundus image to use for the fundus perimetry press OK and the fundus image is set 9 Maintenance and inspection The automatic perimeter is a precision instrument and neglect of daily maintenance and inspection may affect the imaging results Please read this section carefully in order to use this instrument correctly and safely 9 1 Daily maintenance Close the application of the main body when finished See 4 1 Switching on and off the instrument and place the dust cover over the instrument If it will not be used for a long period unplug the instrument from the power outlet for safety When the instrument has not been used for a long period of time confirm if any errors exist for each setting of this instrument 9 2 Daily inspection Inspection items for the user Inspect this instrument in accordance with KOWA AP 7000 daily inspection table below If any abnormality is found during daily inspection and cannot be solved by the maintenance described in this document contact Kowa or your Kowa dealer for specific detail KOWA AP 7000
142. pper right all input information is cleared When you press Input Data2 in the lower left of the patient information input dialog input dialog 2 appears It allows you to input the following information sex doctor visual acuity diagnosis pupil diameter eye pressure comment and drug administration For details on the input method see the subsequent sections When you press OK after inputting necessary items the patient information is entered When you press Cancel the dialog is closed returning to the previous patient information input dialog without any information entered When you press Clear in the upper right all input information is cleared p ro Eeutouul mas mt abit Cear Dat neuen ini Name Date of Birth Correction Registration stDelete rR mE a a es Ooo O Fc eC tc etc O OOOO O OOo O OOo O O OOOO OOO Oooo OoOo O pF ec Si ts O Sti tet O O a OOo CY OOOO O O OOOO O O p ID Name Date of Birth J Correction Program Parameter i ime tandan Input Data2 Visual Acuity Diagnosis Pupildiameter mm IOP Medication s Patient information input dialog 2 4 Preparation for examinations When you press Resistration list Delete the entry list deletion dialog appears It allows you to select and delete items from the lists of doctors diagnosis comments and drug administrations uoo When you select an item
143. r Threshold Center 1 Center 2 Macula 1 Macula 2 lsopter Threshold examinations Thresholds are displayed 3 dimensionally to show the distribution more clearly The relation between the sensitivity and color is the same as Scale You can change the inclination by the up down buttons in the right 6 6 4 Total deviation The difference between the measured threshold of each point and the normal sensitivity curve of the patient s age is displayed Total deviation dB Measured threshold dB Normal sensitivity curve dB For example the patient is 68 years old displayed on the upper screen and the sensitivity at 1 is 4dB lower than that of the normal people of age 68 In the same manner the sensitivity at is 2dB lower The p value is provability variable showing the degree of abnormality of total deviation at each point There are 4 kinds of p values 5 2 1 and 0 5 For example o lt 0 5 is shown in This means that less than 0 5 of the normal 68 years old people have 4dB as the total deviation at the point which is rather abnormal No p value is displayed in which means that the total deviation at this point is within the normal range The 2 points around the blind spot is excluded because the deviation may vary widely depending on the individual position and size of the optic disc 6 6 5 Pattern deviation The difference between the measured sensitivity curve and the normal sensitivity cu
144. ra tn ta at te pad sedead mad alin pid ate a atd alta tal tal ta atl aaa pass 4 Preparation for examinations 3 Calculating near correction value from distant correction value This function should be used to calculate a near correction value by inputting a distant correction value in 2 TERAPAN above when a lens is used If the date of birth is entered Distant gt gt near is active When you press Distant gt gt near the calculated near correction value is input A near correction value is calculated from a distant correction value in the following method No need to correct the distorted vision when the Cyl value is 0 25D or less Sphere equivalent value is used for distorted vision when Cyl is 1 25D or less Spherical equivalent value Spherical diopter power Cylindrical diopter power 2 The spherical diopter power is calculated based on the table shown below Near spherical diopter power calculation table 10 12 ao aeo ooe en X X Distance Distance 50to54 P stance 550 200 1 50 1 00 0 50 x x ai j 2 50 3 25 55to59 Stance 1300 250 2 00 1 50 1 00 050 x Pistance 3 00 3 25 More than Distance Dene o 4395 325 2 75 2 25 1 75 1 25 0 75 fee No lens required Example of calculation 1 48 years old Distance S 2 00 C 2 00 A 120 gt Spherical 4 00D Distorted vision 2 00D Adjust Axi
145. ray Color Scale 3D display Hill of Vision Total value Total value of Threshold examination quadrant Glaucoma staging 8 steps GHT Anderson s Criteria Anderson AGIS CIGTS VFI Total deviation Pattern deviation MD Mean Deviation PSD Pattern Standard Deviation Bebie Curve Total deviation Pattern deviation MD and PSD are shown with actually measured values and p values Chronological All analysis data changes Scale Threshold Total deviation p value Pattern deviation p value Bebie Curve Graphically displays MD PSD VFI AGIS CIGTS Quadrant TD Classification Anderson Boxplot Supporting visual The examination results in the remaining visual field visual efficiency rate of vision loss and field defect grade each direction are displayed determination Comparing Comparisons can be made between results of the Threshold Screening or Supra examination executed twice Combination Center and Periphery examinations can be combined in Threshold and Screening examinations lsopter examination can be combined with Threshold Center or Screening Center examination Display Both a Results of the examination of both eyes of the same patient executed on aa same day are displayed side by side ma Results of the examination executed four times both eyes either eye o m same patient are displayed side by side Patient Information ID Name Date of birth Sex Correction Visual Acuity Diagnosis Doctor Commen
146. re shown in units of percentage and in the format of Number of blind spot responses Number of blind spot stimulations As the value of Number of blind spot responses Number of blind spot stimulations that is the fixation loss rate is increased the reliability of the examination result is decreased If the value reaches 20 or more the fixation loss rate is shown in orange and XX appears on the left XX also appears on the left of the percentage indication when printed If a fixation loss occurs frequently the instrument automatically checks the position of the blind spot again Check the following in case of frequent fixation losses during the examination Check the patient s fixation through the eye fixation monitor If the patient is not fixated pause the examination and instruct the patient to be properly fixated Check the position of the patient s eye through the eye fixation monitor If the eye is not aligned align the eye with the fixation target again by stopping the examination and adjusting the chin rest Check that the eye not being examined is properly covered If it is not properly covered the patient can see the stimulus of the blind spot The instrument may detect fixation loss frequently even though the things above are checked In this case tell the patient not to worry about blinking of the fixation target in case of a fixation loss Deactivate the buzzer for the fixation loss or interrupt the examination and deactivate
147. rmination of the examination start position a maximum of 9 direction buttons appear with the start position at the center Press the button of the direction to move the stimulus When you press the central button the stimulus moves toward the center of the dome If you have selected Center Goal for the goal position setting in the lsopter dialog the moving stimulus stops at the center If you have selected Maximum the stimulus passes through the center to move to the maximum range available for the current examination until the examination finishes P 52 lsopterStandard Specify the measurement start point Moving direction button displayed Moving toward the center after start position selected resulting in a response 5 Examination 2 Moving method Start Goal Press Start Goal to set the stimulus moving method Touch the examination start position Then select one point goal in the moving direction If you have selected Center Goal for the goal position setting in the Isopter dialog the stimulus stops at the goal If you have selected Maximum the stimulus passes through the goal to move to the maximum range available for the examination until the examination in the current direction finishes P 52 To cancel the start point press X lsopterStandard 80 Goal selection screen after start selection 3 Deletion of examination results You can delete the results of an examination executed manuall
148. rve is displayed The local visual field defect can be shown clearly The normal visual field pattern of the patient s sensitivity is estimated and the difference between the measured threshold at each point and the estimated visual field pattern is shown Pattern deviation dB Measured threshold dB Estimated normal visual field pattern dB The p value is the provability variable showing the degree of abnormality of pattern deviation at each point The same kind of p value as the total deviation is used The pattern deviation at the 2 points around the blind spot is excluded because the deviation may vary widely depending on the individual position and size of the optic disc Normal sensitivity curve Estimated normal visual field pattern Measured threshold Sensitivity dB Total deviation Pattern deviation Total Deviation and Pattern Deviation 6 6 6 Bebie curve All the values of total deviation excluding the 2 points around the blind spot are arranged in descending order and shown as acurve The black dotted line shows the Bebie curve when all the values of total deviation are 0 the entire measured threshold is the same as the normal sensitivity curve while the red curve shows all the points of p value 5 of total deviation in descending order The values of all the examined points are displayed so the difference between each point is easy to understand The examination points of the Bebie curve and th
149. s started next time the locally saved data If you proceed there will be no link to the can be coupled to the conventional data e Select Cancel to end KOWA AP 7000 VK any database e Cannot open the database If the examination continues the results will be saved in the local folder separately from previous data 11 Specification Stimulus Presentation Method Projection Stimulus Color White Blue Green Red Stimulus Size Goldmann I I D WV V Maximum Stimulus Intensity 3 183 cd m 10 000 Asb White Stimulus Presentation Time 0 2 sec Stimulus Presentation Interval 0 6 3 3 sec automatically adjusted Background intensity Automatic light adjustment White 10 cd m 31 5 Asb Yellow 100 cd m 314 2 Asb Examination distance 300 mm Measurement range 80 External Interface USB Ethernet Fixation Target Orange LED Center 1 point Auxiliary 4 point Fovea examination 4 point Eye Fixation Monitoring Heijl Krakau method Eye fixation monitor Gaze monitor Printout USB connected printer separately available Operation Screen Touch panel color LCD monitor Data save Built in flash memory Operation Support Oral instruction Chin Rest Operation Motor driven Power Source AC100 230 V 50 60 Hz Power Supply AC100V 200 VA AC230V 200 VA Weight 26 kg Dimensions
150. s to 120 of the lens holder 2 60 years old Distance S 1 50 C 1 00 A 70 gt Spherical 5 25D Spherical equivalent value 2 00D Addition power by age 3 25D 3 32 years old Distance S 3 00 C 0 25 A 40 gt No correction required 4 18 years old Distance S 4 00 gt Spherical 0 75D 5 65 years old Emmetropic S 0 00 gt Spherical 3 25D 6 40 years old Distance S 1 00 gt Spherical 0 50D 4 4 5 Doctor When you press the Doctor input box in patient information input dialog 2 the doctor input dialog appears You can input a doctor s name using up to 32 characters The input method is the same as that of the name When you press Register the input doctor is entered to the doctor list Then when you press the doctor list is displayed in the drop down menu allowing you to select the registered doctor Input Data2 Register _ AP 7000 a ES 4 4 6 Visual Acuity When you press the Visual Acuity text box in patient information input dialog 2 the visual acuity input dialog appears You can input a value in the range of 0 00 to 2 00 For the visual acuity both naked vision and corrected vision can be entered for each eye 4 4 7 Diagnosis When you press the Diagnosis text box in patient information input dialog 2 the diagnosis input dialog appears You can enter a diagnosis using up to 64 characters The input method is the same as that of the n
151. shold of the fovea is examined at the beginning of the Threshold examination The fixation target is automatically set to the 4 points at the lower center After the Fovea examination the fixation target returns to the center and the Threshold examination starts 3 Parameter setting You can set the following parameters Presentation time presentation interval stimulus size blind spot size fixation loss false positive reaction false negative reaction stimulus color background color fixation gaze monitor pupil diameter measurement and AP 340 However if you select Macula 1 the fixation target is automatically set to the 4 points at the lower center disabling gaze monitoring and pupil diameter measurement lL opter There are 4 types of programs the program to examine the isopter only and the programs combined with Screening Center Screening Center 1 and Threshold Center 1 respectively to examine the peripheral field and center field at the same time Isopter Examination Program Examination Time min Program Examination Area and Points To grasp the shape of a visual Standard Within 80 12 18 directions field as an isopter equal sensitivity curve Screening 1 Within 30 82 points To grasp the peripheral visual Quick Within 30 69 points field shape and the result of the Screening within the central Screening 2 Within 30 76 points 7 to 10 30 simultaneously Threshold 10 to 18
152. soeo 74 5 1 Operations available with the examination screen eeesssssseeeeessseecessssseceeessseeeeesssseeeeesssseeeeessseeeeeessseeeee 74 5 2 Operational procedure in examination cccsscccccccsssssssccccssssseecccecssssceeecescesseesccecessseeececesesseeseeeeeeseeees 76 5 3 Programs requiring examination point selection ssseeessssssoessssssoeeesssssoceessssseeesssssoeessssssoeeesssssoeeessssoeese 81 vA Manuala mNaU oN sana E A A ee eens 88 5 5 Fovea threshold examination Fovea examination ccsssscccssssscccsssseccessseccsssseeccsssseecesssseeeesssseeeeeees 95 5 6 The eye fixation of a patient 0oeoosoeosssoeesssoeessseesssseesssseesssseesssseesssseessssoessseeessseeessseeessseeessseeessseeessseeessseees 95 Si Gaze MOMO sia A OE ace eee 95 DG Ex MiNaNon RENAD oen EA OT AT O OA O ees 96 6 Display Print and Analysis of Examination 10 ooer erna E E EE a a a a 7 6 1 Operation available with the result screen cccccssssescceesssscecccessssseeccessesseesecesesssceececesesseesceesseseeees 97 6 2 Examination result switchover and list display ccssssseccccessssseecccesssssscecccessssseecceessssseeeeesssssneees 99 6o PID eee E cree EE EAA ee ee eee eee ee eer 100 64 6 p oe a ee E eee ee er eer eee en eee 101 Mi IU era 104 6 6 Analysis of Threshold Examination Result cccssscccsssrcccssssecccssssesecsssescesese
153. son Early 0 0 General Glaucoma Regional disease Brain disorder General Glaucoma Regional disease Brain disorder Detailed examination by combining with other programs Abnormal visual field in the macular area Optic nerve disease Abnormal visual field in the macular area Optic nerve disease End stage glaucoma Whole visual field Used together with the Center threshold Center wandard Standard I 11 White White OFF False Pos False Neg All Points Ee r r S e HB BD eo s 1 E S S ee Example of threshold examination result display Rest Points G AP 7000 2012 12 11 14 31 4 Preparation for examinations 1 Examination method An examination is performed by making measurements up to the threshold of each examination point with the varied intensity of the stimulus For the Meridian threshold examination a meridian to be examined is first selected When you select Macula the fixation target is automatically set to the 4 points at the lower center The programs other than the Meridian have the quick mode The Center 1 and 2 have 3 kinds of quick mode Quick 1 Quick 2 and Super quick while the Macula and Periphery have one quick mode Quick In the quick mode of the Screening examination fewer points are examined by the same examination method as the normal mode while in the Threshold examination the threshold determining method is changed to reduce the examination time instead of changing t
154. ssage still appears after the restart contact Kowa or your Kowa dealer Cannot back up Check for the current data save destination and data content The Archive drive data is larger than the If there is no problem with the data save destination and data Data drive data Please make sure that the content change the backup media or backup destination Data and Archive data are being saved to the correct destination The remained memory of the drive is less This message appears when the remaining free space of the data than 5 save drive is less than 5 at the time of KOWA AP 7000 startup or search result save Input screen Message Cause and Remedies e The ID is not entered Search has been pressed with ID and Date of birth left blank or e The date of birth is not entered incomplete on the input screen Properly input the ID and Date of e Part of the date of birth is not entered birth on the input screen e The ID and the date of birth are not entered Input again If Prohibit No ID is set to OFF in the Configuration dialog you can press Cancel to proceed with the examination However in this case the quality of the examination will be reduced and some analysis functions will be unavailable e Delete the selected data Delete has been pressed to delete the examination results from e Delete all data of the selected ID the patient ID list or all lists selected in the dialog opened by Open List Press OK to delete or
155. strument should be used no closer to any part of KOWA AP 7000 including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance d 1 2 V P d 1 2 1 P 80 MHz to 800 MHz 2 3 V P 800 MHz to 2 5 GHz Where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer and d is the IEC 61000 4 3 80 MHz to 2 5 GHz recommended separation distance in metres EN 61000 4 3 m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of instrument marked with the following symbol Co NOTE1 At 80MHz and 800MHz the higher frequency range applies NOTE2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which KOWA AP 7000 is used exceeds the
156. symbol O or in their names allow you to select the position of the examination points Each symbol shows the point arrangement of the stimulus to be selected The program provided with symbol O allows you to select one from the stimuli with the examination points arranged concentrically while the one with symbol allows you to select one from the stimuli with the examination points arranged in a rectangular pattern Custom examination program Examination Program Examination Area and Points Time min Circle threshold Within 30 20 points Detailed examination by combining with other programs 1 point Within 30 76 points Manual examination threshold Quadrant Within 30 19 points Examination through a dialog threshold with a patient is available Optional Within 80 select from 331 points An examiner selects the quadrant Regional disease thresholdO brain disorder Optional Within 30 select from 76 points threshold Optional Within 80 select from 331 points screeningO Optional Within 30 select from 76 points Screening 1 Examination method The programs other than those of the 1 point threshold examination perform an examination for which the position of the stimulus can be arbitrarily set in the applicable method The examination method is the same as for the threshold examination and screening examination The 1 point threshold examination is performed manually through dialog with the patient The
157. t Normal eye database Ver 1 0 0 0 issued on 2011 06 09 Age range 20s to 70s Samples 612 persons Criteria Questioning visual acuity reflection eye pressure visual field and fundus Database Patient ID list display All list display Search function ID extraction function Data save Built in flash memory Capacity For approx 20 000 patients 40 000 examinations Patent United States Patent No 7325925 7475987 7475988 and 7658496 12 Technical information 12 1 Examination points of each examination program The following shows the arrangement and quantity of examination points for each examination program when the right eye is subject to examination and the maximum coordinate value is 80 12 1 1 Screening Standard 83 points Standard Quick 64 points Intensity 140 points Intensity Quick 93 points Center 82 points Center Quick 69 points Periphery 58 points Periphery Quick 24 points Glaucoma 117 points Glaucoma Quick 72 points V Meridian 53 points V Meridian Quick 31 points X The examination points of Center 1 and Center 2 programs are arranged in the same way as Threshold Center 1 and Threshold Center 2 respectively 12 Technical information 12 1 2 Supra Macula 21 points Mariotte 21 points Select from optional 331 points D Test 139 points Esterman Both 120 points X Standard is same as Screening Standard 12 1 3 T
158. t button 1973 05 04 4 37 None 2010 09 15 17 20 4 00 19 Center Standard Standard II II White White OFF teat ee B14 G Kes 4 0 0 3 4 0 0 2 6 3 Print If a printer available separately is connected to this instrument you can print an examination result For details on the printer connection see 2 2 connecting an external device When you press Print in the upper left of the screen the specified examination result is printed The printout is as shown in the diagram below The upper portion shows the examination program name patient information reliability indexes examination conditions and the like while the lower portion shows the examination result When you carry out the examination result analysis described in 6 6 Analysis of Threshold Examination Result and press Print the examination result is printed in each analysis result format KOWA AP 7660Ver 1 1 6 2 Norm Ver 2 6 6 6 Initial Program T hresholdCenter1 All R 2011 06 01 22 19 All Points 76 P Time lnterval Standard Standard 07 50 Rest Points 0 Size Color III White White 001 Fix Loss 18 3 16 Target Center Threshold False Pos 14 1 7 Fovea OFF 1943 02 20 False Neg 0 0 5 68 1 94 P lt S Outside Norma Limits Anderson 92 il 17 m 26 Defect rank Bebie Curve 493 25 Total 1940 PatternDeviation ey esl Example of printout all items 6 Display Print and Analysis of Examination Res
159. t it is in normal condition and operates safely 9 Be careful of the possibility that incorrect operation may be caused by strong electromagnetic waves This instrument is examined based on IEC 60601 1 2 2001 The purpose of this standard is to maintain safety against dangerous obstacles in typical medical facilities When this instrument is influenced by another instrument or when it affects another instrument or when there is such fear please move this instrument and the other apparatus to create a distance between the instruments Moreover if there is an unknown point please consult our company or an agency beforehand Components and supplies Introduction Main body 1 Power supply cable 1 Response button 1 Dust cover 1 Input pen 1 Projection lamp Replacement 1 Fuses 2 S Instruction manual 1 Input pen strap 1 Head band2 Contents Introduction cc ccceccsccccscsccsccccsccsceccsceccsceccsceccscecssceccscescsceccscecee Sy POR AUNT S ANE E E N PEE EE PEE ecu PNS EEE E P E 1 Meanings OS VO ONS aces wesc cee es exiccnre tritt rernan oreren tiere reN E as estecet sc eaee EANET ERNANIN E saiuaeset sanstaeauauneses wasters waseunctedeceeceeaeearaes 4 Operating RO CANIN stecicctene cece steciecteres nace ce vteaieaceapnstsacosaciee clap sais evseecictulegeniverseaccesiepeciciseyucxedaveucaausesecssdseseceaguesecesdseneceearests 6 Precautions use of
160. t move Parameter Common Screening Isopter buttons Examination program Date and time G AP 7000 2012 12 07 Menu buttons Setting Open the corresponding screens input screen Allows you to make necessary settings examination screen result screen and Appears in the same way on any screen chronological change screen Not available when the examination screen is These buttons are placed in the same layout on open any screen The button corresponding to the currently opened Patient information screen is shown as if depressed The buttons a which cannot be chosen are shown with black The entered patient information appears letters on a faint color background When a text box is pressed the corresponding input dialog appears Sub menu buttons Examination program Perform the corresponding operation p The buttons which cannot be chosen are shown in The specified examination program and its faint color parameters are shown The buttons vary with the screen When a text box is pressed the corresponding program selection dialog appears Eye fixation monitor l l Date and time Used to monitor the examined eye Touch to enlarge an image Touch again to restore The current date and time are shown the image Shown in the same way on all screens To set the date and time press Setting Chin rest move buttons Move the chin rest up down left and right Used to align the position of the examined eye Caution messa
161. t of place move the chin rest and align the pupil s center of the examined eye with the center of the white cross hairs on the eye fixation monitor In addition since the examination takes a long time depending on the examination program pay due attention to the patient s condition during the examination The stimulus presentation point on the screen is shown by an orange dot every time the stimulus is presented During blind spot stimulus fixation loss check false positive reaction examination or false negative reaction examination those applicable characters are changed to orange in the lower right of the screen For the points where the examination is completed the result is displayed according to the examination During the examination the remaining number of points is shown in the lower right of the examination screen Since the examination takes time depending on the examination program tell the patient about it to grasp the progress status of the examination for example when you have finished half of the examination To stop the examination press Stop If the patient wants to pause to resume the examination press Start To cancel the examination press Finish The patient should keep pushing the response button When the patient releases the button the examination is resumed To change the stimulus presentation interval ON OFF status of reliability indexes fixation loss false positive reaction and false negat
162. tate and then select Search again in the message dialog box e f you are not sure about the cause select Cancel check the network environment and data save destination and then restart the instrument e Ifno abnormality is found in the network environment and data save destination or the same message still appears after removal of the abnormality contact Kowa or your Kowa dealer No serial communication available e Acommunication error has occurred inside the instrument Contact Kowa or your Kowa dealer Cannot open the file e Data drive has a fault Contact Kowa or your Kowa dealer Database repair will begin e Database check and rebuilding are automatically executed Please wait for a while Initializing KOWA AP 7000 Wait for a e Initialization is being performed Please wait for a while while with a cup of coffee e Ifthe base menu screen does not appear after 5 min or more turn off the power and then restart the instrument Cannot initialize the motor Motor cannot be initialized Turn off the power and then restart the instrument If the same message still appears contact Kowa or your Kowa dealer Cannot set the background intensity A head band may be obstructing the sensor in the dome Take the head band out of the dome and restart the instrument If nothing is obstructing the sensor the intensity of the background lamp is reduced If the lamp is lit it is not necessary to replace it immediately However it is
163. ter to move to the maximum range available for examination and the examination in the current direction finishes 4 Start 2 The default is OFF When you select Blind spot the examination is automatically started from the blind spot after the examination specified by Start 1 is completed The parameters set for Start 1 are also applied to Start 2 in the same way However only Stimulus Size Intensity can be set individually for Start 1 and Start 2 You cannot select Blind spot for Isopter Screening 1 lsopter Screening 2 or Isopter Threshold Interval Standard 12 lines Meridians on both sides at a distance of 5 from horizontal and vertical meridians 45 225 meridians and 135 315 meridians 45 8 lines 20 18 lines 30 12 lines D Shift The default is OFF When there are two or more isopters and you set Shift to ON the examination start direction is shifted by the angle half the interval for each isopter and the same examination start direction is set for every other isopter When Shift is OFF the same examination start direction is set for all isopters When Shift is ON you can select whether to shift the examination start direction for even numbered isopters or odd numbered isopters Order Standard Beginning at the superior nasal side the left eye is examined clockwise and the right eye is exam
164. th 1943 02 20 Age 69 Correction None Date 2012 12 10 12 05 Duration 05 08 l y F i f i i p f i i F p i T i i f y y y y i p f f i T f i p f f i p f f i i f i i Target Center P Time Interval Standard Standard i Size Color IAI White White Fix Loss False Pos False Neg All Points Rest Points LL ALAMAAAAALAAAAALAAATAAAAAALAAAAATAL AAS AA SAA Ah kA Custom Optional threshold Perimetry examination fundus images When you select any of the following examinations you can perform the perimetry examination fundus images Threshold Macula 2 Custom Optional thresholdO Custom Optional threshold a Custom Optional screeningO Custom Optional screening You can make settings for fundus images as shown below When you select an examination program with the perimetry examination fundus images available and press Fundus on the input screen the file selection dialog appears as shown below Fundus i O KOWA CE Safely Remove Hardware ok fo canei Example of fundus image file selection dialog When you select a fundus image file to be used a fundus image appears To cancel the selection press Fundus again The fundus image on the right side of Fundus shown in the lower center disappears to cancel the current file selection To re select the fundus image file cancel the file selection once and then select the file agai
165. the power plug may absorb moisture which may result in isolation failure and cause a fire 9 Prohibitory Do not load the power outlet or cable with excess of its rated capacity If the main power supply cable should share a power outlet with other devices and the rated capacity is exceeded there may cause a fire or electrical shock The air vent shown must not be obstructed Obstructing the air vent may increase the internal temperature resulting in malfunction of the instrument or a fire Do not insert any metal object into an air vent or opening of the instrument It may cause electrical shock a fire or malfunctioning of the instrument Do not place the instrument close to wall Because it is too difficult to remove the power supply cable from AC inlet Do not push the instrument It may fall down to cause a failure or an injury Do not place a container or cup containing liquid near the instrument Spilled liquid entering into the instrument may cause electrical shock If liquid should be spilled into the instrument turn OFF the main power immediately unplug the instrument from the power outlet and then contact Warning Kowa or your Kowa dealer for inspection High Voltage Do not plug or unplug the power supply cable with wet hand Otherwise there may occur electrical shock ay Disassembly prohibited Do not disassemble modify or repair the instrument yourself It may cause a fire electr
166. ther or not to change the original patient information with the destination ID press OK and the examination result is moved to the destination ID When you press Cancel the display returns to the examination result screen without changing the ID 6 Display Print and Analysis of Examination Results f Chronological change 7 1 Operations available with the chronological change screen The chronological change screen enables the examination result analysis indexes to be graphically displayed as chronological data This facilitates you to grasp the chronological changes of examined eyes In addition the results of the examination result analysis can be displayed in chronological order When the following conditions are met the chronological changes can be displayed Date of birth is input Examination is completed to the end Examination program is Threshold Center 1 Threshold Center 2 Threshold Macula 2 or Isopter Threshold For the chronological change display of the Isopter Threshold examination program only the threshold examination part is applicable When you press Chart in the menu button area the display switches to the chronological change screen Or the examination results other than those listed above Chart cannot be pressed Date of Birth 1973 05 04 Patient s eye MD 1 29 dB Year p lt 1 0 59 95 Patient s eye Right MD 1 78 dB Year p lt 1 0 69 95 2008 0
167. tion as one which is currently showing on the screen When you press Re Test during display of the examination result the re test selection dialog box appears Run same test s 22 18 22 26 30 23 22422 17 22 we 30 23 22422 27 25 20 2723 21 25 20 Bp 26 25 26 30 28 36 27 30 20 18 17 30 22 29 30 36 23 30 21 29 30 30 20 29 26 25 25 26 27 23 27 17 30 22 29 30 38 29 lt 0 30 29 23 25 25 29 26 29 27 30 30429 30 27 30 28 29 26 27 23 27 31 27 25 23 25 25 29 30 25 22 21 23 19 False Neg All Points Rest Points Ga AP 7OOO 2012 12 13 Re test selection dialog box There are 2 types of re test One is re test of all points which allows you to execute the examination again from the beginning under the same examination conditions The other is re test of each point which allows you to execute again a part of an examination concerning a result of the examination When you press Cancel the re test selection dialog box is closed 6 9 1 Re test of all points When you press Reset all points in the re test selection dialog box an examination is conducted at all points with the same conditions as those used for the examination result currently shown on the screen After transition to the examination screen the examination is conducted in the usual procedure The re test of all points uses the same patient information as that used for the displayed execution result If there is any change to correcti
168. tion grouped into various Clinical settings The brief overview of IEC 60601 1 1 is shown below Medically used room Examples of Practical means Situation No 1a Items A and B are ME EQUIPMENT 1b Items A and B are ME EQUIPMENT powered via a MULTIPLE SOCKET OUTLET 1c Item Ais ME EQUIPMENT and B is non ME EQUIPMENT 1d Item Ais ME EQUIPMENT and B is non ME EQUIPMENT powered via a MULTIPLE SOCKET OUTLET Item A is ME EQUIPMENT powered from specified power supply in item B Item Ais ME EQUIPMENT powered from non ME EQUIPMENT power supply in B PATIENT ENVIRONMENT Non medically used room Outside the PATIENT ENVIRONMENT Inside the Mains Plug A B Plug IEC 60601 IEC 60601 A B IEC 60601 IEC 60601 MULTIPLE SOCKET OUTLET Mains Mains Plug A B Plug A IEC 60601 B IEC xxxxx MULTIPLE SOCKET OUTLET A IEC 60601 Mains R B Plug IEC 60601 EC xxxxx DC AC possible causes for exceeding LEAKAGE CURRENT limits Multiplied APPLIED PARTS of the same type can cause the total PATIENT LEAKAGE CURRENT to exceed limits See Note 1 Earth conductor of the MULTIPLE SOCKET OUTLET is broken See also 1a Due to high TOUCH CURRENT of B The earth conductor of the MULTIPLE SOCKET OUTLET is broken or Due to high TOUCH CURRENT of B Due to high TOUCH CURRENT of B of compliance Apply 16 5 in all situations Verify total PATIENT LEAKAGE CUR
169. trument caused by a combination of connected devices Unplug A N Warning If any abnormal smell sound overheating or smoke should be detected be sure to turn OFF the main power immediately and then unplug the instrument from the power outlet Continued use of the instrument may cause the instrument to malfunction or cause a fire Contact Kowa or your Kowa dealer for inspection When replacing the projection lamp and the fuse make sure the main power is turned OFF and then unplugged from the power outlet Wait for more than 10 minutes or more than 10 minutes if immediately after use before replacing Otherwise there may occur electrical shock or burn Warning High Voltage When replacing the fuse make sure the main power is turned OFF and then unplugged from the power outlet If the fuse holder cover is removed without the instrument unplugged there may occur electrical shock or burn Obligatory Use a designated fuse only Using an undesignated fuse may cause the instrument to malfunction or cause a fire Be sure to plug into the power outlet completely and securely Otherwise there may cause a fire or electrical shock Make sure the instrument is properly grounded to prevent bodily injuries Connect the plug into the three wire grounding type outlet with ground Warning wire Otherwise there may occur electrical shock High Voltage Regularly remove dust on the power plug Dust accumulated on
170. ults 6 4 Both eyes If both eyes of the same ID are examined on the same day or examined before with the same program you can display the results of the eyes side by side by pressing Combination Combination becomes active when an examination result of an eye satisfying the previously mentioned conditions is available in addition to the examination result of an eye being displayed When you press Combination again the screen returns to the display of a single eye In this case the screen shows the result of the most recent examination To display the specific examination result of either eye click the display area of the examination result and press Combination or double click the display area of the examination result If you select a specific result the text stating the left or right eye in the upper area of the result window will turn to red normally it is white For setting the display arrangement of both eyes left right or right left see 4 10 Configuration settings If an examination is interrupted the examination results of both eyes cannot be displayed at the same time When you press Analysis during simultaneous display of examination results of both eyes the result display of both eyes is switched to other at the same time See 6 6 Analysis of Threshold Examination Result 7 input E Exaimirtdtion Result Pros Chart aan Date 2011 06 01 22 33 8 Date 2011 06 012219 i foal Initial
171. umeric value Numeric value O to 10 Axis Numeric value Numeric value 0 to 180 Visual Acuity Examination Threshold Character string program name center quick1 No data is input to the items which are not filled in Example No item is filled in except 1 in ID examination Threshold Center 4 mm TE eT Threshold _ Center T is input to Corrected value even if not filled in X Patient information file in 2 above The file name is ap5 tmp The file content is ID Name Date of birth The content of each item is the same as that in the text file of the examination result file in 1 16 METAS rae pr pra pra pre amii p pr pra You can make settings for voices and buzzers You can specify whether or not to activate the voices and buzzers individually You can check the sound of the voice or buzzer by pressing Test You can also control the volume level of the voices and buzzers and check the currently set volume level by pressing Test 4 Preparation for examinations 17 BA TeMXelAN cle lowe Malcesialeyle You can set the initial display format of threshold examination results For details about f the format see 6 6 Analysis of Threshold Examination Result Color allows you to set the grayscale display to Gray or Color With Quick1 after the second times set to ON a message prompting to select an algorithm appears whe
172. upward downward leftward or rightward the intended direction chin rest move button respectively after starting the instrument Examined eye Verify that L or R is shown when you place your hand on Indication of the examined the right side or left side of the chin rest respectively after eye is changed in the upper starting the instrument left of the examination screen Eye fixation monitor Verify that your hand is displayed on the eye fixation Your hand is displayed on monitor when you place your hand below the head rest after the eye fixation monitor starting the instrument Date and time Start the instrument and verify that the correct date and Date and time are correct time are shown in the lower right of the touch panel 9 Maintenance and inspection 9 3 Regular inspection Maintenance inspection items for the vendor In order to use this instrument safely over its useful life we recommend you to have it inspected annually For the content and cost of the inspection contact Kowa or your Kowa dealer lt Inspection items gt e Exterior e Applied parts e Stimulus presentation function e Eye fixation monitoring function e Background intensity e Operations and functions of the components e Electrical safety test e Battery e Software version 9 4 Disinfect Wipe the forehead rest head bands chin rest and response button with rubbing alcohol as soon as a patient completes the
173. uring examination 5 Examination The examination screen allows you to perform the following operations Turns ON when a selection program of examination point is executed Allow a patient to practice before an examination is started P 76 5 2 1 Practice Start an examination Resume the currently interrupted examination Temporarily interrupt the current examination Complete the current examination Change examination parameter values P 43 4 7 2 Examination parameter setting Available before examination start and during examination interruption but not available during examination snd Make settings for voices before and during examination P 66 4 10 Configuration settings The sub power switch and Setting button are not available when the examination screen is open 5 2 Operational procedure in examination The operation flow of the examination from start to completion is as shown after 5 2 1 Practice In the following examination programs it is necessary to select examination points before starting the examination Threshold Meridian Supra Optional Custom Circle threshold Quadrant threshold Optional thresholdO Optional threshold Optional Screening O Optional Screening For details on these programs see 5 3 Programs requiring examination point selection For details on the manual examinations Custom 1 point threshold and Isopter examination Test Manual Order
174. uring the parameter setting the threshold examination is performed for the points that have been classified as the relative scotoma as a result of screening the points where the patient could not see the stimulus with the Standard intensity in two zones or the points where the patient could not see the stimulus with the Standard Intensity but could see it with Stimulation 2 intensity in three zones As a result of the threshold examination the loss from the normal value is quantified in units of dB For details on the threshold examination see 4 8 3 Threshold 50 Screening Glaucoma Quantify scotoma ON 4 Preparation for examinations X Normal Sensitivity Curve The normal sensitivity curve is a visual field map of a person with a normal visual field The sensitivity differs in individuals and by ages in people however the sensitivity distribution the shape of a visual field is almost the same If a visual field is abnormal if the sensitivity drops partially the relative scotoma appears in the normal sensitivity curve in the Screening examination Sensitivity dB BD m 10 A Z c E aa ey 7 D I00 80 60 40 20 0 20 40 60 Visual angle degrees Visual angle degrees Sensitivity distribution of a normal visual field Left eye Sectional view of the macular area and the Mariotte blind spot Left eye Temporal Nasal an z Normal sensitivity curve E D 5 Standard Stimulus 1
175. where the patient cannot see the stimulus the stimulus is presented with the intensity 5 dB lower than the first intensity Stimulation 1 Finally for the points where the patient still cannot see the stimulus the stimulus is uniformly presented with 10 000 asb 0 dB Simulation 2 Then the examination finishes 2 In case of examination with 2 zones and reference value p value The first stimulus is presented with the intensity of p 5 at each examination point Standard For the points without any response from the patient the stimulus is presented again Then the examination finishes When the reference value is 5 dB the intensity lowered by 5 dB means the intensity 5 dB brighter about three times When the reference value is p value the intensity of p 5 shows the following for example if the patient is X years old and the intensity of p 5 for the X years old people at an examination point is Y dB less than 5 of the X years old healthy people cannot see the stimulus with the intensity of Y dB at the examination point When the patient cannot respond to the stimulus of p Z it is considered that the abnormality degree becomes higher as the value of Z is smaller Therefore when the p value is used as the reference value zone dividing can be performed based on the database of normal visual fields of healthy people When the Quantify scotoma is set to ON d
176. with KOWA VK Series cccescsscescescescsscescesceseee LIS 8 1 Automatic saving of perimetry results into Kowa VK Series ccsssccccsssrcccssssececssseeccesssseceessseeeees 138 8 2 Simplifying the patient information input Operation ccsssscccsssrcccsssscccsssseccessssecessssescesssecesssseeeens 139 8 3 Selecting perimetry examination fundus IMAGES cccccccssssccesssrcccssssecccsssscccessseesesssseescessseecesssseeeess 139 9 Maintenance and inspection cccsecccceseseceeeeeee 140 9i Dally MVM eM ANG eC saeco vcaseesccechecpa n aO 140 9 2 Daily inspection Inspection items for the USer sssccccssssccssssssccssssseccssssecccsssseccesssseecessssesescsseesesssseecesseneeeens 140 9 3 Regular inspection Maintenance inspection items for the VeNdOr csssssccccsssscccsssreccssssecccssssesesssseceessseesens 141 DA MOPS WATS CU icona ET cys esac nso OT E gama ome ee He 141 9 5 Cleaning the exterior and the touch panel cssscccssssscccsssscccsssscccsssseccessssescesssesesesseseessseeeesssseeeens 141 9 62 Projection lamp FeplaGeme nl cjissisc cs ceciteccscecccccnseretecssenaeaeneiees easier ele Oli 142 9 7 FUSE REDIACCIII CIN nnion a cone ciaeceneceussccectaeselecadcsanectisselecciaienc a nsnteaeeneeouarsiecseenaeee 144 9 8 LISCO CONS UIA OS carioci serina N T T deme ae 144 9 9 Backup of examination result data
177. xamination 2 Order Manual For the isopter examination the order of presenting a stimulus can be manually determined To set the presentation order change the isopter parameters in the program change dialog P 53 Press a button adjacent to a meridian that you wish to examine and the stimulus begins to move Each time the examination of a single stimulus is completed the isopter examination is stopped When the next stimulus is selected it begins to move a o ll DDT lsopterStandard S AP 7O0O 2012 12 13 lsopter examination screen Start 1 Periphery 80 Order Manual 5 Examination 5 5 Fovea threshold examination Fovea examination In 3 examinations of Threshold Center 1 Threshold Center 2 and Isopter Threshold the fovea examination can be carried out If you set the fovea examination to ON during program selection the fovea examination is performed in the following procedure when the threshold examination is started 4 When you press Start the following message appears The fovea is examined first The fixation target is at the 4 points at the lower center In the dome the fixation target moves to the 4 points at lower center Then instruct the patient to look at the center of the 4 points When you press OK the fovea examination begins 2 Upon determination of the fovea threshold the following message appears The fixation target is the selected one Next the threshold e
178. xamination results being useful for diagnosis and informed consent For example since the VK system displays a fundus image and a perimetry result side by side as shown below you can easily grasp their correspondence You can thereby understand whether the appearance of abnormality coincides between the fundus image and the examination result or which abnormality precedes the other which can be utilized for diagnosis E f Capture Area arim File Edit View Setting Capture Image Proc Database Archive DICOM Help Image Info Patient ID 1001 Name KOWA SAMPLE Multi display of fundus image and perimetry result on VK equipment X If you set the output content to Print P 59 the images generated during a threshold examination are saved to the VK system in all display formats X If the performed fundus perimetry is Custom Optional threshold O or Custom Optional threshold the numeric value of an image to be saved to the VK system is the total deviation 8 Link with KOWA VK 8 2 Simplifying the patient information input operation If you have not yet performed any examination with KOWA AP 7000 but have already input patient information to the KOWA VK Series system you can read the information from KOWA VK Series to skip the information input operation on KOWA AP 7000 The patient information can be read from KOWA VK Series through the input screen in the following three methods 1 In the I
179. xamination starts In the dome the fixation target goes back to the selected position Center or Auxiliary Then instruct the patient to look at the selected fixation target When you press OK the examination enters the stopped state before the start of the threshold isopter examination Confirm the position of the examined eye on the eye fixation monitor and press Start to proceed with the examination 5 6 The eye fixation of a patient Perimetry presupposes the eye fixation of a patient The eye fixation is very significant for improving the reliability of the examination The eye fixation of a patient is checked through the eye fixation monitor by the examiner Proceed with the examination by checking the eye fixation of the patient using the white cross hairs on the eye fixation monitor as a reference If the eye fixation is insufficient encourage the patient and keep trying to achieve sufficient fixation Check whether the patient can see the fixation target and that the unexamined eye is firmly covered It may occasionally be effective for stable fixation to interrupt the examination and give the patient a break 5 7 Gaze monitor Gaze monitor is a function for evaluating fixation misalignment of the examined eye each time the stimulus is presented Combined use with the fixation loss check using blind spot stimulation will improve the examination reliability The degree of fixation misalignment evaluated by the gaze monitor fun
180. y during the examination Press Delete button and select the examination point you wish to delete A confirmation message appears Press OK to delete the examination result To cancel the deletion press Cancel X You cannot delete any result of the examination that has been executed automatically If you wish to carry out the examination again at particular points after automatic examination perform the re test of each point P 122 X While the Delete button is active you cannot perform any examination To continue the examination after deleting the examination result press Delete again to deactivate the Delete button and proceed with the examination Isopter Delete the selected data Gee AP 7OOO 2012 12 13 Confirmation message for examination result deletion 5 Examination If you activate deletion of the examination result during manual examination of auto manual examination the examination results which cannot be deleted the results of automatic examination are grayed out I rr lsopterStandard Specify the deleted point D AP 7OOO 2012 12 13 Lititttidstssbtbbibitbdbidbbbhibbbbibbbhbbbdbbbikbbbbhbbbbbbbbbbbbbbbhbbbbibbbhbbdbbikkbbibbbbbibbikbbdbbbbbbbikbbtbbbbbbbbhbibdhbbhhhkhdhhddidddhehhe thd hedetedhededed hdd hdd edd In case the Delete button is activated during manual examination of auto manual examination 4 Completion of examination When you press Finish during a manual examination
181. ysis and printing of the examination results which can be used for such purposes as diagnosis progression monitoring or informed consent etc 7 input S Bammnaton Result e Ghart are Initial Program ThresholdCenter1 All 22 18 22 26 Date of Birth Correction Date 2011 06 01 22 19 ge FER Duratior 07 50 TotalDeviation 4 sla 3 194P lt 5 Pie Center n 3 72 P lt 2 P Time interval Standard Standard Outside Normal Limits Size Color III A White White 92 MS FF Anderson s Criteria Anderson Early AGIS CIGTS Stage Fix Loss False Pos False Neg All Points Rest Points Ga AP 7000 2012 12 11 14 31 Examination result screen The examination result screen allows you to perform the following operations Load the patient information and past examination results from the patient ID list P 28 4 3 Loading patient information by Open List Print the examination results P 100 6 3 Print Display the examination results of both eyes side by side on the screen P 101 6 4 Both eyes Display the examination results with the same ID in multi display mode P 104 6 5 6 5Multi Display and switch the analysis result P 109 6 6 Analysis of Threshold Examination Result Retest the examination result being displayed P 124 6 10 Editing of patient information Edit and check the patient information of the examination result being displayed The editing procedure is the same as in 4 4

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