NIDEK RS-1 Easy Start-Up Guide

How to start the system

1. Turn on the isolation transformer.
2. Turn on the computer.
3. Turn on the power of main body RS-1.
4. Double-click the “NAVIS-EX" icon on the Windows desktop.[Note on login path: Login Name: `RS-User`, Password: `user`]
5. Click the Login button to start NAVIS-EX. The Patient List screen appears.

[Description: The system setup involves powering on the isolation transformer, computer, and the main RS-1 unit. Users then launch the NAVIS-EX software by double-clicking its desktop icon. A login screen prompts for credentials.]

Register new patient

1. Click the "New" button in the toolbar.
2. Enter `Patient ID`.
3. Enter `Sex`, `Date of Birth`, and `Race`.[Note: Necessary for OCT NDB analysis. For patients under 20 years old, it is recommended to enter 20 years old and write the correct date in the comment field.]
4. Click "RS-1 Start up".

[Description: To register a new patient, navigate to the "Patient Information-New" screen via the toolbar. Fill in the required fields: Patient ID, Sex, Date of Birth, and Race. Specific guidance is provided for age-related data entry for NDB analysis.]

Auto alignment >> Capture

1. Select a combo title.
2. Place the patient's chin and forehead on the rest.
3. Adjust the chinrest height.
4. Click the "Optimize" button.
5. Check the scan position, “SQI” (Signal Quality Index), and “SSI” (Scan Stability Index).
6. Press the "Capture" button.[Point] Change the scan position and parameters if necessary. Change to Manual alignment if necessary and operate with the joystick.

[Description: This section details the automated image acquisition process. It involves selecting a scan type, positioning the patient, optimizing the scan parameters, verifying quality metrics (SQI, SSI), and initiating the capture. Manual adjustments are possible via joystick.]

Confirmation & Save

1. Check scan position, "SQI", "SSI", and all parameters.
2. Click the "Save" button.
3. Click the "Retake" button to redo the scan if necessary.
4. Click "Exit" to close the OCT Viewer.

[Description: After capturing an image, review the scan parameters and quality indicators. Save the data, or retake the scan if quality is insufficient. The OCT Viewer can then be exited.]

OCT Viewer Overview

The OCT Viewer provides a comprehensive interface for reviewing patient data and OCT scan results. It includes sections for scan information, patient details, a thumbnail list of scans, and detailed analysis results. A "Function/NDB switch" allows for toggling between different analysis modes.

OCT Analysis Correction Parameter & Long Axial Length Normative Database

When capturing a "MACULA LINE", the system determines the axial length (distance between the cornea and retina) to use as a scan width correction parameter. The table below outlines the criteria for using the NDB (Normative Database) and L-NDB (Long Axial Length Normative Database) based on axial length, age, and race.

[CAUTION] The OCT Analysis Correction Parameter value is different from the actual measured value of the axial length and should not be used for IOL diopter calculation.

[Point] When the axial length is 26.0 mm or longer, "L-NDB" appears, indicating that the Long Axial Length Normative Database will be applied automatically on the OCT viewer.

Structural Normality Map

The structural normality map is an image displaying "uncertainty" in each layer segmentation. It is available within the Macula tab of the Retina map, Macula map, and Macula map A views. This map helps in calculating the degree of structural abnormalities and detecting early signs of retinal changes compared to normal structures.

[Point] Calculate the degree of structural abnormalities. Indications of structural changes in retina compared to normal, detection of early signs of retinal changes.

Areas are classified as "Normal" or "Abnormal".

Baseline image registration

1. Click exam data that does not belong to any Follow-up group and click "Follow-up" on the analysis screen.
2. Click "Create a new group", enter a follow-up group name, and click "Save". The image is registered as the baseline.

[Note] Baseline images can also be registered from NAVIS-EX or Capture software.

[Description: To establish a baseline for future comparisons, select existing exam data, initiate the "Follow-up" process, create a new group, and save it. This sets the initial image as the reference.]

Follow-up image capture

1. After selecting patient data and clicking "RS-1 Start-up", the screen automatically switches to Follow-up mode. (The "Prioritize follow-up" setting is enabled by default in user settings.)
2. Perform the same steps as outlined in "Auto alignment >> Capture" (Steps 2 to 6 on page 1).

[Point] Chinrest adjustment is not required as the chinrest height is automatically stored for future visits. The image capture patterns are displayed in a list according to the baseline. The pattern currently being captured is displayed in green.

[Description: For follow-up examinations, the system automatically enters follow-up mode. Subsequent image capture follows the standard auto-alignment and capture procedure, with the benefit of retained chinrest settings and visual cues for the capture pattern.]

Follow-up registration

To facilitate follow-up examinations, register the current examination data to a designated follow-up group.

[Registration from follow-up registration window]

1. Click exam data that does not belong to any Follow-up group and click "Follow-up".
2. Click "Register to an existing group" and click "Save". The image is registered in the selected follow-up group.

[Select images to display in follow-up group]

1. Click the selection icon (e.g., a checkbox or radio button).
2. Select or deselect the data to be displayed in the follow-up analysis screen and click "Save".

[Description: Data can be added to existing follow-up groups or specific images can be selected for display within a group, allowing for comparative analysis over time.]

Anterior segment OCT image capture (optional, manual alignment only)

Before measurement

1. Switch to anterior segment OCT mode to [Cornea].
2. Attach the anterior segment OCT image capture adapter.
3. Attach the forehead rest adapter to the forehead rest.
4. Click [OK] in the message dialog box.[Point] Attach the adapter with the flat side (a) up and the protruding part (b) down.

[Description: For anterior segment imaging, specific adapters are required. The process involves switching the OCT mode, attaching the correct adapter and forehead rest, and confirming the setup.]

CORNEA RADIAL/ACA LINE

1. Click [Cornea Radial] or [ACA LINE] to select the scan type.
2. Place the patient's chin and forehead on the rest.
3. Adjust the chinrest height.
4. Adjust and align the position using the joystick.
5. Click the "Optimize" button.
6. Check the scan position and “SSI”.
7. Press the "Capture" button.

[Tip for CORNEA RADIAL capture] Roll the mouse wheel to align the upper part of the cornea (cornea surface) with the upper line (a). Align the vertical corneal reflection (b) (center of the cornea) with the center line (c).

[Tip for ACA LINE capture] Adjust the capture position so that the anterior chamber angle (a) is displayed near the center of the screen.

[Description: Capturing anterior segment images like Cornea Radial or ACA Line involves selecting the mode, positioning the patient, and fine-tuning the alignment using the joystick and software tools to ensure optimal image quality and data capture.]