Spectralis Hardware Operating Manual
Spectralis Hardware Operating Manual
Spectralis Hardware Operating Manual
Spectralis HRA+OCT
Spectralis HRA
Spectralis OCT
Hardware
Operating Instructions
Art.No. 19963
The manufacturer hereby declares that this product conforms to the requirements
0482 of Directive 93/42/EEC of the Council of the European Community dated 14
June 1993 regarding medical products (MDD 93/42/EEC).
Corporate Headquarters
Heidelberg Engineering GmbH • Tiergartenstr. 15 • 69121 Heidelberg • Germany
Phone +49 6221 6463-0 • Fax +49 6221 646362 • www.HeidelbergEngineering.de
US Main Office
Heidelberg Engineering, Inc. • 1499 Poinsettia Avenue, Suite 160 • Vista, CA 92081
Phone 760 598-3770 • Fax 760 598-3060 • www.HeidelbergEngineering.com
US Service Center
Heidelberg Engineering, Inc. • 410 Harris Road • Smithfield, RI 02917
Phone 401 349-0500 • Fax 401 349-0504 • www.HeidelbergEngineering.com
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Contents
1 General Information............................................................................................................. 5
1.1 Intended Use ................................................................................................................. 5
1.2 Principles of the Technology ........................................................................................ 6
1.2.1 Confocal Laser Scanning........................................................................................ 6
1.2.2 Optical Coherence Tomography (OCT)................................................................. 7
1.2.3 Use of Several Devices, Registration Link ............................................................ 7
1.3 Safety Information, Cautions and Warnings................................................................. 8
1.3.1 General Safety Information .................................................................................... 8
1.3.2 Contraindications for Performing Angiography..................................................... 8
1.3.3 Warnings ................................................................................................................ 8
1.3.4 Precautions ........................................................................................................... 10
1.3.5 Laser Safety.......................................................................................................... 11
1.4 Components of the Instrument, Scope of Delivery..................................................... 12
1.5 System Installation...................................................................................................... 13
1.6 Maintenance, Cleaning and Service............................................................................ 14
2 General Operating Information.......................................................................................... 15
2.1 Turning the Instrument On and Off ............................................................................ 15
2.1.1 Start Up Procedure ............................................................................................... 15
2.1.2 Shut Down Procedure........................................................................................... 15
2.2 Operating the Hardware .............................................................................................. 16
2.2.1 Spectralis Camera and Headrest........................................................................... 16
2.2.2 Exchanging Objectives......................................................................................... 17
2.2.3 Focus Knob........................................................................................................... 17
2.2.4 Filter lever ............................................................................................................ 17
2.2.5 External Fixation Target Lamp ............................................................................ 18
2.2.6 Control Panel........................................................................................................ 18
2.2.7 Foot Switch........................................................................................................... 19
2.2.8 Keyboard .............................................................................................................. 20
2.2.9 Mouse ................................................................................................................... 20
3 Technical Specifications.................................................................................................... 21
3.1 Recommended Isolation Transformers for PC-Components ...................................... 25
3.2 User Training .............................................................................................................. 25
3.3 Labels .......................................................................................................................... 26
3.4 Disposal....................................................................................................................... 27
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1 General Information
This is an introduction to the Heidelberg Spectralis family of devices (Spectralis HRA,
Spectralis OCT and Spectralis HRA+OCT). These operation instructions also contain
important safety information.
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1.2 Principles of the Technology
1.2.1 Confocal Laser Scanning
For acquisition of the digital confocal images, a laser beam is focused on the retina. The laser
beam is deflected periodically by means of oscillating mirrors to sequentially scan a two-
dimensional section of the retina. The intensity of the reflected light or of the emitted
fluorescent light at each point is measured with a light sensitive detector. In a confocal optical
system, light reflected or emitted outside of the adjusted focal plane is suppressed, resulting in
high contrast images. Furthermore (especially during indocyanine green angiography), the
confocal optical system allows to acquire a layer-by-layer three-dimensional image.
The confocal imaging system allows to image the retina with non or poorly dilated pupils.
This is especially important for diabetics because they typically do not dilate very well and
account for a large number of patients seen in the retina clinic.
Fluorescence dyes are excited in relatively narrow wavelength bands. Using a laser is the most
efficient means for excitation, since all the energy is concentrated at one specific wavelength
rather than in a broad continuum as with ordinary flash photography light. Therefore, the
retinal light exposure required for angiography with the Spectralis HRA is considerably less
than that required with a photographic system, thus allowing for safer and more patient-
friendly examination.
The laser sources of the Spectralis HRA emit laser light with three different wavelengths:
1. For excitation of fluorescein, a blue solid state laser (wavelength 488 nm) is used. A
barrier filter at 500 nm separates excitation and fluorescence light. The same
wavelength (but without the barrier filter) is used to create blue reflectance images
(also called red-free images). Furthermore, the Spectralis HRA is capable of high
quality autofluorescence (488 nm) imaging.
2. For excitation of indocyanine green, a diode laser at 790 nm wavelength is used,
together with a barrier filter at 830 nm to separate excitation and fluorescence light.
3. A second diode laser at 820 nm wavelength serves to produce infrared reflectance (IR)
images.
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In the simultaneous imaging modes , each image line is scanned twice subsequently with
alternating lasers. For example, during simultaneous fluorescein and indocyanine green
angiography, only the 488 nm laser is switched on for the first scan of a line, while during the
second scan only the 790 nm laser is switched on..
In every acquisition mode, individual images, temporal image sequences, or a focal series of
images (layered three-dimensional images) can be acquired.
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1.3 Safety Information, Cautions and Warnings
Please read this section carefully and always heed its contents!
1.3.3 Warnings
IMPORTANT Do not make a diagnostic decision on one single examination. Always use
alternative information, history data etc. to assist in a final diagnosis.
CAUTION Do not use PCs, components or accessories that have not been approved by
Heidelberg Engineering. Do not install other software programs as they may
interfere with the functionality of the Heidelberg Engineering software or
equipment. This could include damage to the system as well as incorrect
measurement results.
CAUTION Make sure that the environmental requirements are met when the system is
operated. Exceeding environmental conditions might damage the system or
lead to decreased image quality. (See chapter 3 “Technical specifications”).
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CAUTION Make sure the patient is correctly placed in front of the camera before starting
the examination. Incorrect positioning may lead to poor images and abnormal
diagnostic results.
CAUTION This equipment was tested in accordance to 60601-1-2, Electro Magnetic
Compliance (EMC). Nevertheless it might be influenced by strong
electromagnetic fields. Portable high frequency communication devices might
influence the device.
CAUTION Artifacts (e.g. reflexes) on the images might be misleading. Do not use
images with artifacts.
WARNING Do not operate the system without connecting the System over an IEC 60601-
1 approved isolation transformer. Do not place the isolation transformer on
the floor and do not operate other devices that are not part of the Heidelberg
Engineering system with the same isolation transformer.
WARNING Do not use a network connection without network isolation in accordance to
IEC 60601-1. In case of a failure in the network, there could be a hazard of
electrical shock to the user and patient.
WARNING Do not open the device component housings. Doing so can lead to the
possibility of electrical shock or exposure to harmful laser radiation.
WARNING To avoid the risk of electric shock, this equipment must only be connected to
a grounded power supply.
WARNING To avoid the risk of electric shock, do not touch conductive parts of
connectors and the patient simultaneously.
WARNING Do not use the device outside of the scope of intended use. Doing so may
pose a risk to the patient or operator and may lead to malfunctions or damage
of the device.
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1.3.4 Precautions
• The operator shall be sure that the device settings and adjustments are correct before
examination and diagnostic decision. Incorrect settings and adjustments may lead to
poor image quality or abnormal examination information.
• Make sure the scanners are working (high pitched sound) before sitting a patient in
front of the device. No laser beam should be visible, when the scanners are off. A
hazard for an injury of the retina would exist if the laser beam hits the retina without
being scanned.
• The physician shall be sure to have the correct patient data before a diagnostic
decision. Mismatched patient data may lead to incorrect diagnostic decisions.
• Read chapter “Preparing the patient“ of the Software Operation Instructions carefully
before starting the examination. Incorrect preparation of the patient may lead to poor
image quality and incorrect diagnoses.
• Do not start an examination without informing the patient about the examination
procedure. Incorrect patient behavior during the examination may lead to poor image
quality and incorrect diagnoses.
• Clean and disinfect chin rest and headrest after each examination. Contaminated parts
may lead to infections or disease contraction.
• Read chapter 1.6 “Maintenance, Cleaning and Service” carefully. Missing
maintenance or incorrect adjustment of the device may lead to poor image quality and
incorrect diagnoses.
• Prepare safeguards to ensure that only authorized personnel can access the patient
data. Data loss impedes follow up analyses and may result in wrong diagnostic
decision.
• Be sure to perform periodic data backup procedures. Check the success of the backup
to avoid data losses caused by backup errors.
• Do not operate the system directly after large temperature changes. Let the device
acclimate itself for a minimum of 2 hours to avoid device damage or incorrect
measurement results.
• For the application of contrast or dye fluid, closely follow the package information
leaflet. Because of possible adverse effects of drug injections (as allergic reactions or
shock), we recommend to limit the number of angiography examinations per day to
the minimum necessary. In most cases one injection will be sufficient.
• Before starting the system check the regional power supply specifications to verify
that they fit the required tolerances (100V < U < 240V; 50Hz < f < 60Hz). Incorrect
power supply conditions might lead to malfunctions of the system.
• Be aware that the influence of other physical effects (vibrations, strong
electromagnetic fields as caused by big machines etc. running close-by) might disturb
the proper operating of the device.
• Note that a computer failure during picture acquisition or analysis could lead to
incorrect results.
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1.3.5 Laser Safety
This instrument contains a solid-state laser and two diode lasers as well as a super
luminescence diode. The instrument emits visible and invisible laser light through the
objective lens on the front of the laser scanning camera. The
Spectralis is a Class 1 laser system. It does not pose any safety
hazard whatsoever. The laser class label is located on the rear LASER CLASS 1
panel of the camera housing and the rear panel of the laser
module.
However, hazardous laser radiation may be accessible when the camera housing or the
housing of the laser module is open.
WARNING Never open the housing of the laser scanning camera or the laser module.
When the camera housing or the laser module housing is open, visible and/or
invisible laser radiation of Class IIIB is accessible and can lead to injuries. The
camera housing and laser module housing must only be opened by qualified
service staff.
Laser warning labels to this effect are positioned
WARNING
on the cover of the camera housing (underneath the LASER BEAM CLASS 3B WHEN
electronics card which is located there) and on the OPEN AVOID DIRECT
back side of the laser module. EXPOSURE TO BEAM
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1.4 Components of the Instrument, Scope of Delivery
The Spectralis conforms to all applicable safety standards such as IEC 60601-1, IEC 60601-1-
2, IEC 60601-1-4, UL 60601, and IEC 60825.
The basic components of the Spectralis are:
• Laser scanning camera
• Control Panel (also called Touch Panel)
• Foot switch
• Camera mount with integrated headrest
• Power supply / laser box (PSW PS410 or PWS/FW)
• Cable connecting Control Panel and power supply
• Power Supply Model PWS / FW, IEEE 1394 cable to PC
• CD containing operation software
• Software protector
• Operation Manuals
• Hardware Operation Instructions (this document)
• Software Operation Instructions (Spectralis QuickGuide)
• Manual “Installation and System Configuration”
The Spectralis is operated by a personal computer, in combination with an IEC 60601-1
approved isolation transformer (see chapter 1.5 “System Installation”, as well as chapter 1.3.3
“Cautions and Warnings” for further details). The computer receives the image data generated
by the laser scanning camera and performs the entire image analysis.
The operation software includes functions to communicate with the user, to control image
acquisition, to store images and data, to process and analyze the acquired images, and to
document the examination results.
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1.5 System Installation
Accompanying these operating instructions you will find detailed installation instructions in
the document 'Spectralis – Installation and System Configuration'.
IMPORTANT To ensure the overall safety of the system, only certified staff of your
local Heidelberg Engineering distributor must install the Spectralis.
All power plugs of the Spectralis system (computer, monitor, printer, Spectralis power supply,
table) must be connected to the isolation transformer.
WARNING: The system must not be operated without IEC 60601-1 approved
isolation transformer. (please refer to chapter 1.3.3 “Cautions and
Warnings”)
All cable connections between camera, laser box and computer must be carried out according
to the following connection scheme. All cables must be in good condition and properly
connected.
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1.6 Maintenance, Cleaning and Service
The Spectralis is a precision optical instrument. Please protect the instrument from dust and
moisture, and avoid subjecting it to shocks or strong forces.
The non-optical surfaces of the instrument can be cleaned and/or disinfected whenever
necessary. Any standard cleaning product appropriate for plastic surfaces that does not contain
acetone or hydrogen peroxide (e.g. ethanol and isopropyl alcohol disinfectants) may be used
for this purpose. Before doing this, please turn the instrument off and pull out the power plug.
The lens surface at the front of the laser scanning camera should be carefully cleaned at
regular intervals. For this purpose, it is best to use a cotton swab slightly moistened with pure
(99.9%) ethyl alcohol.
Please be aware that only authorized service personnel can do service and repair operations of
the Spectralis. Do not open the device. If the device is opened by someone other than an
authorized service personnel, the warranty will be discontinued. If the device fails please call
your local distributor or the Heidelberg Engineering support department.
A yearly inspection of the device by a Heidelberg Engineering service engineer is highly
recommended to ensure proper and exact operation.
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2 General Operating Information
2.1 Turning the Instrument On and Off
2.1.1 Start Up Procedure
To turn the Spectralis on, proceed as follows:
(1) Turn the computer on. After the boot sequence has been
completed, the computer will start the Windows operating
system.
(2) Turn on the power supply of the device. The power switch
is located on the front panel of the power supply. The 'On'
position is marked I.
(3) Start the Heidelberg Eye Explorer software.
Use the Heidelberg Eye Explorer shortcut on the desktop to start the application by double
left-clicking on the Eye Explorer Icon on your desktop
or by using the windows start menu:
Start → Programs → Heidelberg Eye Explorer → Heidelberg Eye Explorer
Wait until the software opens to the database view.
Note: It is not recommended to turn the instrument on and off frequently. Even if you are
not using the instrument constantly during the course of a day, it is best to turn it
on in the morning and not to turn it off again until the evening.
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2.2 Operating the Hardware
2.2.1 Spectralis Camera and Headrest
The laser scanning camera is mounted on a special camera
mount which also includes the headrest for the patient.
Familiarize yourself with handling the camera using the
joystick or micromanipulator adjustment controls (x, y, z
movement of the camera). Confident handling of the
controls reduces the time required for the examination,
increases patient comfort and leads to optimal image
quality.
Joystick
Turn the joystick clockwise to move the camera up. Turn
the joystick counter-clockwise to move the camera down.
Move the joystick left / right and forward / backwards to
direct the camera in the same direction.
xyz-Micromanipulator
Use the xyz-Micromanipulator for the adjustment of the
camera position:
• inner knob: Z adjustment (forward/backward)
• middle knob: Y adjustment (height)
• outer knob: x adjustment (left/right)
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2.2.2 Exchanging Objectives
In order to remove the Spectralis Standard Objective, rotate the
objective by about 50° to the left (counter clockwise) and
remove it (bayonet connector). Make sure that the objective is
retained properly; a special wooden box is delivered for the
lenses.
The optional 55° wide angle lens for IR, RF and angiography
wide-field imaging is mounted the same way: it has to be
inserted with the red dot orientated upwards (12 o’clock) and
then rotated by about 50° clockwise until it snaps in.
The Spectralis automatically detects which lens is mounted on the system. For the standard
objective, the field sizes 15°, 20° and 30° are offered on the Control Panel, whereas with the
optional 55° objective the scan angles 25°, 35° and 55° are displayed.
For further information, please refer to the “55° lens” Release Notes.
NOTE: The optional 55° lens is not suitable for OCT imaging.
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2.2.5 External Fixation Target Lamp
The flexible external fixation target can be activated from
within the Control Panel by double tapping on the 3x3 matrix
of blue dots and then selecting ‘External fixation’.
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Once a patient file is open and entries for an acquisition are
made, the Acqusition Window with the live image will
open (see chapter 3.6 “Acquisition Window” of the
Software Operation Manual), and the ‘Start/Stop’ button
(0), on the “System Start” screen of the Control Panel will
change from red to white. Press the white ‘Start/Stop’
button in order to turn on the laser.
The Control Panel menus are explained in the chapter 3 “Image Acquisition” of the Spectralis
Software Operating Instructions).
2.2.6.4 Interlock
An interlock can be triggered if the FA/red free laser power
rises above the pre-set values or if one or both of the
scanners are not working properly.
Stop using the system and contact technical service.
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2.2.8 Keyboard
To use the Spectralis operation software, you need a computer keyboard in order to enter text
and to control certain software functions. The function keys and special keys are often used
and are identified as 'F1', 'F2', etc. in this operation manual.
2.2.9 Mouse
The Spectralis operation software is controlled via a graphical user interface (menu). To
interact with the software and to select a specific menu field, use the mouse to move the
pointer to the field and press either the left or right mouse button for different menus.
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3 Technical Specifications
1
FireWire and the FireWire symbol are trademarks of Apple Computer, Inc., registered in the U.S. and other countries. The
FireWire logo is a trademark of Apple Computer, Inc.
2
Note: If the examination time of a patient exceeds 50 minutes within a given three hours interval, the camera will go to
standby mode. It can be started again directly with a new patient or with the same patient after an appropriate waiting period.
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Light Sources ICG excitation:
Diode laser, wavelength 790 nm, laser class I
IR reflectance:
Diode Laser, wavelength 820nm, laser class 1
FA excitation and blue reflectance:
Solid state laser, wavelength 488nm, laser class 1
Super luminescense diode (SLD), average wavelength 870 nm,
laser class I
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Scanning Laser Specifications Transversal field of view
(30°/ 20°/ 15°) Scan angle: 30°x30°, 20°x20°, 15°x15°
Wide field composite image to 120°
3
FireWire and the FireWire symbol are trademarks of Apple Computer, Inc., registered in the U.S. and other
countries. The FireWire logo is a trademark of Apple Computer, Inc.
4
The i.LINK logo is a trademark of Sony Corporation, registered in the U.S. and other countries.
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PC Requirements Motherboard:
Processor: Intel D975XBX2, BIOS Version 2770 or higher
Chip set: 975x
RAM: 2 GB
2 PCI-Express x16 slots (PCT-Express for Graphics, PEG)
Graphic card: Chip set Geforce 8800 GTX, memory 768 MB
recommended; minimum Open-GL 2.0, 256 MB
Fire Wire Cards: 1 PCI Card IEEE-1394a
1 PCI Express Card IEEE-1394b
Internal HDD 40 GB
DVD/CD-RW drive
Keyboard, Mouse
Operating system: Windows XP professional (SP 2
recommended)
Monitor: High quality TFT or CRT, minimum resolution 1600 x
1200 pixels (e. g. 19" Iiyama AU 4831D or 20" viewsonic VP
201m)
Patient data storage: External IEEE 1394 hard disk (750 GB
recommended)
Archive data storage: 2nd external IEEE 1394 hard disk (same
size as data disk)
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3.1 Recommended Isolation Transformers for PC-Components
The isolation transformer has to be certified in accordance to the standards IEC 60884-1, IEC
60601-1 and / or UL 60601-1. Heidelberg Engineering recommends the following models:
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3.3 Labels
Spectralis
WITH RESPECT TO ELECTRIC SHOCK
FIRE, AND MECHANICAL HAZARDS ONLY
IN ACCORDANCE WITH:
UL2601-1/CAN/CSA C22.2 No. 601.1 and IEC 60825
WARNING
LASER BEAM CLASS 3B WHEN
OPEN AVOID DIRECT
EXPOSURE TO BEAM
Warning Label on
the Power Supply /
Laser unit
Laser Class 1
label on the
LASER CLASS 1
Camera
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R A
Reflexion- Angiography-
Mode Filter on Mode Filter on
the Camera the Camera
Sensitivity
adjustment Focus Function
Control Panel on the Camera
3.4 Disposal
Only Heidelberg Engineering shall dispose the device.
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