Kowa Ophthalmic Medical Equipments

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  • Automatic Perimeter KOWA AP-7000

KOWA AP-7000

smart StrategyTM is born!

  • Murata H, Zangwill LM, Fujino Y, et al. Validating variational Bayes linear regression method with multi-central datasets.
    Invest Ophthalmol Vis Sci. 2018;59:1897-1904. https://doi.org/10.1167/iovs.17-22907
  • Murata H, Araie M, Asaoka R. A new approach to measure visual field progression in glaucoma patients using variational Bayes linear regression.
    Invest Ophthalmol Vis Sci. 2014;55:8386-8392. https://doi.org/10.1167/iovs.14-14625

About smart Strategy

smart Strategy is a short-time measurement algorithm combined with a visual field prediction model based on VBLR. The prediction model learns spatial and temporal patterns of glaucomatous visual field defects using an enormous amount of glaucoma visual field data.
During the test, the visual field prediction model is continually updated according to the responses by the patient. By updating the intensity of stimuli and determining the sensitivity of each point, the number of stimulus presentations are then reduced to shorten test time.
Thanks to a substantial increase in accuracy of visual field prediction, test time is reduced without losing reliability.

3 smart Strategy Programs

smart Strategy is a program that offers shorter examination time without losing reliability by combining the above method with conventional Full-Threshold testing.
smart Strategy Alpha allows shorter examination time by the combination of a highly accurate visual field prediction and Kowa's conventional short-time algorithm (Quick 1).
smart Strategy Alpha+ is the fastest threshold test algorithm in KOWA AP-7000, suggested to be used for screening. It is based on Quick 1 as well as smart Strategy Alpha, but provides even shorter examination time by using further enhanced prediction methods.

Average examination time comparison with conventional programs

Internal material: AP-7000 joint research with The University of Tokyo material No.2
Simulation based on data from 547 glaucoma patients, 911 eyes

Visual field prediction model update and threshold determination
by variational Bayes linear regression method

The test is administered in the following order.

1Prior to the test, there is no visual field information except for the patient's age.

2The threshold values of the primary points (first 4 points) are tested, and the other test points in the visual field prediction model are updated from the results.

34As the threshold value of each test point is determined, the visual field prediction model in the other test points are updated.
The intensity of stimuli is updated, and the threshold is determined.

Threshold

In addition to central 30°, which is used to observe the progression of glaucoma, a wide variety of tests are available including central 10°, which is useful to identify visual field abnormalities in the macula.

Clear Display of Analysis Results

1Threshold (Measured Values)

2Gray Scale
Expressing threshold values in ten levels of gray scale
3Total Deviation
Deviation from the normal value for each age range
4Pattern Deviation
Deviation from the pattern of the normal visual field pattern
5MD(Mean Deviation)
Averaged degree of loss of visual field, across the whole field
6PSD(Pattern Standard Deviation)
Degree of deviation from the normal visual field pattern
7Analysis Indices
Display of various analysis indices
8Bebie Curve
All total deviation values expressed as a curve
9Gaze Monitor
Measures eye fixation loss based on pupil position relative to corneal reflection

Analysis Indices

GHT(Glaucoma Hemifield Test)
For this index, threshold central test points are divided into 10 sectors. Corresponding sectors above and below the axis of the horizontal median are then compared.
VFI(Visual Field Index)
A percentage index in which a normal visual field is 100%, and total loss of visual field is 0%.
Anderson’s Criteria Diagnostic Support Function
This criteria is for glaucomatous visual field defects.
If any of the following conditions are satisfied, the colors turn orange. PSD has p<5% GHT is outside normal limits Pattern deviation probability plot shows a cluster of 3 or more nonedge points that have p<5%, and one of the points has p<1%
(The physician must judge whether the 3 points match the travel of NFL.)
Stereo Field angle : 34°(20°×27°)

Time-series Display

A series of examination results such as examination information, scales, thresholds, total deviations (p-values), pattern deviations (p-values) and Bebie curves are displayed in chronological order. Each column lists the results of a single examination.
Base data can be set allowing the operator to easily observe the changes over time.

Chronological Change Display

Test result analytical indices such as MD, PSD, VFI, box plot, etc. can be graphically displayed as time series data to give a clear understanding of changes over time in the tested eyes.
Furthermore, for MD and VFI, prediction graphs calculated from the linear rate of change of the analytical indices are displayed.

Major threshold test programs

smart Strategy supports Central 30 (30-2), Central 24 (24-2),and Central 10 (10-2) in the threshold test programs.

Isopter

Kinetic visual field examination

Supports automatic mode, manual mode, and automatic + manual mode. Can enlarge an image of a 30°range around the center.

Simultaneous evaluation of the peripheral and central visual fields

Equipped with a program that combines Isopter with other static visual field examinations including threshold, allowing simultaneous examination of both the peripheral and central visual fields.

Supra

  • Enables simple examination with a single intensity level.

Esterman Both

The Esterman Both is an examination to carry out on both eyes (binocularly), which is applicable for patients who normally wear glasses when driving.

Screening

4-zone measurement that goes beyond screening, and programs using probability values (p-values) in intensity steps, are among the features that enable an effective test in less time.

Screening

Supported Languages

English

Chinese

French

German

Italian

Portuguese

Russian

Spanish

Korean

Japanese

Structure and Function

Fundus Oriented Perimetry

Fundus images or OCT images can be imported into the KOWA AP-7000, and selected regions of the fundus can be examined. This examination is particularly designed with a 2° spaced grid which gives more precise information than a general threshold examination with a 6° spaced grid.
Comparing the structure and function of the fundus may help detect glaucoma at an early stage.

RGC displacement

To evaluate the structure and function of the macular area, it is important to consider the difference in displacement between the photoreceptor cells and retinal ganglion cells.
It is said that the photoreceptor cells and retinal ganglion cells are displaced in the macular area. The results of a fundus-oriented visual field examination can be displayed alone or overlaid on a fundus image to reflect this difference.

Network Linkage

Reference

  • ・Sjöstrand, J., Popovic, Z., Conradi, N., & Marshall, J. (1999). Morphometric Study of the Displacement of Retinal GanglionCells Subserving Cones Within the Human Fovea. Graefe's Archives for Clinical and Experimental Ophthalmology, 237, 1014-1023.
  • ・Drasdo N, Millican CL, Katholi CR, Curcio CA. The length of Henle fibers in the human retina and a model of ganglion receptive field density in the visual field. Vision Res. 2007;47(22):2901-2911.

Integration of Structure and Function Provides Increased Interpretation of Visual Field Results

Decibels, deviation maps,and probability plots can be integrated with your patients fundus images.

Network Linkage

Network Linkage

Distribution name:KOWA AP-7000

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