JP2020195486A - Ocular fundus image observation program - Google Patents

Abstract

To appropriately display an image selected by an examiner out of a plurality of ocular fundus images captured by mutually different imaging methods.SOLUTION: An arithmetic control part 70 acquires a plurality of ocular fundus images captured by an ocular fundus imaging device 100 by using mutually different imaging methods. Then, a first display region 201 and a second display region 202 are displayed on a monitor 80. In the first display region 201, ocular fundus images by any one imaging method of the plurality of ocular fundus images captured by the mutually different imaging methods are selectively arranged, and an operation for registering the ocular fundus images as registered images can be received for each of the arranged ocular fundus images. In the second display region 202, the registered images registered for each imaging method can be displayed in a list.SELECTED DRAWING: Figure 3

Description

The present disclosure relates to a fundus image observation program.

In diagnostic imaging in the field of ophthalmology, fundus images taken by a fundus camera are widely used.

In diagnosing and observing the eye to be examined from various angles, it is useful to interpret a plurality of fundus images having different imaging methods. For example, Patent Document 1 discloses a device capable of capturing a color image, an infrared image, a fluorescein contrast image, an indocyanine green contrast image, and a spontaneous fluorescence image of the fundus of the eye with one unit.

Japanese Unexamined Patent Publication No. 2016-59399

However, when the fundus image is photographed by a plurality of imaging methods, the burden on the examiner to select the image to be used for image interpretation from the images tends to be large.

In addition, since fluorescence contrast imaging is performed at a plurality of contrast periods, a plurality of images are captured in a series of imaging. Moreover, fluorescence contrast imaging is an imaging method that causes a burden on the subject by intravenously injecting a contrast medium, so that it cannot be easily retaken. Therefore, a relatively large number of images are taken on the premise that there may be a shooting error. However, even if a large number of images are taken, the burden of the above work is relatively large because only a small number of the images are used for image interpretation.

The present disclosure has been made in view of the above circumstances, and provides a fundus image observation program for appropriately displaying an image selected by an examiner from a plurality of fundus images taken by different imaging methods. It is a technical issue to do.

The fundus image observation program according to the first aspect of the present disclosure includes an acquisition step of acquiring a plurality of fundus images taken by different imaging methods by the fundus imaging apparatus by being executed by a computer processor, and on a monitor. A display control step for displaying one or more of the fundus images, and a fundus image observation program for causing the computer to execute. In the display control step, a plurality of the fundus images captured by different imaging methods. Among them, a first display area capable of selectively arranging fundus images by any of the photographing methods and accepting an operation for registering the fundus image as a registered image for each of the arranged fundus images. Further, a second display area in which the registered images registered for each shooting method can be displayed in a list is displayed on the monitor.

According to the present disclosure, an image selected by an examiner is preferably displayed from a plurality of fundus images taken by different imaging methods.

It is a block diagram which shows the outline of the fundus image observation system which concerns on Example. It is a figure which showed the flow of a series of fluorescence contrast imaging. It is a figure which showed an example of the viewer screen in the 1st display state. It is a figure which showed an example of the viewer screen in the 2nd display state.

Hereinafter, one embodiment in the present disclosure will be described. First, the fundus image observation system according to the embodiment will be described with reference to FIG. The fundus image observation system captures a fundus image by a plurality of different imaging methods and displays the captured fundus image. For convenience of explanation, unless otherwise specified, the fundus image refers to the front image of the fundus in the description of the embodiment.

The difference between the plurality of imaging methods that are different from each other may be the wavelength range of the light applied to the eye to be examined, the difference between the fluorescence imaging and the reflection imaging, and the frontal imaging. There may be a difference from the tomography (cross section), or there may be other differences.

The fundus image observation system includes a computer 1 and a fundus imaging device 100. The computer 1 and the fundus photography device 100 are connected by wire or wirelessly. As a result, the computer 1 and the fundus photography device 100 can communicate with each other. The fundus image observation program according to the embodiment is stored in a non-volatile memory that can be read by the processor of the computer 1. In the present embodiment described below, the fundus photography apparatus 100 and the computer 1 are separate bodies. However, the two devices may be integrated.

<Fundus photography device>
The fundus photography device 100 has at least a photography optical system (not shown). In this photographing optical system, after irradiating the fundus of the eye to be inspected with light, the light returned from the fundus is received by the light receiving element. In the present embodiment, the fundus image is formed based on the light receiving signal from the light receiving element. The fundus image is formed by an image processing circuit (for example, an IC and a processor) of the fundus photography apparatus 100. The image processing circuit does not need to be provided in the fundus photography device 100. For example, the image processing circuit of the computer 1 may also serve as the image processing circuit of the fundus photography apparatus 100.

In the present embodiment, the fundus imaging device 100 captures a fundus image by a plurality of imaging methods different from each other. A fluorescence contrast image as a kind of fundus image may be photographable. Further, it may be possible to take a reflected image as another fundus image. The fluorescence contrast image is an image taken by fluorescence emission of a fluorescence contrast agent administered to a blood vessel of the fundus. The reflected image is an image taken by the fundus reflected light of the illumination light used for fundus irradiation.

The fluorescence contrast image and the reflection image may be simultaneously captured by the imaging optical system of the fundus photography apparatus 100. Simultaneous here is not limited to perfect simultaneous. Some time lag is acceptable. The time difference may be set, for example, within a range that does not cause significant eye movement between the two types of fundus images being taken.

The fundus photography apparatus 100 may capture a fluorescence contrast image by any of, for example, indocyanine green contrast imaging (ICGA) and fluorescein contrast imaging (FA). By intravenously injecting two types of contrast media at the same time, two types of fluorescence contrast images may be taken at the same time. Further, the fundus photography apparatus 100 may be capable of photographing a reflected image by infrared light (hereinafter, referred to as an IR image) and a color image. Further, it may be possible to take a spontaneous fluorescence image.

The fundus photography apparatus 100 according to the embodiment may be an SLO (scanning laser ophthalmoscope). However, the present invention is not necessarily limited to this, and the fundus photography device 100 may be another fundus photography device such as a fundus camera. For the detailed configuration of the SLO capable of simultaneously capturing a fluorescence contrast image and a reflection image, refer to, for example, Japanese Patent Application Laid-Open No. 2016-59399 by the applicant.

<Computer>
The computer 1 acquires at least various fundus images captured by the fundus imaging device 100 and displays them on the monitor 80. The computer 1 includes at least an arithmetic control unit 70. The arithmetic control unit 70 is a processor of the computer 1. As shown in FIG. 1, the arithmetic control unit 70 may be composed of a CPU, RAM, ROM, and the like. The arithmetic control unit 70 executes various processes related to the fundus image in addition to the display control of the fundus image based on the fundus image observation program.

As shown in FIG. 1, the arithmetic control unit 70 of the computer 1 is connected to the memory 71, the operation unit 75, the monitor 80, the fundus photography device 100, and the like via a data bus and the like.

In this embodiment, the memory 71 is a non-volatile storage device. For example, a hard disk, a flash memory, or the like can be applied as the memory 71. In the present embodiment, the fundus image observation program is stored in the memory 71 in advance. The memory 71 may be rewritable. In this case, as described in the following examples, various fundus images acquired from the fundus photography apparatus 100 may be stored in the memory 71. However, the fundus image may be stored in a memory (not shown) separate from the memory in which the fundus image observation program is stored.

The operation unit 75 is an input interface of the computer 1. The arithmetic control unit 70 receives a signal corresponding to an operation input to the operation unit 75. Various devices can be considered as the operation unit 75. For example, at least one of a touchpad, a mouse, and a keyboard may be used as the operating unit 75. The operation unit 75 may also be used as an input interface for the fundus photography device 100. As an input interface (operation unit) of the fundus photography device 100, a joystick, a switch, or the like provided in the fundus photography device 100 may be provided in the fundus photography device 100.

In the present embodiment, the monitor 80 is used as a display unit (display device) of an image captured by the fundus photography device 100. The monitor 80 may be, for example, a general-purpose monitor or a monitor provided in the device. Instead of the monitor 80, another display device such as a head-mounted display may be used as the display unit.

<Operation explanation>
Hereinafter, the operation of the fundus image observation system having the above configuration will be described.

In the examination on the same day, the eye E to be inspected may be photographed by a plurality of imaging methods. The fundus photography apparatus 100 appropriately switches the imaging method according to the operation of the examiner, and the fundus photography apparatus 100 captures an IR image, a color image, a spontaneous fluorescence image, a fluorescence contrast image, and the like. The captured fundus image is stored in the memory of the apparatus in association with the identification information indicating the imaging method.

<Fluorescence contrast photography>
Here, the flow of imaging will be described in detail using fluorescence contrast imaging as an example. When the contrast medium is intravenously injected into the subject, the amount of the contrast medium flowing into the blood vessels of the fundus rapidly increases after a certain period of time has passed from the intravenous injection, and then gradually decreases. In the initial stage of contrast immediately after intravenous injection, the contrast medium flows in the order of thick blood vessels → thin blood vessels. At this time, the change in the state of fluorescence emission at the fundus is large and rapid. On the other hand, in the middle stage of the contrast medium and the late stage of the contrast medium, which is more time after the injection of the contrast medium, the contrast medium is sufficiently distributed in the blood vessels, so that the change in the state of fluorescence emission in the fundus is small.

Therefore, in a series of fluorescence contrast imaging from the initial stage of contrast enhancement to the latter stage of contrast enhancement, continuous imaging of the fluorescence contrast image may be started based on the imaging trigger signal (first trigger signal in the present embodiment) at the initial stage of contrast enhancement. In continuous imaging, a fluorescence contrast image is continuously captured for at least 10 seconds to several minutes or several tens of minutes after the imaging trigger signal is output. That is, during this period, light is projected onto the fundus and the return light is received by the light receiving element. As a result of continuous shooting, a group of shot images is acquired by the fundus photography device 100.

The captured image group includes a continuous plurality of frames of fluorescence contrast images (fundus image by fluorescence) captured at regular intervals after the output timing of the capture trigger signal (first trigger signal in the present embodiment). In SLO, by periodically scanning a predetermined range of the fundus, it is possible to obtain one frame of captured images every time the predetermined range is scanned once (that is, for one cycle). The captured image group may be composed of fluorescence contrast images obtained by fundus scanning of each cycle during the imaging period. Alternatively, the fluorescence contrast image obtained by the fundus scanning of 1 cycle, (or 2 cycles, 3 cycles, ... n cycles) may constitute a group of captured images. The fundus photography apparatus 100 obtains captured images of several frames at least every second.

In the following, each fluorescence contrast image included in the captured image group may be hereinafter referred to as a frame image for convenience.

Further, in a series of fluorescence contrast imaging, a fluorescence contrast image may be taken in a single shot based on the output of the imaging trigger signal (second trigger signal in the present embodiment) in the middle stage and the late stage of contrast. In this case, a still image of the fluorescence contrast image is taken in a single shot immediately after the output of the shooting trigger signal. The single-shot imaging referred to here means that at least one predetermined number of fluorescence contrast images can be obtained by using the output of the imaging trigger signal as an opportunity. In single-shot shooting, shooting is performed in a shorter time than continuous shooting. The number of fluorescence contrast images obtained for each imaging trigger signal is preferably limited to about ten at most. The fluorescence contrast image obtained as a result of single-shot imaging is hereinafter referred to as a contrast still image for convenience. The contrast still image may be an image having a larger number of pixels (for example, higher resolution) than the frame image obtained by continuous contrast imaging.

Fluorescence contrast imaging is not necessarily limited to these described methods. A contrast still image may be taken in the early stage of contrast, and a continuous contrast may be taken in the latter stage of contrast.

A part or all of the plurality of fluorescence contrast images obtained as a result of a series of fluorescence contrast imaging may be additive images. In both FA and ICGA, the fluorescence from the fundus is weak, which is particularly remarkable in the early stage of contrast enhancement and the late stage of contrast enhancement. Therefore, for example, a good fluorescence contrast image may be obtained by acquiring fluorescence contrast images for a plurality of consecutive frames and adding them (may be an addition average, a weighted average, or the like).

The fundus photography device 100 captures a reflection image at the same time as each fluorescence contrast image. The reflected image can be used to associate the positional relationship of each fluorescence contrast image. The details of the reflected image will be described later.

Next, a specific example of the operation of the apparatus in fluorescence contrast imaging will be described with reference to FIG.

[T0: Alignment and shooting condition settings]
First, the examiner aligns the device with respect to the eye to be inspected, and also sets the imaging conditions. The imaging conditions set in this case include at least conditions regarding the wavelength of the light that irradiates the fundus as the excitation light. For example, in the case of FA, blue or green light is set as the excitation light. In the case of ICGA, light in the infrared region is set as excitation light. When FA and ICGA are performed at the same time, two types of wavelength ranges corresponding to each are set as excitation light. Further, in the present embodiment, the light in the second infrared region is further set as the light to be applied to the fundus. The light in the second infrared region is also used as light for observing the fundus and light for obtaining a reflected image. The second infrared region and the infrared region for ICG excitation belong to different wavelength regions.

[T1: Start of fluorescence contrast imaging]
After the alignment and imaging conditions have been set, the examiner intravenously injects the contrast medium into the subject. At the same time (or immediately after), an operation input for starting a series of fluorescence contrast imaging is performed on the input interface of the fundus photography apparatus 100. As a result, the fundus photography apparatus 100 starts fluorescence contrast imaging.

Along with the fluorescence contrast imaging, the contrast timer is activated in the fundus photography apparatus 100. The contrast timer is a time measuring means for measuring the passage of time from the start of contrast. That is, the contrast time (also referred to as the time phase) is managed by the contrast timer. The contrast timer may be displayed on the monitor 80. In this embodiment, the measurement time of the contrast timer at the imaging timing is stored in the memory in association with each fundus image (fluorescence contrast image and reflection image) captured by the series of fluorescence contrast imaging.

During a series of fluorescence imaging, the fundus is continuously irradiated with excitation light (further scanning in SLO), and a fundus image due to fluorescence from the fundus caused by irradiation with excitation light is obtained by a fundus photography apparatus. By 100, it may be acquired sequentially. The images sequentially acquired may be displayed on the monitor 80 as observation images (real-time moving images). As a result, the shooting range and the deviation of the fixation can be confirmed from the reflected image. In addition, the examiner can perform the trigger operation at an appropriate timing by confirming the observation image by fluorescence.

[T1-t2: Initial stage of contrast enhancement]
In the present embodiment, continuous contrast imaging is started from the start timing of a series of fluorescence contrast imaging. That is, the imaging trigger signal for continuous contrast imaging is output based on the start operation for continuous contrast imaging. As a result of continuous contrast imaging, a group of captured images including a plurality of frames of fluorescence contrast images is stored in the memory. At the same time, in the present embodiment, the reflection image taken at the same time as each fluorescence contrast image may be stored in the memory. The continuous contrast imaging may be automatically terminated after a certain period of time has elapsed from the start, may be terminated manually based on a predetermined operation on the input interface of the fundus imaging apparatus 100, or other termination conditions may be satisfied. It may end when

In the present embodiment, the frame images (fluorescence contrast images) that are sequentially acquired are displayed on the monitor 80 as real-time moving images. At the same time, the reflected image taken together with each frame image may be displayed as a moving image. The examiner can confirm the shooting range and the deviation of the fixation from the reflected image.

Of the group of captured images acquired as a result of continuous contrast imaging, the images used for image interpretation and the like may be a part. Therefore, a part of the frame images in one captured image group may be registered as a key frame. The "key frame" referred to here is an image showing a desired contrast state among a plurality of frame images obtained as a result of continuous contrast imaging.

For example, a frame image or the like formed within a few seconds when the contrast medium flows into the CNV (choroidal neovascularization), which is useful in diagnosis, may be selected as one of the key frames. A plurality of frames of keyframes can be selected for one continuous contrast imaging. For example, it may be a frame image acquired at a predetermined timing, or it may be a frame image acquired at a timing when a predetermined trigger operation is performed during continuous contrast imaging. In addition, keyframes may be selectable after the shooting.

In the present embodiment, the key frame is preferentially displayed on the viewer screen described later as compared with other frame images of the captured image group. For example, other frame images may require more operation input than keyframes from the time the viewer screen is started until they are displayed, and other frame images are hidden on the viewer screen. You may be.

[T2 to t3: middle and late contrast enhancement]
Then, the contrast-enhanced still image is taken at an appropriate time of several minutes to several tens of minutes. At the time of this imaging, the fundus imaging device 100 acquires an observation image and causes the monitor 80 to display the acquired image. The imaging operation is performed (for example, pressing the release button) while confirming the contrast state or the imaging range using the observation image at arbitrary timings in the middle stage and the late stage of contrast enhancement. An imaging trigger signal (second trigger signal) is input to the fundus photography apparatus 100 based on the imaging operation. As a result, the fundus photography device 100 acquires a contrast-enhanced still image. At this time, by projecting the light for photographing the reflected image on the fundus together with the excitation light, the reflected image can be obtained at the same time as the contrasted still image. In this way, in the middle and late stages of imaging, the contrast-enhanced still image and the reflected image are simultaneously acquired and stored in the memory for each imaging operation.

The number of contrast still images taken in the middle stage and the late stage of contrast enhancement is smaller than the number of frame images constituting the captured image group taken in the initial stage of contrast enhancement. Therefore, in the present embodiment, each contrast-enhanced still image is displayed with the same priority as the key frame on the viewer screen described later.

<Acquisition of shooting results>
The fluorescence contrast image and the reflection image taken by the fundus photography apparatus 100 as described above are stored in a memory (here, memory 71) accessible from the processor of the computer 1. As a result, in the present embodiment, the fundus images taken by a plurality of different photographing methods are acquired by the computer 1. In detail, a plurality of frames of fluorescence contrast images obtained by a series of fluorescence contrast imaging are acquired. Further, a reflected image may be further acquired.

Further, as described above, in the present embodiment, information indicating the measurement time of the contrast timer when each fluorescence contrast image and reflection image is taken is further stored in the memory 71.

<Display of viewer screen>
The arithmetic control unit 70 of the computer 1 displays the viewer screen on the monitor 80. The fundus image is displayed on the viewer screen. This viewer screen is used for selecting a fundus image to be output as a report or the like, or for editing (processing an image) or the like.

3 and 4 show an example of the viewer screen. The viewer screens shown in FIGS. 3 and 4 are used to display at least a fundus image taken on a shooting day designated by the examiner. On the viewer screen in this embodiment, the first display area 201 (see FIG. 3) and the second display area 202 (see FIG. 4) are selectively displayed. Further, in this embodiment, various widgets are arranged on the viewer screen. Widgets here are a general term for GUI interface parts (UI parts), and are also called controls. As specific examples of widgets, various things such as buttons, sliders, check boxes, text boxes, etc. are known.

Some of the widgets displayed on the viewer screen include, at least, those that are manipulated to switch the display area on the viewer screen. On the viewer screen, the first display area 201 (see FIG. 3) and the second display area 202 (see FIG. 4) are switched and displayed based on the operation input to the widget.

<Various widgets on the viewer screen>
On the viewer screens of FIGS. 3 and 4, a plurality of tabs 211 to 216 are arranged above the display areas 201 and 202 as an example of the widget used for the operation of switching the display area. The display areas 201 and 202 are switched by selecting and operating any one of the plurality of tabs 211 to 216 via the pointing device. Further, the fundus images displayed in the respective display areas 201 and 202 can be appropriately enlarged according to a predetermined operation. By selecting the fundus image based on a predetermined operation, magnified observation on another screen (second viewer screen) may be possible.

In the first display area 201, among a plurality of fundus images taken by different shooting methods, the fundus image by any of the shooting methods is selectively arranged. That is, the fundus image captured by a single imaging method can be displayed in the first display area 201. Tabs 212 to 216 (for example, ICGA tab 212, FA tab 213, Color tab 214, FAF tab 215, and IR tab 216) corresponding to each shooting method correspond to the first display area 201. When any of these is selected, the first display area 201 is displayed on the viewer screen. In the first display area 201, the fundus image according to the selected tab and the corresponding photographing method is selectively displayed.

Further, in this embodiment, the second display area 202 is displayed on the viewer screen by selecting the tab for comparison display (Comparison tab 211). In the second display area 202, a plurality of fundus images taken by different photographing methods and registered as registered images in advance can be selectively displayed. The "registered image" may be used, for example, for comparison with other fundus images having different imaging methods.

As other widgets, the viewer screen shown in FIGS. 3 and 4 has a left / right eye switching button 231, a follow-up button 232, a data output button 234, an image editing button 235, and the like.

The left / right eye switching button 231 is operated to switch the fundus image displayed on the viewer screen between the image of the right eye and the image of the left eye.

The follow-up button 232 is operated to display fundus images having different shooting dates in parallel on the display areas 201 and 202. After operating the follow-up button 232, it becomes possible to further accept an operation for designating the shooting date. In the present embodiment, the fundus image on the shooting date specified at this time is displayed in parallel with the fundus image already displayed in the display areas 201 and 202. Reports suitable for follow-up observation can be created via the viewer screen.

The data output button 233 is operated to output the fundus image selected, edited, etc. on the viewer screen. For example, when the button 233 is operated, it may be output in a predetermined report format. The output may be a display output, a data output, or a print output.

The image editing button 234 is a fundus image displayed in the display area and is operated when editing the image selected by the examiner. Through the image editing button 234, execution of various image processing such as brightnessness, contrast correction, gamma correction, sharpening, and smoothing may be accepted.

<First display area>
As shown in FIG. 3, the fundus image by a single photographing method is displayed in the first display area 201.

For example, when either FA tab 212 or ICGA tab 213 is selected, the fundus image obtained by fluorescence contrast imaging is displayed in the first display area 201. In this case, from the plurality of frames of fluorescence contrast images obtained for each imaging trigger signal, a fluorescence contrast image captured at an arbitrary imaging time can be selected and registered as a registration image.

In the present embodiment, a key frame and a contrast still image are displayed in the display area among a large number of fundus images obtained by a series of fluorescence contrast imaging. As a result, the registration work of the registered image can be efficiently performed.

Further, in the first display area 201, an operation for registering the fundus image as a registered image can be accepted for each fundus image displayed in the first display area 201. As shown in FIG. 3, a check box 237 (an example of a second widget) may be arranged around each fundus image in the first display area 201 (upper part in the figure). The check box 237 is selected, and the checked fundus image is registered as a registered image.

When a fluorescence contrast image is displayed on the viewer screen, information indicating the contrast time is displayed in association with each fluorescence contrast image. The information indicating the contrast time may be the value of the contrast timer at the time of imaging, or may be the imaging date and time. As an example, in the viewer screen shown in FIGS. 3 and 4, the contrast time is graphically shown by using the contrast bar 240. The ratio of the fill to the margin on the contrast bar 240 indicates the ratio of the elapsed time to the remaining time. As a result, the examiner can intuitively grasp the contrast time in each fundus image.

Further, for example, when the Color tab 214 is selected, a color image is displayed, when the FAF tab 215 is selected, a spontaneous fluorescence image is displayed, and when the IR tab 216 is selected, an infrared image is displayed. In this case as well, the registered image may be registered by the same operation as when the FA tab 212 or the ICGA tab 213 is selected. Note that these tabs are only examples, and other tabs may be provided as appropriate depending on the shooting method. For example, a tab corresponding to a wide-angle fundus image may be provided. Tabs corresponding to the wide-angle fundus image may be further provided for each detailed imaging method (for example, FA, ICGA, Color imaging, FAF imaging, IR imaging, etc. at wide angle, respectively).

<Second display area>
As shown in FIG. 4, in the second display area 202, registered images registered in advance for each shooting method can be displayed side by side in the second display area 202. At this time, in the second display area 202, a plurality of fundus images having different imaging methods may be arranged in a mixed manner. Since each fundus image is picked up for each shooting method in the first display area 201, even if a plurality of fundus images having different shooting methods are mixed in the second display area 202, they can be viewed. It's easy to do. Therefore, according to the viewer screen of the present embodiment, an image selected by the examiner is preferably displayed from among a plurality of fundus images taken by different imaging methods.

Identification information indicating an imaging method is attached to each fundus image on the viewer screen shown in FIGS. 3 and 4. As an example, a frame portion (for example, a header portion) in each fundus image is colored according to the photographing method. Further, the tabs 212 to 216 are also colored according to the shooting method. This makes it easier for the examiner to intuitively grasp the photographing method in each fundus image displayed in the second display area 202. The identification information indicating the photographing method may be, for example, text indicating the photographing method or other information.

In the viewer screen shown in FIGS. 3 and 4, the operation for switching the display area is sufficient for the selection operation of tabs 211 to 216. In other words, it is satisfied with one-action operation input. Since the display state is switched by one action, workability is improved in the work of the examiner selecting the registered image in the first display area 201 and comparing the selected images with each other in the second display area 202. .. The one-action operation referred to here is the only operation required for switching the display area. In other words, in switching the display area, confirmation is not required after the operation is performed.

<Reuse of registration results>
The registration result of the registration work may be reused between the left and right eyes. More specifically, the control unit 70 automatically registers the ophthalmologic image registered as the registered image for one eye and the fundus image for the opposite eye taken under the same conditions as the registered image for the opposite eye. May be good. For example, after the registered image is registered for one eye, the registered image for the opposite eye may be automatically set by operating the left / right eye switching button 231. The same condition means that the conditions for one or both of the imaging method and the imaging timing (for example, the contrast timing) are the same. In this embodiment, since the left and right eyes cannot be photographed at the same time, strict identity in the imaging timing is not required. For example, the image of each eye taken within a predetermined time may be treated as an image taken under the same conditions regarding the shooting timing. As a result, the work of registering the registered images for both the left and right eyes can be efficiently advanced.

Further, the present invention is not limited to this, and the registration result of the registration work at one time may be reused in the subsequent registration work. That is, a fundus image taken under the same conditions as each fundus image arranged in the second display area 202 at a certain time may be automatically set as a registered image at the time of a new registration operation. ..

"Transformation example"
Although the above description has been made based on the embodiment, the present disclosure is not limited to the above embodiment. The present disclosure may include various modifications to the above embodiments.

<Simultaneous display of the first display area 201 and the second display area 202>
In the above embodiment, the first display area 201 and the second display area 202 are selectively displayed on the viewer screen based on the operation of tabs 201 to 206. However, the present invention is not necessarily limited to this, and the first display area 201 and the second display area 202 may be displayed simultaneously (in other words, in parallel) on the viewer screen. In this case, by dragging and dropping the fundus image displayed in the first display area 201 to the second display area 202, a registration operation for registering the dragged and dropped fundus image as a registered image may be performed. ..

<Pre-setting of conditions to be registered in the registered image>
In the above embodiment, in order to register various fundus images acquired by the computer 1 as registered images, a registration operation on the viewer screen is required for each image.

On the other hand, by setting the conditions to be registered as the registered images in advance, among the fundus images acquired by the computer 1, the images that meet the conditions may be registered as the registered images in advance. Such an image may be displayed as a registered image on the viewer screen without requiring a registration operation via the viewer screen.

The preset conditions may be selectable from, for example, the following three conditions. These conditions may be set for each shooting method.
First condition: All images taken by a specific shooting method are registered as registered images.
Second condition: An image obtained in a fluorescence contrast image with a predetermined elapsed time is registered as a registered image.
Third condition: The registered image is not pre-registered.

The first condition is suitable for color images, spontaneous fluorescence images, and IR images. Since the number of times these images are taken in one day is generally smaller than that of the fluorescence contrast image, each fundus image is registered by being registered as a registered image in the default setting. The burden on the examiner required for image setting work is reduced.

The second condition is useful when the contrast examination is routinely worked in the facility. The elapsed time in the second condition may be set to any time, or may be set to a plurality.

<Alignment>
For example, in the above embodiment, the fundus images displayed on the viewer screen may be displayed in a state of being aligned with each other (positional deviation is corrected). For the alignment process at this time, for example, the technique disclosed in Japanese Patent Application Laid-Open No. 2016-59400 by the applicant may be used.

<Defective judgment>
For example, in the above embodiment, the computer 1 may determine whether or not the fundus image stored in the memory 71 is defective in imaging, and may exclude the image determined to be defective in imaging from the display target on the viewer screen. .. When the fluorescence contrast image is poorly photographed, the reflected image taken at the same time is also poorly photographed. Therefore, the above determination may be made based on the reflected image. In particular, in the initial stage of contrast enhancement, the contrast state changes significantly and quickly. Therefore, it may be difficult to determine the imaging defect from the fluorescence contrast image itself. However, since the imaging conditions of the reflected image are constant, it is possible to easily determine the imaging defect.

<Application to other modality>
Further, the fundus image observation program of the embodiment is not limited to application to fluorescence contrast imaging, and a large number of images are acquired as a result of outputting multiple imaging trigger signals in a series of imaging (for example, imaging on the same day). It is also applicable when a desired image is extracted from the captured image of the eye to be inspected. For example, the applicable images of the eye to be examined are diverse. Specific examples thereof include an OCT image, a functional OCT image (specific example, a motion contrast image), an OCT image or an Enface image based on the functional OCT image, a fundus image, and an anterior segment image. In addition, the fundus image observation program of the embodiment may be used when administering the drug and evaluating the reaction to the drug over time in the eye to be examined.

Further, in the above embodiment, the plurality of fundus images acquired by the computer 1 and displayed on the viewer screen may be captured by a single photographing optical system. The fundus image acquired by the computer 1 and displayed on the viewer screen may additionally include a fundus image taken by another photographing optical system. For example, the computer 1 may further acquire an OCT image of the eye to be inspected acquired through an OCT optical system (not shown) and display it on the viewer screen together with the SLO image.

1 Computer 70 Arithmetic control unit (processor)
80 Monitor 100 Fundus photography device 201 First display area 202 Second display area

Claims (6)

By being executed by the computer's processor
An acquisition step of acquiring a plurality of fundus images taken by different imaging methods depending on the fundus imaging device, and
A fundus image observation program for causing the computer to execute a display control step of displaying one or more fundus images on a monitor.
In the display control step,
Of the plurality of fundus images taken by different imaging methods, the fundus image by any of the imaging methods is selectively arranged, and the fundus image is registered as a registered image for each of the arranged fundus images. A first display area that can accept operations for
Further, a fundus image observation program for displaying a second display area on which the registered images registered for each photographing method can be displayed in a list on the monitor. The fundus image observation program according to claim 1.
In the display control step,
The first display area and the second display area are selectively displayed on the monitor, and the first display area and the second display area are selectively displayed on the monitor.
A widget for switching the display area to be selectively displayed is displayed on the monitor.
The first display area and the second display area are switched and displayed based on the operation input for the widget. The fundus image observation program according to claim 1 or 2.
In the display control step, the first display area and the second display area are switched based on the one-action operation input to the widget. The fundus image observation program according to any one of claims 1 to 3.
The plurality of fundus images taken by different imaging methods include at least a fluorescence contrast image taken by a series of fluorescence contrast imaging. The fundus image observation program according to claim 4.
When the fluorescence contrast image is displayed in the first display state, information indicating the contrast time is displayed in association with each of the fluorescence contrast images. The fundus image observation program according to any one of claims 1 to 5.
In the display control step, the fundus image displayed in the display area includes a common imaging range.

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