JP6271927B2 - Laser treatment system - Google Patents

Description

  The present invention relates to a laser treatment system used in the ophthalmic field.

  An ophthalmic laser treatment system is used for photocoagulation or photoablation of tissue. In a conventional laser treatment system, aiming is performed while observing a front image of an eye using an observation device such as a slit lamp microscope or a surgical microscope. In recent years, laser treatment systems incorporating an optical coherence tomography apparatus (OCT) apparatus capable of acquiring a cross-sectional image of the eye have also appeared.

  Further, in the laser treatment system, the sighting light composed of a spot pattern of a predetermined arrangement is projected onto the fundus oculi, and thereby the treatment laser light is sequentially irradiated to a plurality of positions aimed at. Are known.

Japanese Patent No. 4126054 Special table 2010-538700 gazette Japanese Patent No. 4377405 Special table 2009-514564 gazette

  In laser treatment, it is important to aim accurately at a diseased part. Aiming is performed by observing the patient's eyes from the front using a slit lamp microscope or a surgical microscope. However, in the conventional laser treatment system, there is a case where a site to be observed such as a diseased part cannot be reliably illuminated.

  In addition, it is also important to appropriately control the irradiation of the laser beam in order to reliably treat the diseased part and to prevent the normal site from being irradiated with the laser beam as much as possible. For this purpose, it is necessary to accurately image a laser beam irradiation site and to perform this imaging substantially in real time. The diseased part is not limited to the surface of the fundus and the like, and the thermal energy applied by the laser light diffuses three-dimensionally, so this imaging is preferably a cross-sectional measurement.

  An object of the present invention is to provide a technique capable of reliably illuminating a site to be observed in laser treatment in the ophthalmic field.

  Another object of the present invention is to provide a technique capable of performing OCT measurement of a laser beam irradiation site substantially in real time while maintaining positional accuracy.

The laser treatment system according to the embodiment includes an illumination optical system for illuminating a patient's eye, an observation optical system for observing the patient's eye illuminated by the illumination optical system, a treatment laser beam, and the treatment laser. The irradiation optical system for irradiating the patient's eye with the aiming light for aiming the light, the light from the light source is divided into measurement light and reference light, and the return light of the measurement light from the patient's eye and the reference An interference optical system that guides interference light obtained by superimposing the light to the detection means, and an optical path synthesis that combines the optical path of the illumination optical system, the optical path of the irradiation optical system, and the optical path of the measurement light substantially coaxially. Means, optical scanning means provided closer to the patient's eye than the combined position of the optical path of the irradiation optical system and the optical path of the measurement light by the optical path combining means, control of the irradiation optical system, and the interference optical system Control and control of the optical scanning means Patients have a and control means, wherein the optical path combining portion includes a first synthetic members for synthesizing substantially coaxial and optical path of the light path and the measuring beam of the illumination optical system, than the first synthetic member A second combining member that is provided on the eye side and combines the optical path of the irradiation optical system and the measurement light by the first combining member and the optical path of the illumination optical system substantially coaxially; And the optical scanning means is disposed in the synthetic optical path between the first synthetic member and the second synthetic member, and the first synthetic member has a third light guide having a plurality of light guides. Each of the aiming light and the therapeutic laser light includes a first light guide path determined in advance among the plurality of light guide paths, the light scanning means, and the second combining member. And the measurement light is emitted from the plurality of light guide paths in front of the patient's eye. A predetermined second light guide path different from the first light guide path, the optical scanning means, and the second combining member are irradiated to the patient's eye, and the plurality of light guide paths are The first optical waveguide includes two or more optical waveguides having different diameters, and the irradiation optical system selectively enters each of the aiming light and the therapeutic laser light with respect to the two or more optical waveguides. The second light guide path is disposed along a central axis of the third light guide means, and the two or more light guide paths as the first light guide paths are the second light guide paths. It is arranged around the light guide.
In the laser treatment system according to the embodiment, the third light guide unit includes a fiber bundle configured by bundling a plurality of optical fibers as the plurality of light guide paths, or a plurality of the plurality of light guide paths. It may be a multi-core fiber having a plurality of cores.

  According to the embodiment, a site to be observed can be reliably illuminated.

  In addition, according to the embodiment, OCT measurement of a laser beam irradiation site can be performed substantially in real time while maintaining positional accuracy.

It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the example of the pattern of the irradiation light by the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment. It is the schematic which shows the structural example of the laser treatment system which concerns on a modification. It is the schematic which shows the structural example of the laser treatment system which concerns on a modification. It is the schematic which shows the structural example of the laser treatment system which concerns on embodiment.

  An example of an embodiment of a laser treatment system according to the present invention will be described in detail with reference to the drawings. In addition, in embodiment, it is possible to use arbitrarily the technique described in the literature referred in this specification.

  The direction used in the embodiment is defined. The direction from the apparatus optical system toward the patient is referred to as “front direction”, and the opposite direction is referred to as “rear direction”. Further, a horizontal direction orthogonal to the front direction is referred to as a “left-right direction”. The left direction and the right direction may be arbitrarily set (for example, the left eye side of the patient is the left direction and the right eye side is the right direction). Furthermore, a direction perpendicular to both the front-rear direction and the left-right direction is referred to as “vertical direction”. The upward direction substantially coincides with the vertically upward direction, and the downward direction substantially coincides with the vertically downward direction.

<First Embodiment>
A configuration example of the laser treatment system according to the first embodiment is shown in FIG. 1A. The optical system of the laser treatment system 1000 includes an illumination optical system 1100, an observation optical system 1200, an irradiation optical system 1300, an interference optical system 1400, a first synthesis member 1510, a second synthesis member 1520, and light. A scanning unit 1600. The control unit 1800 controls each part of the laser treatment system 1000.

  The illumination optical system 1100 illuminates the fundus oculi Ef of the patient's eye E. The observation optical system 1200 is used to observe the fundus oculi Ef illuminated by the illumination optical system 1100.

  The observation optical system 1200 is configured to guide return light from the fundus oculi Ef illuminated by the illumination optical system 1100 to an eyepiece and / or an imaging device. The former is used for visual observation of the fundus oculi Ef, and the latter is used for observation of a display image of the fundus oculi Ef. This display image is provided by controlling the display unit 1900 by the control unit 1800 that has received a signal from the imaging apparatus.

  Note that the return light from the fundus oculi Ef is guided to the observation optical system 1200 via the left and right positions of the reflection mirror 1210. An example of an optical system for this purpose is shown in FIG. 1B. The reflection mirror 1210 has a wide part and a narrow part. In the example illustrated in FIG. 1B, a narrow portion is provided on the second composite member 1520 side (upper side). The light output from the illumination optical system 1100 passes through the second synthesis member 1520 and reaches the reflection mirror 1210, is reflected by the reflection mirror 1210 at a narrow width portion, and enters the patient's eye E. The fundus reflection light passes through both sides (left and right positions) of the narrow portion of the reflection mirror 1210 and enters the observation optical system 1200. In the example shown in FIG. 1B, the optical path passing through the optical scanning unit 1600 is described so as to be guided to the patient's eye E through a portion where the width of the reflection mirror 1210 is narrow. May be configured to pass through a wide portion. Further, the optical path may be configured to pass through both a narrow part and a wide part. That is, the optical path may be configured to pass through a narrow part or a wide part depending on the deflection direction by the optical scanning unit 1600.

  The irradiation optical system 1300 has a function of irradiating the fundus Ef with the treatment laser light and a function of irradiating the fundus Ef with the aiming light for aiming the treatment laser light. The irradiation position of the treatment laser light and the aiming light on the fundus oculi Ef is moved by the optical scanning unit 1600.

  The interference optical system 1400 divides the light from the light source into measurement light and reference light, and guides interference light obtained by superimposing the return light from the fundus oculi Ef of the measurement light and the reference light to the detection means. In the laser treatment system 1000, for example, spectral domain type or swept source type OCT is applied. The irradiation position of the measurement light on the fundus oculi Ef is moved by the optical scanning unit 1600.

  When spectral domain type OCT is applied, the light source includes a low-coherence light source that emits low-coherence light, and the detection unit uses spectral information of the interference light generated by the interference optical system 1400 based on the low-coherence light. Includes a spectrometer to acquire. The spectral information acquired by the spectroscope is input to the image forming unit 1700. The image forming unit 1700 forms an image of the fundus oculi Ef based on the spectral information input from the spectroscope. This image is a two-dimensional cross-sectional image or a three-dimensional cross-sectional image. The control unit 1800 causes the display unit 1900 to display the image formed by the image forming unit 1700.

  When the swept source type OCT is applied, the light source includes a wavelength swept light source capable of sweeping the output wavelength, and the detection means is generated by the interference optical system 1400 based on the light output from the wavelength swept light source. A photodetector for detecting interference light. The photodetector sends a signal as a detection result of the interference light to the image forming unit 1700. The image forming unit 1700 forms a fundus oculi Ef image based on the detection results sequentially obtained by the photodetector as the output wavelength is swept. This image is a two-dimensional cross-sectional image or a three-dimensional cross-sectional image. The control unit 1800 causes the display unit 1900 to display the image formed by the image forming unit 1700.

  The first synthesis member 1510 and the second synthesis member 1520 are substantially coaxial with the optical path of the illumination optical system 1100, the optical path of the irradiation optical system 1300, and the optical path of the measurement light guided by the interference optical system 1400. It functions as optical path combining means for combining. The optical scanning unit 1600 is provided closer to the patient's eye E than the combined position of the optical path of the irradiation optical system 1300 and the optical path of the measurement light. In this example, the first combining member 1510 combines the optical path of the irradiation optical system 1300 and the optical path of measurement light substantially coaxially. The second combining member 1520 is provided closer to the patient's eye E than the first combining member 1510, the combined optical path of the irradiation optical system 1300 and the measurement light by the first combining member 1510, and the optical path of the illumination optical system 1100. Are synthesized substantially coaxially. The optical scanning unit 1600 is disposed between the first combining member 1510 and the second combining member 1520. That is, the optical scanning unit 1600 is arranged on the first combining member 1510 side in the combined optical path of the irradiation optical system 1300 and the measurement light with respect to the position where the combined optical path is combined with the optical path of the illumination optical system 1100. .

[Concrete example]
A specific example of the laser treatment system according to this embodiment is shown in FIG. The laser treatment system 1 is used for performing laser treatment on the fundus oculi Ef of the patient's eye E to be treated. The laser treatment system 1 also has a function for observing the fundus oculi Ef from the front and a function for acquiring a cross-sectional image of the fundus oculi Ef.

  The laser treatment system 1 includes a light source unit 2, a slit lamp microscope 3, an optical fiber 4, a processing unit 5, an operation unit 6, a display unit 7, an OCT unit 8, and an optical fiber 9. Instead of the slit lamp microscope 3, a known observation device such as a surgical microscope or a fundus camera may be used.

  The light source unit 2 and the slit lamp microscope 3 are optically connected via an optical fiber 4. The optical fiber 4 has one or more light guide paths. When two or more light guide paths are provided, the optical fiber 4 may be a multi-core fiber or a fiber bundle. The optical fiber 4 may be an image fiber (image transmission fiber).

  The OCT unit 8 and the slit lamp microscope 3 are optically connected via an optical fiber 9. The optical fiber 9 is, for example, a single mode fiber.

  The processing unit 5 is connected to each of the light source unit 2, the slit lamp microscope 3, the operation unit 6, the display unit 7 and the OCT unit 8 so as to be able to transmit signals. The signal transmission form may be wired or wireless.

  The processing unit 5 includes a computer that operates in cooperation with hardware and software. The processing executed by the processing unit 5 will be described later. The operation unit 6 includes various hardware keys and / or software keys (GUI). Examples of hardware keys include buttons, handles, and knobs provided on the slit lamp microscope 3, and keyboard pointing devices (mouse, trackball) provided on a computer (processing unit 5, etc.) connected to the slit lamp microscope 3. Etc.) and a separate foot switch / operation panel. The software key is displayed, for example, on a slit lamp microscope 3 or a display device provided in the computer.

(Light source unit 2)
The light source unit 2 generates light irradiated to the fundus oculi Ef. The light source unit 2 includes an aiming light source 2a, a therapeutic laser light source 2b, a galvano mirror 2c, and a light shielding plate 2d. Note that members other than the members shown in FIG. 2 can be provided in the light source unit 2. For example, an optical element (such as a lens) for causing the light generated by the light source unit 2 to enter the end face of the optical fiber 4 can be provided immediately before the optical fiber 4.

(Aiming light source 2a)
The aiming light source 2a emits aiming light LA for aiming at a site where laser treatment is performed. An arbitrary light source is used as the aiming light source 2a. For example, if the configuration aiming while observing the fundus oculi Ef with the naked eye is applied, a light source for emitting a recognizable visible light by the operator's eye E ₀ (a laser light source, light emitting diode, or the like) is used as an aiming light source 2a. In addition, when a configuration in which the aim is adjusted while observing a captured image of the fundus oculi Ef is applied, a light source (laser light source, light emitting diode, or the like) that emits light in a wavelength band in which the imaging element for acquiring the captured image has sensitivity is used. Used as the aiming light source 2a. The aiming light LA is guided to the galvanometer mirror 2c. The operation of the aiming light source 2a is controlled by the processing unit 5.

(Therapeutic laser light source 2b)
The treatment laser light source 2b emits light (treatment laser light LT) used for laser treatment (photocoagulation, photoablation, etc.) of the fundus oculi Ef. The therapeutic laser beam LT may be a visible laser beam or an invisible laser beam depending on the application. The therapeutic laser light source 2b may be a single laser light source or a plurality of laser light sources that emit laser beams of different wavelength bands. The therapeutic laser beam LT is guided to the galvanometer mirror 2c. The operation of the treatment laser light source 2 b is controlled by the processing unit 5.

(Galvano mirror 2c)
The galvano mirror 2c includes a mirror having a reflecting surface and an actuator that changes the direction of the mirror (the direction of the reflecting surface). The aiming light LA and the treatment laser light LT reach the same position on the reflection surface of the galvanometer mirror 2c. The aiming light LA and the therapeutic laser light LT may be collectively referred to as “irradiation light”. The direction of the galvano mirror 2c (the reflection surface thereof) is at least a direction in which the irradiation light is reflected toward the optical fiber 4 (irradiation direction) and a direction in which the irradiation light is reflected toward the light shielding plate 2d (stop direction). And changed. The operation of the galvano mirror 2 c is controlled by the processing unit 5.

(Light shielding plate 2d)
When the galvanometer mirror 2c is arranged in the stopping direction, the irradiation light reaches the light shielding plate 2d. The light shielding plate 2d is a member made of, for example, a material and / or form that absorbs irradiation light, and has a light shielding effect.

  In this embodiment, the aiming light source 2a and the therapeutic laser light source 2b each continuously emit light. And the irradiation light is irradiated to the patient eye E by arrange | positioning the galvanometer mirror 2c in the direction for irradiation. Moreover, the irradiation of the irradiation light with respect to the patient's eye E is stopped by arrange | positioning the galvanometer mirror 2c in the direction for a stop. Instead of the galvanometer mirror 2c, the irradiation of the irradiation light to the patient's eye E / irradiation stop is switched by turning on / off the output of the aiming light source 2a and / or the therapeutic laser light source 2b. It is also possible.

(Slit lamp microscope 3)
The slit lamp microscope 3 is an apparatus used for observing the anterior segment of the patient's eye E and the fundus oculi Ef. More specifically, the slit lamp microscope 3 is an ophthalmologic apparatus for illuminating the patient's eye E with slit light and magnifying the irradiation field. Note that “observation” includes one or both of observation with the naked eye and observation of a captured image. The slit lamp microscope 3 of this embodiment has a configuration capable of realizing both the naked eye observation and photographing of the patient's eye E.

  The slit lamp microscope 3 includes an illumination unit 3a, an observation unit 3b, and an eyepiece unit 3c. The illumination unit 3a accommodates the illumination optical system 10 shown in FIG. Moreover, although mentioned later for details, the optical fiber 4 extended from the light source unit 2 and the optical fiber 9 extended from the OCT unit 8 are connected to the illumination part 3a. An observation optical system 30 is stored in the observation unit 3b and the eyepiece unit 3c.

  Although not shown, the slit lamp microscope 3 is provided with operation members such as a lever, a handle, a button, and a knob as in the conventional case. These operation members are functionally included in the operation unit 6. In the configuration shown in FIG. 2, the processing unit 5 that receives the signal from the operation unit 6 controls the slit lamp microscope 3, but a mechanism that operates using such an electric driving force. In addition, a mechanism that operates by a force applied by the operator can be applied.

(Optical system of slit lamp microscope 3)
The optical system of the slit lamp microscope 3 will be described with reference to FIG. FIG. 3 shows a contact lens CL used for laser treatment of the fundus oculi Ef. The slit lamp microscope 3 includes an illumination optical system 10 and an observation optical system 30.

  The illumination unit 3 a of the slit lamp microscope 3 includes an optical system for synthesizing the optical path of the irradiation light input from the light source unit 2 with the illumination optical system 10, and the optical path of the measurement light input from the OCT unit 8. An optical system for combining with the illumination optical system 10 is provided. These optical systems are called synthetic optical systems.

(Illumination optical system 10)
The illumination optical system 10 outputs illumination light for observing the patient's eye E. The illumination unit 3a is configured to be able to change the direction of the optical axis (illumination optical axis) 10a of the illumination optical system 10 in the left-right direction, the up-down direction, the rotation direction, and the elevation direction. Thereby, the illumination direction of the patient's eye E can be changed arbitrarily.

  The illumination optical system 10 includes a light source 11, a converging lens 12, filters 13, 14 and 15, a slit diaphragm 16, imaging lenses 17, 18 and 19, and a deflecting member 20.

  The light source 11 outputs illumination light. The illumination optical system 10 may be provided with a plurality of light sources. For example, both a light source (halogen lamp, LED, etc.) that outputs steady light and a light source (xenon lamp, LED, etc.) that outputs flash light can be provided as the light source 11. Further, a light source for corneal observation and a light source for fundus observation may be provided separately. The converging lens 12 is a lens (or a lens system) that collects the light output from the light source 11. The operation of the light source 11 is controlled by the processing unit 5.

  Each of the filters 13 to 15 is an optical element having an action of removing or weakening a specific component of illumination light. Examples of the filters 13 to 15 include a blue filter, a non-red filter, a neutral density filter, a heat filter, a corneal fluorescent filter, a color temperature conversion filter, a color rendering conversion filter, an ultraviolet cut filter, and an infrared cut filter. Each of the filters 13 to 15 can be inserted into and removed from the optical path of the illumination light. Insertion / removal of the filters 13 to 15 is controlled by the processing unit 5.

  The slit diaphragm 16 forms a slit for generating slit light (slit light). The slit diaphragm 16 has a pair of slit blades. The slit width is changed by changing the interval between the slit blades. A diaphragm member other than the slit diaphragm 16 can be provided in the illumination optical system 10. Examples of the diaphragm member include an illumination diaphragm for changing the amount of illumination light, and an illumination field diaphragm for changing the size of the illumination field. Moreover, it is possible to change the light quantity of illumination light and the size of an irradiation field using members other than these diaphragm members. An example of such a member is a liquid crystal shutter. The operations of the slit diaphragm 16, the illumination diaphragm, the illumination field diaphragm, and the liquid crystal shutter are controlled by the processing unit 5.

  The imaging lenses 17, 18 and 19 are lens systems for forming an image of illumination light. The deflecting member 20 deflects the illumination light that has passed through the imaging lenses 17 to 19 to irradiate the patient's eye E. As the deflection member 20, for example, a reflection mirror or a reflection prism is used.

  Members other than those described above can be provided in the illumination optical system 10. For example, a diffusing plate can be provided in the rear stage of the deflecting member 20 so as to be detachable. The diffusing plate diffuses the illumination light to make the brightness of the illumination field uniform. In addition, a background light source that illuminates the background area of the illumination field with illumination light can be provided.

(Synthetic optics)
The combining optical system is provided in the illumination unit 3 a and functions to combine the optical path from the light source unit 2 and the optical path from the OCT unit 8 with the illumination optical system 10.

  The combining optical system in this embodiment includes a collimator lens 51, a galvano scanner 52, relay lenses 53 and 54, a dichroic mirror 55, a dichroic mirror 91, and a collimator lens 92. The dichroic mirror 91 synthesizes the optical path of the irradiation light from the light source unit 2 and the optical path of the measurement light from the OCT unit 8 substantially coaxially. The combined optical path of the irradiation light and the measuring light obtained by the dichroic mirror 91 is combined substantially coaxially with the optical path of the illumination optical system 10 by the dichroic mirror 55 provided between the slit diaphragm 16 and the imaging lens 17. Is done.

  The irradiation light emitted from the optical fiber 4 is converted into a parallel light flux by the collimator lens 51, reflected by the dichroic mirror 91, and incident on the galvano scanner 52. The galvano scanner 52 deflects the irradiation light two-dimensionally. Irradiation light emitted from the galvano scanner 52 reaches the dichroic mirror 55 via the relay lenses 53 and 54. The dichroic mirror 55 reflects the incident light so as to enter the illumination optical system 10. Irradiation light is incident on the patient's eye E via the imaging lenses 17, 18 and 19 and the deflection member 20.

  The measurement light emitted from the optical fiber 9 is converted into a parallel light beam by the collimator lens 92, passes through the dichroic mirror 91, and enters the galvano scanner 52. The galvano scanner 52 deflects the measurement light two-dimensionally. The measurement light emitted from the galvano scanner 52 reaches the dichroic mirror 55 via the relay lenses 53 and 54. The dichroic mirror 55 reflects the measurement light and makes it incident on the illumination optical system 10. The measurement light enters the patient's eye E through the imaging lenses 17, 18 and 19 and the deflection member 20.

  The galvano scanner 52 includes, for example, a galvanometer mirror for deflecting incident light in the left-right direction and a galvanometer mirror for deflecting incident light in the up-down direction. In these galvanometer mirrors, the deflectable directions of the reflecting surfaces are orthogonal to each other. By changing the directions of these galvanometer mirrors independently, two-dimensional deflection of incident light is realized. The operation of the galvano scanner 52 is controlled by the processing unit 5.

(Observation optical system 30)
The observation optical system 30 is an optical system that guides the surgeon's eye E ₀ the reflected light of the illumination light by the patient's eye E. The observation optical system 30 has a pair of left and right optical systems that enable observation with both left and right eyes. Since the left and right optical systems have substantially the same configuration, only one optical system is shown in FIG.

  The observation unit 3b is configured so that the direction of the optical axis (observation optical axis) 30a of the observation optical system 30 can be changed in the horizontal direction and the vertical direction. Thereby, the direction in which the patient's eye E is observed can be arbitrarily changed.

  The observation optical system 30 includes an objective lens 31, variable magnification lenses 32 and 33, a protective filter 34, an imaging lens 35, an erecting prism 36, a field stop 37, and an eyepiece lens 38. The observation optical system 30 is provided with a photographing system described later.

  The objective lens 31 is disposed at a position facing the patient's eye E. The objective lens 31 may be common to the left and right optical systems, or may be provided separately on the left and right.

  The variable power lenses 32 and 33 constitute a variable power optical system (zoom lens system). The variable power lenses 32 and 33 are movable along the observation optical axis 30a. Thereby, the magnification (view angle) of the naked eye observation image of the patient's eye E and the captured image can be changed. The magnification is changed, for example, by manually operating a magnification changing knob provided in the observation unit 3b. Further, the processing unit 5 may control the magnification based on an operation by a switch or the like included in the operation unit 6.

  A plurality of variable power lens groups that can be selectively inserted into the optical path of the observation optical system 30 may be provided as the variable power optical system. These variable power lens groups are configured to give different magnifications. A variable power lens group disposed in the optical path of the observation optical system 30 is used as the variable power lenses 32 and 33. The magnification change, that is, the switching of the variable power lens group disposed in the optical path of the observation optical system 30 is performed by manually operating a magnification change knob provided in the observation unit 3b, for example.

The protective filter 34 is a filter that shields the laser light applied to the patient's eye E. Thereby, it is possible to protect the operator's eye E ₀ from the laser light. The protective filter 34 is inserted into the optical path in response to a start trigger of laser treatment (or laser output), for example. During normal observation, the protective filter 34 is retracted from the optical path. The insertion / removal of the protective filter 34 is controlled by the processing unit 5. Alternatively, a band-pass filter configured to block only laser light (especially therapeutic laser light LT) can be used as the protective filter 34. In this case, the band-pass filter may be always disposed in the optical path (that is, the insertion / removal mechanism may not be provided).

  The imaging lens 35 is a lens (lens system) that forms an image of the patient's eye E. The erecting prism 36 is an optical member that converts an image observed through the eyepiece lens 38 into an erecting image, and includes prisms 36a and 36b. The eyepiece 38 moves integrally with the erecting prism 36. The erecting prism 36 and the eyepiece lens 38 are stored in the eyepiece 3c. Other members constituting the observation optical system 30 are stored in the observation unit 3b.

  An imaging system for imaging the patient's eye E will be described. The imaging system includes an imaging device 42 provided on an optical path branched from the observation optical axis 30a. This branching is realized by a beam splitter (half mirror or the like) 41 provided between the imaging lens 35 and the erecting prism 36. That is, the imaging system in this example includes the objective lens 31, the variable power lenses 32 and 33, the protection filter 34, the imaging lens 35, the beam splitter 41, and the imaging device 42. The imaging device 42 includes an imaging element such as a CCD image sensor or a CMOS image sensor. The imaging device 42 may include an optical element such as a lens.

  The imaging device 42 includes an imaging element having sensitivity in a wavelength band of irradiation light (aiming light LA and / or therapeutic laser light LT). Therefore, when photographing is performed by the imaging device 42 in a state in which the irradiation light is irradiated on the fundus oculi Ef, a projection pattern of the irradiation light on the fundus oculi Ef is depicted in the captured image. Further, the imaging device may have sensitivity in the wavelength band of illumination light from the illumination optical system 10. In that case, the form of the fundus oculi Ef (that is, the front image of the fundus oculi Ef) and the projection pattern of the irradiation light are depicted in the captured image.

  An object to be imaged using the imaging device 42 is not limited to the fundus oculi Ef but may be the anterior eye segment. Selection of a subject to be photographed by the imaging device 42 is performed, for example, by controlling the imaging lens 35 or a lens inside the imaging device 42.

(Optical fiber 4)
The configuration of the optical fiber 4 that optically connects the light source unit 2 and the slit lamp microscope 3 will be described. Furthermore, control of irradiation light according to the configuration of the optical fiber 4 will be described.

  The optical fiber 4 may be a multi-core fiber having a plurality of cores having different diameters. The plurality of cores correspond to a plurality of options related to the diameter (spot size) of the light beam irradiated to the patient's eye E. At the incident end of the optical fiber 4 (fiber end on the light source unit 2 side), the incident ends of the plurality of cores are exposed.

  The processing unit 5 controls the galvanometer mirror 2c so that the irradiation light is incident on one incident end of the plurality of cores. The processing unit 5 stores in advance information (corresponding information) in which a plurality of options relating to the spot size and a plurality of cores (that is, the contents of control for the galvano mirror 2c) are associated one-to-one. . The user or the processing unit 5 designates the spot size applied to the patient's eye E. The processing unit 5 refers to the correspondence information, acquires the control content corresponding to the designated spot size, and controls the galvanometer mirror 2c based on the control content. Thereby, the irradiation light of the designated spot size is applied to the patient's eye E.

  The configuration of the galvanometer mirror 2c can be determined according to the arrangement of the incident ends of the plurality of cores. For example, when the plurality of cores and the light shielding plate 2d are arranged substantially linearly, the galvano mirror 2c only needs to be configured so that the direction of the reflecting surface thereof can be changed one-dimensionally. When the plurality of cores and the light shielding plate 2d are not linearly arranged, that is, when the plurality of cores and the light shielding plate 2d are two-dimensionally arranged when viewed from the galvano mirror 2c side, the galvano mirror 2c is The direction of the reflecting surface can be changed two-dimensionally. The direction of the reflecting surface can be defined as the direction of the normal of the reflecting surface, for example.

  A configuration example of the optical fiber 4 is shown in FIG. FIG. 4 shows the incident end of the optical fiber 4. The optical fiber 4 has a plurality of cores 4a, 4b, 4c and 4d having different diameters. For example, the diameters of the cores 4a, 4b, 4c and 4d are 50 μm, 100 μm, 200 μm and 400 μm, respectively. Note that the diameter of the core and the size of the spot projected onto the fundus oculi Ef do not have to match. However, the core diameter and the spot size have a known correspondence. This correspondence is defined by the design of the optical system between the optical fiber 4 and the fundus oculi Ef, for example.

  The plurality of cores 4 a, 4 b, 4 c and 4 d are arranged around the central axis 4 </ b> A of the optical fiber 4. This arrangement corresponds to an example in which a plurality of cores and the light shielding plate 2d are two-dimensionally arranged.

  In this example, the optical system can be configured such that the central axis 4A of the optical fiber 4 and the optical axis of an OCT optical system described later are coaxial. As shown in FIG. 3, the optical path of the irradiation light related to the laser treatment and the optical path of the light (measurement light) for performing the OCT measurement are synthesized by a dichroic mirror 91. For example, the dichroic mirror 91 may be configured to transmit light emitted from the optical fiber 4 and reflect light emitted from the optical fiber 9. Further, instead of the dichroic mirror 91, a synthetic member such as a half mirror may be used to synthesize these optical paths.

(OCT unit 8)
The OCT unit 8 will be described. FIG. 5 shows a configuration example of the OCT unit 8.

  The OCT unit 8 is provided with an optical system for acquiring an OCT image of the fundus oculi Ef. This optical system has, for example, the same configuration as a conventional spectral domain type OCT apparatus. That is, this optical system divides the low-coherence light into reference light and measurement light, and generates interference light by causing the measurement light passing through the fundus oculi Ef and the reference light passing through the reference optical path to generate interference light. It is configured to detect spectral components. This detection result (detection signal) is sent to the processing unit 5.

  The type of OCT applied to the laser treatment system is not limited to the spectral domain type. For example, when a swept source type OCT is used, a wavelength swept light source is provided in the light source unit 81, and a balanced photodetector such as a balanced photodiode is provided in the detection unit 89. Generally, a known technique corresponding to the type of OCT is applied to the configuration of the OCT unit 8.

  The light source unit 81 outputs light L0 for performing OCT. Since spectral domain type OCT is used in this example, the light L0 output from the light source unit 81 is broadband low-coherence light. The low coherence light L0 includes, for example, a near-infrared wavelength band (about 800 nm to 900 nm) and has a temporal coherence length of about several tens of micrometers. Note that near-infrared light having a wavelength band that cannot be visually recognized by the human eye, for example, a center wavelength of about 1040 to 1060 nm, may be used as the low-coherence light L0.

  The light source unit 81 includes a super luminescent diode (SLD), an LED, and an optical output device such as an SOA (Semiconductor Optical Amplifier).

  The low coherence light L0 output from the light source unit 81 is guided to the fiber coupler 83 by the optical fiber 82, and is divided into the measurement light LM and the reference light LR. The optical path of the measurement light LM is called a measurement arm and the optical path of the reference light LR is called a reference arm.

  The reference light LR is guided by the optical fiber 84. A collimator 85 that converts the reference light LR emitted from the optical fiber 84 into a parallel light beam is provided at the end of the optical fiber 84 on the side opposite to the fiber coupler 83. The reference light LR converted into a parallel light beam is converged by the converging lens 86 and reaches the reference mirror 87. The reflection surface of the reference mirror 87 is orthogonal to the optical axis of the reference arm. The reference light LR reflected by the reference mirror 87 becomes a parallel light beam by the converging lens 86, is converged by the collimator 85, enters the optical fiber 84, and is guided to the fiber coupler 83.

  On the other hand, the measurement light LM generated by the fiber coupler 83 is guided by the optical fiber 9 to the illumination unit 3a of the slit lamp microscope 3 (see FIG. 3). The measurement light LM emitted from the optical fiber 9 is converted into a parallel light beam by the collimator lens 92, transmitted through the dichroic mirror 91, deflected by the galvano scanner 52, reflected by the dichroic mirror 55 via the relay lenses 53 and 54. , Enters the optical path of the illumination optical system 10. Further, the measurement light LM is irradiated to the patient's eye E via the optical path of the illumination optical system 10. By sequentially irradiating the measurement light LM while changing the deflection direction by the galvano scanner 52, scanning of the fundus oculi Ef by the measurement light LM (OCT scan) is executed.

  The measurement light LM irradiated to the fundus oculi Ef is scattered at various depth positions of the fundus oculi Ef. The backscattered light of the measurement light LM from the fundus oculi Ef travels in the same direction as the forward path in the reverse direction and is guided to the dichroic mirror 55. Further, the backscattered light of the measurement light LM is reflected by the dichroic mirror 55, passes through the relay lenses 54 and 53 and the galvano scanner 52, passes through the dichroic mirror 91, and is converged by the collimator lens 92 to the optical fiber 9. Incident. The backscattered light of the measurement light LM incident on the optical fiber 9 is guided to the fiber coupler 83.

  The fiber coupler 83 superimposes the measurement light LM that has passed through the measurement arm (that is, the backscattered light of the measurement light LM) and the reference light LR that has passed through the reference arm. Thereby, the interference light LC is generated. The interference light LC is guided to the detection unit 89 by the optical fiber 88.

  In the spectral domain type, the detection unit 89 is provided with a collimator lens, a spectroscopic element, a converging lens, and a detection device. The spectroscopic element is, for example, a diffraction grating. The detection device is a line sensor, for example. The interference light LC emitted from the optical fiber 88 is converted into a parallel light beam by the collimator lens, dispersed (spectral decomposition) by the spectroscopic element, converged by the converging lens, and projected onto the light receiving surface of the detection device. The detection device photoelectrically converts the interference light LC to generate a detection signal. This detection signal is sent to the image forming unit 103 in the processing unit 5.

  In this embodiment, a Michelson type interferometer is employed, but any type of interferometer such as a Mach-Zehnder type can be appropriately employed. As the detection device, a CCD image sensor or a CMOS image sensor is used.

  The OCT unit 8 may include an optical attenuator (attenuator), a polarization adjuster (polarization controller), and the like. The optical attenuator and the polarization adjuster are provided in the reference arm, for example. The optical attenuator automatically adjusts the amount of the reference light LR passing through the optical fiber 84 under the control of the processing unit 5 using, for example, a known technique. In addition, the polarization adjuster adjusts the polarization state of the reference light LR passing through the optical fiber 84 by, for example, applying stress to the looped optical fiber 84 from the outside. The OCT unit 8 may include other devices.

  Further, the device used for scanning the irradiation light and the measurement light LM is not limited to the galvano scanner 52. For example, the scanning can be performed using a polygon mirror, a resonant scanner, an acousto-optic modulator, a rotating prism, a vibrating prism, or the like.

[Pattern of irradiated light]
The pattern of irradiation light (aiming light LA, therapeutic laser light LT) will be described. There are various conditions (irradiation conditions) in the pattern of irradiation light. A projection image of irradiation light (that is, an irradiation range of irradiation light on the fundus) is called a spot. Irradiation conditions include multiple spot arrays (array conditions), array sizes (array size conditions), array orientations (array direction conditions), spot sizes (spot size conditions), spot spacing (spot spacing conditions) ) And the number of spots (spot number condition).

  The arrangement condition is a condition indicating how a plurality of spots are arranged. There are various arrangement conditions, for example, as described in the above-mentioned patent document. Specific examples include a circular array (FIG. 6A), an elliptical array (FIG. 6B), a rectangular array (FIG. 6C), an arc array (FIG. 6D), a linear array (FIG. 6E), and a disk array (FIG. 6F), elliptical plate arrangement (FIG. 6G), rectangular plate arrangement (lattice arrangement: FIG. 6H), sector plate arrangement (FIG. 6I), wide circular arrangement (annular arrangement (FIG. 6J)), There are an arcuate array with a width (part of an annular array: a partial annular array (FIG. 6K)), a linear array with a width (a strip array (FIG. 6L)), and the like. It is also possible to configure the user to arbitrarily set the array. It is also possible to use a combination of two or more sequences. The arrangement condition is used for controlling the galvano scanner 52.

  The array size condition is a condition indicating what size the array is projected in a certain array. For example, in a circular array, a parameter indicating the size (for example, diameter) is the array size condition. About arrangement | sequence size conditions, you may comprise so that this can be set arbitrarily, and you may comprise so that the option (for example, large, medium, small) of this may be provided. The array size condition is used for controlling the galvano scanner 52.

  The arrangement direction condition is a condition indicating in which direction the arrangement is projected in a certain arrangement. For example, the parameter indicating the direction of the arcuate arrangement is the arrangement direction condition. The arrangement direction condition may be configured to be arbitrarily set, or may be configured to provide options (for example, upward, downward, leftward, rightward). The arrangement direction condition is used for controlling the galvano scanner 52.

  The spot size condition is a condition indicating the size of each spot to be projected. For example, in a circular arrangement, a circular arrangement with a different pattern can be applied by changing the projection size (diameter, area, circumference length, etc.) of each spot. About spot size conditions, you may comprise so that this can be set arbitrarily, and you may comprise so that the option (for example, large, medium, small) of this may be provided. Note that not all spot sizes need be the same in a certain array. In that case, a certain arrangement can be divided into a plurality of parts, and the spot size can be individually set for each part.

  A configuration for changing the spot size will be described. When the optical fiber 4 includes a single light guide, an optical member for changing the spot size is provided in the optical path of the irradiation light. This optical member is, for example, a variable power lens (lens system). The processing unit 5 realizes the set spot size by moving the zoom lens along the optical axis (irradiation optical axis) of the optical path of the irradiation light.

  When the optical fiber 4 has two or more light guide paths, these light guide paths can have different diameters. In this case, the spot size of the light irradiated to the patient's eye E is changed by selectively using two or more light guide paths. The processing unit 5 arranges the galvanometer mirror 2c of the light source unit 2 in the direction in which the irradiation light is incident on the light guide path corresponding to the target spot size. An example of such a configuration is when the multi-core fiber shown in FIG. 4 is used as the optical fiber 4. Each core of the multi-core fiber corresponds to a light guide path.

  The optical fiber 4 may be an image fiber capable of transmitting light while holding a pattern. In this case, an optical member (such as a variable magnification lens) for changing the spot size is provided at an arbitrary position before or after the optical fiber 4. The control of this optical member is the same as when the optical fiber 4 consists of a single light guide. Further, the light source unit 2 is provided with a galvano scanner capable of two-dimensional scanning for making the irradiation light of a predetermined pattern incident on the optical fiber 4 (image fiber). This galvano scanner is provided instead of the galvano mirror 2c, for example.

  The spot interval condition is a condition indicating at what interval (pitch) the adjacent spots are projected. The spot interval condition may be configured to be arbitrarily set, or may be configured to provide options (for example, sparse or dense). Note that not all spot intervals need be the same in a certain array. In that case, it is possible to divide a certain array into a plurality of parts and to set the spot interval for each part individually. The spot interval condition is used for controlling the galvano scanner 52.

  Irradiation conditions include those related to matters other than the pattern of irradiation light. For example, when multiple types of irradiation light can be selectively used, the type of irradiation light can be included in the irradiation conditions. Specific examples of types of irradiation conditions include types (wavelength, application, etc.) of aiming light LA and therapeutic laser light LT. Such irradiation light type conditions are used to control the aiming light source 2a and / or the therapeutic laser light source 2b.

  Further, the irradiation condition may include a condition related to the intensity of irradiation light. As an example of the irradiation intensity condition, there is an output intensity condition indicating the output intensity of irradiation light from the aiming light source 2a and the therapeutic laser light source 2b. The output intensity condition is used to control the aiming light source 2a and / or the therapeutic laser light source 2b. The output intensity condition may include a parameter indicating the energy of the therapeutic laser beam (laser beam) output from the therapeutic laser light source 2b.

  As another example of the irradiation intensity condition, there is a condition (a dimming condition) for adjusting the amount of irradiation light by the light reducing member. There is a neutral density filter as the neutral density member. More specifically, there are a configuration in which one neutral density filter is inserted into and removed from the optical path, and a configuration in which a plurality of neutral density filters having different transmittances can be selectively disposed in the optical path.

  Moreover, the irradiation conditions may include conditions relating to the time for irradiating irradiation light. As an example of this irradiation time condition, there is a duration of irradiation when irradiation light is continuously irradiated. Moreover, when irradiating irradiation light intermittently, the duration of each irradiation, the repetition frequency of irradiation, etc. may be contained in irradiation time conditions. Note that the irradiation condition can be set in consideration of the irradiation intensity condition and the irradiation time condition.

[Control system]
A control system of the laser treatment system 1 will be described with reference to FIG. The control system of the laser treatment system 1 is mainly configured by a control unit 101 provided in the processing unit 5.

(Control unit 101)
The control unit 101 controls each unit of the laser treatment system 1. For example, the control unit 101 performs control of the light source unit 2, control of the display unit 7, control of the illumination optical system 10, control of the observation optical system 30, control of the OCT unit 8, and the like.

  As control of the light source unit 2, the control unit 101 performs control of the aiming light source 2a, control of the treatment laser light source 2b, control of the galvanometer mirror 2c, and the like. Control of the aiming light source 2a and the therapeutic laser light source 2b includes on / off of the output of the irradiation light, control of the output intensity (output light amount) of the irradiation light, and the like. Further, when a configuration in which a plurality of types of treatment laser light LT can be output by one or more treatment laser light sources 2b is applied, the control unit 101 performs treatment so as to selectively output the treatment laser light LT. The laser light source 2b is controlled. Control of the galvanometer mirror 2c includes control for changing the direction of the reflecting surface of the galvanometer mirror 2c. Thereby, on / off switching of the output of the irradiation light and switching of the spot size of the irradiation light are realized.

  The display unit 7 displays various information under the control of the control unit 101. The display unit 7 includes an arbitrary display device such as a flat panel display such as an LCD or a CRT display. The display unit 7 is provided, for example, in the slit lamp microscope 3 or the processing unit 5 (computer). Alternatively, the display unit 7 is an external display connected to the processing unit 5. When the operation unit 6 includes a GUI, the control unit 101 performs GUI display control and operation control of each unit of the apparatus based on an operation on the GUI.

  As control of the illumination optical system 10, the control unit 101 performs control of the light source 11, control of the filters 13 to 15, control of the slit diaphragm 16, control of other diaphragm members, and the like. Control of the light source 11 includes ON / OFF of illumination light output, control of output intensity (output light amount) of illumination light, and the like.

  Control of the filters 13-15 includes control which inserts / removes the filters 13-15 each independently with respect to the illumination optical axis 10a. The filters 13 to 15 are controlled by controlling the filter driving unit 13A. 13 A of filter drive parts contain actuators, such as a solenoid and a pulse motor, and the mechanism which transmits the driving force generated by this actuator to the filters 13-15.

  The control of the slit diaphragm 16 includes control for changing the distance between the pair of slit blades, control for moving the pair of slit blades integrally, and the like. The former control corresponds to slit width change control. The latter control corresponds to control for changing the irradiation position of the illumination light (slit light) while keeping the slit width constant. As described above, other diaphragm members include an illumination diaphragm for changing the amount of illumination light and an illumination field diaphragm for changing the size of the illumination field. The slit diaphragm 16, the illumination diaphragm, and the illumination field diaphragm are controlled independently by controlling the diaphragm driver 16A. The aperture driving unit 16A includes an actuator such as a pulse motor and a mechanism for transmitting a driving force generated by the actuator to the aperture member.

  As control of the observation optical system 30, the control unit 101 performs control of the variable power lenses 32 and 33, control of the protection filter 34, control of the imaging lens 35, and the like. The zoom lenses 32 and 33 are controlled by controlling the zoom drive unit 32A to move them along the observation optical axis 30a. Thereby, the observation magnification (angle of view) is changed. The variable magnification drive unit 32A includes an actuator such as a pulse motor and a mechanism for transmitting a driving force generated by the actuator to the variable magnification lenses 32 and 33. When a plurality of variable magnification lens groups are provided as the variable magnification optical system, the variable magnification drive unit 32A includes a mechanism for selectively inserting these variable magnification lens groups into the optical path of the observation optical system 30. The control unit 101 changes the observation magnification (view angle) by controlling the magnification driving unit 32A.

The control of the protection filter 34 is to control the protection filter drive unit 34A to insert and remove the protection filter 34 with respect to the observation optical axis 30a. The imaging lens 35 is controlled by moving the imaging lens 35 along the observation optical axis 30a by controlling the imaging drive unit 35A. Thus, focusing the image observed by the operator's eye E ₀ is performed.

  The control unit 101 controls the photographing system. Control of the imaging system includes control of the imaging device 42. Control of the imaging device 42 includes control of the accumulation time of the image sensor, focus control by a built-in optical element, and the like. Further, as other controls of the imaging system, similarly to the control of the observation optical system 30 described above, the control of the variable power lenses 32 and 33 (control for changing the photographing magnification and the angle of view) and the control of the imaging lens 35 (focusing). For example). Further, when the beam splitter 41 is configured to be detachable with respect to the optical path of the observation optical system 30, the control unit 101 controls a mechanism for performing the operation.

  As a control for applying the irradiation light to the patient's eye E, the control unit 101 controls the galvano scanner 52 in addition to the control of the light source unit 2 described above. As described above, the galvano scanner 52 includes a galvanometer mirror (first galvanometer mirror) for deflecting in the horizontal direction and a galvanometer mirror (second galvanometer mirror) for deflecting in the vertical direction. Including. The control unit 101 independently changes the direction of the reflecting surface of the first galvanometer mirror and the direction of the reflecting surface of the second galvanometer mirror. Thereby, the irradiation light incident from the light source unit 2 via the optical fiber 4 can be deflected two-dimensionally.

  As control of the OCT unit 8, the control unit 101 performs control of the light source unit 81, control of the converging lens 86 and the reference mirror 87, control of the detection unit 89, and the like. The control of the light source unit 81 includes ON / OFF of the output of the light L0 (low coherence light, wavelength swept light, etc.), control of the output intensity (output light amount) of the light L0, and the like. In addition, when a configuration capable of outputting a plurality of types of light L0 from one or more light sources provided in the light source unit 81 is applied, the control unit 101 causes the light source unit 81 to selectively output the light L0. Control.

  The converging lens 86 and the reference mirror 87 are controlled by controlling the reference driving unit 87A to move them integrally along the optical axis of the reference arm. Thereby, the optical path length of the reference arm is changed. The change of the optical path length of the reference arm is used for correcting the optical path length according to the axial length of the patient's eye E, adjusting the interference state in OCT measurement, and the like. The reference drive unit 87A includes an actuator such as a pulse motor and a mechanism for transmitting the driving force generated by the actuator to the converging lens 86 and the reference mirror 87.

  In this embodiment, the difference between the optical path length of the reference arm and the optical path length of the measurement arm is changed by changing the position of the reference mirror 87 or the like. However, the configuration for changing the optical path length difference is not limited to this. For example, it is possible to apply a configuration in which the optical path length of the reference arm and / or the optical path length of the measurement arm is changed by providing a corner cube and a mechanism for moving the corner cube in the reference arm and / or the measurement arm. . Moreover, it is also possible to change the optical path length of the measurement arm by moving the laser treatment system 1 with respect to the patient's eye E, thereby changing the optical path length difference.

  As described above, the detection unit 89 includes a collimator lens, a spectroscopic element (such as a diffraction grating), a converging lens, and a detection device (such as a line sensor). The converging lens is controlled by moving a driving mechanism (not shown) along the optical axis. Thereby, the convergence state of the interference light LC with respect to the light receiving surface of the detection device can be adjusted. Control of the detection device includes control of accumulation time and the like.

  Further, it is possible to perform a position adjustment between the optical fiber 88 that guides the interference light LC and the detection unit 89. As an example, at least one of the output end (end on the detection unit 89 side), the collimator lens, the spectroscopic element, the converging lens, and the detection device of the optical fiber 88 is driven to operate under the control of the control unit 101. A mechanism (not shown) can be provided.

  The control unit 101 performs a process for reading data stored in the storage unit 102 and a process for writing data to the storage unit 102.

  The control unit 101 includes a microprocessor, a RAM, a ROM, a hard disk drive, and the like. This hard disk drive stores a control program in advance. The operation of the control unit 101 is realized by the cooperation of this control program and the hardware. The control unit 101 may include a communication device for communicating with an external device.

(Storage unit 102)
The storage unit 102 stores various data and computer programs. Examples of data stored in the storage unit 102 include OCT image data, fundus image data, and patient eye information. The patient eye information includes information about the patient such as patient ID and name, and information about the patient such as left / right eye identification information. The storage unit 102 includes a storage device such as a RAM, a ROM, and a hard disk drive.

(Image forming unit 103)
The image forming unit 103 forms a cross-sectional image of the fundus oculi Ef based on the detection signal input from the detection device of the detection unit 89. This process includes processes such as noise removal (noise reduction), filter processing, dispersion compensation, and FFT (Fast Fourier Transform) as in the conventional spectral domain type optical coherence tomography. The cross-sectional image formed thereby includes a plurality of one-dimensional image data (A line data) extending in the z direction from a plurality of scanning points on the scanning line. Each A line data is assigned xy coordinates corresponding to the position of the corresponding scanning point.

  In the case of another type of OCT apparatus, the image forming unit 103 executes a known process corresponding to the type. The image forming unit 103 includes a dedicated circuit board and / or a microprocessor.

(Operation unit 6, display unit 7)
As described above, the operation unit 6 includes various hardware keys and / or software keys. The display unit 7 displays various information.

  The operation unit 6 is used for setting irradiation conditions of irradiation light. The irradiation condition setting operation is performed using, for example, a predetermined hardware key or software key. Specific examples of the former include arbitrary conditions such as array conditions, array size conditions, array direction conditions, spot size conditions, spot interval conditions, spot number conditions, irradiation light type conditions, irradiation intensity conditions (output intensity conditions, dimming conditions), etc. A hardware key for setting irradiation conditions is provided in the operation unit 6 in advance. The user sets the irradiation condition by operating the hardware key corresponding to the desired irradiation condition. As a specific example of the latter, a setting screen for setting the irradiation conditions as described above is displayed on the display unit 7 by the control unit 101. The user sets the irradiation condition by operating the GUI provided on the displayed setting screen with the operation unit 6.

  The operation unit 6 is used to move the irradiation position of irradiation light on the fundus oculi Ef. The movement operation of the irradiation position is also performed using a predetermined hardware key or software key. The irradiation position is moved, for example, by the control unit 101 controlling the galvano scanner 52 or moving the optical system of the slit lamp microscope 3. In the latter case, the slit lamp microscope 3 is provided with a moving mechanism (optical system moving mechanism) for moving the optical system. The optical system moving mechanism is electrically controlled, and includes an actuator and a mechanism that transmits a driving force generated by the actuator. Moreover, it is also possible to move the optical system by moving the optical system of the slit lamp microscope 3 using the operation performed by the user as a driving force.

  In FIG. 7, the operation unit 6 and the display unit 7 are shown separately, but they can also be configured integrally. As a specific example, a touch panel LCD can be used.

(Data processing unit 110)
The data processing unit 110 performs various data processing. As an example of this data processing, there are processing related to laser treatment, processing related to OCT, and processing linked to laser treatment and OCT.

  As an example of processing related to laser treatment, there is processing for determining an irradiation pattern of the therapeutic laser beam LT based on the irradiation pattern of the aiming light LA. In this process, for example, a spot image of the aiming light LA is extracted from the photographed image of the fundus oculi Ef in a state where the aiming light LA is irradiated, and the pattern of the extracted spot image is set as the irradiation pattern of the therapeutic laser light LT. Is done.

  As an example of processing related to OCT, various types of image processing and analysis processing are performed on an image formed by the image forming unit 103. For example, the data processing unit 110 executes various correction processes such as image brightness correction. In addition, the data processing unit 110 performs various image processing and analysis processing on the image (fundus image, anterior eye image, etc.) obtained by the imaging device 42.

  The data processing unit 110 performs three-dimensional image data of the fundus oculi Ef by performing known image processing such as interpolation processing that interpolates pixels between a plurality of cross-sectional images obtained along a plurality of scanning lines. To do. The three-dimensional image data means image data in which pixel positions are defined by a three-dimensional coordinate system. As the three-dimensional image data, there is image data composed of voxels arranged three-dimensionally. This image data is called volume data or voxel data.

  When displaying an image based on the volume data, the data processing unit 110 performs rendering processing (volume rendering, MPR (Multi Planar Reconstruction), MIP (Maximum Intensity Projection): maximum value projection on the volume data. ) And the like) to form pseudo three-dimensional image data when viewed from a specific viewing direction. This pseudo three-dimensional image is displayed on the display unit 7.

  It is also possible to form stack data of a plurality of cross-sectional images as 3D image data. The stack data is image data obtained by three-dimensionally arranging a plurality of cross-sectional images obtained along a plurality of scanning lines based on the positional relationship of the scanning lines. That is, the stack data is obtained by expressing image data of a plurality of cross-sectional images originally defined by individual two-dimensional coordinate systems by one three-dimensional coordinate system (that is, embedding in one three-dimensional space). Image data.

  An example of a linkage process between laser treatment and OCT will be described. The data processing unit 110 can align the fundus image obtained by photographing the fundus oculi Ef subjected to laser treatment with the imaging device 42 and the volume data of the fundus oculi Ef. This alignment processing includes, for example, image matching between a fundus image and a two-dimensional image obtained by adding at least a part of voxels of volume data along the A line. Further, the data processing unit 110 can specify an image region in the volume data corresponding to the site subjected to the laser treatment based on the alignment result. Further, the data processing unit 110 can obtain information indicating the degree of laser treatment performed by analyzing the volume data. This information includes, for example, the degree of cauterization and the reaching depth by the therapeutic laser beam LT. Furthermore, the data processing unit 110 can create information that expresses the degree of ablation and the distribution state of the reaching depth with images and graphs.

(Input / output unit 120)
The input / output unit 120 has a function of receiving information input from an external device or a recording medium, and a function of outputting information to the external device or the recording medium. The input / output unit 120 may include a communication interface for performing information communication with an external device (server, computer terminal, ophthalmologic apparatus, etc.) via a communication line. Further, the input / output unit 120 may include a drive device for performing processing for reading information recorded on the recording medium and processing for writing information on the recording medium.

  The input / output unit 120 can accept data acquired in the past by an external device. As this data, there is an image of the patient's eye E acquired by imaging performed in the past using another ophthalmologic imaging apparatus (OCT apparatus, fundus camera, slit lamp microscope, scanning laser ophthalmoscope, etc.). The data may include the patient's medical information (such as electronic medical record information) recorded in the medical institution and the patient's medical information transmitted from another medical institution. The data received by the input / output unit 120 is not limited to these. The control unit 101 can cause the display unit 7 to display data received by the input / output unit 120. According to such a configuration, it is possible to refer to data acquired in the past, for example, in follow-up imaging or preoperative postoperative observation. In addition, it cannot be overemphasized that the data acquired in the past using this laser treatment system 1 can be displayed on the display unit 7. FIG.

[effect]
The effect of the laser treatment system according to this embodiment will be described.

  The laser treatment system according to the embodiment includes an illumination optical system, an observation optical system, an irradiation optical system, an interference optical system, an optical path synthesis unit, an optical scanning unit, and a control unit.

  In the example shown in FIG. 1A, the “illumination optical system” includes the illumination optical system 1100, the “observation optical system” includes the observation optical system 1200, the “irradiation optical system” includes the irradiation optical system 1300, and the “interference optical system”. "Includes an interference optical system 1400," optical path combining means "includes a first combining member 1510 and a second combining member 1520," optical scanning means "includes an optical scanning unit 1600, and" control means "controls A unit 1800 is included.

  2-7, the “illumination optical system” includes the illumination optical system 10, the “observation optical system” includes the observation optical system 30, the “irradiation optical system” includes the light source unit 2, The “interference optical system” includes the OCT unit 8, the “optical path combining unit” includes the dichroic mirror 55 and the dichroic mirror 91, the “optical scanning unit” includes the galvano scanner 52, and the “control unit” includes the control unit 101. .

  The illumination optical system illuminates the patient's eye (E). In this embodiment, the illumination optical system illuminates the fundus (Ef). The observation optical system is used for observing the patient's eye illuminated by the illumination optical system. The irradiation optical system irradiates the patient's eye with therapeutic laser light (LT) and aiming light (LA) for aiming the therapeutic laser light. The interference optical system divides the light (L0) from the light source (light source unit 81) into measurement light (LM) and reference light (LR), and superimposes the return light of the measurement light from the patient's eye and the reference light. The interference light (LC) obtained in this way is guided to detection means (detection unit 89).

  The optical path synthesis means synthesizes the optical path of the illumination optical system, the optical path of the irradiation optical system, and the optical path of the measurement light substantially coaxially. The optical scanning unit is provided closer to the patient's eye than the combined position of the optical path of the irradiation optical system and the optical path of the measurement light by the optical path combining unit. The control means at least controls the irradiation optical system, the interference optical system, and the optical scanning means.

  According to such an embodiment, since the optical path of the illumination optical system and the optical path of the irradiation optical system are arranged substantially coaxially, the site irradiated with the aiming light or the therapeutic laser light, or the therapeutic laser light Can be reliably illuminated by the illumination optical system. Therefore, it is possible to reliably illuminate and observe the site to be observed in the laser treatment.

  Further, according to this embodiment, since the optical path of the irradiation optical system and the optical path of the interference optical system are arranged substantially coaxially, the cross section of the part to which laser treatment is performed or the part to which laser treatment is performed Measurement can be performed reliably. Furthermore, it is possible to perform control so that cross-sectional measurement of the part is performed substantially in real time. Therefore, it is possible to perform OCT measurement of the target site of laser treatment substantially in real time while maintaining positional accuracy.

  Further, according to this embodiment, since the optical path of the illumination optical system and the optical path of the interference optical system are arranged substantially coaxially, the part where the OCT measurement is performed or the part where the OCT measurement is performed is illuminated. Illumination can be ensured by the optical system. Therefore, it is possible to reliably illuminate, observe, photograph, and record a site to be observed in the OCT measurement.

  Note that “substantially coaxial” includes not only the case of being completely coaxial but also the case of having a predetermined error. This error may be included in a range in which the above effect is ensured. The range is determined in advance based on, for example, the beam diameter (spot size) of illumination light irradiated to the patient's eye by the illumination optical system, the spot size of aiming light or treatment laser light, and the like.

  Hereinafter, examples of configurations applicable in the laser treatment system according to this embodiment will be shown.

  As an arrangement of the optical system, the following configuration can be applied. The optical path synthesis means includes a first synthesis member (first synthesis member 1510, dichroic mirror 91) and a second synthesis member (second synthesis member 1520, dichroic mirror 55) as described below. The first synthesis member synthesizes the optical path of the irradiation optical system and the optical path of the measurement light substantially coaxially. The second combining member is provided closer to the patient's eye than the first combining member, and substantially includes a combined optical path of the irradiation optical system and measurement light by the first combining member, and an optical path of the illumination optical system. Synthesize coaxially. In this configuration, the optical scanning unit is disposed in the combined optical path between the first combining member and the second combining member.

  Further, the following configuration can be applied. The irradiation optical system includes a first light guide unit (optical fiber 4) for guiding the aiming light and the therapeutic laser beam, and a first collimator (collimator) for converting the light emitted from the first light guide unit into a parallel light beam. Lens 51). The interference optical system also includes a second light guide means (optical fiber 9) for guiding the measurement light, and a second light guide means for converting the measurement light emitted from the end of the second light guide means on the patient's eye side into a parallel light beam. 2 collimators (collimator lens 92). In the embodiment shown in FIG. 3 and the like, the collimator lens 92 further has a function of causing the return light of the measurement light LM from the patient's eye E to converge and enter the optical fiber 9. The first composite member (dichroic mirror 91) is disposed closer to the patient's eye than the first collimator and the second collimator.

  Further, the following configuration can be applied. In the irradiation optical system and the interference optical system, the optical path of the light (sighting light LA, therapeutic laser light LT) that has passed through the first collimator and the optical path of the measurement light (LM) that has passed through the second collimator are substantially (See FIG. 3). The first combining member includes a first transmission / reflection mirror provided at a position where the optical path of the light passing through the first collimator and the optical path of the measuring light passing through the second collimator intersect. The first transmission / reflection mirror is a mirror configured to have predetermined transmission characteristics and predetermined reflection characteristics. For example, this transmission characteristic is a property of transmitting a predetermined wavelength component, and this reflection property is a property of reflecting a predetermined wavelength component. The first transmission / reflection mirror is, for example, a dichroic mirror (91) that reflects the aiming light and the treatment laser light and transmits the measurement light. Alternatively, the first transmission / reflection mirror is a dichroic mirror that transmits the aiming light and the treatment laser light and reflects the measurement light.

  In addition, the following configuration can be applied. The first light guide means (optical fiber 4) for guiding the aiming light and the treatment laser light has a plurality of light guide paths having different diameters. The irradiation optical system includes a selection unit (galvano mirror 2c) that selectively causes each of the aiming light and the treatment laser light to enter the plurality of light guide paths. The selection means is controlled by the control means, thereby changing the spot size of the aiming light and the treatment laser light.

  Further, the following configuration can be applied (see FIG. 4). The plurality of light guide paths in the first light guide means are arranged around the central axis (4A) of the first light guide means. In addition, the irradiation optical system and the interference optical system are configured such that the central axis of the first light guide means and the optical axis of the interference optical system are substantially coaxial via the first combining member. With this configuration, the irradiation optical system and the interference optical system are arranged substantially coaxially.

  In addition, the following configuration can be applied. As the first light guiding means (optical fiber 4) for guiding the aiming light and the treatment laser light, a fiber bundle or a multi-core fiber can be used. The fiber bundle is configured by bundling a plurality of optical fibers as the plurality of light guide paths described above. The multi-core fiber has a plurality of cores as the plurality of light guide paths described above.

  Further, the following configuration can be applied (see FIG. 3). The illumination optical system, illumination optical system, and interference optical system are configured such that the combined optical path of the illumination optical system and interference optical system and the optical path of the illumination optical system are substantially orthogonal. The second combining member includes a third transmitting / reflecting mirror provided at a position where the combined optical path and the optical path of the illumination optical system intersect. The third transmission / reflection mirror is a mirror configured to have predetermined transmission characteristics and predetermined reflection characteristics. For example, this transmission characteristic is a property of transmitting a predetermined wavelength component, and this reflection property is a property of reflecting a predetermined wavelength component. The third transmission / reflection mirror is, for example, a dichroic mirror (55) that reflects the aiming light, the treatment laser light, and the measurement light and transmits the illumination light. Alternatively, the third transmission / reflection mirror is a dichroic mirror that transmits the aiming light, the treatment laser light, and the measurement light and reflects the illumination light.

  Further, the following configuration can be applied (see FIGS. 6A to 6L). The control means can control the irradiation optical system to perform the following operations: irradiating the patient's eye with aiming light having a preset first pattern; based on the first pattern The patient's eye is irradiated with a therapeutic laser beam having the set second pattern. The first pattern is set by the user or the control means. The same applies to the second pattern. The second pattern may be the same as or different from the first pattern. As an example of the latter case, the second pattern consists of a part of the first pattern. Alternatively, the second pattern is obtained by adding one or more spots to part or all of the first pattern.

  The OCT applied in the embodiment may be a spectral domain type. In this case, the OCT light source (light source unit 81) includes a low-coherence light source that emits low-coherence light. The detection means (detection unit 89) includes a spectroscope that acquires spectral information of interference light generated by the interference optical system based on low-coherence light. The spectral information acquired by the spectroscope is sent to the image forming means (image forming unit 1700, image forming unit 103). The image forming unit forms an image based on the spectral information input from the spectroscope. The control means causes the display means (display unit 1900, display unit 7) to display the image formed by the image forming means.

  Further, the OCT applied in the embodiment may be a swept source type. In this case, the OCT light source (light source unit 81) includes a wavelength swept light source capable of sweeping the output wavelength. The detection means (detection unit 89) includes a photodetector that detects interference light generated by the interference optical system based on light output from the wavelength swept light source. This photodetector is, for example, a balance-side photodetector. The detection results by the photodetector are sequentially sent to the image forming means (image forming unit 1700, image forming unit 103). The image forming unit forms an image based on the detection results sequentially obtained by the photodetector with the sweep of the output wavelength. The control means causes the display means (display unit 1900, display unit 7) to display the image formed by the image forming means.

  The timing for performing the OCT measurement as described above is arbitrary. For example, OCT measurement can be performed in parallel with observation of a patient's eye using an illumination optical system and an observation optical system. Moreover, OCT measurement can be performed in parallel with the operation of irradiating the patient's eye with aiming light or therapeutic laser light. In addition, observation of the patient's eyes, laser treatment, and OCT measurement can be performed in parallel.

  The observation optical system is configured to guide the return light from the patient's eye illuminated by the illumination optical system and the return light from the patient's eye of the aiming light irradiated by the irradiation optical system to the eyepiece lens (38). It may be. The observation optical system guides the return light from the patient's eye illuminated by the illumination optical system and the return light from the patient's eye of the aiming light irradiated by the irradiation optical system to the imaging device (42). It may be configured. In this case, the control unit can cause the display unit to display the image acquired by the imaging device. According to these configurations, the irradiation position of the aiming light on the patient's eye (that is, the irradiation target of the therapeutic laser beam) can be observed with the naked eye or can be observed with an image.

<Second Embodiment>
In the first embodiment, the optical path of the irradiation optical system for laser therapy and the optical path of the interference optical system for OCT are combined substantially coaxially in space. On the other hand, in the second embodiment, an example in which these two optical paths are combined substantially coaxially with an optical fiber will be described.

  A configuration example of a laser treatment system according to the second embodiment is shown in FIG. The optical system of the laser treatment system 2000 includes an illumination optical system 2100, an observation optical system 2200, an irradiation optical system 2300, an interference optical system 2400, a first synthesis member 2510, a second synthesis member 2520, and light. A scanning unit 2600. The control unit 2800 controls each part of the laser treatment system 2000.

  The illumination optical system 2100 illuminates the fundus oculi Ef of the patient's eye E. The observation optical system 2200 is used to observe the fundus oculi Ef illuminated by the illumination optical system 2100.

  The observation optical system 2200 is configured to guide return light from the fundus oculi Ef illuminated by the illumination optical system 2100 to an eyepiece and / or an imaging device. In the latter case, a signal from the imaging device is input to the control unit 2800. The control unit 2800 displays a front image of the fundus oculi Ef on the display unit 2900 based on this signal. Note that the return light from the fundus oculi Ef is guided to the observation optical system 2200 through the left and right positions of the reflection mirror 2210.

  The irradiation optical system 2300 has a function of irradiating the fundus Ef with therapeutic laser light and a function of irradiating the fundus Ef with aiming light for aiming the therapeutic laser light. The irradiation position of the treatment laser light and the aiming light on the fundus oculi Ef is moved by the optical scanning unit 2600.

  The interference optical system 2400 divides the light from the light source into measurement light and reference light, and guides interference light obtained by superimposing the return light from the fundus oculi Ef of the measurement light and the reference light to the detection means. In the laser treatment system 2000, for example, spectral domain type or swept source type OCT is applied. The irradiation position of the measurement light on the fundus oculi Ef is moved by the optical scanning unit 2600.

  When spectral domain type OCT is applied, the light source includes a low-coherence light source that emits low-coherence light, and the detection unit uses spectral information of the interference light generated by the interference optical system 2400 based on the low-coherence light. Includes a spectrometer to acquire. The spectral information acquired by the spectroscope is input to the image forming unit 2700. The image forming unit 2700 forms an image of the fundus oculi Ef based on the spectral information input from the spectroscope. This image is a two-dimensional cross-sectional image or a three-dimensional cross-sectional image. The control unit 2800 displays the image formed by the image forming unit 2700 on the display unit 2900.

  When the swept source type OCT is applied, the light source includes a wavelength swept light source capable of sweeping the output wavelength, and the detection means is generated by the interference optical system 2400 based on the light output from the wavelength swept light source. A photodetector for detecting interference light. The photodetector sends a signal as a detection result of the interference light to the image forming unit 2700. The image forming unit 2700 forms a fundus oculi Ef image based on the detection results sequentially obtained by the photodetector as the output wavelength is swept. This image is a two-dimensional cross-sectional image or a three-dimensional cross-sectional image. The control unit 2800 displays the image formed by the image forming unit 2700 on the display unit 2900.

  The first combining member 2510 and the second combining member 2520 are substantially coaxial with the optical path of the illumination optical system 2100, the optical path of the irradiation optical system 2300, and the optical path of the measurement light guided by the interference optical system 2400. It functions as optical path combining means for combining. The optical scanning unit 2600 is provided closer to the patient's eye E than the combined position of the optical path of the irradiation optical system 2300 and the optical path of measurement light. In this example, the first combining member 2510 combines the optical path of the irradiation optical system 2300 and the optical path of the measurement light substantially coaxially. The second combining member 2520 is provided closer to the patient's eye E than the first combining member 2510, the combined optical path of the irradiation optical system 2300 and the measurement light by the first combining member 2510, and the optical path of the illumination optical system 2100. Are synthesized substantially coaxially. The optical scanning unit 2600 is disposed between the first composite member 2510 and the second composite member 2520. That is, the optical scanning unit 2600 is disposed on the first combining member 2510 side of the combined optical path of the irradiation optical system 2300 and the measurement light with respect to the position where the combined optical path is combined with the optical path of the illumination optical system 2100. .

  In this embodiment, the first composite member 2510 includes light guide means (third light guide means) having a plurality of light guide paths. As this light guide means, for example, a fiber bundle configured by bundling a plurality of optical fibers as a plurality of light guide paths, or a multi-core fiber having a plurality of cores as a plurality of light guide paths is used.

  Light (aiming light and therapeutic laser light) output from the irradiation optical system 2300 includes a predetermined first light guide path among the plurality of light guide paths of the light guide means, the optical scanning unit 2600, and the second light guide path. The patient's eye E is irradiated via the synthetic member 2520. Further, the measurement light output from the interference optical system 2400 includes a predetermined second light guide path different from the first light guide path among the plurality of light guide paths of the light guide means, the optical scanning unit 2600, and the second light guide path. The patient's eye E is irradiated via the synthetic member 2520.

[Concrete example]
A specific example of the laser treatment system according to this embodiment is shown in FIG. The laser treatment system according to this embodiment has a configuration similar to that of the first embodiment (see FIGS. 2 to 7). Hereinafter, a different part from 1st Embodiment is demonstrated. The configuration other than the portion shown in FIG. 9 is the same as that of the first embodiment (see FIGS. 2, 3, and 5 to 7). In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment.

  The light source unit 2 that outputs the aiming light LA and the therapeutic laser light LT and the illumination unit 3 a of the slit lamp microscope 3 are optically connected by a fiber bundle 210. The fiber bundle 210 is formed by bundling optical fibers 210 a, 210 b, 210 c and 210 d and the optical fiber 9. The optical fibers 210a to 210d are connected to the light source unit 2, and the optical fiber 9 is connected to the OCT unit 8 as in the first embodiment. The number of optical fibers connected to the light source unit 2 is arbitrary.

  The optical fibers 210a to 210d and the optical fiber 9 are bundled at least on the illumination unit 3a side. FIG. 10 shows a cross-sectional configuration of the fiber bundle 210 in a portion where the optical fibers 210a to 210d and the optical fiber 9 are bundled. The optical fibers 210a to 210d have different diameters. This “diameter” indicates the diameter of the light guide, that is, the diameter of the core. As an example, the diameters of the cores of the optical fibers 210a to 210d are 50 μm, 100 μm, 200 μm, and 400 μm, respectively. Note that the diameter of the core and the size of the spot projected onto the fundus oculi Ef do not have to match. However, the core diameter and the spot size have a known correspondence. This correspondence is defined by, for example, the design of the optical system between the fiber bundle 210 and the fundus oculi Ef.

  An optical fiber 9 extending from the OCT unit 8 is provided at the center position of the cross section of the fiber bundle 210. Optical fibers 210 a to 210 d extending from the light source unit 2 are arranged around the optical fiber 9.

  Similarly to the first embodiment, the light source unit 2 includes an aiming light source 2a, a therapeutic laser light source 2b, a galvano mirror 2c, and a light shielding plate 2d. Furthermore, the light source unit 2 includes collimator lenses 200a, 200b, 200c, and 200d. The collimator lenses 200a to 200d are disposed at positions facing the incident ends of the optical fibers 210a to 210d, respectively.

  The arrangement of the incident ends of the optical fibers 210a to 210d, that is, the arrangement of the collimator lenses 200a to 200d is arbitrary. The configuration of the galvanometer mirror 2c can be determined according to the arrangement of the plurality of incident ends. For example, when the plurality of incident ends and the light shielding plate 2d are arranged substantially linearly, the galvano mirror 2c only needs to be configured so that the direction of the reflecting surface thereof can be changed one-dimensionally. When the plurality of incident ends and the light shielding plate 2d are not linearly arranged, that is, when the plurality of incident ends and the light shielding plate 2d are two-dimensionally arranged when viewed from the galvano mirror 2c side, the galvanometer mirror 2c is configured so that the direction of the reflecting surface can be changed two-dimensionally.

  A collimator lens 220 is provided at a position facing the emission end of the fiber bundle 210. Further, a galvano scanner 52, relay lenses 53 and 54, and a dichroic mirror 55 similar to those of the first embodiment are provided at the tip of the collimator lens 220, respectively. The dichroic mirror 55 combines the optical path through the fiber bundle 210 and the optical path (optical axis 10a) of the illumination optical system 10 substantially coaxially.

  In the first embodiment, a dichroic mirror 91 is used as a first combining member that combines the optical path of irradiation light (aiming light LA and therapeutic laser light LT) and the optical path of measurement light for OCT. On the other hand, in this embodiment, the fiber bundle 210 is used as the first composite member. The first combining member combines the two optical paths substantially coaxially. In order to satisfy this requirement, the fiber bundle 210 is designed so that the distance between the optical fibers 210a to 210d with respect to the optical fiber 9 is sufficiently small.

[effect]
The effect of the laser treatment system according to this embodiment will be described.

  The laser treatment system according to the embodiment includes an illumination optical system, an observation optical system, an irradiation optical system, an interference optical system, an optical path synthesis unit, an optical scanning unit, and a control unit.

  In the example shown in FIG. 8, the “illumination optical system” includes the illumination optical system 2100, the “observation optical system” includes the observation optical system 2200, the “irradiation optical system” includes the irradiation optical system 2300, and the “interference optical system”. "Includes interference optical system 2400," optical path combining means "includes first combining member 2510 and second combining member 2520," optical scanning means "includes optical scanning unit 2600, and" control means "controls Unit 2800 is included.

  Further, in the examples shown in FIGS. 9 and 10 and the reference drawings from the first embodiment, the “illumination optical system” includes the illumination optical system 10, the “observation optical system” includes the observation optical system 30, and “ The “irradiation optical system” includes the light source unit 2, the “interference optical system” includes the OCT unit 8, the “optical path combining unit” includes the dichroic mirror 55 and the fiber bundle 210, and the “optical scanning unit” includes the galvano scanner 52. The “control means” includes the control unit 101.

  The functions of the illumination optical system, the observation optical system, the irradiation optical system, the interference optical system, the optical path synthesis unit, the optical scanning unit, and the control unit are the same as those in the first embodiment.

  The optical path combining means of this embodiment includes the following first combining member (first combining member 2510, fiber bundle 210) and second combining member (second combining member 2520, dichroic mirror 55). including. The first synthesis member synthesizes the optical path of the irradiation optical system and the optical path of the measurement light substantially coaxially. The second combining member is provided closer to the patient's eye than the first combining member, and substantially includes a combined optical path of the irradiation optical system and measurement light by the first combining member, and an optical path of the illumination optical system. Synthesize coaxially. In this configuration, the optical scanning unit is disposed in the combined optical path between the first combining member and the second combining member.

  Furthermore, the 1st synthetic | combination member contains the 3rd light guide means (fiber bundle 210) which has a some light guide path (optical fiber 210a-210d, the optical fiber 9). Each of the aiming light and the treatment laser light passes through a predetermined first light guide path (optical fibers 210a to 210d) among the plurality of light guide paths, the optical scanning unit, and the second combining member. The patient's eyes are irradiated. The measurement light passes through a predetermined second light guide path (optical fiber 9) different from the first light guide path among the plurality of light guide paths, the optical scanning means, and the second combining member. The patient's eyes are irradiated.

  According to such an embodiment, since the optical path of the illumination optical system and the optical path of the irradiation optical system are arranged substantially coaxially, the site irradiated with the aiming light or the therapeutic laser light, or the therapeutic laser light Can be reliably illuminated by the illumination optical system. Therefore, it is possible to reliably illuminate and observe the site to be observed in the laser treatment.

  Further, according to this embodiment, since the optical path of the irradiation optical system and the optical path of the interference optical system are arranged substantially coaxially, the cross section of the part to which laser treatment is performed or the part to which laser treatment is performed Measurement can be performed reliably. Furthermore, it is possible to perform control so that cross-sectional measurement of the part is performed substantially in real time. Therefore, it is possible to perform OCT measurement of the target site of laser treatment substantially in real time while maintaining positional accuracy.

  Further, according to this embodiment, since the optical path of the illumination optical system and the optical path of the interference optical system are arranged substantially coaxially, the part where the OCT measurement is performed or the part where the OCT measurement is performed is illuminated. Illumination can be ensured by the optical system. Therefore, it is possible to reliably illuminate and observe a site to be observed in OCT measurement.

  Hereinafter, examples of configurations applicable in the laser treatment system according to this embodiment will be shown.

  The third light guide means includes a fiber bundle (210) configured by bundling a plurality of optical fibers (optical fibers 210a to 210d, optical fibers 9) as a plurality of light guide paths, or a plurality of light guide paths. It is a multi-core fiber having a core. The configuration shown in FIGS. 9 and 10 corresponds to an example of the former.

  On the other hand, the example of a structure in case a multi-core fiber is used is shown in FIG. 11 and FIG. In this example, an optical fiber 9 extending from the OCT unit 8 is connected to the light source unit 2. The light source unit 2 and the illumination unit 3 a of the slit lamp microscope 3 are optically connected by a multi-core fiber 300. Although illustration is omitted, a collimator lens, an optical scanning unit, a relay lens, and a second synthesis member are provided at a position facing the end of the multi-core fiber 300 on the illumination unit 3a side.

  A collimator lens 2e is provided at a position facing the end of the optical fiber 9 on the light source unit 2 side, and a transmission / reflection mirror 2f and a collimator lens array 2g are provided at the end thereof. The transmission / reflection mirror 2f synthesizes the optical path of the irradiation light (aiming light LA and therapeutic laser light LT) and the optical path of the measurement light emitted from the optical fiber 9 substantially coaxially. The transmission / reflection mirror 2f is, for example, a dichroic mirror or a half mirror disposed at a position where these two optical paths orthogonal to each other intersect with each other so as to form the same angle with respect to the two optical paths. The collimator lens array 2g has a plurality of collimator lenses formed at positions corresponding to the arrangement of a plurality of cores of the multi-core fiber 300 described below. Irradiation light and measurement light are converted into convergent light by a corresponding collimator lens and enter a predetermined core.

  A configuration example of the multi-core fiber 300 is shown in FIG. FIG. 12 shows the form of the end face of the multi-core fiber 300 on the light source unit 2 side. The multi-core fiber 300 has a plurality of cores 300a, 300b, 300c, and 300d having different diameters. These cores 300a to 300d are used to guide the aiming light LA and the therapeutic laser light LT. For example, the diameters of the cores 300a, 300b, 300c, and 300d correspond to spot sizes of 50 μm, 100 μm, 200 μm, and 400 μm, respectively.

  At the center position of the multi-core fiber 300, a core 300A for guiding measurement light for OCT is provided. The plurality of cores 300a to 300d for laser treatment are arranged around the core 300A for OCT. In addition, arrangement | positioning of these cores 300a-300d and 300A is not limited to this, For example, the linear arrangement | positioning shown in the said embodiment may be sufficient.

  In this example, the measurement light emitted from the OCT unit 8 is guided to the light source unit 2 through the optical fiber 9, converted into a parallel light beam by the collimator lens 2e, reflected by the transmission / reflection mirror 2f, and multi-core by the collimator lens array 2g. The light enters the core 300 </ b> A of the fiber 300. The aiming light LA and the treatment laser light LT travel toward one of the cores 300a to 300d of the multi-core fiber 300 by the galvanometer mirror 2c, and are incident on the core by the collimator lens array 2g. This is the end of the description of the configuration example illustrated in FIGS. 11 and 12.

  In this embodiment, the plurality of light guide paths of the third light guide means may include two or more light guide paths having different diameters. In this case, the irradiation optical system may include selection means (galvanomirror 2c) that selectively causes the aiming light and the treatment laser light to be incident on the two or more light guide paths. In this configuration, the two or more light guides are used as the first light guide.

  Furthermore, the second light guide for guiding the OCT measurement light may be arranged along the central axis of the third light guide. In this case, the two or more light guides for laser treatment may be arranged around the second light guide for OCT.

  The laser treatment system according to this embodiment may have the following configuration, as in the first embodiment.

  The illumination optical system, the irradiation optical system, and the interference optical system may be configured such that the combined optical path of the irradiation optical system and the interference optical system and the optical path of the illumination optical system are substantially orthogonal. Further, the second combining member may include a third transmitting / reflecting mirror provided at a position where the combined optical path and the optical path of the illumination optical system intersect.

  The control means can control the irradiation optical system to perform the following operations: irradiating the patient's eye with aiming light having a preset first pattern; based on the first pattern The patient's eye is irradiated with a therapeutic laser beam having the set second pattern.

  The OCT applied in the embodiment is, for example, a spectral domain type or a swept source type. The configuration applied in these cases is the same as that in the first embodiment. Also, the timing for performing the OCT measurement is arbitrary as in the first embodiment.

  The observation optical system is configured to guide the return light from the patient's eye illuminated by the illumination optical system and the return light from the patient's eye of the aiming light irradiated by the irradiation optical system to the eyepiece lens (38). It may be. The observation optical system guides the return light from the patient's eye illuminated by the illumination optical system and the return light from the patient's eye of the aiming light irradiated by the irradiation optical system to the imaging device (42). It may be configured. In this case, the control unit can cause the display unit to display the image acquired by the imaging device.

<Third Embodiment>
FIG. 13 shows a configuration example of a laser treatment system according to the third embodiment. The optical system of the laser treatment system 3000 includes an illumination optical system 3100, an observation optical system 3200, an irradiation optical system 3300, a deflection unit 3310, an interference optical system 3400, and a first composite member (a transmission / reflection mirror 3510 and a guide). Optical means 3520), a second combining member 3530, and an optical scanning unit 3600. The control unit 3800 controls each part of the laser treatment system 3000.

  The illumination optical system 3100 illuminates the fundus oculi Ef of the patient's eye E. The observation optical system 3200 is used to observe the fundus oculi Ef illuminated by the illumination optical system 3100.

  The observation optical system 3200 is configured to guide return light from the fundus oculi Ef illuminated by the illumination optical system 3100 to an eyepiece and / or an imaging device. In the latter case, a signal from the imaging device is input to the control unit 3800. Based on this signal, the control unit 3800 displays a front image of the fundus oculi Ef on the display unit 3900. Note that the return light from the fundus oculi Ef is guided to the observation optical system 3200 via the left and right positions of the reflection mirror 3210.

  The irradiation optical system 3300 has a function of irradiating the fundus Ef with therapeutic laser light and a function of irradiating the fundus Ef with aiming light for aiming the therapeutic laser light. The irradiation position of the treatment laser light and the aiming light on the fundus oculi Ef is moved by the deflection unit 3310 and the optical scanning unit 3600. Deflection unit 3310 includes, for example, a galvanometer mirror that operates under the control of control unit 3800.

  The interference optical system 3400 divides the light from the light source into measurement light and reference light, and guides interference light obtained by superimposing the return light of the measurement light from the fundus oculi Ef and the reference light to the detection means. In the laser treatment system 3000, for example, spectral domain type or swept source type OCT is applied. The irradiation position of the measurement light on the fundus oculi Ef is moved by the optical scanning unit 3600. The configuration of the optical system when the spectral domain type OCT is applied or when the swept source type OCT is applied may be the same as that of the first embodiment. The image forming unit 3700 forms a fundus oculi Ef image based on the detection result by the detection means. The control unit 3800 causes the display unit 3900 to display the image formed by the image forming unit 3700.

  The transmission / reflection mirror 3510, the light guide unit 3520, and the second combining member 3530 substantially change the optical path of the illumination optical system 3100, the optical path of the irradiation optical system 3300, and the optical path of the measurement light guided by the interference optical system 3400. It functions as an optical path synthesizing unit that synthesizes coaxially. The optical scanning unit 3600 is provided closer to the patient's eye E than the combined position of the optical path of the irradiation optical system 3300 and the optical path of measurement light. In this example, the optical path of the irradiation optical system 3300 and the optical path of measurement light are combined substantially coaxially by the transmission / reflection mirror 3510. The light guide unit 3520 guides light passing through these optical paths while maintaining the positional relationship between the two optical paths substantially made coaxial by the transmission / reflection mirror 3510. The second combining member 3530 is provided closer to the patient's eye E than the light guiding means 3520, and substantially combines the combined optical path of the irradiation optical system 3300 and measurement light by the transmission / reflection mirror 3510, and the optical path of the illumination optical system 3100. Are synthesized coaxially. The optical scanning unit 3600 is disposed between the light guide unit 3520 and the second composite member 3530.

  In this embodiment, the transmission / reflection mirror 3510 is disposed, for example, at a position where the optical path of the irradiation light and the optical path of the measurement light intersect each other at an angle so as to form the same angle with respect to these two optical paths. It is a dichroic mirror or a half mirror. The light guide unit 3520 has a plurality of light guide paths and functions as a third light guide unit. The light guide means 3520 is, for example, a fiber bundle configured by bundling a plurality of optical fibers as a plurality of light guide paths, or a multi-core fiber having a plurality of cores as a plurality of light guide paths.

  Irradiation light (aiming light and therapeutic laser light) output from the irradiation optical system 2300 is transmitted through the transmission / reflection mirror 3510 by the deflection unit 3310, and the first light beam determined in advance among a plurality of light guide paths of the light guide means 3520 is used. 1 enters the light guide path. The irradiation light emitted from the light guiding unit 3520 is irradiated to the patient's eye E via the optical scanning unit 3600 and the second synthesis member 3530. In addition, the measurement light output from the interference optical system 3400 passes through the transmission / reflection mirror 3510 to a predetermined second light guide path different from the first light guide path among the plurality of light guide paths of the light guide means 3520. Incident. The measurement light emitted from the light guiding unit 3520 is irradiated to the patient's eye E via the optical scanning unit 3600 and the second synthesis member 3530.

[effect]
The effect of the laser treatment system according to this embodiment will be described.

  The laser treatment system according to the embodiment includes an illumination optical system, an observation optical system, an irradiation optical system, an interference optical system, an optical path synthesis unit, an optical scanning unit, and a control unit.

  In the example shown in FIG. 13, the “illumination optical system” includes the illumination optical system 3100, the “observation optical system” includes the observation optical system 3200, the “irradiation optical system” includes the irradiation optical system 3300, and the “interference optical system”. "Includes an interference optical system 3400," optical path combining means "includes a transmission / reflection mirror 3510, a light guiding means 3520, and a second combining member 3530," optical scanning means "includes an optical scanning unit 3600, and" control means " Includes a control unit 3800.

  The functions of the illumination optical system, the observation optical system, the irradiation optical system, the interference optical system, the optical path synthesis unit, the optical scanning unit, and the control unit are the same as those in the first embodiment.

  Further, the optical path combining means of this embodiment includes the following first combining member (transmission / reflection mirror 3510 and light guiding means 3520) and second combining member (second combining member 3530). The first synthesis member synthesizes the optical path of the irradiation optical system and the optical path of the measurement light substantially coaxially. The second combining member is provided closer to the patient's eye than the first combining member, and substantially includes a combined optical path of the irradiation optical system and measurement light by the first combining member, and an optical path of the illumination optical system. Synthesize coaxially. In this configuration, the optical scanning unit is disposed in the combined optical path between the first combining member and the second combining member.

  Further, the first combining member includes third light guide means (light guide means 3520) having a plurality of light guide paths. Each of the aiming light and the treatment laser light is irradiated to the patient's eye through a first light guide path, a light scanning unit, and a second combining member that are determined in advance among the plurality of light guide paths. . In addition, the measurement light is irradiated to the patient's eye via a predetermined second light guide different from the first light guide among the plurality of light guides, the optical scanning unit, and the second synthesis member. Is done.

  In addition, the first combining member includes a second transmitting / reflecting mirror (transmitting / reflecting mirror) that combines the optical path of the irradiation optical system and the optical path of the measurement light before the third light guiding unit (the light guiding unit 3520). 3510). Further, the irradiation optical system includes a deflecting unit (deflection unit 3310) for causing the aiming light and the therapeutic laser light to enter the first light guide through the second transmission / reflection mirror.

  According to such an embodiment, since the optical path of the illumination optical system and the optical path of the irradiation optical system are arranged substantially coaxially, the site irradiated with the aiming light or the therapeutic laser light, or the therapeutic laser light Can be reliably illuminated by the illumination optical system. Therefore, it is possible to reliably illuminate and observe the site to be observed in the laser treatment.

  Further, according to this embodiment, since the optical path of the irradiation optical system and the optical path of the interference optical system are arranged substantially coaxially, the cross section of the part to which laser treatment is performed or the part to which laser treatment is performed Measurement can be performed reliably. Furthermore, it is possible to perform control so that cross-sectional measurement of the part is performed substantially in real time. Therefore, it is possible to perform OCT measurement of the target site of laser treatment substantially in real time while maintaining positional accuracy.

  Further, according to this embodiment, since the optical path of the illumination optical system and the optical path of the interference optical system are arranged substantially coaxially, the part where the OCT measurement is performed or the part where the OCT measurement is performed is illuminated. Illumination can be ensured by the optical system. Therefore, it is possible to reliably illuminate and observe a site to be observed in OCT measurement.

  The laser treatment system according to this embodiment may have the following configuration, as in the first embodiment.

  The illumination optical system, the irradiation optical system, and the interference optical system may be configured such that the combined optical path of the irradiation optical system and the interference optical system and the optical path of the illumination optical system are substantially orthogonal. Further, the second combining member may include a third transmitting / reflecting mirror provided at a position where the combined optical path and the optical path of the illumination optical system intersect.

  The control means can control the irradiation optical system to perform the following operations: irradiating the patient's eye with aiming light having a preset first pattern; based on the first pattern The patient's eye is irradiated with a therapeutic laser beam having the set second pattern.

  The OCT applied in the embodiment is, for example, a spectral domain type or a swept source type. The configuration applied in these cases is the same as that in the first embodiment. Also, the timing for performing the OCT measurement is arbitrary as in the first embodiment.

  The observation optical system is configured to guide the return light from the patient's eye illuminated by the illumination optical system and the return light from the patient's eye of the aiming light irradiated by the irradiation optical system to the eyepiece lens (38). It may be. The observation optical system guides the return light from the patient's eye illuminated by the illumination optical system and the return light from the patient's eye of the aiming light irradiated by the irradiation optical system to the imaging device (42). It may be configured. In this case, the control unit can cause the display unit to display the image acquired by the imaging device.

  The plurality of embodiments described above are merely examples for carrying out the present invention. A person who intends to implement the present invention can make arbitrary modifications, omissions, additions and the like within the scope of the present invention.

1, 1000, 2000, 3000 Laser treatment system 2 Light source unit 2a Aiming light source 2b Treatment laser light source 2c Galvano mirror 2d Light shielding plate 2e Collimator lens 2f Transmission / reflection mirror 2g Collimator lens array 3 Slit lamp microscope 4 Optical fiber 5 Processing unit 6 Operation Unit 7 Display unit 8 OCT unit 9 Optical fiber 10, 1100, 2100, 3100 Illumination optical system 30, 1200, 2200, 3200 Observation optical system 42 Imaging device 51 Collimator lens 52 Galvano scanner 55, 91 Dichroic mirror 81 Light source unit 89 Detection unit 101 Control Unit 210 Fiber Bundle 300 Multicore Fiber 1300, 2300, 3300 Irradiation Optical System 1400, 2400, 3400 Interference Optical System 1510, 2510 One composite member 1520, 2520, 3530 Second composite member 1600, 2600, 3600 Optical scanning unit 1700, 2700, 3700 Image forming unit 1800, 2800, 3800 Control unit 1900, 2900, 3900 Display unit 3310 Deflection unit 3510 Transmission reflection Mirror 3520 Light guide means LA Aiming light LT Laser light for treatment LM Measurement light E Patient eye Ef Fundus

Claims (2)

An illumination optical system for illuminating the patient's eyes;
An observation optical system for observing a patient's eye illuminated by the illumination optical system;
An irradiation optical system for irradiating a patient's eye with a treatment laser beam and a sighting beam for aiming the treatment laser beam;
An interference optical system that divides light from a light source into measurement light and reference light, and guides interference light obtained by superimposing the return light from the patient's eye of the measurement light and the reference light to detection means;
Optical path combining means for combining the optical path of the illumination optical system, the optical path of the irradiation optical system, and the optical path of the measurement light substantially coaxially;
An optical scanning unit provided on the patient's eye side with respect to the combined position of the optical path of the irradiation optical system and the optical path of the measurement light by the optical path combining unit;
Have a control means for controlling the illumination optical system control, the control and the optical scanning unit of the interference optical system,
The optical path combining means is
A first combining member that combines the optical path of the irradiation optical system and the optical path of the measurement light substantially coaxially;
Provided on the patient's eye side with respect to the first combining member, and the combined optical path of the irradiation optical system and the measurement light by the first combining member and the optical path of the illumination optical system are substantially coaxial. A second composite member to be combined;
Including
The optical scanning means is disposed in the synthetic optical path between the first synthetic member and the second synthetic member;
The first combining member includes a third light guide unit having a plurality of light guide paths,
Each of the aiming light and the treatment laser light passes through the first light guide path determined in advance among the plurality of light guide paths, the optical scanning means, and the second combining member, and then the patient. Irradiated to the eyes,
The measurement light passes through the second light guide path determined in advance different from the first light guide path among the plurality of light guide paths, the optical scanning means, and the second combining member, and then the patient. Irradiated to the eyes,
The plurality of light guide paths include two or more light guide paths having different diameters as the first light guide paths,
The irradiation optical system includes a selection unit that selectively makes each of the aiming light and the treatment laser light enter the two or more light guide paths,
The second light guide path is disposed along a central axis of the third light guide means;
The laser treatment system in which the two or more light guides serving as the first light guide are disposed around the second light guide . The third light guide means is a fiber bundle configured by bundling a plurality of optical fibers as the plurality of light guide paths, or a multi-core fiber having a plurality of cores as the plurality of light guide paths. The laser treatment system according to claim 1.