JP6500071B2 - 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, a laser treatment system in which an optical coherence tomography apparatus (OCT) apparatus capable of acquiring a cross-sectional image of an eye has been introduced (see Patent Document 1).

  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. It is known (see Patent Document 2).

  In addition, in order to improve the non-uniformity of coagulation spots due to the light absorption characteristics of the tissue, the formation state (color and size) of coagulation spots is monitored based on the front image of the eyes over time, and the laser light irradiation conditions There is known a laser treatment system configured to control (output, irradiation time) in real time (see Patent Document 3).

Japanese Patent No. 4126054 Japanese Patent No. 4377405 Patent No. 3889904

  In laser treatment, it is important not only to accurately irradiate a target site with laser light, but also to appropriately irradiate the target site with laser light. In the invention described in Patent Document 3, control is performed so that the laser beam is appropriately irradiated by referring to the formation state of coagulation spots grasped from the front image of the eye.

  On the other hand, there is a case where a target portion existing in a region that cannot be recognized by the front image of the eye is treated. For example, laser treatment may be applied to a site existing in a deep region of the retina such as the retinal pigment epithelium (RPE). In such a case, it is difficult to grasp how much the target site (RPE) has been cauterized from the front image (image of the retina surface).

  Further, according to the technique described in Patent Document 3, the degree of cauterization of the surface texture represented by the front image can be recognized, but it is difficult to grasp the progress of cauterization in the depth direction.

  An object of the present invention is to provide a technique capable of appropriately irradiating a target site with laser light in a laser treatment system in the ophthalmic field.

According to the first aspect of the present invention, there is provided an irradiation optical system for irradiating the fundus of a patient 's eye with a treatment laser beam for photocoagulation of the retina via the first optical scanning means, and a light from the light source as a measurement light. The detection light is divided into reference light, the measurement light is irradiated onto the fundus via the second light scanning means, and the interference light obtained by superimposing the return light of the measurement light from the fundus and the reference light is used as the detection means. Controlling the irradiation optical system to sequentially irradiate a plurality of positions of the fundus based on a guiding interference optical system and a preset array of spot patterns, and the treatment laser An optical system control means for controlling the interference optical system so that the measurement light is irradiated to the position of the fundus that is irradiated with light and / or the position of the fundus that is irradiated with therapeutic laser light; light Kohi the three-dimensional region of the fundus including the position In the three-dimensional image data obtained by applying the Reference tomography, a laser treatment system comprising a specifying means for specifying the image area to the treatment laser beam corresponds to the position irradiated.
The invention according to claim 2 is the laser treatment system according to claim 1, further comprising an imaging system for imaging the fundus , wherein the specifying means includes an image obtained by the imaging system Alignment with the three-dimensional image data is performed, and the image region is specified based on the alignment result.
A third aspect of the present invention is the laser treatment system according to the second aspect, wherein the specifying means includes at least a part of the image obtained by the imaging system and the three-dimensional image data in the alignment. The image matching with the two-dimensional image obtained by adding the two along the A line is performed.
Invention of Claim 4 is a laser treatment system as described in any one of Claims 1-3, Comprising: The information which shows the degree of laser treatment in the position where the laser beam for treatment was irradiated is calculated | required It further has an information acquisition means.
The invention according to claim 5 is the laser treatment system according to claim 4, wherein the three-dimensional image data includes a position where the optical system control unit is irradiated with a treatment laser beam and / or treatment. Acquired by controlling the interference optical system so that the measurement light is irradiated to the position irradiated with the laser beam for use, and the information acquisition means obtains the information by analyzing the three-dimensional image data It is characterized by.
A sixth aspect of the present invention is the laser treatment system according to the fifth aspect, wherein the information obtained by the information acquisition means includes a degree and / or a range of ablation by the therapeutic laser beam. And
The invention according to claim 7 is the laser treatment system according to claim 6, wherein the information obtained by the information acquisition means includes at least the degree of cauterization by the therapeutic laser beam, An image or a graph expressing the distribution state is created.
Invention of Claim 8 is the laser treatment system as described in any one of Claims 1-7, Comprising: The said detection means which detected the interference light obtained by control by the said optical system control means Further, it has an irradiation condition control means for controlling the irradiation condition of the therapeutic laser beam in real time based on the output from the laser beam.

  According to the laser treatment system according to the embodiment, it is possible to appropriately irradiate the target site of the patient's eye with laser light.

It is the schematic which shows the example of a structure of the laser treatment system which concerns on embodiment. It is the schematic which shows the example of a structure of the laser treatment system which concerns on embodiment. It is the schematic which shows the example of a structure of the laser treatment system which concerns on embodiment. It is the schematic which shows the example of a structure of the laser treatment system which concerns on embodiment. It is the schematic which shows the example of a structure of the laser treatment system which concerns on embodiment. It is the schematic which shows the example of a structure 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 example of a structure of the laser treatment system which concerns on embodiment. It is the schematic which shows the example of a structure of the laser treatment system which concerns on embodiment. It is a flowchart which shows the example of operation | movement of the laser treatment system which concerns on embodiment. It is a flowchart which shows the example of operation | movement of the laser treatment system which concerns on embodiment. It is a flowchart which shows the example of operation | movement of the laser treatment system which concerns on embodiment. It is a flowchart which shows the example of operation | movement 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.

  A configuration example of the laser treatment system 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 display unit 1900 displays information under the control of the control unit 1800. The operation unit 1950 accepts an operation by the user and inputs a signal (operation signal) corresponding to this operation to the control unit 1800. The control unit 1800 controls each part of the system based on this operation signal.

  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 therapeutic 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 combining member 1510 and the second combining 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. .

  In the above configuration, the optical scanning unit 1600 is disposed on the patient's eye E side with respect to the first combining member 1510. That is, the deflection of the treatment laser light, the aiming light, and the measurement light is performed by the single optical scanning unit 1600. It is also possible to apply a configuration in which two or more optical scanning units are provided. For example, it is possible to configure so that the treatment laser beam and the aiming beam are deflected by the first optical scanning unit, and the measurement light deflection is performed by the second optical scanning unit.

  Further, in the above configuration, a part of the optical path of the treatment laser light and the aiming light and a part of the optical path of the measurement light are common. That is, these optical paths are common in the portion closer to the patient's eye E than the first combining member 1510. On the other hand, these optical paths can be provided separately. Alternatively, the optical path of the therapeutic laser light, the optical path of the aiming light, and the optical path of the measurement light can be provided separately.

  According to the laser treatment system having the above-described configuration, the OCT measurement of the irradiation position is performed during or after the irradiation of the treatment laser beam, and the treatment laser beam is generated based on the data obtained by the OCT measurement. Irradiation conditions can be controlled in real time. According to the OCT measurement, information indicating the tissue degeneration state at the irradiation position of the therapeutic laser beam can be obtained. This information is a signal output from the interference optical system 1400 or information obtained by processing this signal (for example, an image formed by the image forming unit 1700). Based on this information (that is, based on the tissue degeneration state), the control unit 1800 determines the irradiation condition of the therapeutic laser beam and controls the irradiation optical system 1300 and / or the optical scanning unit 1600. A specific example of irradiation conditions will be described later.

  The laser treatment system according to the embodiment can project aiming light including a spot pattern of a predetermined arrangement onto the fundus and sequentially irradiate the treatment laser light to a plurality of irradiation positions that are aimed. . Furthermore, it is possible to execute the above OCT measurement and control of irradiation conditions in parallel with such pattern irradiation.

  Here, in general, the time for performing one OCT measurement (the time required for the A scan, that is, the irradiation time of the measurement light) is sufficiently shorter than the irradiation time of the therapeutic laser beam for each irradiation position. The OCT measurement is performed while the therapeutic laser beam is irradiated or while the irradiation position of the therapeutic laser beam is changed.

  In the former case, the irradiation condition is controlled in order to adjust the irradiation condition related to the irradiation position where the therapeutic laser beam is actually applied or the irradiation position where the therapeutic laser beam is applied thereafter. In the latter case, the irradiation condition is controlled in order to adjust the irradiation condition for the irradiation position where the therapeutic laser beam is applied next or the irradiation position where the therapeutic laser beam is applied thereafter.

  The timing at which the adjusted irradiation conditions are applied is the time required for OCT measurement, the time required for processing for obtaining new irradiation conditions, and the control of the irradiation optical system 1300 and / or the optical scanning unit 1600 based on the new irradiation conditions. Based on the time it takes. Such processing corresponds to real-time control of irradiation conditions.

  When the OCT measurement time is sufficiently shorter than the treatment laser light irradiation time, OCT measurement is performed a plurality of times for one irradiation position (spot) of the treatment laser light, and the data obtained by these OCT measurements It is possible to control the irradiation conditions based on the above. According to this configuration, it is possible to improve accuracy and accuracy in controlling irradiation conditions by statistically processing a plurality of data obtained by a plurality of times of OCT measurement.

  In general, the size of the beam cross section of the measurement light is sufficiently smaller than the size of the beam cross section of the therapeutic laser light. That is, the size of the spot formed by the measurement light on the fundus oculi Ef is sufficiently smaller than the size of the spot formed by the treatment laser beam on the fundus oculi Ef. In this case, it is possible to perform OCT measurement for each of a plurality of positions in the spot of the therapeutic laser beam. According to this configuration, it is possible to improve accuracy and accuracy in controlling the irradiation conditions by finely measuring the inside of the treatment laser light irradiation region.

  When OCT measurement is performed on a plurality of positions in the spot of the therapeutic laser beam, OCT measurement can be performed twice or more for one or more positions among the plurality of positions.

  A specific example of a laser treatment system that can be applied to realize real-time control of irradiation conditions as described above will be described below.

[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 laser 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 laser 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 laser 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.

(Laser light source unit 2)
The laser light source unit 2 generates light that irradiates the fundus oculi Ef. The laser 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 laser light source unit 2. For example, an optical element (such as a lens) for causing the light generated by the laser 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 laser 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.

  Further, 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 laser light source unit 2 with the illumination optical system 10, and the optical path of the measurement light input from the OCT unit 8. Are combined with the illumination optical system 10. 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 laser 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 laser 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 laser 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 laser 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 another wavelength band, 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, a device used for scanning with irradiation light or 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 laser light source unit 2 in the direction in which the irradiation light is incident on the light guide 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 laser light source unit 2 is provided with a galvano scanner capable of two-dimensional scanning for making irradiation light of a predetermined pattern enter 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 FIGS. 7 and 8. FIG. 8 shows an example of the internal configuration of the control unit 101 and the data processing unit 110 shown in 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 laser 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. The control unit 101 includes an irradiation optical system control unit 101a and an OCT optical system control unit 101b. The irradiation optical system control unit 101a executes a control process related to irradiation of irradiation light (aiming light LA and therapeutic laser light LT). The OCT optical system control unit 101b executes control processing related to OCT measurement.

  As control of the laser light source unit 2, the control unit 101 (irradiation optical system control unit 101a) performs control of the aiming light source 2a, control of the therapeutic 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. In addition, when a configuration in which a plurality of types of therapeutic laser light LT can be output by one or more therapeutic laser light sources 2b is applied, the control unit 101 selectively outputs the therapeutic laser light LT. The therapeutic 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 control for applying the irradiation light to the patient's eye E, the control unit 101 (irradiation optical system control unit 101a) controls the galvano scanner 52 in addition to the control of the laser 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, it is possible to deflect the irradiation light incident from the laser light source unit 2 through the optical fiber 4 in a two-dimensional manner.

  As control of the OCT unit 8, the control unit 101 (OCT optical system control unit 101b) 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.

  The z direction indicates the traveling direction of the measurement light (the depth direction of the fundus oculi Ef), and the xy direction indicates a two-dimensional coordinate system set on a plane orthogonal to the z direction. In other words, in the definition of the direction described above, the z-axis is set in the front-rear direction, the x-axis is set in the left-right direction, and the y-axis is set in the up-down direction.

(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.

  In the embodiment, the irradiation condition set via the operation unit 6 is applied, for example, when a series of laser treatments are disclosed (that is, used as an initial condition). Further, it is possible to set the irradiation condition via the operation unit 6 while performing a series of laser treatments or between a series of laser treatments and a series of laser treatments. An example of a series of laser treatments is laser treatment based on a predetermined pattern of spot patterns.

  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 and range (depth of arrival, spread, etc.) of cauterization by the therapeutic laser beam LT. Furthermore, the data processing unit 110 can create information that expresses the distribution state of the degree of cauterization with an image or a graph.

  The data processing unit 110 includes an irradiation condition setting unit 111. The irradiation condition setting unit 111 includes an irradiation position selection unit 112 and an irradiation order setting unit 113.

(Irradiation condition setting unit 111)
The laser treatment system according to this embodiment projects aiming light LA having a predetermined pattern of spot patterns onto the fundus oculi Ef, and sequentially irradiates the treatment laser light LT to a plurality of irradiation positions that have been aimed. To do. Furthermore, the laser treatment system performs OCT measurement and control of irradiation conditions in parallel with such pattern irradiation. This OCT measurement is executed for a position where the therapeutic laser beam LT is actually irradiated, or a position where the therapeutic laser beam LT has already been irradiated.

  The irradiation condition setting unit 111 sets the irradiation condition of the therapeutic laser beam LT based on the output from the detection unit 89 that detects the interference light LC obtained by the OCT measurement. This process is executed in real time in parallel with pattern irradiation. The irradiation condition setting unit 111 sends a signal indicating the set irradiation condition to the irradiation optical system control unit 101a. The irradiation optical system control unit 101a changes the irradiation condition of the therapeutic laser beam LT based on this signal. The combination of the irradiation condition setting unit 111 and the irradiation optical system control unit 101a corresponds to “irradiation condition control means”. An example of processing executed by the irradiation condition setting unit 111 will be described below.

  A first example will be described. The control unit 101 sends a signal (detection signal) output from the detection unit 89 to the irradiation condition setting unit 111. The irradiation condition setting unit 111 sets the irradiation condition of the therapeutic laser beam LT by analyzing the detection signal. A specific example of this process will be described. The irradiation condition setting unit 111 stores in advance correspondence information in which the characteristics (intensity, frequency, pattern, etc.) of the detection signal are associated with the irradiation conditions. Irradiation conditions include 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. Includes irradiation conditions. The irradiation condition setting unit 111 obtains an irradiation condition corresponding to the detection signal by referring to the correspondence information.

  A second example will be described. The image forming unit 103 forms image data based on the detection signal output from the detection unit 89. The control unit 101 sends the image data formed by the image forming unit 103 to the irradiation condition setting unit 111. The irradiation condition setting unit 111 sets the irradiation condition of the therapeutic laser beam LT by analyzing the image data. This process is executed, for example, by referring to correspondence information in which image data characteristics (pixel values, patterns, etc.) are associated with irradiation conditions, as in the first example.

  The image data used for the process for setting the irradiation condition is one-dimensional image data, two-dimensional image data, or three-dimensional image data. The one-dimensional image data is luminance image data representing the reflection intensity distribution of the measurement light LM from the one-dimensional region of the fundus oculi Ef along the traveling direction (z direction) of the measurement light LM, and includes A line data, an A scan image, and the like. be called. This one-dimensional image data represents a one-dimensional region at a position where the therapeutic laser beam LT is actually irradiated or a position where the therapeutic laser beam LT has already been irradiated.

  When the one-dimensional image data is used, the irradiation condition setting unit 111 obtains information representing the ablation state, such as the degree and / or range (depth) of the ablation at the irradiation position of the therapeutic laser beam LT, for example. This information may include distribution information such as a one-dimensional distribution of the ablation state. In the correspondence information, the cautery state and the irradiation condition are associated in advance. The irradiation condition setting unit 111 sets irradiation conditions based on the input one-dimensional image data and correspondence information.

  The two-dimensional image data is luminance image data representing a two-dimensional area stretched by the moving direction and the z direction, which is obtained by moving the irradiation position of the measurement light LM on the fundus oculi Ef one-dimensionally. OCT measurement performed by moving the irradiation position of the measurement light LM in a one-dimensional manner is called a B-scan or the like, and two-dimensional image data obtained thereby is called a B-scan image or the like. The two-dimensional image data represents a two-dimensional cross section including a position where the therapeutic laser beam LT is actually irradiated or a position where the therapeutic laser beam LT has already been irradiated.

  When the two-dimensional image data is used, the irradiation condition setting unit 111 obtains information representing the ablation state, such as the degree and / or range (two-dimensional distribution or the like) of the ablation at the irradiation position of the therapeutic laser beam LT, for example. In the correspondence information, the cautery state and the irradiation condition are associated in advance. The irradiation condition setting unit 111 sets irradiation conditions based on the input two-dimensional image data and correspondence information.

  As described above, the three-dimensional image data is formed by the data processing unit 110. The three-dimensional image data is luminance image data representing a three-dimensional region stretched by the two-dimensional movement direction and the z direction, which is obtained by two-dimensionally moving the irradiation position of the measurement light LM on the fundus oculi Ef. is there. OCT measurement performed by moving the irradiation position of the measurement light LM two-dimensionally is called three-dimensional scan, volume scan, etc., and the three-dimensional image data obtained thereby is called volume data, voxel data, stack data, etc. . This three-dimensional image data represents a three-dimensional region including a position where the therapeutic laser beam LT is actually irradiated or a position where the therapeutic laser beam LT has already been irradiated.

  When the three-dimensional image data is used, the irradiation condition setting unit 111, for example, information indicating the ablation state, such as the degree of ablation at the irradiation position of the therapeutic laser beam LT and / or the range of the ablation site (three-dimensional distribution or the like). Ask for. In the correspondence information, the cautery state and the irradiation condition are associated in advance. The irradiation condition setting unit 111 sets irradiation conditions based on the input three-dimensional image data and correspondence information.

(Irradiation position selection unit 112)
The irradiation position selection unit 112 selects at least a part of a plurality of irradiation positions in pattern irradiation based on the output from the detection unit 89 (detection signal, image data based on this, etc.). The irradiation position selection unit 112 operates when “preliminary irradiation” is performed in pattern irradiation. Preliminary irradiation refers to performing OCT measurement while irradiating a part of a plurality of irradiation positions in pattern irradiation (one or more irradiation positions) with the therapeutic laser beam LT, and is obtained by this OCT measurement. Pattern irradiation (a part or all of a plurality of irradiation positions) is performed based on the data. The irradiation position selection unit 112 selects, based on the data obtained by this OCT measurement, the irradiation position of the treatment laser beam LT in the latter pattern irradiation, that is, some or all of the plurality of irradiation positions in the former pattern irradiation. To do.

  An example of processing executed by the irradiation position selection unit 112 will be described. First, the irradiation position selection unit 112 obtains information (a cautery level, a range, etc.) indicating the ablation state based on data obtained by OCT measurement in preliminary irradiation. This process is executed, for example, in the same manner as the process related to the irradiation condition setting unit 111.

  Next, the irradiation position selection unit 112 performs a determination process based on information indicating the obtained ablation state. This determination processing includes, for example, threshold processing for determining whether the degree of cauterization at the irradiation position to which preliminary irradiation is applied is greater than or equal to a threshold, and / or threshold processing for determining whether the range of cauterization is greater than or equal to the threshold. . Such a determination process is executed for each irradiation position in the preliminary irradiation. The threshold value is set in advance.

  When the number of irradiation positions in the preliminary irradiation is two or more, the irradiation position selection unit 112 can statistically process the determination result. As an example of this statistical process, there is an arithmetic process for obtaining a statistical value of a difference with respect to a threshold (average value, sum, standard deviation, variance, maximum value, minimum value, etc.).

  The irradiation position selection unit 112 selects an irradiation position based on the result of the determination process (or statistical process). As an example of this processing, when the degree and range of irradiation are equal to or greater than the threshold value, the irradiation position selection unit 112 can select a portion obtained by removing the irradiation positions applied in the preliminary irradiation from all irradiation positions. As another example in the case where the degree and range of irradiation are equal to or greater than a threshold, the irradiation position selection unit 112 may select a portion obtained by removing the irradiation positions whose degree of irradiation and range are equal to or greater than the threshold from all irradiation positions. it can. The parameter for selecting the irradiation position may be only one of the degree and range of irradiation. In the irradiation position selection process, when the degree and / or range of irradiation is greater than a threshold value by a predetermined value or more, an irradiation position in the vicinity of the irradiation position can be excluded.

  The irradiation position selection unit 112 sends information indicating the selected irradiation position to the irradiation optical system control unit 101a and / or the irradiation order setting unit 113. Further, the information indicating the selected irradiation position may include information indicating the cauterization state. When information is sent to the irradiation optical system control unit 101a, the irradiation optical system control unit 101a selects the treatment laser beam LT under the irradiation condition set by the irradiation condition setting unit 111 by the irradiation position selection unit 112. The irradiation optical system (the therapeutic laser light source 2b, the galvano mirror 2c, the galvano scanner 52, etc.) can be controlled so that the irradiation position is sequentially irradiated. When information is sent to the irradiation order setting unit 113, the irradiation order setting unit 113 executes processing described below.

(Irradiation order setting unit 113)
The irradiation order setting unit 113 irradiates the treatment laser beam LT to the irradiation position selected by the irradiation position selection unit 112 based on the output from the detection unit 89 (detection signal, image data based thereon, etc.). Set the order (irradiation order).

  An example of processing for setting the irradiation order will be described. First, the irradiation order setting unit 113 determines whether or not the degree and / or range of irradiation is greater than a threshold value by a predetermined value or more. In addition, when the irradiation position selection part 112 performs the same determination process, the irradiation order setting part 113 receives the determination result by the irradiation position selection part 112.

  When it is determined that the degree of irradiation (irradiation range) is greater than the threshold by a predetermined value or more, the irradiation order setting unit 113 sets the irradiation order so that the irradiation position corresponding to this determination result is postponed. Here, “post-rotation” is to change the order of the irradiation positions in the pattern irradiation after the preliminary irradiation after the default order, for example, to the last order of the pattern irradiation.

  On the other hand, when it is determined that the degree of irradiation (range of irradiation) is greater than the threshold by a predetermined value or more, the irradiation order setting unit 113 applies, for example, a default order in pattern irradiation after preliminary irradiation.

  The irradiation order setting unit 113 sends information indicating the irradiation order set for the irradiation position selected by the irradiation position selection unit 112 to the irradiation optical system control unit 101a. The irradiation optical system control unit 101a performs irradiation optical system (treatment laser light source 2b, galvano mirror 2c, galvano scanner so that irradiation of the treatment laser light LT on the selected irradiation position is executed according to the irradiation order. 52 etc.) can be controlled.

(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 an 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.

[Operation]
The operation of the laser treatment system according to the embodiment will be described. Hereinafter, some examples of the operation of the laser treatment system will be described. The laser treatment system according to the embodiment may be configured to be able to execute any of the following operation examples. In addition, the laser treatment system should just contain the component regarding the operation example which can be performed. Further, any two or more of the following operation examples can be combined.

[Operation Example 1]
The operation example shown in FIG. 9 will be described. In this operation example, the irradiation position selection unit 112 and the irradiation order setting unit 113 are not used.

(Step S1: Observation of the fundus is started)
First, observation of the fundus oculi Ef is started. Specifically, the control unit 101 turns on the light source 11 and causes the display unit 7 to display an image based on a signal output from the imaging device 42. This image (observation image) is, for example, a real-time infrared moving image.

(Step S2: irradiating the fundus with aiming light)
The control unit 101 (irradiation optical system control unit 101a) controls the irradiation optical system (aiming light source 2a, galvano mirror 2c, galvano scanner 52, etc.) to irradiate the fundus Ef with the aiming light LA. At this time, the aiming light LA having a predetermined pattern of spot patterns is irradiated. The spot pattern to be applied is preset. An image of the aiming light LA projected on the fundus oculi Ef, that is, a plurality of spot images corresponding to the spot pattern, is drawn on the observation image whose display is started in step S1.

(Step S3: The user performs aiming)
The user (operator) performs aiming while observing the observation image or performing visual observation through the eyepiece lens 38. This aiming is performed, for example, by changing the projection positions of a plurality of spot images on the fundus oculi Ef using the operation unit 6.

(Step S4: Start treatment laser beam irradiation and OCT measurement)
When the aiming in step S3 is completed, the user inputs an instruction for starting irradiation (preliminary irradiation) of the therapeutic laser beam LT via the operation unit 6. Upon receiving this trigger, the control unit 101 starts irradiation of the therapeutic laser beam LT and OCT measurement. Irradiation of the therapeutic laser beam LT is performed by the irradiation optical system control unit 101a, and OCT measurement is performed by the OCT optical system control unit 101b.

  Here, the irradiation pattern of the treatment laser beam LT and a part (sub-pattern) of the irradiation pattern applied to the preliminary irradiation are set in advance. The irradiation pattern of the therapeutic laser beam LT may be the same as or different from that of the aiming light LA. In the latter case, the irradiation pattern of the therapeutic laser beam LT is, for example, a part of that of the aiming light LA. A scan pattern of the measurement light LM in OCT measurement is also set in advance.

(Step S5: Start processing for setting irradiation conditions)
Corresponding to the start of OCT measurement in step S4, the irradiation condition setting unit 111 starts a process of setting irradiation conditions based on data sequentially obtained by this OCT measurement.

(Step S6: Set irradiation conditions)
The irradiation condition setting unit 111 sets the irradiation condition of the therapeutic laser beam LT based on data obtained by OCT measurement performed in parallel with the preliminary irradiation. Information indicating the set irradiation conditions is sent to the irradiation optical system controller 101a.

(Step S7: Change irradiation conditions)
The irradiation optical system control unit 101a changes the irradiation condition of the therapeutic laser beam LT to the irradiation condition set in step S6.

(Step S8: Completion of laser irradiation with a predetermined pattern)
The irradiation optical system control unit 101a irradiates the therapeutic laser beam LT based on the irradiation pattern set in advance and the irradiation condition changed in step S7. The irradiation with the therapeutic laser beam LT at this stage is performed as a series of laser treatments following the preliminary irradiation, for example.

  Laser irradiation at this stage is executed for a preset irradiation position. For example, the laser irradiation at this stage may be a pattern irradiation for an irradiation position to which preliminary irradiation has not been applied. That is, the laser irradiation at this stage may be a laser irradiation to an irradiation position (referred to as a remaining irradiation position) excluding a portion where preliminary irradiation is applied from all irradiation positions in the irradiation pattern. In this case, the control unit 101 controls the irradiation optical system so that the treatment laser light LT under the irradiation condition set in step S6 is sequentially irradiated to the remaining irradiation positions.

  Or the irradiation position used as the object of the laser irradiation in this step may contain at least one part of the irradiation position to which preliminary irradiation was applied. In that case, the same irradiation condition can be applied to all irradiation positions in the laser irradiation at this stage, or different irradiation conditions are applied to the irradiation position where the preliminary irradiation is applied and the remaining irradiation positions. You can also

(Step S9: Is laser treatment further performed?)
The user determines whether to perform further laser treatment. When further laser treatment is performed (step S9: Yes), it returns to step S2. On the other hand, when further laser treatment is not performed (step S9: No), laser treatment is complete | finished (end).

[Operation example 2]
The operation example shown in FIG. 10 will be described. In this operation example, the irradiation position selection unit 112 is used, and the irradiation order setting unit 113 is not used.

(Step S1 to Step S6)
Step S1 (start of fundus observation) to step S6 (setting of irradiation conditions) may be the same as those in the first operation example.

(Step S11: Select an irradiation position)
The irradiation position selection unit 112 selects at least a part of all irradiation positions in the irradiation pattern based on data obtained by OCT measurement performed in parallel with the preliminary irradiation.

(Step S12: Change irradiation conditions)
The irradiation optical system control unit 101a changes the irradiation condition of the treatment laser beam LT to the irradiation position set in step S11 to the irradiation condition set in step S6.

(Step S13: Completion of laser irradiation with a predetermined pattern)
The irradiation optical system control unit 101a irradiates the irradiation position set in step S11 with the therapeutic laser beam LT having the irradiation condition changed in step S12.

(Step S9: Is laser treatment further performed?)
As in the first operation example, the user determines whether to perform further laser treatment. When further laser treatment is performed (step S9: Yes), it returns to step S2. On the other hand, when further laser treatment is not performed (step S9: No), laser treatment is complete | finished (end).

[Operation Example 3]
The operation example shown in FIG. 11 will be described. In this operation example, the irradiation position selection unit 112 and the irradiation order setting unit 113 are used.

(Step S1 to Step S6)
Step S1 (start of fundus observation) to step S6 (setting of irradiation conditions) may be the same as those in the first operation example.

(Step S11: Select an irradiation position)
As in the operation example 2, the irradiation position selection unit 112 selects at least a part of all irradiation positions in the irradiation pattern based on data obtained by OCT measurement performed in parallel with the preliminary irradiation. To do.

(Step S21: Set the irradiation order)
The irradiation order setting unit 113 sets the irradiation order of the therapeutic laser light for the irradiation position selected in step S11 based on data obtained by OCT measurement performed in parallel with the preliminary irradiation.

(Step S12: Change irradiation conditions)
Similar to the operation example 2, the irradiation optical system control unit 101a changes the irradiation condition of the treatment laser light LT to the irradiation position set in step S11 to the irradiation condition set in step S6.

(Step S22: Completion of laser irradiation with a predetermined pattern)
The irradiation optical system control unit 101a irradiates the irradiation position set in step S11 with the therapeutic laser beam LT having the irradiation condition changed in step S12. Irradiation of the treatment laser beam LT to these irradiation positions is executed according to the irradiation order set in step S21.

(Step S9: Is laser treatment further performed?)
As in the first operation example, the user determines whether to perform further laser treatment. When further laser treatment is performed (step S9: Yes), it returns to step S2. On the other hand, when further laser treatment is not performed (step S9: No), laser treatment is complete | finished (end).

[Operation Example 4]
In the laser treatment system according to this operation example, two or more different irradiation conditions are applied in the preliminary irradiation for setting the irradiation conditions, and the data obtained by the OCT measurement performed in parallel with the preliminary irradiation is used. Based on this, the irradiation condition is controlled.

  The irradiation conditions applied here include, for example, irradiation conditions that can affect the cautery state of the tissue of the fundus oculi Ef. Examples of such irradiation conditions include irradiation conditions (spot size conditions, irradiation light type conditions, irradiation intensity conditions (output intensity conditions, dimming conditions), irradiation time conditions, etc. that can affect the ablation state for a single spot. ) And irradiation conditions (such as spot interval conditions) that can affect the ablation state in nearby spots.

  By performing preliminary irradiation using two or more different irradiation conditions in this way, it is possible to collect a variety of data compared to the case of performing preliminary irradiation under a single irradiation condition. It becomes possible to improve the accuracy and accuracy of condition control.

  In the operation example 4, the use of the irradiation position selection unit 112 and the irradiation order setting unit 113 is arbitrary. That is, in the operation example 4, these may not be used, only one of them may be used, or both of them may be used. For example, the preliminary irradiation operation and the irradiation condition control according to the operation example 4 can be applied to any one of the operation example 1, the operation example 2, and the operation example 3. Hereinafter, the case where the characteristic operation in the operation example 4 is applied to the operation example 1 will be described with reference to FIG.

(Step S1 to Step S3)
Step S1 (start of fundus observation) to step S3 (sighting) are executed in the same manner as in the first operation example.

(Step S31: Start irradiation and OCT measurement of therapeutic laser light under different irradiation conditions)
When the aiming in step S3 is completed and the user performs a trigger operation, the control unit 101 starts irradiation with the therapeutic laser beam LT and OCT measurement.

  Irradiation of the therapeutic laser beam LT starts with preliminary irradiation. In this preliminary irradiation, two or more spots are irradiated with the therapeutic laser beam LT. Furthermore, in this preliminary irradiation, two or more different irradiation conditions are applied. For example, when preliminary irradiation is performed on two spots, the irradiation condition of the therapeutic laser beam LT applied to the first spot and the irradiation condition of the therapeutic laser beam LT applied to the second spot The irradiating optical system control unit 101a operates so as to be different.

  Here, similarly to the operation example 1, the irradiation pattern of the therapeutic laser beam LT and the sub-pattern (including two or more spots) applied to the preliminary irradiation are set in advance.

(Step S32: Start processing for setting irradiation conditions)
Corresponding to the start of OCT measurement in step S31, the irradiation condition setting unit 111 starts a process of setting irradiation conditions based on data sequentially obtained by this OCT measurement.

  In the preliminary irradiation of this operation example, two or more different irradiation conditions are applied. For each spot for which preliminary irradiation is executed, the control unit 101 associates the irradiation condition applied to the spot with the data obtained by OCT measurement for the spot, and sends the associated irradiation condition to the irradiation condition setting unit 111. The irradiation condition setting unit 111 executes a process for setting the irradiation condition based on the irradiation condition and the OCT data.

(Step S33: Set irradiation conditions)
The irradiation condition setting unit 111 sets the irradiation condition of the therapeutic laser beam LT based on data obtained by OCT measurement performed in parallel with the preliminary irradiation. Information indicating the set irradiation conditions is sent to the irradiation optical system controller 101a.

  An example of irradiation condition setting processing in this operation example will be described. When two or more different spot size conditions are applied, at least ablation areas with different sizes are obtained. The irradiation condition setting unit 111 sets new irradiation conditions (for example, including spot size conditions) based on the OCT data regarding these ablation regions. This process is performed by, for example, determining whether a sufficient area (one-dimensional area (depth in the A-scan direction), two-dimensional area (expansion in the B-scan direction), three-dimensional area) is cauterized, adjacent ablation area Includes a process of determining whether or not there is interference.

  When two or more different irradiation intensity conditions are applied, ablation regions having at least different degrees of ablation are obtained. The irradiation condition setting unit 111 sets new irradiation conditions (for example, including irradiation intensity conditions) based on the OCT data regarding these ablation regions. This process includes, for example, a process of determining whether the degree of shochu is sufficient.

  When two or more different irradiation light type conditions are applied, ablation regions having at least different cauterization levels and / or different types of tissues being cauterized are obtained. The irradiation condition setting unit 111 sets new irradiation conditions (including irradiation light type conditions, for example) based on the OCT data regarding these ablation regions. This process includes, for example, a process for determining whether the degree of cauterization is sufficient, and particularly a process for determining whether the tissue being cauterized is appropriate.

  When two or more different irradiation time conditions are applied, ablation regions having at least a cauterization level and / or ablation range are obtained. The irradiation condition setting unit 111 sets a new irradiation condition (for example, including an irradiation time condition) based on the OCT data regarding these ablation regions. This process includes, for example, a process for determining whether the degree of cauterization is sufficient and a process for determining whether the cautery range is appropriate.

  When two or more different spot spacing conditions are applied, at least two ablation regions with different spacings are obtained. The irradiation condition setting unit 111 sets a new irradiation condition (for example, including a spot interval condition) based on the OCT data regarding these ablation regions. This process includes, for example, a process of determining whether adjacent cautery areas interfere.

  The number of irradiation conditions changed in the preliminary irradiation is not limited to one. For example, preliminary irradiation can be performed while changing two or more irradiation conditions in the above examples. In that case, the irradiation condition setting unit 111 can set a new irradiation condition based on a combination of two or more irradiation conditions.

(Step S34: Change irradiation conditions)
The irradiation optical system control unit 101a changes the irradiation condition of the therapeutic laser beam LT to the irradiation condition set in step S33.

(Step S35: Completion of laser irradiation with a predetermined pattern)
The irradiation optical system control unit 101a executes laser treatment using the treatment laser light LT under the irradiation condition changed in step S34.

(Step S9: Is laser treatment further performed?)
As in the first operation example, the user determines whether to perform further laser treatment. When further laser treatment is performed (step S9: Yes), it returns to step S2. On the other hand, when further laser treatment is not performed (step S9: No), laser treatment is complete | finished (end).

[Operation Example 5]
When a wide range of laser treatment is performed, a series of pattern irradiations may be repeated. In such a case, preliminary irradiation can be performed for each pattern irradiation (for example, “Yes” in step S9 of Operation Example 1), and irradiation conditions set based on preliminary irradiation in one pattern irradiation are set. It is also possible to apply in pattern irradiation performed thereafter. The operation example 5 corresponds to the latter case.

  In the operation example 5, the use of the irradiation position selection unit 112 and the irradiation order setting unit 113 is arbitrary. For example, in the case of “Yes” in Step S9 of Operation Example 1 (flowchart in FIG. 9), the irradiation condition set in Step S6 is applied in the pattern irradiation that is subsequently performed. This operation is realized, for example, by the irradiation optical system control unit 101a continuously executing pattern irradiation while maintaining the irradiation condition changed in step S7.

  It is also possible to perform the preliminary irradiation and the OCT measurement again at any stage in such repetitive pattern irradiation, and to set and change the irradiation conditions again. As triggers for executing such re-control, pattern irradiation has been repeated a predetermined number of times, the user has instructed execution thereof, and the target site of pattern irradiation has changed (for example, from the fundus periphery to the macula) The target part has moved in the vicinity).

[Operation Example 6]
It is possible to perform the OCT measurement a plurality of times for one spot of the therapeutic laser beam LT in the preliminary irradiation, and set the irradiation conditions based on the plurality of OCT data obtained thereby. This processing includes the following two modes.

  As a first aspect, when the size of the beam cross section of the measurement light LM is sufficiently smaller than the size of the beam cross section of the treatment laser light LM, each of the plurality of positions in the spot of the treatment laser light LM OCT measurement can be performed. According to this aspect, it is possible to improve the accuracy and accuracy in controlling the irradiation conditions by finely measuring the inside of the irradiation region of the therapeutic laser beam LT.

  Moreover, as a 2nd aspect, OCT measurement can be performed in multiple times about the substantially same position in the spot of the therapeutic laser beam LM. According to this aspect, by statistically processing a plurality of OCT data obtained by a plurality of times of OCT measurement, it is possible to improve accuracy and accuracy in controlling irradiation conditions.

[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 irradiation optical system, an interference optical system, an optical system control unit, and an irradiation condition control unit.

  The irradiation optical system has a configuration for performing laser treatment of the patient's eye. The irradiation optical system irradiates the patient's eye (E) with the therapeutic laser beam (LT) via the first optical scanning unit. In the example shown in FIG. 1A and the like, the irradiation optical system includes an irradiation optical system 1300 and an optical scanning unit 1600 (first optical scanning unit). In the specific example shown in FIG. 2 and the like, the irradiation optical system includes a laser light source unit 2 and a galvano scanner 52 (first optical scanning unit).

  The interference optical system has a configuration for performing OCT measurement. The interference optical system divides the light (L0) from the light source into measurement light (LM) and reference light (LR), irradiates the patient's eye with the measurement light via the second optical scanning unit, and The interference light (LC) obtained by superimposing the return light of the measurement light and the reference light is guided to the detection means. In the example shown in FIG. 1A and the like, the interference optical system includes an interference optical system 1400 and an optical scanning unit 1600 (second optical scanning unit). 2 and the like, the interference optical system includes an OCT unit 8 and a galvano scanner 52 (second optical scanning unit). In the specific example shown in FIG. 2 etc., the detection unit 89 is an example of a detection means.

  The optical system control means controls the irradiation optical system and the interference optical system. Control of the irradiation optical system includes controlling the irradiation optical system so that a plurality of positions in a preset pattern are irradiated with therapeutic laser light (LT). Control of the interference optical system includes one or both of the following controls: controlling the interference optical system so that the measurement light is irradiated at the position where the therapeutic laser beam is actually irradiated; Control the interference optical system so that the measurement light is irradiated to the already irradiated position. In the example shown in FIG. 1A and the like, the optical system control means includes a control unit 1800. In the specific example shown in FIG. 2 and the like, the optical system control means includes a control unit 101 (irradiation optical system control unit 101a, OCT optical system control unit 101b).

  The irradiation condition control means controls the irradiation condition of the therapeutic laser beam in real time. The irradiation condition control means controls the irradiation condition of the therapeutic laser light in real time based on the output from the detection means that detects the interference light obtained by the control by the optical system control means. In the example shown in FIG. 1A and the like, the optical system control means includes a control unit 1800. 2 and the like, the optical system control means includes a control unit 101 (irradiation optical system control unit 101a) and a data processing unit 110.

  According to such an embodiment, the irradiation condition of the therapeutic laser beam can be controlled based on the data obtained by the OCT measurement performed together with the irradiation of the therapeutic laser beam. Therefore, it is possible to appropriately irradiate the target site of the patient's eye with laser light.

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

  The optical system control unit can perform the above-described control (OCT measurement) on the interference optical system while the first portion of the plurality of positions in the preset pattern is irradiated with the therapeutic laser light. . This process corresponds to parallel execution of preliminary irradiation and OCT measurement. In this case, it is possible to further execute the following processing: the irradiation condition control means controls the irradiation conditions based on the output from the detection means in this OCT measurement; the optical system control means performs this control. The irradiation optical system is controlled so that the therapeutic laser beam under the irradiation condition is irradiated to at least a part of the plurality of positions.

  According to this configuration, the irradiation conditions can be controlled using a series of pattern irradiation sub-processes (preliminary irradiation), and laser treatment can be facilitated.

  In the case where the preliminary irradiation is performed, the optical system control unit excludes the first part from the plurality of positions in the preset pattern of the treatment laser beam under the irradiation condition controlled by the irradiation condition control unit. The irradiation optical system may be controlled so that the second portion is irradiated. Here, the first portion corresponds to a set of positions to which preliminary irradiation is applied, and the second portion corresponds to a complement set obtained by removing the first portion from the entire pattern. Further, the “remaining irradiation position” described in the specific example corresponds to the second portion.

In the case where the preliminary irradiation is performed, the optical system control means may perform the first and second controls described below.
First control: controlling the irradiation optical system such that at least a part of the first part is irradiated with the therapeutic laser beam under the first irradiation condition controlled by the irradiation condition control means.
Second control: Irradiation so that the therapeutic laser beam under the second irradiation condition controlled by the irradiation condition control means is irradiated to the second portion excluding the first portion from the entire pattern. Control the optical system.
Here, the first irradiation condition and the second irradiation condition may be different. Thereby, the irradiation condition (first irradiation condition) of the therapeutic laser light irradiated again on a part or all of the first part to which the preliminary irradiation is applied and the remaining irradiation position (second irradiation) The irradiation condition of the therapeutic laser beam irradiated to the portion) can be different. As a specific example, when the irradiation intensity condition is applied, the irradiation intensity in the first irradiation condition is set lower than the irradiation intensity in the second irradiation condition. This is because the laser irradiation under the first irradiation condition is the second laser irradiation, and the laser irradiation under the second irradiation condition is the first laser irradiation.

  When performing preliminary irradiation, the irradiation condition control means may include an irradiation position selection means for selecting at least a part of the entire pattern (the plurality of positions) based on the output from the detection means. In this case, the optical system control means controls the irradiation optical system so that the treatment laser light under the irradiation condition controlled by the irradiation condition control means is emitted to the position selected by the irradiation position selection means. Do. In the example shown in FIG. 1A and the like, the irradiation position selection means includes a control unit 1800. In the third example, the irradiation position selection unit includes an irradiation position selection unit 112.

  According to this configuration, it is possible to suitably select the position to be irradiated with the therapeutic laser beam by referring to the ablation state recognizable by the OCT data acquired together with the preliminary irradiation.

  In the case where the preliminary irradiation is performed, the irradiation condition control means includes an irradiation order setting means for setting the irradiation order of the therapeutic laser light to the position selected by the irradiation position selection means based on the output from the detection means. You can leave. In this case, the optical system control means causes the irradiation optical system to irradiate the treatment laser light to the position selected by the irradiation position selection means according to the irradiation order set by the irradiation order setting means. Control can be performed. In the example shown in FIG. 1A and the like, the irradiation order setting means includes a control unit 1800. In the example shown in the third and the like, the irradiation order setting unit includes an irradiation order setting unit 113.

  According to this configuration, it is possible to suitably set the irradiation order with respect to a plurality of positions to be irradiated with the therapeutic laser light by referring to the ablation state recognizable by the OCT data acquired together with the preliminary irradiation. It is.

  In the case of performing preliminary irradiation, the first portion may include two or more positions. In that case, the optical system control means irradiates two or more positions with the therapeutic laser light with different irradiation conditions, and the irradiation condition control means further based on the output from the detection means corresponding to the two or more positions. It is possible to configure to control the irradiation conditions.

  According to this configuration, since different irradiation conditions can be applied to two or more spots in the preliminary irradiation, it is possible to improve the accuracy and accuracy of the irradiation conditions obtained by the irradiation condition control means.

When preliminary irradiation is performed and pattern irradiation is performed a plurality of times, the following first to third controls can be executed. In addition, after performing the 1st irradiation control for irradiating the treatment laser beam to the plurality of positions of the first pattern, the treatment laser beam is irradiated to the plurality of positions of the second pattern. Suppose that the 2nd irradiation control for this is performed.
First control: The optical system control means performs control (OCT measurement) on the interference optical system in parallel with the first irradiation control (preliminary irradiation).
Second control: The irradiation condition control means controls the irradiation conditions based on the output from the detection means in this OCT measurement.
Third control: The optical system control means performs the second irradiation control by the treatment laser light under the irradiation condition by the second control.

  According to this configuration, further pattern irradiation can be executed by applying the irradiation conditions obtained by the already performed pattern irradiation. Thereby, it is possible to facilitate the laser treatment.

Regardless of whether or not preliminary irradiation is performed, it is possible to execute the following first and second controls.
First control: The optical system control means controls the interference optical system so that the measurement light is irradiated a plurality of times to one irradiation position of the therapeutic laser beam. That is, a plurality of OCT measurements are performed for one spot of the therapeutic laser beam.
Second control: The irradiation condition control means controls the irradiation conditions based on the output from the detection means in this OCT measurement.

  According to this configuration, it is possible to perform OCT measurement at a plurality of different positions in the spot of the therapeutic laser beam, and to repeat OCT measurement at the same position, so that accuracy and accuracy in controlling irradiation conditions are improved. Is possible.

  The laser treatment system according to the embodiment may include an image data forming unit that forms image data based on an output from the detection unit. In this case, the irradiation condition control means can control the irradiation conditions based on the image data formed by the image data forming means. In the example shown in FIG. 1A and the like, the image data forming unit includes an image forming unit 1700. In the example illustrated in FIG. 2 and the like, the image data forming unit includes an image forming unit 103 (and a data processing unit 110).

  This configuration corresponds to an embodiment in which irradiation conditions are controlled based on image data obtained by OCT. On the other hand, the irradiation condition can be controlled based on data other than image data, for example, data (signal) output from the detection means.

  When the irradiation condition is controlled based on the image data, the image data used for the control may be one-dimensional image data, two-dimensional image data, or three-dimensional image data. The one-dimensional image data is image data representing a one-dimensional area along the traveling direction of the measurement light. The two-dimensional image data is image data obtained by controlling the interference optical system so that the measurement light is irradiated to a plurality of positions arranged one-dimensionally (that is, obtained by performing a B scan). The image data represents a two-dimensional region stretched by the line where the plurality of positions are arranged and the traveling direction of the measurement light. The three-dimensional image data is image data obtained by controlling the interference optical system so that the measurement light is irradiated to a plurality of positions arranged two-dimensionally (that is, by performing a three-dimensional scan). This is image data obtained) and represents a three-dimensional region stretched by the surface on which the plurality of positions are arranged and the traveling direction of the measurement light. The irradiation condition control means controls the irradiation conditions based on such image data. In addition, when three-dimensional image data is acquired, it is also possible to control irradiation conditions based on two-dimensional image data of an arbitrary cross section obtained by MPR.

  The laser treatment system according to the embodiment may include optical path synthesis means for synthesizing the optical path of the therapeutic laser light and the optical path of the measurement light. In this case, an optical scanning unit serving as both the first optical scanning unit for laser therapy and the second optical scanning unit for OCT measurement is provided at a position closer to the patient's eye than the optical path combining position by the optical path combining unit. It is possible. In the example shown in FIG. 1A and the like, the first combining member 1510 corresponds to an optical path combining unit, and the optical scanning unit 1600 corresponds to an optical scanning unit. In the third example, the dichroic mirror 91 corresponds to the optical path combining unit, and the galvano scanner 52 corresponds to the optical scanning unit.

  According to this configuration, the measurement light can be reliably irradiated to the irradiation position of the therapeutic laser beam, so that OCT data for grasping the ablation state by the therapeutic laser beam can be reliably acquired. It is.

  The effect can be improved by configuring the optical path combining means so that the optical path of the therapeutic laser light and the optical path of the measurement light are substantially coaxial. Here, “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 therapeutic laser light, the beam system (spot size) of measurement light, and the like.

  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.

  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.

  The laser treatment system according to the embodiment may include an illumination optical system and an observation optical system. The illumination optical system illuminates the patient's eye. The observation optical system is used for observing the patient's eye illuminated by the illumination optical system. When this configuration is applied, the irradiation optical system irradiates the patient's eye with aiming light (LA) for aiming the therapeutic laser light through the first optical scanning unit.

  Further, 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 eyepiece lens (38). It may be configured.

  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 laser treatment system includes a display control unit that causes the display unit to display an image acquired by the imaging device. In the example shown in FIG. 1 and the like, the control unit 1800 functions as display control means. In the example shown in FIG. 2 and the like, the control unit 101 functions as a display control unit. The display means may be included in the laser treatment system or may be provided outside.

  According to such a configuration, it is possible to observe the irradiation position of the aiming light on the patient's eye (that is, the irradiation target of the therapeutic laser light) with the naked eye or with an image.

  The embodiment described above is only an example 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.

DESCRIPTION OF SYMBOLS 1,1000 Laser treatment system 2 Laser light source unit 2a Aiming light source 2b Treatment laser light source 3 Slit lamp microscope 5 Processing unit 6 Operation unit 7 Display unit 8 OCT unit 52 Galvano scanner 81 Light source unit 89 Detection unit 101 Control unit 101a Irradiation optical system Control unit 101b OCT optical system control unit 103 Image forming unit 110 Data processing unit 111 Irradiation condition setting unit 112 Irradiation position selection unit 113 Irradiation order setting unit 1300 Irradiation optical system 1400 Interference optical system 1510 First synthetic member 1600 Optical scanning unit 1700 Image forming unit 1800 Control unit 1900 Display unit 1950 Operation unit LA Aiming light LT Treatment laser light LM Measurement light LR Reference light LC Interference light E Patient eye Ef Fundus

Claims (8)

An irradiation optical system for irradiating the fundus of the patient 's eye with a therapeutic laser beam for photocoagulation of the retina via the first optical scanning means;
The light from the light source is divided into measurement light and reference light, the measurement light is irradiated to the fundus via the second light scanning unit, and the return light of the measurement light from the fundus and the reference light are superimposed. An interference optical system for guiding the obtained interference light to the detection means;
The irradiation optical system is controlled so that a plurality of positions on the fundus are sequentially irradiated with the treatment laser light based on a preset spot pattern of the array, and the treatment laser light is emitted. Optical system control means for controlling the interference optical system so that measurement light is irradiated to the position of the fundus and / or the position of the fundus irradiated with the therapeutic laser beam;
Specifying means for specifying an image region corresponding to a position irradiated with therapeutic laser light in three-dimensional image data obtained by applying optical coherence tomography to the three-dimensional region of the fundus including the plurality of positions; A laser treatment system. A photographing system for photographing the fundus ;
2. The image processing apparatus according to claim 1, wherein the specifying unit performs alignment between an image obtained by the imaging system and the three-dimensional image data, and specifies the image region based on the alignment result. Laser treatment system. The specifying unit performs image matching between the image obtained by the imaging system and a two-dimensional image obtained by adding at least a part of the three-dimensional image data along the A line in the alignment. The laser treatment system according to claim 2. The laser treatment system according to any one of claims 1 to 3, further comprising information acquisition means for obtaining information indicating a degree of laser treatment at a position irradiated with the treatment laser light. The three-dimensional image data is transmitted from the interference optical system so that the optical system control means irradiates the measurement light to the position irradiated with the therapeutic laser light and / or the position irradiated with the therapeutic laser light. Obtained by controlling,
The laser treatment system according to claim 4, wherein the information acquisition unit obtains the information by analyzing the three-dimensional image data. The laser treatment system according to claim 5, wherein the information obtained by the information acquisition unit includes a degree and / or a range of ablation by treatment laser light. The said information calculated | required by the said information acquisition means includes at least the grade of the cauterization by the laser beam for treatment, and produces the image or graph showing the distribution state of the said cauterization degree. Laser treatment system. It further has irradiation condition control means for controlling the irradiation condition of the therapeutic laser light in real time based on the output from the detection means that has detected the interference light obtained by the control by the optical system control means. The laser treatment system according to any one of claims 1 to 7.

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