AU657918B2

AU657918B2 - System and method for projecting an image onto the retina

Info

Publication number: AU657918B2
Application number: AU83184/91A
Authority: AU
Inventors: Daniel R. Peters; John Taboada
Original assignee: Individual
Current assignee: Individual
Priority date: 1990-08-17
Filing date: 1991-07-29
Publication date: 1995-03-30
Anticipated expiration: 2011-07-29
Also published as: AU8318491A; JPH06501171A; CA2086746A1; TW203551B; KR930701131A; WO1992003088A1; EP0544709A1

Description

OPI DATE 17/03/92 AOJP DATE 30/04/92

INTERNAT.

APPLN. ID 83184 91 PCT NUMBER PCT/US91/05359

I'REATY(PCT)

(51) International Patent Classification 5 International Publication Number: WO 92/03088 A61B 5/0496, 3/12, 3/125 Al (43) International Publication Date: 5 March 1992 (05.03.92) (21) International Application Number: PCT/US91/05359 (81) Designated States: AT (European patent), AU, BE (European patent), CA, CH (European patent), DE (Euro- (22) International Filing Date: 29 July 1991 (29.07.91) pean patent), DK (European patent), ES (European patent), FR (European patent), GB (European patent), GR (European patent), IT (European patent), JP, KR, LU Priority data: (European patent), NL (European patent), SE (Euro- 570,123 17 August 1990 (17.08.90) US pean patent).

(71)72) Applicants and Inventors: PETERS, Daniel, R. [US/ Published US]; 1305 East Stanley Drive, Medical Lake, WA 99022 With international search report.

TABOADA, John [US/US]; 12530 Elm Country Before the expiration of the time limit for amending the Lane, San Antonio, TX 78230 claims and to be republished in the event of the receipt of amendments.

(74) Agent: MILLS, Jerry, Baker Botts, 2001 Ross Avenue, Suite 800, Dallas, TX 75201-2916 (US).

6 5 7 914 (54)Title: SYSTEM AND METHOD FOR PROJECTING AN IMAGE ONTO THE RETINA (57) Abstract A pattern ERG (PERG) projector includes a coherent light source (32) for generating a projection beam, modulation optics (34) for modulating the projection beam with an alternating ERG interference pattern (with a selected spatial and alternation frequency), segmentation optics (35) for selectively segmenting the ERG interference pattern, and wide-angle imaging optics (36) for focusing the projection beam such that it passes through the pupil, and then diverges to project onto the entire retinal field-ofview, including the anterior retina out to the far periphery. A PERG testing program can be used to selectively probe the entire retina and develop a retinal map PERG data has been correlated with retinal ganglion cell viability, and is therefore useful in diagnosing and monitoring retinal degeneration caused by glaucoma and other diseases.

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8LI VVOO 1 vti JiI.jJJ SYSTEM AND METHOD FOR PROJECTING AN IMAGE ONTO THE RETINA TECHNICAL FIELD OF THE INVENTION The invention relates generally to ophthalmic instruments, and more particularly to a retinal-projection system and method for projecting an image onto a selected area of the retina, which can be significantly anterior to the posterior retina. In even greater particularity, the invention relates to such a system and method used as a pattern electroretinogram (PERG) projector capable of projecting ERG patterns that can be segmented to probe selected areas of the retina (posterior, medial and/or anterior out to the far periphery) for evaluating retinal degeneration caused by glaucoma and other diseases.

WO 92/03088 PCI'/US91/05359 2 BACKGROUND OF THE INVENTION As an improved ophthalmic technique for diagnosing and monitoring glaucoma (and other diseases that cause retinal degeneration), electroretinogram (ERG) measurement appears to have considerable promise. Current research indicates that dynamic ERG response to retinal stimulation from an alternating pattern may be a significantly better and earlier indicator of retinal degeneration than conventional intraocular pressure, visual field tests and cup-to-disc ratios.

The specific problem to which the invention can be applied is a pattern electroretinogram (PERG) system capable of assessing the function of the retinal ganglion cell layer and nerve fiber layer, and evaluating retinal degeneration, significantly anterior to the posterior retina, such as for glaucoma diagnosis and management. In addition to permitting the entire retina to be evaluated, the test should have the following features: (1) Sensitivity and specificity; Reproducibility; Ease of use in very young, elderly and disabled patients; (4) Brevity of performance; Easy interpretation; (6) Minimal requirement for patient response and/or attention; Reliability in spite of ocular media opacities; and (8) Freedom from refractive correction.

Ophthalmologists have traditionally relied on relatively few clinical tests and findings to diagnose and follow patients with open-angle glaucoma. Recently, the sensitivity of even the most sophisticated tests have been questioned. One recent study has shown that glaucoma suspects may lose up to fifty percent of their optic nerve fibers before developing visual loss detectable by kinetic perimetry (Reference 10, listed at the end of the Background). Moreover, in glaucoma, loss of the nerve fibers and, subsequently, the ganglion cells themselves, WO 92/03088 PCT/JiS91/05359 3 have been shown by histopathologic studies (References 1,8,9,11).

Newly developed automated threshold static perimetry has also failed to solve this problem because, in many cases, it is difficult to distinguish progressive visual field loss from short- and long-term fluctuations, as well as from the effects of media opacities and miosis.

Additionally, these tests require a significant amount of concentration and participation from patients that is sometimes difficult, require administration by trained personnel, and require a high degree of understanding for accurate interpretation.

Other parameters used to evaluate glaucoma, namely cup to disc ratios and intraocular pressures, also have significant disadvantages. Even with the best tools and methods, both inter- and intra-observer variability of the C/D ratio assessment are inevitable (Reference In addition, up to fifty percent of the optic nerve fibers may be lost prior to detectable visual field abnormalities.

Elevated Intraocular Pressure (lOP) is well known to be far more prevalent than is open-angle glaucoma as defined by visual field loss. In addition, the IOP is extremely variable even in patients with known glaucoma and, as a sole parameter for glaucoma management, is grossly inadequate (Reference 12).

Pattern ERG (PERG) has significant advantages over these cu ant approaches to diagnosing and evaluating retinal degeneration from glaucoma. In PERG, the patient views a pattern image (such as light and dark squares shown on a CRT), and the retina is stimulated by alternating the pattern (such as by light/dark pattern reversal), generating an ERG amplitude response. Many studies have confirmed that the PERG amplitude is significantly reduced in patients with glaucoma (References 3-7,13).

WO 92/03088 PCT/US91/05359 4 PERG is particularly advantageous because research indicates that the PERG response signal is generated only by the proximal (inner) layers, which are precisely the layers selectively damaged by glaucoma. Thus, PERG has great potential for diagnosing and monitoring retinal degeneration caused by glaucoma (References 3-7,13,14).

Moreover, at least one study has shown that abnormal PERG amplitudes are manifested in patients with only ocular hypertension glaucoma suspects) (Reference 14). This group of patients have elevated IOP, but no demonstrable visual field or C/D abnormalities. Many of these patients later go on to develop visual field or C/D abnormalities and hence are diagnosed to have glaucoma. The PERG abnormalities found in these patients suggest that PERG i" a more sensitive indicator of early glaucomatous degeneration than are currently utilized tests, at least in some patients.

Conventional PERG has several important advantages: Direct measurement, minimal cognitive patient response is required for generating of PERG data; (2) Brevity, one pattern alternation generates a corresponding PERG response; and Specificity, i.e., PERG response is generated by the ganglion cells (the retinal component damaged in glaucoma).

However, the current technique for performing PERG measurements based on viewing a CRT pattern has at least two important limitations: It requires an accurate refractive correction to obtain sharp pattern contrast; and It tests only the posterior retina.

The field of view limitation is particularly disadvantageous because the posterior retina survives best to end stage glaucoma, while the ganglion cells in the more anterior retina, and especially in the far anterior periphery, are frequently lost first. This phenomenon of glaucomnatous damage is demonstrated by the generalized constriction seen on standard visual field testing of patients with glaucoma. This pattern of vision loss progresses until only a central island of vision remains, and it is precisely this most resistant region that is being stimulated by a standard PERG.

The entire retina can be stimulated by a flash ERG (FERG) procedure. In a standard flash ERG (FERG), a flash of light generates a dynamic ERG amplitude response caused by the stimulation of both the distal (photoreceptor) and proximal (ganglion) layers of the retina in all retinal regions (posterior, middle and anterior).

This mass retinal response is of no advantage in monitoring glaucomatous retinal degeneration, which selectively affects only the nerve fibers and their parent ganglion cells.

Systems are available for projecting images directly into the eye laser interferometers and potential acuity meters used to evaluate visual acuity in subjects for cataract surgery. The interferometer projects an interference pattern, while the potential acuity meter projects an eye chart. These projection systems have not been S 15 used for PERG testing, and in any event, are only capable of projecting into the posterior retina.

REFERENCES

1. Apple, D.J. and Rabb, M.F. (1978) Clinico pathologic correlations of ocular disease; a text and stereoscopic atlas. St. Louis, C.V. Mosby.

S 20 2. Balazsi, Drance, Schulzer, Douglas, G.R. (1984) Neuroretinal rim area in suspected glaucoma and early chronic open-angle glaucoma: ee IN:\libttl00328:cg WO 92/03088 PCT/US91/05359 6 correlation with parameters of visual function. Arch Ophthalmol 102:1011-1014.

3. Bobak, Bodis-Wollner, Harnois, Maffei, L., Mylin, Podos, Thornton, J. (1983) Pattern electroretinograms and visual-evoked potentials in glaucoma and multiple sclerosis. Am J Ophthalmol 96, 72-83.

4. Marx, Podos, Bodis-Wollner, I., Howard-Williams, Siegel, Teitelbaum, C.S., Maclin, Severin, C. (1986) Flash and pattern electroretinograms in normal and laser-induced glaucomatous primate eyes. Invest Ophthalmol Vis Sci 27:378-386, 1986.

Marx, Podos, Bodis-Wollner, Lee, P., Wang, Severin, C. (1988) Signs of early damage in glaucomatous monkey eyes: low spatial frequency losses in the pattern ERG and VEP. Exp. Eye Res. 46, 173-184.

6. Papst, Bopp, Schnaudigel, O.E. (1984) Pattern electroretinogram and visually evoked cortical potentials in glaucoma. Graefe's Arch *Clin Exp Ophthalmol 222:29-33.

7. Price, Drance, Price, Schulzer, M., Douglas, Tansley, B. (1988) The pattern electroretinogram and visual-evoked potential in glaucoma. Graefe's Arch Clin Exp Ophthalmol 226:542-547.

8. Quigley, Addicks, Green, Maumenee, A.E. (1981) Optic nerve damage in human glaucoma. II.

The site of injury and susceptibility to damage. Arch Ophthalmol 99:635-649.

9. Quigley, Miller, George, T. (1980) Clinical evaluation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage. Arch Opthalmol 98:1564-1571.

WO 92/03088 WO 9203088PCT/US91/05359 7 Quigley, Sanchez, Dunkelberger, G.R., L'Hernault, Baginski, T.A. (1987) Chronic glaucoma selectively damages large optic nerve f ibers.

Invest Ophthalmol Vis Sci 28:913-920.

11. Sommer, Miller, Pollack, Mauiuenee, A.E., George, T. (1977) The ne3rve fiber layer in the diagnosis of glaucoma. Arch Ophthalmol 95:2149-2156.

12. Sponsel, W.E. (1989) Tonometry in Question: Can visual screening tests play a more decisive role in glaucoma diagnosis and management? Surv Ophthalmol 33 (suppl) 291-300.

13. Wanger, P. and Persson, H.E. (1983) Pattern-reversal electroretinograms in unilateral glaucoma. Invest Ophthalmol Vis Sci 24:749-753.

14. Wanger, P. and Persson, H.E. (1985) Pattern-reversal electroretinograms in ocular hypertension. Docuinenta Ophthalmologica 61, 27-31.

It is an object of the present invention to overcome or substantially ameliorate the above disadvantages.

SUMMARY OF THE INVENTION As one application, the system can be used to project an ERG pattern for evaluating degeneration in any area of the retina (posterior, medial and/or anterior out to the far periphery).

There is disclosed herein a retinal-projection system for selectively projecting an image onto a selected area of the retina, comprising: a light source for providing a projection beam of at least partially coherent light; modulation optics for modulating the projection beam with a desired image; and wide-angle imaging optics for focusing the modulated projection beam, such that the projection beam passes through the pupil and diverges to provide a field-ofview that includes any portion of the retina anterior to the posterior region.

There is further disclosed herein an ERG pattern projection (PERG) system for projecting an ERG pattern onto a selected area of the retina, comprising: a light source for providing a projection beam of at least partially coherent light; modulation optics for modulating the projection beam to create a desired ERG pattern, and for selectively shifting the pattern to create an ERG response; imaging optics for focusing the modulated projection beam, such that the ERG pattern is projected onto a selected area of the retina with a field-of-view that includes any portion of the retina anterior to the posterior region.

There is further disclosed herein an ERG pattern projection (PERG) system for projecting an ERG pattern onto a selected area of the retina, comprising: a light source for providing a projection beam of at least partially coherent light; modulation optics for modulating the projection beam to create a desired ERG pattern, and for selectively shifting the pattern to create an ERG response; segmentation optics for selectively segmenting the ERG pattern; and imaging optics for focusing the modulated projection beam, such that the segmented ERG pattern is projected onto a selected area of the retina.

IN:\llbctl0328:cg 8A- There is further disclosed herein a retinal-projection method for selectively projecting an image onto a selected area of the retina, comprising the steps of: generating a projection beam of at least partially coherent light; modulating the projection beam with a desired image; and focusing the modulated projection beam, such that the projection beam passes through the pupil and diverges to provide a field-of-view that includes any portion of the retina anterior to the posterior region.

There is further disclosed herein an ERG pattern projection (PERG) method for projecting an ERG pattern onto a selected area of the retina, comprising: generating a projection beam of at least partially coherent light; modulating the projection beam to create a desired ERG pattern; focusing the modulated projection beam, such that the ERG pattern is projected onto a selected area of the retina with a field-of-view that includes any portion of the retina anterior to the posterior region; and selectively shifting the pattern to create an ERG response.

There is further disclosed herein an ERG pattern projection (PERG) method for projecting an ERG pattern onto a selected area of the retina, comprising: generating a projection beam of at least partially coherent light; modulating the projection beam to create a desired ERG pattern; selectively segmenting the ERG pattern; focusing the modulated projection beam, such that the ERG pattern is projected onto a selected area of the retina; and selectively shifting the pattern to create an ERG response.

In preferred embodiments of the invention, an exemplary PERG projector includes imaging optics that provide wide-angle projection of an alternating, selectively segmented ERG interference pattern, enabling the entire retina (posterior, medial and/or anterior out to the far periphery) to be probed. Interferometry modulation optics modulates the projection beam with an ERG interference pattern characterized by a selected fringe line spacing, and selectively alternates the interference Y N\ibt032:C [N;AIIbttJ00328:C9 WO 92/03088 PCT/US91/05359 9 pattern to create the ERG pattern shift that stimulates an ERG response. Segmentation optics allows the ERG pattern to be selectively segmented for stimulating a selected area of the retina.

In one embodiment, the interferometry optics comprises a shearing interferometer. A pair of prisms are separated by a gap defined by opposing non-parallel surfaces that define a shearing angle. One of tt, prisms is pivotally mounted for selectively changing the shearing angle to provide precision angle tuning of the interference pattern.

The incident projection beam partially reflects from one opposing prism surface, and after transiting the prism gap, partially reflects from the opposing prism surface. The two reflected projection beams interferometrically combine to form an interference pattern. The prism gap is filled with a Kerr fluid and the opposing prism surfaces are coated with transparent conductive electrode layers, such that an adjustable time-varying electric field can be used to change the refractive index in the prism gap, and alternate (reverse) the interference pattern.

In another embodiment, the interferometry optics includes a piano convex lens and a reflective optical flat.

The lens is coated antireflective on a flat side so that it paztially reflects and partially transmits the incident projection beam. The reflective optical flat reflects the transmitted portion of the incident projection beam back through the piano convex lens, thereby creating an interference pattern with the two reflected projection beams. The optical flat can be selectively translated to shift the interference pattern.

The wide-angle imaging optics can be formed by an aspheric parabolic lens, followed by a positive meniscus lens. The lenses are configured to allow the projection beam to be brought to a sufficiently sharp focus in the area of the eye lens to transmit through even a constricted WO 92/03088 PCT/US91/05359 pupil, and then diverge to fill substantially the entire field-of-view of the retina (posterior and anterior out to the far periphery).

As an alternate application, the retinal-projection system can be used to project video or printed information directly into the eye. In this application, the modulation optics can be formed by a LCD video panel.

The technical advantages of the invention include the following. The retinal-projection system can be used to project selected images, including video, text and other information, onto the retina with a field-of-view significantly anterior to the posterior retina. Laser light can be used for projection to bypass potential ocular media opacities, and to obviate the need for any refractive correction. In a PERG application, an ERG pattern (such as an alternating interference pattern) can be projected into any selected area of the retina posterior, medial and/or anterior out to the far periphery providing the ability to test the retinal elements damaged by glaucoma in the areas where they are most likely to be affected first the ganglion cells in the anterior retina and especially in the periphery). The ERG pattern can be selectively segmented to probe selected areas of the retina, allowing a retinal map to be developed for the entire retinal field, and allowing the different retinal regions to be compared to each other. The ERG interference pattern can be modulated both spatially (spatial frequency or fringe line spacing) and temporally (alternation frequency).

For a more complete understanding of the invention, and for further features and advantages, reference is now made to the following Detailed Description of an exemplary embodiment of the invention, taken in conjunction with the accompanying Drawings. Although the Detailed Description, and the Drawings, are with respect to a specific, exemplary WO 92/03088 PCT/US91/05359 11 embodiment of the invention, various changes and modifications may be suggested to one skilled in the art, and it is intended that the invention encompass such changes and modifications as fall within the scope of the appended claims.

WO 92/03088 PCT/US91/05359 12 BRIEF DESCRIPTION OF THE DRAWINGS FIGURE 1 is a functional block diagram of the retinalprojection system of the invention; FIGURE 2a illustrates an application of the retinalprojection system as a PERG projector capable of projecting an ERG pattern onto the entire field-of-view of the retina, including a shearing interferometer for generating an ERG interference pattern; FIGURE 2b illustrates an exemplary segmentation of the ERG pattern from the PERG projector, to allow selected segments of the entire retina to be probed; FIGURE 3 is a functional block diagram of a PERG system for performing under computer control PERG testing using a PERG projector according to the invention; FIGURE 4 illustrates an alternative embodiment using a Newton's ring interferometer to generate an ERG interference pattern.

FIGURE 5 illustrates an alternative embodiment of the interferometry optics using a Michaelson interferometer; and FIGURE 6 illustrates an alternative embodiment of the interferometry optics using a pressure driven interferometer.

WiO 92/03088 PCT/US91/05359 13 DETAILED DESCRIPTION OF THE INVENTION The Detailed Description of exemplary embodiments of the retinal-projection system of the invention is organized as follows: 1. Retinal-projection Technique 2. Exemplary PERG Projector 2.1. Laser Light Source 2.2. Interferometry Modulation Optics 2.3. Segmentation Optics 2.4. Wide-Angle Imaging Optics ERG Detection System 2.6. PERG Program 2.7. Alternate Interferometry Optics 3. Alternate Applications While the Detailed Description is in relation to an exemplary application of the retinal-projection system as a pattern electroretinogram projector, such as for use in evaluating and treating glaucoma, the invention has general applicability to projecting images (modulated light) onto the retina with a field-of-view that can be significantly anterior to the posterior retina.

I. Retinal-projection Technique. FIGURE 1 illustrates the retinal-projection technique of the invention. A projection beam 11 is generated by a light source 12 that is at least partially coherent. The light is modulated by modulation optics 14 to form a modulated projection beam 15 with the desired pattern or image.

The modulated projection beam 15 is input to wideangle imaging optics 16, adjacent to the eye 20. The wideangle imaging optics brings the modulated projection beam to a sharp focus in the area of the eye lens 22, enabling the beam to pass through a constricted pupil. After passing through the pupil, the beam diverges rapidly within the eyz, and is projected onto the entire retina 24.

WO 92/03088 PCT/US91/05359 14 That is, the retinal-projection technique enables a pattern or other image to be projected with a field-ofview that is significantly anterior to the posterior retina, including out to the far periphery 2. Exemplarv PERG Prolector. The exemplary PERG projection system provides wide-angle ERG pattern projection onto the entire retina posterior, medial and anterior out to the far periphery. Then ERG pattern can be selectively segmented to probe selected areas of the retina for degeneration caused by glaucoma or other diseases.

FIGURE 2a illustrates an exemplary embodiment of the PERG projector 30, including a laser light source 32 for providing a coherent projection beam 33, modulation optics 34 for generating a PERG interference pattern, segmentation optics 35 for selectively segmenting the PERG pattern, and wide-angle imaging optics 36 for imaging the PERG pattern onto the retina. The ERG response is detected by an ERG detection system 37 that includes an ERG electrode 37a.

A PERG processor 38 controls modulation optics 34 and segmentation optics 35 to produce the desired interference pattern and the desired segmentation, and receives the resulting ERG responses from the ERG detection system 37.

FIGURE 2b illustrates an exemplary segmentation of the retina. The entire field-of-view for the retina is represented by a circle 40 divided into seventeen representative segments. The retinal field-of-view is separated iibo concentric posterior 41 and anterior 42 regions, separated by a medial region 43. In addition, the field-of-view in the anterior and medial regions is sectored by radial sector lines 45, defining segments such as 47.

The PERG processor executes a PERG program to appropriately control the modulation optics 34 and the segmentation optics 35, controlling the retinal segments WOv 92/03088 PCT/US91/05359 (regions and sectors) stimulated by the PERG, and the spatial and temporal frequencies for the projected ERG pattern. As a result, the retinal segments can be selectively probed to develop an accurate map of the entire retinal field. Using this retinal map, the retina can be evaluated for degeneration caused by glaucoma (or other disease).

2.1. Laser Light Source. Referring to FIGURE 2a, light source 32 includes a laser 51 (such as helium neon or argon) that generates a projection beam 52 of coherent light. Alternatively, a point source of light could be used to provide partially coherent light.

The projection beam is directed through a polarizer 53 and an analyzer 54, which are polarized sheets. The projection beam 52 is adjusted in intensity by rotating the polarizer relative to the plane of polarization established by the analyzer to be perpendicular to the drawing sheet.

The projection beam is expanded by a lens recollimated by a lens 56, and directed toward modulation optics 34.

The intensity of the laser light can be controlled to maintain a comfortable and safe level, but sufficient to induce an ERG response.

2.2. Interferometr Modulation Optics.

Modulation optics 34 comprises a shearing interferometer.

Alternate interferometer configurations are described in Section 2.5. Other suitable interferometers include the Michaelson and Twyman-Green interferometers (see Section 2.6).

The exemplary shearing interferometer includes two prisms 61 and 62 with respective opposing partially reflecting surfaces 61a and 62a, separated by a gap 63.

The prisms are mounted such that the reflecting prism surfaces are non-parallel, and define a shearing angle Theta.

WO 92/03088 PCT/US91/05359 16 The incident projection beam 33 enters prism 61, partially reflecting from prism surface 61a to provide a first-reflection beam 67, and partially transmitting across gap 63. The partially transmitted projection beam partially reflects from prism surface 62a, back across gap 63 to provide a second-reflection beam 68.

The first- and second-reflection beams combine interferometrically into a PERG interference beam 69, producing an ERG interference pattern of light and dark fringe lines. The PERG pattern is controlled in spatial frequency the fringe line spacing) by the shearing angle Theta.

Prism 61 is stationary, while prism 62 is springloaded and pivotally mounted at a pivot point 62b. Prism 62 can be selectively pivoted by a motor-driven micrometer 64. Pivoting micrometer 64 is responsive to control signals from PERG processor 38 to control the shearing angle Theta between non-parallel prism surfaces 61a and 62a, providing precision angle-tuning of the spatial frequency for the interference pattern.

To implement the pattern-shifting required to produce a PERG response,- the PERG interference pattern is alternated through a light-dark cycle with a selected frequency of alternation. Interferometer prisms 1l and 62 are at least partially immersed in a Kerr cell 72 filled with a Kerr fluid (such as carbon disulfide), such that the Kerr fluid fills the gap 63 between the prisms.

The opposing prism surfaces 61a and 62a that define the gap 63 are coated with a transparent conductive material such as indium-tin-oxide. The conductive coatings are coupled to a high voltage amplifier 74.

The high voltage amplifier receives a low frequency 1- Hz signal from PERG processor 38. As a result, an electric field is established in the gap 63, and applied to WO S12/03088 PCT/US91/05359 17 the Kerr fluid, which changes refractive index in response to changes in the electric field.

By controlling the electric field in the gap, the effective path length through the gap for the secondreflected beam 68 can be changed. This path modulation results in a selective shift in the light/dark ares of the interference pattern.

The PERG interference beam 69, modulated with an interference pattern characterized by a selected angletuned spatial frequency, and a selected alternation frequency, is directed to segmentation optics 2.3. Secmentation Optics. Segmentation optics provides the desired segmentation for the projected ERG pattern. The time-varying PERG interference beam 69 is first expanded by lenses 82 and 84, and directed through a spatial light modulator 86.

The exemplary spatial light modulator 86 is conventionally formed by liquid crystal films sandwiched between transparent electrode plates. The modulator is configured to provide the segmentation of the retinal field-of-view illustrated in FIGURE 2b.

In response to control signals from PERG processor 38, spatial light modulator 86 selectively passes the entire time-varying PERG interference beam 69 the entire ERG interference pattern), or any selected segment. For example, the modulator could be controlled to pass the ERG interference pattern only in the anterior region (42 in FIGURE 2b), or only in one sector of that region (47 in FIGURE 2b).

After selective segmentation, the time-varying PERG interference bean. is directed to the wide-angle imaging optics 36.

2.4. Wide-Angle ImaginQ Optics. For the exemplary PERG system, wide-angle imaging optics 36 injects the PERG interference beam into the eye, projecting the WO9 92/03088 PCT/US91/05359 18 segmented ERG pattern into the entire field-of-view of the retina.

For the exemplary embodiment, wide-angle imaging optics includes two lenses located adjacent, but not in contact with, the eye a parabolic aspheric lens 92 with a back focal length of about 30mm, followed by a positive meniscus lens 94 with a focal length of about Parabolic lens 92 is made aspheric to correct for spherical aberration. Alternatively, a contact lens could be used for at least a portion of the imaging optics.

The incident PERG interference beam is brought to a sharp focus at the eye lens, such that the beam can pass through a constricted pupil. The beam then diverges rapidly to project onto the entire retina, filling the field-of-view out to the far periphery.

Since the projected PERG beam is collimated, it does not depend on the accommodation of the subject eye. Alsc, if any lens opacity exists, it can be circumvented to some extent by focal point adjustment.

A suitable fixation beam 102 may be steered into the eye along the optical axis by a micro-miniature mirror 104.

During the PERG test, the patient fixates on the fixation spot while the PERG processor executes a PERG program.

If it is desired to project the PERG beam only into the posterior retina, zoom optics such as described in Section 2.6 can be included in the optical path to control the diameter of the projected PERG pattern. Alternatively, imaging optics that do not provide for wide-angle projection can be used.

The resulting electrophysiological signal from the eye is detected by ERG detection system 37, and a corresponding ERG response is provided to the PERG processor 38.

ERG Detection System. The ERG detection system 37 converts the electrophysiological ERG response WO 92/03088 PCT/US91/05359 19 from the eye to a corresponding digital ERG response for input to the PERG processor.

The electrophysiological ERG response is detected by an electrode 37a, such as a fine gold leaf placed beneath the lower eye lid. Alternatively, the electrode may be placed on a part of a contact lens.

The electrophysiological ERG response is input to ERG detection system 37. The ERG detection system operates conventionally in providing signal amplification and analog-to-digital conversion, outputting a corresponding digital ERG response signal.

2.6. PERG Program. FIGURE 3 is a functional diagram illustrating a PERG system 100 for implementing a processor-controlled PERG program. This PERG program is a routine extension of the conventional approach to acquiring PERG data.

A PERG projector 101 according to the invention is coordinated with a PERG processor 102. The PERG projector receives pattern-control signals from the PERG processor, creating a desired ERG interference pattern that is projected onto the retina. Specifically, tae PERG processor provides pattern modulation signals that control spatial frequency (pattern fringe line spacing) and alternation frequency (pattern phase shifting). Thus, for a given fringe line spacing, the program determines how frequently the interference pattern is shifted to produce an ERG response.

The resulting ERG electrophysiological response is acquired by an ERG detection system 103. The ERG detection system is controlled by the PERG processor, which receives the ERG response data.

A PERG program 104, executed by the PERG processor, carries out a series of PERG pattern tests using segmented patterns to probe the retina, and develop an ERG response map of the entire retinal field. Using the retinal map, an WO 92/03088 PCT/US91/05359 ERG analysis is performed by the PERG processor, and reported in an output device 106.

2.7. Alternate Interferometry Optics. FIGURES 4, and 6 illustrate alternate embodiments of the interferometry optics used to modulate the projection beam with an alternating interference pattern.

FIGURE 4 illustrates a PERG projector in which the interferometry optics is based on a Newton's ring interferometer design. A laser projection beam 111 is expanded and collimated as in the embodiment described in Sections 2.1-2.4, and polarized normal to the plane of the FIGURE. The projection beam is reflected from a mirror 112 to a polarizing beam splitter cube 114.

The projection beam is completely reflected by the beam splitter cube through a quarter-wave rotating plate 116, toward a Newton's ring interferometer 120 for modulating the beam with a Newton's ring interference pattern. The interferometer is formed by a plano convex lens 122 and an optical flat 124. The plano convex lens is antireflective (AR) coated on the flat side 122a.

As the projection beam propagates to the left of the beam splitter cube, it is imparted with a circular polarization of one-quarter wave rotation by the quarterwave rotating plate 116. The quarter-rotated projection beam is partially reflected from the plano convex lens 122, and then reflected partially from the optical flat 124.

The two reflected beams combine interferometrically to create a PERG interference beam 126 with the Newton's ring interference pattern.

The interference pattern can be alternated (periodically reversing light-dark interference rings) by translating optical flat 124 in a back-and-forth motion along the optical axis. Such translation may be imparted by a conventional electromagnetic mechanism 128, such as a WOo 92/03088 PCT/US91/05359 21 speaker coil diaphragm operating at the desired alternation frequency.

The PERG interference beam, now propagating to the right, is again quarter-rotated by the quarter-wave rotating plate 116. The resulting 90° polarization rotation allows the PERG interference beam the interference pattern) to pass through the beam splitter cube 114.

The PERG; interference beam is directed to segmentation optics formed by a ring aperture 132 and a sectoring aperture 134. The ring aperture allows the ERG pattern to be segmenlted into, for example, posterior, medial and anterior regions (41, 43 and 42 in FIGURE 2b) The sectoring iaperture allows the interference pattern to be further sectored, for example, along radial lines (45 in FIGURE 2B).

The selectively segmented PERG interference beam is directed to wide-angle imaging optics 140, which includes a zoom lens 142, and focusing lenses 144 and 146. The zoom lens adjusts (variably) beam diameter. The pair of focusing lenses (which do not necessarily contact the cornea) have aspheric surfaces which produce extremely short focusing of the beam to a point within eye 150, near the surface of the eye lens 151.

After transmitting through the pupil, the light pattern rapidly diverges, and is projected onto the retina.

The diameter of the PERG interference beam, and hence the area of the retina onto which the beam is projected, can be controlled location on the retina, of the ring pattern is controlled by the zoom lens 142. Alternatively, the beam can be projected onto the entire retina (out to the far periphery), and the ring aperture used to control the region of the retina (posterior, medial and/or anterior) receiving the ERG pattern.

WO 92/03088 PCT/US91/05359 22 As with the embodiment described in Sections 2.1-2.4, various components of the PERG projector can be controlled by a PERG processor (not shown) executing a PERG program.

For example, the PERG processor can control the rate and amplitude of the translation of the optical flat 124, the setting of the sectoring aperture 134, and the magnification of zoom lens 142.

FIGURE 5 illustrates an embodiment of the interferometry optics (34 in FIGURE 2a) based on a Michaelson interferometer design. Interferometry optics 160 includes two mirrors 161 and 162, and a beam splitter 163 arranged in a Michaelson interferometer configuration.

The optical path for the mirror 161 includes a Kerr cell 164, to which are attached electric field plates 165.

The electric field plates are coupled to a high voltage amplifier 166 controlled by the PERG processor in a manner analogous to the HVA 74 in FIGURE 2a (see Section 2.2).

Mirror 161 is stationary, while mirror 162 is springloaded and pivotally mounted at pivot point 168. Mirror 162 can be selectively pivoted by a motor-driven micrometer 168. MDM 168 is controlled by the PERG processor in a manner analogous to the MDM 64 in FIGURE 2a (see Section providing precision angle-tuning of the spatial frequency (fringe line spacing) for the interference pattern.

In operation, a collimated projection beam 170 (33 in FIGURE 2a) is split by splitter 163 into separate beams 171 and 172. Beam 171 passes through the Kerr cell and reflects from mirror 161 passing back through the Kerr cell. Beam 172 reflects from tuning mirror 173, but with a slight angular displacement Theta.

The two beams combine at beam splitter 163 to form a projection beam 175 modulated with an interference pattern having a selected spatial frequency determined by the tuning angle Theta. The electric field across the Kerr WO 92/03088 PCT/US91/05359 23 cell 164 is controlled to modulate the phase of the beam 161 such that the fringes can be made to alternate at a selected frequency, creating the pattern shift that produces a PERG response.

FIGURE 6 illustrates an embodiment of the interferometry optics (34 in FIGURE 2a) based on a pressure controlled interferometer design. Interference pattern modulation is accomplished by selectively varying the index of refraction of a gas media by varying its pressure.

A gas cell 180 replaces the Kerr cell 164 in FIGURE The gas cell contains a suitable gas media (such as a fluorocarbon). The pressure of the gas in the cell is controlled by a flexible diaphragm 181, and is modulated by a ferromagnetic plunger 182 moved by an electromagnetic coil 183. Pattern phase modulation is accomplished by controlling the coil current such as with a driver amplifier 185 that responds to control signals from the PERG processor.

3. Alternate Applications. The retinal-projection technique of the invention can be used in any application in which images (modulated ligl need to be projected into the eye with a field-of-view that is significantly anterior to the posterior retina (including out to the far periphery).

For example, the retinal-projection technique can be used to project video or printed information directly into the eye. Referring to FIGURE 2a, for such an application, the interferometry modulation optics could be eliminated, and the LCD spatial light modulator 86 could be used to modulate the projection beam with video or printed information. This informat on could be imaged by the wideangle imaging optics 36 onto the entire field-of-view of the retina.

Claims

24- The claims defining the invention are as follows: 1. A retinal-projection system for selectively projecting an image onto a selected area of the retina, comprising: a light source for providing a projection beam of at least partially coherent light; modulation optics for modulating the projection beam with a desired image; and wide-angle imaging optics for focusing the modulated projection beam, such that the projection beam passes through the pupil and diverges to provide a field-of- 1o view that includes any portion of the retina anterior to the posterior region. 2. The retinal-projection system of Claim 1, wherein the image is projected over substantially the entire retina, including the anterior retina out to the far periphery. 3. The retinal-projection system of Claim 1 or Claim 2, wherein the wide-angle imaging optics focuses the image near the front of the eye lens. 4. The retinal-projection system of any one of Claims to 3, wherein the image presents video c r printed information. The retinal-projection system of any one of Claims 1 to 4, wherein the modulation optics includes an LCD panel. 6. The retinal-projection system of any one of Claims 1 to 5, wherein the wide-angle imaging optics images the projection beam onto substantially the entire retina, and the modulation optics includes an aperture for blocking a selected portion of the projection beam, such that the image is projected onto a selected area of the retina. 7. The retinal-projection system of Claim 6, wherein the image is an ERG pattern. 8. The retinal-projection system of Claim 7, wherein the modulation optics includes an interferometer for modulating the projection beam with an interference pattern to create the ERG pattern, and for selectively alternating the interference pattern to create an ERG pattern shift. 9. An ERG pattern projection (PERG) system for projecting an ERG pattern onto a selected area of the retina, comprising: a light source for providing a projection beam of at least partially coherent light; modulation optics for modulating the projection beam to create a desired ERG pattern, and for selectively shifting the pattern to create an ERG response; imaging optics for focusing the modulated projection beam, such that the ERG pattern is projected onto a selected area of the retina with a field-of-view that includes any portion of the retina anterior to the posterior region. IN:\libtI00328:cg The PERG projection system of Claim 9, wherein the modulation optics includes an interferon-eter for modulating the projection beam with an interference pattern to form the ERG pattern, and for selectively altering the interference pattern to cause an ERG pattern shift. 11. The PERG projection system of Claim 10, wherein the interferometer modulates the projection beam with a selected spatial frequency to produce a selected fringe line spacing, and with a selected alternation frequency to produce an ERG response. 12. The PERG projection system of Claim 10, wherein the interferometry optics comprises a shearing interferometer. 13. The PERG projection system of Claim 12, wherein the shearing interferometer comprises first and second prisms separated by a gap defined by respective opposing first and second non-parallel surfaces that define a shearing angle, wherein: the incident projection beam partially reflects from the first opposing prism surface to form a first-reflection beam, and after transiting the prism gap, partially reflects from the opposing prism surface to form a second-reflection beam; the first and second reflection beams interferometrically combine to form an interference pattern; and the second prism is pivotally mounted for selectively changing the shearing angle to provide precision angle tuning of the interference pattern. 14. The PERG projection system of Claim 13, wherein: the prism gap is filled with a Kerr fluid; the opposing first and second prism surfaces are coated with transparent conductive electrode layers coupled to a controlled voltage source; and an adjustable time-varying electric field is produced in the gap for controlling the refractive index in the prism gap so as to selectively shift the interference pattern. The PERG projection system of Claim 10, wherein the interferometer comprises a Newton's ring interferometer. 16. The PERG projection system of Claim 15, wherein the Newton's ring interferometer comprises: a piano convex lens coated antireflective on one side; and a reflective optical flat, wherein the incident projection beam is partially reflected by the piano convex lens to form a first reflection beam, and is then reflected from the optical flat to form a second reflection beam, such that the first and second reflection beam interferometrically combine to form an interference pattern. 17. The PERG projection system of Claim 16, further including translation means for selectively translating the optical flat to shift the interference pattern. IN:\IbttiOO328:cg -26- 18. An ERG pattern projection (PERG) system for projecting an ERG pattern onto a selected area of the retina, comprising: a light source for providing a projection beam of at least partially coherent light; modulation optics for modulating the projection beam to create a desired EF'T pattern, and for selectively shifting the pattern to create an ERG response; segmentation optics for selectively segmenting the; ERG pattern; and imaging optics for focusing the modulated projection beam, such that the segmented ERG pattern is projected onto a selected area of the retina within a field-of- view that includes any portion of the retina anterior to the posterior region. 19. The PERG projection system of Claim 18, wherein the ERG pattern is segmented into posterior, medial and anterior regions, and further into sectors of the medial and anterior regions. The PERG projection system of Claim 18 or Claim 19, wherein the segmentation optics comprises an LCD panel. 21. The PERG projection system of Claim 18 or Claim 19, wherein the segmentation optics comprises: a ring aperture for segmenting the projection beam ;nto posterior, medial and anterior regions; and a sectoring aperture for segmenting at least the medial and anterior regions into angular sectors. 22. The PERG projection system of Claim 9, wherein the imaging optics include aspheric surfaces to provide a short focal length. 23. The PERG projection system of Claim 22, wherein the imaging optics includes zoom optics for selectively adjusting the diameter of the projection beam. 24. The PERG projection system of any one of Claims 9, 22 or 23, wherein the imaging optics do not contact the eye. The PERG projection system of Claim 9, wherein the PERG projection system is used to evaluate retinal degeneration caused by glaucoma.
26. A retinal-projection method for selectively projecting an image onto a selected area of the retina, comprising the steps of: generating a projection beam of at least partially coherent light; modulating the projection beam with a desired image; and focusing the modulated projection beam, such that the projection beam passes through the pupil and diverges to provide a field-of-view that includes any portion of the retina anterior to the posterior region.
27. The retinal-projection method of Claim 26, wherein the image is projected over substantially the entire retina, including the anterior retina out to the far i, periphery. IN:\Ilbttl00328:HRW 27
28. The retinal-projection method of Claim 26 or Claim 27, wherein the image presents video or printed information.
29. The retinal-projection method of any one of Claims 26 to 28, wherein the modulation step comprises the use of an LCD panel.
30. The retinal-projection method of Claim 26, further comprising the step of blocking a selected portion of the projection beam, such that the image is projected onto a selected area of the retina.
31. The retinal-projection method of Claim 30, wherein the image is an ERG pattern.
32. An ERG pattern projection (PERG) method for projecting an ERG pattern onto a selected area of the retina, comprising: generating a projection beam of at least partially coherent light; modulating the projection beam to create a desired ERG pattern; focusing the modulated projection beam, such that the ERG pattern is projected onto a selected area of the retina with a field-of-view that includes any portion of the retina anterior to the posterior region; and selectively shifting the pattern to create an ERG response.
33. The PERG projection method of Claim 32, wherein the step of modulating the projection beam comprises the step of modulating the projection beam with an interference pattern to form the ERG pattern.
34. The PERG projection method of Claim 33, wherein the projection beam is modulated with a selected spatial frequency to produce a selected fringe line spacing, and with a selected alternation frequency to produce an ERG response. The PERG projection method of Claim 33, wherein the step of modulating the projection beam is accomplished by a shearing interferometer.
36. The PERG projection method of Claim 32, wherein the step of modulating the projection beam is accomplished by a Newton's ring interferometer.
37. The PERG projection method of any one of Claims 32 to 36, further comprising the step of selectively adjusting the diameter of the projection beam. 2 8. The PERG projection method of any one of Claims 32 to 37, wherein the PERG projection method is used to evaluate retinal degeneration caused by glaucoma.
39. An ERG pattern projection (PERG) method for projecting an ERG pattern onto a selected area of the retina, comprising: generating a projection beam of at least partially coherent light; modulating the projection beam to create a desired ERG pattern; selectively segmenting the ERG pattern; 1I.libo00328HMW 28- focusing the modulated projection beam, such that the ERG pattern is projected onto a selected area of the retina within a field-of-view that includes any portion of the retina anterior to the posterior region; and selectively shifting the pattern to create an ERG response.
40. The PERG projection method of Claim 39, wherein the ERG pattern is segmented into posterior, medial and anterior regions, and further into sectors of the medial and anterior regions.
41. The retinal-projection system of Claim 1, wherein the field-of-view for the wide-angle imaging optics includes any portion of the retina that is anterior to the posterior region.
42. The PERG projection system of Claim 9, wherein the field-of-view for the imaging optics includes any portion of the retina that is anterior to the posterior region.
43. The retinal-projection method of Claim 26, wherein the field-of-view includes any portion of the retina that is anterior to the posterior region.
44. The PERG projection method of Claim 32, wherein the field-of-view includes any portion of the retina that is anterior to the posterior region. A retinal-projection system substantially as hereinbefore described with reference to Figs. 1 to 3 or any one of Figs. 4 to 6.
46. An ERG pattern projection (PERG) system substantially as hereinbefore described with reference to Figs. 1 to 3 or any one of Figs. 4 to 6. 47 A retinal-projection method, the method being substantially as hereinbefore described with reference to Figs. 1 to 3 or any one of Figs. 4 to 6.
48. An ERG pattern projection (PERC' method, said method being substantially as hereinbefore described with reference to Figs. 1 to 3 or any one of Figs. 4 to 6. DATED this Twenty-sixth Day of December 1994 Daniel R Peters and John Taboada Patent Attorneys for the Applicant SPRUSON FERGUSON (N:\libttl00328:HRW