CN101018501A - Perimeter - Google Patents
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- CN101018501A CN101018501A CN 200580030851 CN200580030851A CN101018501A CN 101018501 A CN101018501 A CN 101018501A CN 200580030851 CN200580030851 CN 200580030851 CN 200580030851 A CN200580030851 A CN 200580030851A CN 101018501 A CN101018501 A CN 101018501A
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Abstract
A diopsimeter comprises a display (1), an infrared light-emitting diode (2), a CCD camera (3), a half-silvered mirror (4), an image processing device (5), a computer (6), and an operation switch (7). The computer (6) displays a fixing target for fixing the line of sight of a subject and light stimulus targets for giving light stimulus to the pupil of the subject at predetermined positions of the display (1). The infrared light-emitting diodes (2) projects infrared radiation toward the eye ball of the subject. The CCD camera (3) images the eye ball of the subject by using the projected infrared radiation. The image processing device (5) detects the diameter of the pupil of the subject from captured image. The computer (6) measures the field of view from the variation of the detected pupil diameter. The characteristic point of the invention is that the display (1) is so constructed that the luminance of the background of the screen and the luminances of the light stimulus targets can be independently adjusted.
Description
Technical field
The present invention relates to the perimeter in a kind of person under inspection of measurement visual field.
Background technology
The inspection (being perimetry) of carrying out the visual field is in order to diagnose the contraction in the visual field, and this contraction is the symptom of diseases such as glaucoma.In traditional perimetry, the measurement in the person under inspection visual field is to show sighting target (eye-target) by the ad-hoc location in person under inspection's eyes front, allows the person under inspection answer then and whether sees sighting target.This inspection is based on the subjective determination that person under inspection's subjectivity is answered, and person under inspection's field range is by in the display position that changes sighting target one by one, measures repeatedly that the visual field determines.In this subjective determination, problem is that check result is easy to be subjected to the influence of person under inspection's physical qualification and attention or the like, can not check accurately.In addition, must repeat repeatedly owing to show sighting target, the sequence of operations that allows the person under inspection answer then, so be problematic in that, carry out this inspection length consuming time, the person under inspection bears heavily.
Japan's ophthalmology summary (Folia ophthalmologica Japonica) (the 49th volume, No. 9,733-737 page or leaf, 1998) discloses a kind of perimeter, and it can not rely on the objective perimetry that person under inspection's subjectivity is answered.In this perimeter, in order to measure person under inspection's the visual field, fixation target is incident upon on the screen that is arranged at person under inspection's eyes front, watch attentively under the condition of fixation target the person under inspection then, the photostimulation sighting target is incident upon a plurality of positions on the screen one by one, thereby the retina to the person under inspection provides photostimulation, detects the myosis reaction (being the luminous reflectance of pupil) that pupil produces owing to photostimulation then.
In addition, Japanese unexamined patent publication No. publication number No.5-146404 and Japanese unexamined patent publication No. publication number No.2004-216118 disclose a kind of perimeter, it is by utilizing luminaire for example diode displaying fixation target and photostimulation sighting target, and detects and measure person under inspection's the visual field objectively at the luminous reflectance that whether occurs pupil when the person under inspection provides photostimulation.
In this objective perimeter, background luminance is dark more with respect to the photostimulation sighting target, and is just easy more to the detection of the luminous reflectance of pupil.But if background luminance is too dark, the light of photostimulation sighting target is scattered so, therefore photostimulation can not be provided to the amphiblestroid accurate position of person under inspection.In addition, person under inspection's pupil need adapt to the dark of background for a long time, makes the review time elongated.On the other hand, if background luminance is too bright, the luminance difference between background and the photostimulation sighting target diminishes so, and the luminous reflectance of pupil also diminishes, and is therefore, difficult to the detection change of reaction.In addition, preferably change the size and the stimulus intensity thereof of photostimulation sighting target according to the person under inspection.
As mentioned above, in objective perimeter, preferably can the regulated at will background luminance, sighting target brightness and sighting target size or the like.But, in above-mentioned traditional perimeter, because sighting target is incident upon on the screen, or use light emitting diode to come display light to stimulate sighting target, so exist the problem that can not regulate background luminance, sighting target brightness and sighting target size easily.
Summary of the invention
Consider the problems referred to above, the purpose of this invention is to provide and a kind ofly can easily regulate background luminance, sighting target brightness and sighting target size or the like, and can measure the objective perimeter in the visual field rapidly, exactly.
Perimeter of the present invention comprises: display device, sighting target control device, infraluminescence device, camera head, housing, pupil detector and perimetry device.The a plurality of precalculated positions of described sighting target control device in described display device show the photostimulation sighting target that is used for fixing the fixation target of person under inspection's sight line and is used for providing to described person under inspection's pupil photostimulation.Described infraluminescence device is to described person under inspection's eyes emission infrared light.Described camera head utilizes the infrared light of described infraluminescence device emission, absorbs the image of described person under inspection's eyes.Ccontaining described display device in the described housing, described infraluminescence device and described camera head, described housing has peep-hole, by described peep-hole, described person under inspection watches described fixation target and the described photostimulation sighting target that is presented in the described display device from the outside.Described pupil detector is based on the described person under inspection's of image detection of described camera head picked-up pupil diameter.When seeing described person under inspection under the condition of described fixation target, when described sighting target control device shows described photostimulation sighting target, described perimetry device is measured described person under inspection's the visual field based on the variation of the detected described person under inspection's of described pupil detector pupil diameter.
The invention is characterized in: described display device comprises the display device of the brightness of the background luminance that can regulate screen respectively and described photostimulation sighting target.Therefore, perimeter of the present invention can easily be regulated the background luminance of screen and the brightness of photostimulation sighting target, and can be optimum with the background luminance of screen and the brightness settings of photostimulation sighting target.Certainly, because also can easily change the size of sighting target and the demonstration time of sighting target, perimeter of the present invention can show best sighting target according to the person under inspection.Therefore, perimeter of the present invention can be measured the visual field rapidly, exactly.
Preferably, described perimeter also comprises the display position adjusting device, can be with respect to the vertical direction of described peep-hole and/or the position of horizontal direction and/or the described display device of fore-and-aft direction adjusted.By the display position adjusting device is provided, just can display device be moved to the optimum position according to the position of person under inspection's eyes and person under inspection's vision.
Preferably, described perimeter also comprises the picture pick-up device adjusting device, can regulate the camera position and the shooting direction of described camera head.By the picture pick-up device adjusting device is provided, just can regulate the position and the angle of camera head according to person under inspection's pupil.In this case, more preferably, described perimeter also comprises the picture pick-up device control device, be used for testing result based on described pupil detector, camera position and shooting direction by described picture pick-up device adjusting device is regulated described camera head make described person under inspection's pupil diameter reach peak value.By the picture pick-up device control device is provided, just camera head can be adjusted to optimum position and optimum orientation automatically.
Preferably, described perimeter also comprises console switch, its operation that responds described person under inspection is to described perimetry device output function signal, and described perimetry device is measured the visual field based on described person under inspection's pupil diameter variation and from the operation signal of described console switch input.In this case, except objective perimetry, can also carry out subjective perimetry, thereby improve the reliability of measurement result.
Preferably, the emissivity of the inner surface of described housing is generally 1 (that is, its reflectance is zero).In this case, the light that display device is sent in the housing is almost all absorbed by the inner surface of housing, therefore can prevent from photostimulation is provided to the unnecessary position of pupil, and can improve the accuracy of measurement.
For the photostimulation sighting target, use photostimulation usually with the of short duration flicker of impulse form.Preferably, described sighting target control device shows pulse type photostimulation sighting target at least twice continuously in described display device.With show the pulse type photostimulation only once situation compare, by continuous demonstration pulse type photostimulation at least twice, even when light quantity is identical, also can amplify the variation of pupil diameter.Therefore, be easy to measure the visual field.
Incidentally, even do not having under the state of photostimulation, the size of pupil diameter also can be drifted about, and therefore such situation can occur: be difficult to judge that whether the variation of pupil diameter is owing to photostimulation causes.In this case, preferably, described sighting target control device shows the periodically variable photostimulation sighting target of light intensity in described display device.By showing the periodically variable photostimulation sighting target of light intensity, when the variation of pupil diameter is when causing owing to the photostimulation sighting target, pupil diameter with the mode cyclically-varying of the cycle synchronisation of light.Therefore, whether the variation that is easy to judge pupil diameter owing to photostimulation causes, and can improve the reliability of measurement result.
The periodically variable photostimulation sighting target of described light intensity can be the sighting target that light pulse sequence or light intensity change in sinusoidal wave mode.
In this case, preferably, described sighting target control device has the function in the light intensity cycle that changes described photostimulation sighting target or has the function of the size that changes described photostimulation sighting target.By this function is provided, just can show best sighting target according to the person under inspection.
In addition, when showing the periodically variable photostimulation sighting target of light intensity, preferably, described perimetry device has the function according to the amplitude of variation of the described pupil diameter of magnitude determinations of the fluctuation range of described pupil diameter or described pupil diameter.When pupil diameter during, be easy to obtain the local minimum and the local maximum of pupil diameter along with the light intensity cyclically-varying.Therefore, poor by with between the local minimum of pupil diameter and the local maximum, just the fluctuation range of pupil diameter (the perhaps amplitude of pupil diameter, just half of fluctuation range) is defined as the amplitude of variation of pupil diameter, just can easily obtain the amplitude of variation of pupil diameter.In the time that a plurality of fluctuation range can be obtained, its meansigma methods can be defined as the amplitude of variation of pupil diameter.In this case, can relax the fluctuation (injustice) of data.
In addition, preferably, the ratio between the amplitude of variation of the pupil diameter that described perimetry device obtains more than calculating and the light intensity of photostimulation sighting target, and based on described ratio measure person under inspection's visual field sensitivity.That is to say, when the variation of pupil diameter for light intensity hour, just can judge that the sensitivity in the visual field is degenerated, and by this way, based on the sensitivity in the described ratio measure visual field.
In addition, preferably, described perimetry device has the function of the synchronicity between light intensity cycle of calculating described photostimulation sighting target and described person under inspection's the period of change of pupil diameter.In this case, can use described synchronicity as one of information of judging the measurement result reliability.
In addition, preferably, described perimetry device has the variation based on described person under inspection's pupil diameter, judges whether the position that shows described photostimulation sighting target is the function in described person under inspection's normal visual field zone.In this case, can judge automatically that display light stimulates whether the position of sighting target is person under inspection's normal visual field zone.
Preferably, described sighting target control device has the function of the color that changes described photostimulation sighting target.In this case, can check the cone cell that in the retina cell color is reacted.
Description of drawings
Fig. 1 is the sketch map that illustrates according to the perimetric formation of the embodiment of the invention;
Fig. 2 is the sketch map of explanation perimetric internal configurations shown in Figure 1;
Fig. 3 is the sketch map of the installation method of explanation perimetric liquid crystal display shown in Figure 1;
Fig. 4 A is the sketch map of the installation method of explanation perimetric CCD photographic head shown in Figure 1;
Fig. 4 B is the sketch map of the installation method of explanation perimetric CCD photographic head shown in Figure 1
Fig. 5 is the sketch map of an example that the screen of perimetric liquid crystal display shown in Figure 1 is shown;
Fig. 6 A is the sketch map that an example of CCD photographic head institute pickup image in the perimeter shown in Figure 1 is shown;
Fig. 6 B is the sketch map that an example of detected pupil diameter in the perimeter shown in Figure 1 is shown;
Fig. 7 is the sketch map of explanation perimetric measuring principle shown in Figure 1;
Fig. 8 is the sketch map that an example of sighting target display position in the perimeter shown in Figure 1 is shown;
Fig. 9 A is the sketch map that an example of the myosis rate that records in the perimeter shown in Figure 1 is shown;
Fig. 9 B is the sketch map that another example of the myosis rate that records in the perimeter shown in Figure 1 is shown;
Figure 10 carries out the sketch map of the measurement result of static vision field measurement simultaneously for being illustrated under the gray scale to the person under inspection of Fig. 9 A and Fig. 9 B;
Figure 11 A is the sketch map that another example of the myosis rate that records in the perimeter shown in Figure 1 is shown;
Figure 11 B carries out the sketch map of the measurement result of static vision field measurement simultaneously for being illustrated under the gray scale to the person under inspection of Figure 11 A;
Figure 12 A is the sketch map that an example of photostimulation sighting target in the perimeter shown in Figure 1 is shown;
Figure 12 B is the sketch map that another example of photostimulation sighting target in the perimeter shown in Figure 1 is shown;
Figure 13 is the sketch map that another example of photostimulation sighting target in the perimeter shown in Figure 1 is shown;
Figure 14 is the sketch map that another example of photostimulation sighting target in the perimeter shown in Figure 1 is shown;
Figure 15 is the sketch map that another example of photostimulation sighting target in the perimeter shown in Figure 1 is shown.
The specific embodiment
Below, describe the present invention in detail with reference to accompanying drawing.Fig. 1 is the sketch map that the perimetric formation of present embodiment is shown.Perimeter comprises: liquid crystal display 1, infrarede emitting diode 2, CCD photographic head 3, half mirror 4, image processing equipment 5, computer 6 and console switch 7.As shown in Figure 2, liquid crystal display 1, infrarede emitting diode 2, CCD photographic head 3 and half mirror 4 are contained in the box-like housing 8.On a side of housing 8 peep-hole 10 is arranged, by peep-hole 10, the person under inspection can see the liquid crystal display 1 that is installed in the housing 8; Lower jaw supporting base 9 also is installed on this side, is used to support person under inspection's lower jaw.
Liquid crystal display 1 (display device) shows the photostimulation sighting target L that is used for fixing the fixation target F of person under inspection's sight line and is used for providing to person under inspection's pupil photostimulation.The displaying contents of liquid crystal display 1 is by computer 6 controls.As an example, liquid crystal display 1 has 19 inches diagonal screens, SXGA resolution (1280 * 1024 points), and high-high brightness is 400cd/m
2, contrast ratio is 450 to 1 (450: 1), and the about 16.77M of Show Color is 160 degree at the visual angle of vertical and horizontal direction, and response speed is 12ms.Distance between liquid crystal display 1 and the peep-hole 10 is about 29cm, and therefore, the field range that can measure is ± 26 degree angles in vertical direction, and the field range that can measure is ± 21 degree angles in the horizontal direction.Utilize liquid crystal display 1 as display device, can regulate the background luminance of screen and the brightness of photostimulation sighting target respectively.Therefore, provide the luminance difference that needs by brightness, thereby provide enough photostimulation, be easy to produce the luminous reflectance of pupil to person under inspection's pupil P to background luminance and photostimulation sighting target.In addition, because for perimeter, do not need to make the background luminance deepening to surpass the necessary time,, thereby can shorten the time of checking the visual field so the person under inspection adapts to time (the being the dark adaptation time) weak point of background dark.Certainly, because can also arbitrarily change size, the shape and mobile of sighting target, so can show best sighting target according to the person under inspection.Preferably, background luminance is set in about 3.18 * 10
-1To 3.18cd/m
2(that is 1 to 10asb (1asb=1/ π cd/m,
2)) scope in.Preferably, the brightness settings of photostimulation sighting target about 286 to 382cd/m
2In the scope of (that is, 900 to 1200asb).
Infrarede emitting diode 2 (infraluminescence device) be installed in respectively with respect to the eye E of person under inspection S obliquely the position and oblique under the position, thereby can not stop person under inspection's sight line.Infrarede emitting diode 2 is about the infrared light of 850nm to person under inspection's eye E emission wavelength.
CCD photographic head 3 (camera head) has 400000 pixel resolutions, and to the infrared light sensitivity, therefore, under the light dark surrounds seldom of natural light, CCD photographic head 3 can utilize the infrared light of infrarede emitting diode 2 to absorb the image of person under inspection's eye E.Because people's retina can not the perception infrared light, so the infrared light of infrarede emitting diode 2 can not cause the luminous reflectance of pupil.
Image processing equipment 5 (pupil detector) is handled the image of CCD photographic head 3 picked-ups, and partly measures pupil diameter by extract pupil from the image of eye E, and the measurement result with pupil diameter outputs to computer 6 then.
Be about 1.0 black matrix coating except the viewing area of liquid crystal display 1, the surface of emission of infrarede emitting diode 2, the receiving plane of CCD photographic head 3 and all coated emissivity of other all parts the half mirror 4 in the inner surface of housing 8 and the housing 8.The light of liquid crystal display 1 emission is absorbed by the black matrix coating, thereby has prevented following situation: the unnecessary part that light is reflected and enter person under inspection's eyes by other parts, therefore can not carry out perimetry accurately.Replace applying the black matrix coating, also can apply ARC with antiradar reflectivity.
As shown in Figures 2 and 3, liquid crystal display 1 is installed on the display position governor motion 11 (display position adjusting device), and display position governor motion 11 can be with respect to the vertical direction of peep-hole 10 and/or the position of horizontal direction and/or fore-and-aft direction adjusted liquid crystal display 1.Display position governor motion 11 comprises: X-axis platform 11A, drive by motor 12A, and can go up in horizontal direction (X-direction) and move with respect to peep-hole 10; Y-axis platform 11B is installed on the X-axis platform 11A, is driven by motor 12B, can go up mobile with respect to the fore-and-aft direction (Y direction) of peep-hole 10; And Z pillow block 11C, be installed on the Y-axis platform 11B, drive by motor 12C, can go up in vertical direction (Z-direction) and move with respect to peep-hole 10.Liquid crystal display 1 is installed on the Z pillow block 11C.Under person under inspection S is placed on its lower jaw situation on the lower jaw supporting base 9, by regulating the position of X-axis platform 11A and Z pillow block 11C, the center adjustment of liquid crystal display 1 can be arrived the right eye of person under inspection S or the center of left eye, just can utilize liquid crystal display 1 to measure the visual field thus with the small screen.In addition, though person under inspection S myopia or hypermetropia, also can be by the Y-axis platform 11B that moves up in front and back, thus liquid crystal display 1 is moved to the position that person under inspection S can see clearly.Therefore, person under inspection S does not need glasses or contact lens just can carry out perimetry, thereby can measure the visual field more accurately.
Shown in Fig. 4 A and Fig. 4 B, CCD photographic head 3 is connected on the connecting plate 13, and connecting plate 13 is arranged on the half mirror 4 the almost position of level, thereby CCD photographic head 3 can move up in front and back, and can rotate around X-axis.By utilizing for example servomotor of picture pick-up device adjusting device (not shown), CCD photographic head 3 is moved up in front and back and rotate around X-axis, can regulate the camera position and the shooting direction of CCD photographic head 3, make that the center of CCD photographic head 3 is corresponding with the position of person under inspection's pupil P.In addition, rotate around X-axis, can regulate the reflection angle of eye E in half mirror 4 by making CCD photographic head 3.Therefore, be adjusted to the CCD photographic head is seen eyes up from the below angle, just can absorb the image of pupil and make that eyelashes can be not overlapping with pupil P, thus, can prevent that eyelashes from reducing the accuracy in detection of pupil diameter by camera angle with CCD photographic head 3.Preferably, computer 6 comprises picture pick-up device control function (picture pick-up device control device), be used to control for example servomotor of picture pick-up device adjusting device, and regulate the camera position and the shooting direction of CCD photographic head 3, make person under inspection's pupil diameter reach peak value (in other words, person under inspection's pupil diameter reaches maximum).Like this, just the position and the shooting direction of CCD photographic head 3 automatically can be adjusted to optimum position and best shooting direction.
The perimetric measuring principle of the present invention below is described.Fig. 5 illustrates the screen of liquid crystal display 1, shows fixation target F at the center of screen.The person under inspection is instructed to an eye fixation fixation target F, and as person under inspection during with an eye fixation fixation target, computer 6 randomly in a plurality of precalculated positions of screen one by one display light stimulate sighting target L.In Fig. 5, the example of the photostimulation sighting target L of the current demonstration of mark " ● " expression, other examples of the display position of mark " zero " expression photostimulation sighting target L.
When display light stimulated sighting target L, CCD photographic head 3 utilized the image of the infrared light picked-up eye E of infrarede emitting diode 2.Fig. 6 A illustrates an example of institute's pickup image.
Shown in Fig. 6 B, image processing equipment 5 extracts pupil P from the image that is absorbed, and detects pupil diameter D.
Incidentally, the size of pupil is regulated by sphincter pupillae and dilator pupillae, and sphincter pupillae is controlled by parasympathetic nervous system, and dilator pupillae is controlled by sympathetic nervous system.Therefore, when in the optional position in normal visual field zone when eye E provides photostimulation, information is passed to parasympathetic nervous system, sphincter pupillae reflexive ground shrinks then.Afterwards, when removing photostimulation, pupil dilation.This neurotransmission is the brain stem reflection, and therefore, the person under inspection can not independently control usually, and this neurotransmission takes place discontinuously along with photostimulation.This is called the luminous reflectance of pupil, and polished bard is intense strong, and it is big more that the reaction of the luminous reflectance of pupil becomes.In other words, can think that the display position of photostimulation sighting target has high retina sensitivity in the big place of reaction, have low retina sensitivity in the little place of reaction.
Fig. 7 illustrates because the example that the luminous reflectance of pupil causes pupil diameter to change.When computer 6 at an arbitrary position display light stimulate sighting target in the time of 0.1 second, behind about 0.2 to 0.3 second dt time delay (latent time), myosis (contraction of pupil) takes place.After myosis began time in the past ta, pupil diameter reached its maximum collapse point (minima).After reaching minima, pupil diameter enlarges (so-called platycoria) gradually.In Fig. 7, curve C 1 and C2 represent when two diverse locations of area of visual field provide the photostimulation sighting target, the variation of pupil diameter.Compare with curve C 1, curve C 2 is with respect to little (that is D1＞D2), of the pupil diameter excursion of photostimulation.When the pupil diameter variation is little,, just think that the optic nerve that is in the position that shows this photostimulation sighting target has some unusual, has reduced the sensitivity in the visual field thus as curve C 2.
Computer 6 (perimetry device) is based on the variation of image processing equipment 5 detected pupil diameter, calculate maximum myosis amount, myosis rate (pupil contraction rate, the ratio between promptly maximum myosis amount and the pupil initial size), contracted pupil speed and platycoria speed.
Below utilize result's the example in above-mentioned principle actual measurement glaucoma person under inspection's the visual field by Fig. 8 to Figure 11 B explanation.In this is measured, fixation target F is presented at screen center, the person under inspection is instructed to an eye fixation fixation target F, and as shown in Figure 8, when the person under inspection watches fixation target F attentively, in person under inspection's the visual field along a left side the oblique photostimulation sighting target L of display white pulse at random of a plurality of precalculated position M0 to M20 on the straight line of side's trend, the pupil diameter D that records according to image processing equipment 5 of computer 6 calculates the myosis rate then.The background luminance of liquid crystal display 1 is about 0.5cd/m
2, the brightness of photostimulation sighting target is about 300cd/m
2, the size of photostimulation sighting target is 2.0deg, and the demonstration time of photostimulation sighting target is about 0.2 second.
Fig. 9 A is the measurement result in the visual field, top of person under inspection's right eye.That is, express relation between the display position (illumination angle) of myosis rate when the photostimulation sighting target is presented at each position M0 to M10 of Fig. 8 and photostimulation sighting target with diagrammatic form.Solid line is represented measurement result, and dotted line is represented normal person's myosis rate.Fig. 9 A shows that for all illumination angles person under inspection's myosis rate all is greater than or equal to normal person's myosis rate.Therefore, can judge that the visual field, top of person under inspection's right eye is normal.
On the other hand, Fig. 9 B is the measurement result in the visual field, bottom of person under inspection's right eye.That is, express relation between the display position (illumination angle) of myosis rate when the photostimulation sighting target is presented at each position M11 to M20 of Fig. 8 and photostimulation sighting target with diagrammatic form.As Fig. 9 A, solid line is represented measurement result, and dotted line is represented normal person's myosis rate.Fig. 9 B shows, in the part (that is, position M17 to M20) in person under inspection's nasal side zone (that is, position M11 to M15) and person under inspection's territory, ear lateral areas, person under inspection's myosis rate is less than normal person's myosis rate.That is to say, can think that in these zones, the sensitivity in the person under inspection visual field is degenerated.
In addition, Figure 10 is for carrying out the result that static perimeter (subjective perimeter) is measured to same person under inspection simultaneously.When using static perimeter to check, the person under inspection is instructed to when he sees the photostimulation sighting target, the push switch, if person under inspection's push switch when the photostimulation sighting target shows, judge that then display position is person under inspection's normal visual field zone, if and the person under inspection does not have the push switch when the photostimulation sighting target shows, judge that then display position is unusual area of visual field.And, represent person under inspection's the visual field with gray scale, in gray scale, normal area of visual field represents that with white unusual area of visual field is represented with black.Figure 10 shows that as the measurement result of Fig. 9 A and Fig. 9 B, person under inspection's upper area is the normal visual field zone, and person under inspection's lower area partly is unusual area of visual field.
In the bright perimeter of we, can also utilize console switch 7 to carry out the inspection identical, and, can improve the reliability of measurement result by to carry out subjective perimetry with the bonded mode of objective perimetry with the inspection of above-mentioned use static perimeter.
Incidentally, Figure 11 A illustrates and uses the objective measurement result of perimeter of the present invention to the visual field, bottom of person under inspection's left eye, and Figure 11 B is for using the subjective measurement result of static perimeter to person under inspection's left eye visual field.Referring to Figure 11 A, in the zone of person under inspection's ear side (around the M13), the myosis rate descends, and can think that therefore person under inspection's visual field sensitivity degenerates.Yet referring to Figure 11 B, the lower area of person under inspection's ear side is a white, that is to say, judges that this zone is the normal visual field zone.In other words, though judge that in subjective result this zone is the normal visual field zone, this regional visual field sensitivity of judgement is degenerated in objective results.This can think that before subjective symptom appears in the person under inspection objective determination can capture symptom in early days.As mentioned above, objective perimeter is hopeful the development that captures symptom in early days and end symptom.
Though in above-mentioned practical measuring examples, computer 6 is measured person under inspection's the visual field according to the change calculations myosis rate of pupil diameter as indication, but except the function of calculating the myosis rate, computer 6 (perimetry device) can also have judges that display light stimulates whether the position of sighting target is the function in person under inspection's normal visual field zone.For example, computer 6 is made comparisons myosis rate and predetermined threshold, if the myosis rate greater than predetermined threshold, then computer is judged as the normal visual field zone, and if the myosis rate less than predetermined threshold, then computer is judged as unusual area of visual field.In this case, preferably, this threshold value changes with person under inspection's age and/or sex.Perhaps, (for example person under inspection's area of visual field can be divided into four zones, four zones comprise that first quartile (right upper quadrant) is to four-quadrant (right lower quadrant)), and the high cut zone of visual field sensitivity degeneration density can be judged as unusual area of visual field.
Computer 6 (sighting target control device) can have the function of the color that changes the photostimulation sighting target.In this case, because amphiblestroid sensitivity changes with color wavelength, so can check specific retinal area by the color that changes the photostimulation sighting target.That is to say that usually, retina cell can be divided into to the aitiogenic staff cell of black and white and to the aitiogenic cone cell of color, therefore, by showing colored photostimulation sighting target, just can check the reaction of various cone cells.
Though only stimulate sighting target along display light on the tiltedly square straight line that moves towards in a left side in person under inspection's the visual field in above-mentioned inspection, the display position of photostimulation sighting target is not limited to above-mentioned example.
Incidentally, the myosis rate can descend with advancing age, and therefore for some persons under inspection, even the photostimulation of pulse type is provided, the luminous reflectance of pupil also may be less.In this case, preferably, in latent time, show the photostimulation sighting target at least twice of pulse type continuously.Figure 12 A illustrates when the pulse type photostimulation L1 that shows 0.2 second, the variation of pupil diameter (referring to curve C 3), Figure 12 B illustrates when the pulse type photostimulation twice (referring to L2 and L3) that shows 0.1 second with 0.1 second interval continuously, the variation of pupil diameter (referring to curve C 4).When comparison diagram 12A and Figure 12 B, the total time of photostimulation all is 0.2 second among each figure, is equal to each other, and still, the variation of pupil diameter is greater than the variation of pupil diameter among Figure 12 A among Figure 12 B.As mentioned above, by continuous demonstration pulse type photostimulation at least twice, be expected to obtain the luminous reflectance of bigger pupil.
In addition, even do not having under the steady statue of photostimulation, the size of pupil diameter also can be drifted about, and therefore such situation can occur: be difficult to judge that whether the variation of pupil diameter is owing to photostimulation causes.In this case, preferably, on liquid crystal display, show the periodically variable photostimulation sighting target of light intensity.Figure 13 illustrates when light pulse sequence L4 is presented at center, the visual field as the periodically variable photostimulation sighting target of light intensity, and the example that pupil diameter changes in light pulse sequence L4, shows pulse 5 times continuously with 2 seconds intervals.In Figure 13, though show that even pupil diameter has just been drifted about before the photostimulation sighting target is shown, when demonstration had the pulse train L4 of 5 pulses, L4 was synchronous with pulse train, and pupil diameter also changes (referring to curve C 5) 5 times.As mentioned above, when the light intensity cyclically-varying, if person under inspection's the visual field is normal, then caused pupil diameter variation also has periodically.Therefore, when the variation of observing pupil diameter had periodicity as Figure 13, so this variation was likely owing to photostimulation causes.Though the example that Figure 13 is illustrated in the center in the visual field when showing the periodically variable photostimulation sighting target of light intensity is also like this when showing the periodically variable photostimulation sighting target of light intensity in other each zone in the visual field.Therefore, show the periodically variable photostimulation sighting target of light intensity by a plurality of precalculated positions at liquid crystal display, the variation of measuring pupil diameter simultaneously just can be measured person under inspection's the visual field.
Whether the variable number by checking photostimulation P is corresponding to the variable number of pupil diameter (in other words, local minimum and local peaked repetition number), can judge the synchronicity between the period of change of light intensity cycle of photostimulation sighting target and pupil diameter.Perhaps, carry out autocorrelation analysis and check its periodicity, can judge synchronicity by serial data to pupil diameter.
In addition, preferably, computer 6 (perimetry device) has and utilizes for example autocorrelation analysis, the synchronicity between the light intensity cycle of calculating the photostimulation sighting target and the period of change of pupil diameter, and the synchronicity of calculating is notified gauger's's (just doctor etc.) function.In this case, the gauger by checking the photostimulation sighting target the light intensity cycle and the synchronicity between the period of change of pupil diameter, can judge the reliability of measurement result.
Under the periodically variable situation of pupil diameter, be easy to obtain the local minimum and the local maximum of pupil diameter.Therefore, preferably, computer 6 (perimetry device) poor with between the local minimum of pupil diameter and the local maximum, the fluctuation range of pupil diameter just is defined as the amplitude of variation of pupil diameter.Perhaps, with the amplitude of pupil diameter, half of fluctuation range just is defined as the amplitude of variation of pupil diameter.As shown in figure 13, in the time can obtaining poor between a plurality of local minimums and the local maximum, its meansigma methods can be defined as the amplitude of variation of pupil diameter of the display position of photostimulation sighting target.In this case, can relax the fluctuation (injustice) of pupil diameter.
Preferably, the ratio between the amplitude of variation of the pupil diameter that computer 6 (perimetry device) obtains more than calculating and the light intensity of photostimulation sighting target, and based on this visual field sensitivity than the measurement person under inspection.In very small retinal area under the normal situation in its peripheral region, if the photostimulation sighting target strides across abnormal area and normal region to amphiblestroid transmitting boundary, pupillary reaction can take place unusually.In this case, think that the size of pupillary reaction changes along with the ratio between the size of the size of abnormal area and normal region, therefore, can calculate the sensitivity in the visual field by the size of measuring pupillary reaction.The size of pupillary reaction depends on the intensity of photostimulation, and polished bard is intense strong, and pupillary reaction is big more.Therefore, computer 6 by calculating pupil diameter amplitude of variation and the ratio (that is, the size of the size of pupillary reaction/photostimulation sighting target) between the light intensity of photostimulation sighting target, can measure person under inspection's visual field sensitivity.Therefore if it is little that this than little, just means the pupillary reaction of high light, can think that amphiblestroid sensitivity degenerates.
Under the situation that shows the periodically variable photostimulation sighting target of light intensity, preferably, computer 6 (sighting target control device) has the function that changes the light intensity cycle.An example when Figure 14 illustrates display light pulse train L5 in light pulse sequence L5, shows a pulse with one second interval.Relatively with Figure 14 of showing a pulse in one second at interval with to show Figure 13 of a pulse in 2 seconds at interval, the amplitude of the pupil diameter of Figure 14 is less than the amplitude of the pupil diameter of Figure 13, and the periodic feature of Figure 14 is not obvious.Before pupil fully enlarged, next photostimulation showed more early, and the cycle just becomes short more, and the variation of pupillary reaction size also diminishes.Therefore, in order to improve the readability of pupil diameter amplitude of variation, preferably, the above-mentioned cycle is not too short.On the other hand, if the cycle is long, the review time is also elongated, so person under inspection's burden strengthens.Therefore, preferably, computer 6 has the function that changes the light intensity cycle, when the periodicity that changes when pupil diameter is obvious, computer 6 shortens the light intensity cycle, thereby shortens the review time, and when the periodicity of pupil diameter variation is not obvious, computer 6 prolongs the cycle that photostimulation occurs, thereby increases the visibility of waveform.
Though light intensity changed with the constant cycle in Figure 13 and Figure 14, light intensity needn't change with the constant cycle of strictness.By the variation of real-time measurement pupil diameter D,, and, can amplify the variation of pupil diameter at the appropriate stimulation of display light constantly sighting target according to the pupillary reaction cyclomorphosis light intensity cycle.
Though in Figure 13, display light pulse train L4 is as the periodically variable photostimulation sighting target of light intensity, can use sighting target L6 that light intensity changes in sinusoidal wave mode as the substituting of light pulse sequence, as shown in figure 15.Referring to Figure 15, when showing the sighting target L6 that light intensity changes in sinusoidal wave mode, though the variation of pupil diameter (referring to curve C 7) with sinusoidal wave some depart from, the variation of pupil diameter is still corresponding with photostimulation.When the variation of observing pupil diameter has periodicity as Figure 15, just think that this variation is likely owing to photostimulation causes.As mentioned above, as the sighting target L6 that light intensity is changed in sinusoidal wave mode during, be easy to judge that whether the variation of pupil diameter is owing to photostimulation causes as light pulse sequence alternative.
In addition, in Figure 15, the offset component of pupil diameter (DC value) is on a declining curve.When the variation of pupil diameter had this trend, if use single photostimulation, the variation of pupil diameter was because this trend causes or because single photostimulation causes just very not obvious so.Yet because in Figure 15, pupil diameter periodically changes, and be because photostimulation causes so be easy to judge this variation, and corresponding retinal area is normal.
In addition, preferably, computer 6 (sighting target control device) has the function that changes photostimulation sighting target size.Usually, the photostimulation sighting target is big more, and the luminous reflectance amplitude of pupil is big more, and the readability of waveform improves.Yet, also big if sighting target is big to amphiblestroid stimulated zone, so just can not measure exactly.On the other hand, if the visual angle of sighting target is little, the readability of waveform reduces so, but can measure accurately, and is hopeful disease such as early diagnosis glaucoma.That is to say, the readability of waveform and measure accurately between a balance relation is arranged.Therefore, preferably, computer 6 has the function that changes photostimulation sighting target size, and when hope was measured exactly, computer 6 made sighting target diminish on direction of observation, and when hope improved data readable, computer 6 made sighting target become big.In order to improve the readability of waveform, when sighting target diminished, preferably the number of iterations with the photostimulation sighting target increased, and perhaps background luminance is reduced, and made the variation of pupil become big.
Should note: as mentioned above, because the perimeter of present embodiment adopts liquid crystal display 1 as display device, so be easy to change intensity, cycle and the size of photostimulation sighting target as mentioned above.
Though present embodiment adopts liquid crystal display 1 as display device, other display device for example CRT, PDP, ELD, FED or the like can substituting as liquid crystal display 1.
In addition, can constitute the head-type perimeter, it has little liquid crystal display in protective eye lens shape housing.
As mentioned above, can construct different embodiments of the invention widely and do not break away from its spirit and scope, should be understood that, the invention is not restricted to its specific embodiment, unless in appended claims, limit.
Claims (17)
1, a kind of perimeter comprises:
Display device;
The sighting target control device, a plurality of precalculated positions in described display device show the photostimulation sighting target that is used for fixing the fixation target of person under inspection's sight line and is used for providing to described person under inspection's pupil photostimulation;
The infraluminescence device is used for the eyes emission infrared light to described person under inspection;
Camera head utilizes the infrared light of described infraluminescence device emission, absorbs the image of described person under inspection's eyes;
Housing, wherein ccontaining described display device, described infraluminescence device and described camera head, described housing has peep-hole, and by described peep-hole, described person under inspection watches described fixation target and the described photostimulation sighting target that is presented in the described display device from the outside;
Pupil detector based on the image of described camera head picked-up, detects described person under inspection's pupil diameter;
The perimetry device, when seeing described person under inspection under the condition of described fixation target, when described sighting target control device shows described photostimulation sighting target, described perimetry device changes based on the detected described person under inspection's of described pupil detector pupil diameter, measures described person under inspection's the visual field;
Wherein,
Described display device comprises the display device of the brightness of the background luminance that can regulate screen respectively and described photostimulation sighting target.
2, perimeter as claimed in claim 1 also comprises:
The display position adjusting device can be with respect to the vertical direction of described peep-hole and/or the position of horizontal direction and/or the described display device of fore-and-aft direction adjusted.
3, perimeter as claimed in claim 1 also comprises:
The picture pick-up device adjusting device, camera position and the shooting direction that can regulate described camera head.
4, perimeter as claimed in claim 3 also comprises:
The picture pick-up device control device, based on the testing result of described pupil detector, camera position and shooting direction by described picture pick-up device adjusting device is regulated described camera head make described person under inspection's pupil diameter reach peak value.
5, perimeter as claimed in claim 1 also comprises:
Console switch, the operation that responds described person under inspection be to described perimetry device output function signal,
Described perimetry device is measured the visual field based on described person under inspection's pupil diameter variation and from the operation signal of described console switch input.
6, perimeter as claimed in claim 1, wherein,
The emissivity of the inner surface of described housing is generally 1.
7, perimeter as claimed in claim 1, wherein,
Described sighting target control device shows pulse type photostimulation sighting target at least twice continuously in described display device.
8, perimeter as claimed in claim 1, wherein,
Described sighting target control device shows the periodically variable photostimulation sighting target of light intensity in described display device.
9, perimeter as claimed in claim 8, wherein,
Described photostimulation sighting target is a light pulse sequence.
10, perimeter as claimed in claim 8, wherein,
The light intensity of described photostimulation sighting target changes in sinusoidal wave mode.
11, perimeter as claimed in claim 8, wherein,
Described sighting target control device has the function in the light intensity cycle that changes described photostimulation sighting target.
12, perimeter as claimed in claim 8, wherein,
Described sighting target control device has the function of the size that changes described photostimulation sighting target.
13, perimeter as claimed in claim 8, wherein,
Described perimetry device has the function according to the amplitude of variation of the described pupil diameter of magnitude determinations of the fluctuation range of described pupil diameter or described pupil diameter.
14, perimeter as claimed in claim 13, wherein,
Described perimetry device has the ratio between the light intensity of the amplitude of variation of calculating described pupil diameter and described photostimulation sighting target, and based on the function of the described person under inspection's of described ratio measure visual field sensitivity.
15, perimeter as claimed in claim 8, wherein,
Described perimetry device has the function of the synchronicity between light intensity cycle of calculating described photostimulation sighting target and described person under inspection's the period of change of pupil diameter.
16, perimeter as claimed in claim 1, wherein,
Described perimetry device has the variation based on described person under inspection's pupil diameter, judges whether the position that shows described photostimulation sighting target is the function in described person under inspection's normal visual field zone.
17, perimeter as claimed in claim 1, wherein,
Described sighting target control device has the function of the color that changes described photostimulation sighting target.
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| JP268638/2004 | 2004-09-15 | ||
| JP2004268638 | 2004-09-15 | ||
| JP084550/2005 | 2005-03-23 |
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| CN100528070C CN100528070C (en) | 2009-08-19 |
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| CN101336823B (en) * | 2008-08-27 | 2010-06-09 | 中国科学院光电技术研究所 | Adaptive optics eyes micro-vision defect evaluation system |
| CN102283633A (en) * | 2011-07-19 | 2011-12-21 | 中国科学院光电技术研究所 | Self-adaptive optical microperimeter |
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