CN113116287A - Method for testing macular visual field by utilizing high-pass E-shaped visual target and application of method - Google Patents
Method for testing macular visual field by utilizing high-pass E-shaped visual target and application of method Download PDFInfo
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- CN113116287A CN113116287A CN202110258788.6A CN202110258788A CN113116287A CN 113116287 A CN113116287 A CN 113116287A CN 202110258788 A CN202110258788 A CN 202110258788A CN 113116287 A CN113116287 A CN 113116287A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
- A61B3/024—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for determining the visual field, e.g. perimeter types
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
- A61B3/028—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing visual acuity; for determination of refraction, e.g. phoropters
- A61B3/032—Devices for presenting test symbols or characters, e.g. test chart projectors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/113—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining or recording eye movement
Abstract
The invention discloses a method for testing macular visual field by utilizing a high-pass E-shaped sighting mark, which comprises the following steps: s1, informing a tested person to always watch a fixation point in a screen, S2, simultaneously displaying the fixation point and a high-pass E-shaped visual target with random orientation in the screen, S3, starting answering when the visual target appears, S4, randomly displaying the high-pass E-shaped visual target with random orientation around the fixation point for multiple times, answering by the tested person, and S5, calculating a test result according to the answering result of the tested person. The testing method simplifies the detection flow, and the orientation of the high-pass E-shaped visual target is used for detecting the visual field of the macular region, so that the testing sensitivity is improved, and the macular visual field can be subjected to self-testing, thereby being used for screening or progress tracking of macular function damage diseases.
Description
Technical Field
The invention relates to the field of vision capability testing, in particular to a method for testing macular visual field by utilizing a high-pass E-shaped sighting mark and application thereof.
Background
The macular region is an important region of the retina, located in the posterior pole of the eye, and is mainly related to visual functions such as fine vision and color vision. Once the macula area is diseased, visual deterioration, dark shadow before the eye or deformation of the vision often occur. Maculopathy can be caused by hereditary diseases, senile changes, inflammatory diseases, and other ocular fundus diseases. The hereditary macular degeneration can have family genetic history, the onset age is from infancy to old age, but the hereditary macular degeneration is most common in adolescence and is relatively intractable in treatment; age-related macular degeneration mainly comprises changes of age-related macular degeneration, age-related idiopathic epiretinal membranes, age-related macular holes and the like, and the condition of the disease can be improved or stabilized through early diagnosis and proper treatment; inflammatory macular degeneration is commonly seen in various retinochoroiditis, such as toxoplasmosis, uveitis, etc.; in addition, retinal vein occlusion, retinal vasculitis, diabetic retinopathy, high myopia, traumatic choroidal rupture, and the like can cause damage to the macular region; the etiology of some pathological changes, such as central serous choroidopathy and central exudative choroidopathy, is not completely clear, but edema or hemorrhage in the macular area can cause some visual impairment. Since macular degeneration can be caused by a variety of factors, care should be taken to avoid the factors that cause injury to the macular area. Once the vision changes or the object changes, the specialized diagnosis and treatment should be reached in time to clarify the cause and treatment and protect the vision function.
Macular degeneration belongs to a macular region visual function damage disease, for example, glaucoma and optic neuropathy can also cause macular region visual function damage, the macular region visual detection is required at present, and currently, professional instruments are mainly used for testing the macular region visual detection in hospitals, or some simple image testing methods are provided, so that the macular region visual function damage disease cannot be discovered at an early stage. Many retinal or optic nerve related pathologies have impaired macular visual function already in the subclinical stage, and this impairment is not currently sensitively detected by clinical routine visual field examination.
Disclosure of Invention
The invention aims to provide a test scheme which is more sensitive to the macular region visual function damage than a conventional perimeter, and the macular region visual function damage of various diseases can be found out more early.
According to the above objects, there is provided a method for macular visual field test using a high-pass E-shaped optotype, comprising the steps of:
s1, informing a tested person to always watch a watching point in a screen,
s2, simultaneously presenting a fixation point and a high-pass E-shaped visual target with random orientation in a screen,
s3, starting to answer when the sighting mark appears,
s4, the high-pass E-shaped visual marks with random orientation randomly appear around the fixation point for a plurality of times and are answered by a tester,
and S5, calculating a test result according to the response result of the tester.
Preferably, the fixation point is yellow, and the fixation point changes into a hollow white circle.
Preferably, in S3, the gazing point changes to green when the tester responds correctly and to red when the tester responds incorrectly.
Preferably, the point of regard appears at different locations on the screen.
Preferably, before S1, a nine-point calibration is performed using a front camera, a calibration is performed using eye tracking, and after the test is completed, the fixation point appears at the center of the nine-point calibration.
Preferably, prior to the test at S1, physiological blind spot detection is performed.
Preferably, the high-pass E-type optotypes randomly appear on blind spots during the test to calculate the loss rate of fixation.
Preferably, the simulation test is performed before the official test, so that the tester is familiar with the test flow and after three correct responses, the official test is performed.
Preferably, the high-pass E-font optotype with random orientation has 4 random orientations, up, down, left, and right, respectively, and the tester answers the input four different orientations.
Furthermore, the application of the method for testing the macular visual field by using the high-pass E-shaped sighting target on a fixed or mobile device is provided.
The invention can accurately test the macular visual field, can be applied to mobile equipment to carry out visual self-test, has the macular area visual function damage in the subclinical stage of a plurality of retina or optic nerve related pathological changes, and can not sensitively find the damage in the current clinical routine visual field inspection.
Drawings
FIG. 1 is a schematic view of a high-pass E-word optotype,
figure 2 visual stimulus distribution and parameter description,
FIG. 3 is a schematic diagram of a nine-point calibration method,
figure 4 is a schematic diagram of a simulation test,
FIG. 5 is a graphical illustration of the results.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the embodiments of the present invention, and it is obvious that the embodiments described are only some representative embodiments of the present invention, rather than all embodiments, and all other embodiments obtained by a person skilled in the art without creative efforts belong to the protection scope of the present invention.
Example macular visual field test procedure
High-pass E-shaped visual target description
As shown in figure 1 of the drawings, in which,
1) a three-stroke equal-length square E-shaped sighting target is adopted, and each stroke or gap of the sighting target is 1/5 with the side length of the square.
2) Designing a boundary by using a high-pass visual target: the core is as follows: boundary 1:2: 1; ② the average brightness of the E-letter (black core and white border) matches the brightness of the gray background.
And (3) testing distance: 57cm
Test range: 5 degree
Monitoring the eye movement: gaze monitoring mode + physiological blind spot location monitoring
Visual stimulus distribution location: the 16 test points are uniformly distributed in a square area with the side length of 10 cm.
Contrast ratio: defined by Michelson Contrast and has the formula
The results are shown in figure 2 of the drawings,
the test distance was 57cm (1cm ═ 1 °)
Test range: 5 degree
Corresponding to the size of the letter: 0.6cm, square inner circle; 1.0cm, square outer ring.
The test points are spaced by about 3.3cm in transverse and longitudinal distance,
test range: a 0.3cm diameter circle of fixation point.
The high-pass visual target is a visual target which presents black and white alternately on a uniform gray background and well simulates the sensitivity of human eyes at different spatial frequencies. In normal people, the detection threshold value and the resolution threshold value are consistent, and a visual stimulation program designed based on the visual target is proved to have better consistency of repeated measurement and has special significance in neurological visual damage (such as glaucoma and age-related macular degeneration).
The threshold strategy specifies that the threshold is improved, thereby increasing the detection rate.
1) The procedure starts from a range of possible thresholds and then continually advances towards a true threshold.
2) The program plans 2 "stacks," an upper limit stack and a lower limit stack.
3) Set visual stimulus contrast range: 1% to 100%.
4) The specific process introduction: the upper limit is 1% and the lower limit is 100%. Firstly, presenting a median value of a set upper limit value and a set lower limit value, and adding the median value into a lower limit stack if a user answers correctly; the value in the contrast range is presented again until the user replies with an error, and the value is added to the upper limit stack.
5) End point: until 2 reversals occur, (i.e. "user answers correctly" to "user answers incorrectly" or vice versa), and the contrast between the upper and lower limits is ≦ 10%. The final output threshold is defined as the midpoint between the upper and lower limits when the two conditions are met.
6) There are another 2 possible responses:
a. if the 2 continuous visual stimuli are correctly replied, selecting an upper limit value for the contrast of the visual target at the next time, and if the visual stimuli are incorrectly replied, continuing the program; if a correct reply is still received, the value is "popped" from the upper limit stack to replace the last stored upper limit value. The next visual stimulus contrast is determined according to the midpoint of the modified upper and lower stack values. Similarly, if the 2 visual stimuli given continuously receive the wrong reply, the contrast of the visual target at the next time selects a lower limit value, and if the correct reply is received, the program continues; if an error reply is still received, the value "pops" off the lower bound stack to replace the last lower bound value. The next visual stimulus contrast is determined by the midpoint of the upper stack value and the modified lower stack value.
b. If the upper and lower limits (100%, 1%) of the initially set threshold are presented and then the "answer is correct" and the "answer is wrong" are presented for 2 times continuously, the threshold range is directly output, and the test is terminated.
Test flow
1) Preparation work
Firstly, taking the sitting position (the set distance is 57cm), adjusting the position and wearing the eyeshade.
And secondly, the eye movement follows the eye position to be detected, and the eye movement monitoring is carried out on the two-dimensional code of the opposite side eye packet.
And thirdly, calibrating the front lens by a 9-point calibration method.
And fourthly, detecting and monitoring physiological blind spots.
And fifthly, performing simulation test by using a demonstration program until the testee is familiar with the flow test process.
2) Formal test
The center of the screen shows a watching target "·", and a testee is informed to watch the target in the whole testing process.
Monitoring the head position and the eye position in an eye movement following mode in the whole process of the eye movement program.
Thirdly, the physiological blind spot monitoring program monitors the eye position in the whole process: and calculating the false positive rate.
And fourthly, informing the testee to answer with the keyboard direction buttons.
And fifthly, the optotypes appear in the set area in the screen randomly and sequentially, and the display duration is 2 seconds.
After the display time of 2 seconds, the watching circle is changed into white to be filled, response is waited, and the response time is not limited.
Seventhly, when answering, the middle small point of the fixation sighting mark displays green for 1 second, and when answering, the middle small point displays red for 1 second.
Description of 9-Point calibration method
Head and eye position monitoring simultaneously, as shown in FIG. 3
1) The two-dimensional code monitors the head position (the two-dimensional code is pasted on the eye bag), and the head position moving distance exceeds 5cm to prompt readjustment.
2) Eye position calibration: the front camera is calibrated by a 9-point calibration method.
In fig. 1, 9 points appear in sequence, and the eye tracker performs eye tracking and calibration, wherein the central point is the fixation point position in the subsequent test process.
Physiological blind spot detection
1) Physiological blind spot monitoring sighting target size: 0.43 degree
2) Contrast ratio: 100 percent
3) Determination of physiological blind spot locations: when the right eye is measured, the fixation point is positioned on the left of the screen. The middle of the white screen is provided with 1 watching red point with the diameter of 0.5cm, an examinee is ordered to watch the red point, at the moment, 1 black solid round point appears from the right side of the screen, the diameter of the black point is 0.5cm, the black point gradually moves towards the red point, when the examinee finds that the black point disappears from the visual field, a certain button is clicked for confirmation, the step is repeated for 3 times, and the position is averaged to determine the position of the physiological blind point. When the physiological blind spot of the left eye is measured, the fixation point is positioned on the right side of the screen, the black spot enters from the left side of the screen, and the rest is the same as the right eye (a 10-degree visual field measurement range is reserved).
4) Determining positions in two directions, and respectively recording results; but the display position is the midpoint of the two side values.
5) The physiological blind spot monitoring sighting mark appears 8-10 times in the whole process.
Description of simulation test
As shown in fig. 4, a fixation target "yellow dot" appears. The subject is informed to always look at the target.
Several optotypes appear in a random, sequential manner in a defined area of the screen, with a display duration of 2 seconds until the patient is familiar with the procedure.
Note that: the optotypes do not appear in the same position on both presentations.
The subject is informed to respond with the keyboard direction buttons.
The yellow point is a fixation point and appears for 2s with the visual target; the yellow dot was then replaced with an open white circle, indicating a wait for a response; when answering, the middle fixation target is changed into green for 1 s; at the time of the answer, it turned red for 1 s. The next procedure was entered with 3 consecutive answers.
Description of eye movement detection
1) The main flow of the eyeball center recognition algorithm is that firstly, a face area is divided from an image through a face detector (realized based on a cascade Haar classifier) in an open source computer vision library OpenCV. And secondly, dividing possible regions of the human eyes according to the prior information of the positions of the human eyes on the human face. And thirdly, in the human eye area, calculating the gradient of each pixel point of the image, and regarding the point where the pixel gradients are converged and the pixel value is low as the human eye center. Specific algorithm details refer to the paper Accurate eye center localization by means of gradients
2) The algorithm achieved 82.5% pupil location accuracy and 93.4% iris location accuracy in the BioID face dataset. The algorithm can rapidly and robustly extract the center of the human eye in difficult scenes such as wearing glasses, facial shadow, slight shielding of hair and the like, and is used for human eye tracking application.
The results show that:
1) form (a): data + hotspot graph
2) Eye identification information
3) Time-consuming information
4) Reliability: physiological blind spot monitoring-answering times/total number of occurrences
As shown in fig. 5, 1) a three-stroke, equal-length square "E" shaped visual target is used, each stroke or space of which is 1/5 of the side length of the square. 2) Designing a boundary by using a high-pass visual target: the core is as follows: boundary 1:2: 1; ② the average brightness of the E-letter (black core and white border) matches the brightness of the gray background.
Various modifications may be made to the above without departing from the spirit and scope of the invention as defined by the appended claims. The scope of the invention is therefore intended to be limited not by the above description, but rather by the scope of the appended claims.
Claims (10)
1. A method for testing macular visual field by utilizing a high-pass E-shaped visual target is characterized by comprising the following steps:
s1, informing a tested person to always watch a watching point in a screen,
s2, simultaneously presenting a fixation point and a high-pass E-shaped visual target with random orientation in a screen,
s3, starting to answer when the sighting mark appears,
s4, the high-pass E-shaped visual marks with random orientation randomly appear around the fixation point for a plurality of times and are answered by a tester,
and S5, calculating a result according to the answer result of the tester.
2. The method of claim 1, wherein the gaze point is yellow and the gaze point changes to a hollow white circle.
3. The method for macular visual field testing using highpass E-type optotypes according to claim 1, wherein the gazing point is changed to green when the tester responds correctly and to red when the tester responds incorrectly at S3.
4. The method of claim 1, wherein the gaze point is at a different location on the screen.
5. The method of claim 4, wherein the nine-point calibration with the front camera and the eye tracking are performed before S1, and the gazing point appears at the center of the nine-point calibration after the test is finished.
6. The method of claim 1, wherein the physiological blind spot detection is performed prior to the S1 test.
7. The method of claim 6, wherein the high-pass E-type optotype is randomly placed on the blind spot during the testing.
8. The method of claim 1, wherein the testing is performed in a simulation mode before the formal testing so that the tester is familiar with the testing procedure and the formal testing is performed after three correct responses.
9. The method as claimed in claim 1, wherein the hpht-E type optotype with random orientation has 4 random orientations, up, down, left and right, and the tester responds by inputting four different orientations.
10. Use of a method for macular visual field testing using a high-pass E-font eyepoint according to any one of claims 1 to 9 on a mobile device.
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Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105147237A (en) * | 2015-07-08 | 2015-12-16 | 郑伟宏 | Vision test method |
| CN109310315A (en) * | 2016-06-09 | 2019-02-05 | Qd激光公司 | Visual field visual acuity test system, visual field equipment for examining vision, visual field eyesight exam method, visual field eye test program and server unit |
| CN111904375A (en) * | 2020-07-13 | 2020-11-10 | 中山大学中山眼科中心 | Visual chart for self-test and use method thereof |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105147237A (en) * | 2015-07-08 | 2015-12-16 | 郑伟宏 | Vision test method |
| CN109310315A (en) * | 2016-06-09 | 2019-02-05 | Qd激光公司 | Visual field visual acuity test system, visual field equipment for examining vision, visual field eyesight exam method, visual field eye test program and server unit |
| CN111904375A (en) * | 2020-07-13 | 2020-11-10 | 中山大学中山眼科中心 | Visual chart for self-test and use method thereof |
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Application publication date: 20210716 |