CN113380366A - Visual field abnormal data evaluation system - Google Patents

Visual field abnormal data evaluation system Download PDF

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Publication number
CN113380366A
CN113380366A CN202110934135.5A CN202110934135A CN113380366A CN 113380366 A CN113380366 A CN 113380366A CN 202110934135 A CN202110934135 A CN 202110934135A CN 113380366 A CN113380366 A CN 113380366A
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visual field
patient
area
distortion
blind spot
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边桂彬
李桢
付攀
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Institute of Automation of Chinese Academy of Science
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Institute of Automation of Chinese Academy of Science
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    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • 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
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F3/00—Input arrangements for transferring data to be processed into a form capable of being handled by the computer; Output arrangements for transferring data from processing unit to output unit, e.g. interface arrangements
    • G06F3/01—Input arrangements or combined input and output arrangements for interaction between user and computer
    • G06F3/048—Interaction techniques based on graphical user interfaces [GUI]
    • G06F3/0484—Interaction techniques based on graphical user interfaces [GUI] for the control of specific functions or operations, e.g. selecting or manipulating an object, an image or a displayed text element, setting a parameter value or selecting a range
    • G06F3/04845—Interaction techniques based on graphical user interfaces [GUI] for the control of specific functions or operations, e.g. selecting or manipulating an object, an image or a displayed text element, setting a parameter value or selecting a range for image manipulation, e.g. dragging, rotation, expansion or change of colour
    • G06T3/18—
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

The invention provides a universal visual field abnormal data evaluation system, which provides various evaluation indexes and comprises the following steps: number of blind/dim/fuzzy areas of the patient's visual field; the area of each patient visual field blind spot/dim/fuzzy area accounts for the ratio of Amsler table area; patient visual field blind spot/dim/fuzzy area maximum/minimum area; patient visual field blind spot/dim/blurry score; the proportion of the distorted visual field of the patient in the Amsler table area; patient field of view distortion zone cluster number; the distortion degree of each region of the visual field of the patient is scored; patient visual field distortion overall degree score; and performing automatic comparative analysis and evaluation on the two adjacent measurement result graphs of the time nodes: each blind spot/dim/fuzzy area of the field of view diffuses or transfers a trend vector; the field of view distorts the respective cluster spread or shift trend vector.

Description

Visual field abnormal data evaluation system
Technical Field
The application relates to the field of data acquisition and evaluation, in particular to a visual field abnormal data evaluation system.
Background
The macular area is located in the center of the retina, which is the most sensitive area of human vision, and a large number of cone cells responsible for vision and color vision are distributed in the macular area, so that any pathological changes affecting the macula can cause obvious reduction of central vision, dark color and deformation of visual objects, and the like. With the increase of the average age of the population in China and the popularization and use of various electronic products, the degeneration of the macular part has rapidly become a blind killer seriously influencing the vision. By 2020, the number of patients with macular degeneration has been nearly 2 billion worldwide, and this number is still on the steep rise. The symptoms of age-related macular degeneration appear similar to those of presbyopia, but the harm is far better than that of presbyopia. Macular degeneration can cause distortion, central vision reduction or shadow shielding when people look at things, great discomfort is brought to normal life of patients, and permanent blindness and even life threatening are easily caused when treatment is not timely carried out.
At present, after the senile macular degeneration is cured, the existing vision can only be maintained or the vision decline is delayed, and the original vision can not be recovered, so that the effect can hardly reach the expected value of a patient. Since the damage to the eyes is irreversible, it is difficult for the patients to pay attention to the disease until the disease develops to a serious degree. However, with the development of technology, although the current ophthalmic diagnosis and treatment can provide patients with precise micro-visual field examination, physiological tissue coherence tomography, laser-assisted fine minimally invasive surgery and the like, most potential patients often have slight vision or no obvious detection of macular degeneration, which results in visual field defects and early symptoms of deformation, or frequent false negative conditions due to inaccurate diagnosis means, the patients have serious conditions when really feel great discomfort or are finally diagnosed through multiple screening, and even if the treatment means for various lesions is continuously updated and advanced, the harm caused by missing the optimal treatment time is difficult to offset.
Amsler grid is a table containing horizontal and vertical lines that can be used to determine a person's central field of view. This form was designed by the ophthalmologist mark armsler (Marc Amsler) of switzerland, used earliest since 1945. This table is a means for detecting retinopathies that can cause abnormal vision, particularly macular degeneration (e.g., macular degeneration, epiretinal membrane disease, etc.), as well as optic neuropathy and visual pathway changes in the brain. In particular, it can be used to screen three classes of diseases that cause blind spots in the visual field: AMD age-related macular degeneration, central serous retinopathy, acute macular neuroretinopathy, can also be used to screen for two types of lesions that cause a distorted field of vision: AMD age-related macular degeneration and epiretinal membrane proliferation.
The existing methods for measuring the visual field distortion and the visual field damage are mostly limited to qualitative self-check of patients by using paper-printed Amsler tables, because most of the patients suffering from maculopathy are middle-aged and elderly people, the patients often suffer from other diseases such as cataract, high myopia, astigmatism and the like, and the patients can only judge whether the tables in the visual field are deformed when taking the paper Amsler tables, but can hardly say that more details such as the deformed positions, types, sizes, visual field defect areas, visual field fuzzy areas and the like are clear.
As shown in fig. 2, the standard Amsler table design was originally in the form of a grid of black lines with white background, consisting of 20 x 20 small squares with a side length of 0.5cm, with a black dot in the center. When the table is used, a patient places the table on the sight line about 30cm away from eyes, according to the usual reading habit of the patient (the patient needs to wear glasses when using presbyopic glasses or other glasses at ordinary times, namely, the best observation eyesight, observation conditions and the like are ensured under the existing auxiliary conditions), a single eye is shielded, the other eye watches the central black point, all the squares just correspond to the core area of the macular area of the retina of the patient at the moment, the 20-degree visual angle is totally corresponded, and each small square corresponds to the 0.5-degree visual angle.
Publication No. CN107550451A provides a system for natural objective assessment of visual field function, the system comprising: the system comprises a host control unit, a display unit and a human-computer interaction unit; the host control unit comprises a calculation module, a judgment module, an adjustment module and a storage module, and the human-computer interaction unit comprises a receiving module and a feedback module. The system for naturally and objectively evaluating the visual field function provides a system for naturally and objectively evaluating the visual field function for a subject by changing a visual masking technology in basic research of visual psychophysics so as to quantitatively evaluate the functional level of the visual field, and can be widely popularized to clinical diagnosis of neuroophthalmology.
Patent number US5892570A provides a method and apparatus for evaluating and measuring deformations. The apparatus includes a pattern generator that displays a deformable pattern, such as an Amsler grid, on a computer monitor. The rectilinear grid comprises substantially parallel and equally spaced lines intersecting at vertices. The patient or the technician uses an input device, such as a mouse, to detect areas of the pattern where the object is not visible, so that dark spot areas can be marked. The input device is also used to adjust the position of the vertices and deform the mesh until the mesh appears substantially rectilinear with the subject. The deformation of the pattern is then recorded and can be retrieved for comparison with subsequent test results, so that visual field defects or changes in deformation can be detected sensitively, even corrected by lenses that distort the image into the same pattern.
The existing Amsler table-based visual field distortion and defect measurement and evaluation software mainly comprises the following types:
the first type is field distortion mapping type measurement software. The software runs on a touch screen device, an original standard Amsler table is used as a background picture, a function of drawing along a hand or a touch pen sliding track through a brush on the background is provided for a patient, the patient draws grid lines seen in eyes of the patient on a screen, the grid lines are finally recorded by the software, and a measurement result of the distortion of the visual field of the patient is obtained through comparison with the standard Amsler table. Firstly, the method is influenced by factors such as drawing power and hand shaking of the patient, and the drawn curve cannot accurately reflect the real visual field condition of the patient. Secondly, only under the condition that the size of the table is in fixed proportion to the distance between the patient and the table and the patient gazes at the central fixation point of the table by a single eye, the visual field of the patient can just reflect the pathological changes of the macular region, and when the patient gazes at the central fixation point by the single eye, the patient is difficult to accurately draw the whole table seen by the patient by only matching the residual light with a finger or a touch pen, so the method obviously cannot ensure the accuracy of the drawing result. Finally, the patients with macular degeneration mainly complain about visual object deformation, visual field defects, blurred vision and other conditions, and the software is not designed with means for measuring the two symptoms of the patients, so that the patient's condition cannot be comprehensively measured.
The second category is visual field defect measurement software. The software imitates an Amsler table to set a table area obtained by multiplying a plurality of rows and columns, fills squares into black by setting an area with the size of a single square grid of the Amsler table as a minimum filling area, and adds, enlarges or reduces the filling area according to the judgment of a patient whether the area filled into black just completely covers the visual field defect part of the patient, thereby simulating the defective dark spot in the visual field of the patient. This type of software focuses on addressing visual field defect measurement functions, but this term alone is far from sufficient for the assessment of the disease condition of patients with macular degeneration.
Although some software is called an electronic Amsler table, the software is limited to using an Asmler table as a background reference object for drawing and moving a drawing board from a paper surface to a screen, a curve still needs to be drawn manually in the whole process, various accumulated errors caused by the problems that the precision of hands is insufficient, the curve drawing shape is too random, the sight line moves during drawing and the like are not fundamentally solved, and the software does not have a large practical application value. In the blind spot measurement software, the used marking pattern is too single (the square with fixed size is used more), the size of the marking pattern cannot be adjusted instantly and quickly, the blind spot needs to be drawn on a graph firstly during marking each time, a patient can judge whether the blind spot is correct in area and size, if not, all drawn patterns are erased by one key, so that the drawn correct patterns are erased together, great inconvenience is caused, and time is wasted. Furthermore, there is no software that integrates the functions of the two types of software, nor is there software that uses the Amsler chart to quantify the measurement and assessment of visual field abnormalities in patients. In order to solve the problems, the invention designs the ophthalmologic visual field abnormity measuring and evaluating software which integrates the dynamic electronic Amsler table measuring function based on the spline curve, visual field blind points with multiple drawing modes, dim and fuzzy area marking functions, and patient visual field abnormity condition tracking, quantifying and evaluating functions.
Disclosure of Invention
In view of the above, the present invention provides a visual field abnormality data evaluation system. Specifically, the invention is realized by the following technical scheme:
a visual field abnormality data evaluation system comprising: the system comprises an information input unit, an information query unit, a visual field distortion measurement unit, a visual field abnormity evaluation unit and a data persistence unit;
an information entry unit: inputting information according to the actual condition of the patient, including the name, sex, birth year and month, diagnosis and treatment card number, the attending doctor, the eye disease, the past medical history, other eye disease examination result images and other disease notes of the patient;
an information inquiry unit: inputting the name, age and diagnosis and treatment card number information of a patient, and carrying out fuzzy query or accurate query;
visual field distortion measuring unit: based on a dragging spline family of QtCharts, each grid line forming the square table independently forms a spline curve, and a user can change the shape of each spline curve by moving the position of a control point on the spline curve through human-computer interaction, so that the whole Amsler square table accurately edits dynamic areas of shapes and colors of all parts; the grid lines include: horizontal grid lines and vertical grid lines; the dynamic area takes the lower left corner as the origin of coordinates, and the right side is the positive direction of the x axis and the upward side is the positive direction of the y axis; setting a plurality of control points on the grid line, wherein the control points are arranged on the grid line at equal intervals, and the positions of the control points are changed by a user in a mode of controlling movement or mouse pressing and dragging by a point-by-point direction key; in the mode of controlling the movement by the direction key point by point: the control points of the grid lines can move in any direction, and the control points move in a single time to fix the step pitch; the mouse is pressed and dragged in the following mode: the control points of the grid lines can move towards any direction;
visual field abnormality evaluation unit:
(1) the measurement result of the vision distortion measurement unit is provided with various evaluation indexes, including: the number of blind spots/dim-down/fuzzy areas of the visual field of a patient; the area of each blind spot/dim-light/fuzzy area of the visual field of the patient accounts for the proportion of the Amsler table area; the maximum/minimum area of the blind spot/dim/fuzzy area of the visual field of the patient; fourthly, scoring the blind spots/dim/fuzzy degree of the visual field of the patient; the distorted field of vision of the patient accounts for the area proportion of the Amsler table; sixthly, the cluster number of the visual field distortion area of the patient is counted; seventhly, grading the distortion degree of each region of the distorted visual field of the patient; eighthly, scoring the total degree of distortion of the visual field of the patient;
the data persistence unit: each measurement is reliably saved for later review or statistical analysis.
Preferably, the visual field abnormality evaluation unit further provides an index for performing automatic comparative analysis and evaluation on the measurement result graphs adjacent to the two time nodes after the same patient has measured a plurality of times and the measurement results of different time nodes are obtained:
diffusion or transfer of trend vectors of each blind point/dim/fuzzy area of a visual field;
② the visual field distorts the respective cluster diffusion or transfer trend vector.
Preferably, the visual field abnormality assessment unit further gives an index of macroscopic data analysis assessment as the number of measured patients and the number of accumulated test cases increase:
the patient's average visual field distortion level, average visual field blind spot/dim-out/blurry level;
measuring a visual field distortion degree change curve, a visual field blind spot/dim-light/fuzzy degree change curve for the same patient for multiple times;
the same type of symptom patient has distorted visual field, blind spot/dim/fuzzy degree distribution map of visual field.
Preferably, the specific scoring method for the blind spot/dim/fuzzy degree score of the visual field of the patient is as follows: the disease area of the patient with the most serious disease is the largest and is used as 0 grade, the undetected disease area is used as 100 grade, and then the position of the newly detected disease area of the patient is graded from 0 grade to 100 grade; dividing the area of the actual measurement blind spot area of the new patient by the area of the disease area of the most serious patient, and expressing the fraction by area ratio percentage;
the most severe definition of the disease is: the area of the total disease area is the largest.
Preferably, the specific calculation method of the cluster number of the distorted visual field areas of the patient is as follows: for a certain measurement result, because the position of a sampling point on a spline curve is moved, the position of the sampling point on the whole curve is possibly changed, so that according to a certain sampling frequency, the displacement of the sampling points can be obtained, a threshold value k is set, if the displacement is smaller than k, the point is regarded as not distorted, a sign that no distortion occurs is made, and if the displacement is larger than k, a sign that distortion occurs is made; traversing the whole table, and communicating continuous acquisition points with the distortion generation marks to form a plurality of areas, wherein the areas are distortion areas, and each single distortion area is called a distortion area cluster; each individual warp field is found by means similar to edge detection, contour detection in image processing.
Preferably, k is one tenth of the width of each cell in the Amsler table.
Preferably, the specific calculation method for the distortion degree score of each region of the distorted visual field of the patient is as follows: performing curve fitting on all grid lines in a twisting area one by using a curve fitting method, dividing a curve obtained by fitting each grid line into a plurality of sections of sub-curves according to different convexities and concavities, wherein the bending degree of each sub-curve is represented by the rotation angle of tangent vectors of the curve sections at two end points relative to the arc length, the bending degree of the grid lines is represented by the average bending degree of all sub-curves forming the line, and the twisting area is represented by the average bending degree of all grid lines in the area; the average curvature of the newly-received patient's distorted visual field was divided by the average curvature of the most-severe patient's distorted visual field, and the fraction was expressed as percent curvature.
Preferably, the specific calculation method for the score of the overall degree of distortion of the visual field of the patient is as follows: the mean of the distortion scores for all patients with distorted visual field.
Preferably, each blind spot/dim/blurred region of the field of view spreads or shifts the trend vector: the blind spot marker region would be saved as: center coordinate, type andsize data structures, where blind spot size is expressed in terms of area occupied; between two adjacent measurement results, the parameters of the blind spot marking region measured last time are consistent with the parameters of the blind spot marking region measured this time, and the condition of the patient is regarded as unchanged; if the blind spot size variation quantity is within the threshold value n, the blind spot size variation quantity is regarded as the occurrence of blind spot area transfer to point to the subsequent blind spot center from the original center; m is 3cm, n is 3cm2。
Preferably, the field of view distorts the respective cluster diffusion or metastasis tendency vector: the warp field would be saved as: a data structure of center coordinates, type and size, wherein the size of the warp field is expressed in terms of occupied area; between two adjacent measurement results, the parameters of the distortion region measured last time are consistent with the parameters of the distortion region measured this time, and the condition of the patient is considered to be unchanged; if the distance between the measured distortion region and the center coordinate of the current distortion region is within a threshold value i, and the size variation of the blind spot is within a threshold value j, if the measured distortion region exists, the measured distortion region is regarded as the distortion region transfer, so that the original center points to the center of the subsequent distortion region; i is 3cm, and j is 3cm2。
Compared with the prior art, the technical scheme provided by the embodiment of the application has the following advantages:
according to the method provided by the embodiment of the application, the Amsler table originally used for simple qualitative analysis is skillfully digitized and accurate, so that quantitative analysis is achieved, and rapid and accurate data acquisition of distorted visual field is realized while the burden of self-drawing of a deformation curve and self-judgment of a user is not increased.
Drawings
FIG. 1 is a functional block diagram of a visual field anomaly data evaluation system according to an embodiment of the present invention;
FIG. 2 is a standard Amsler grid table provided by an embodiment of the present invention;
FIG. 3 is a view center blind spot gaze table showing diagonal assist presence provided by an embodiment of the present invention;
FIG. 4 is a partial view lower curve shape adjustment provided by an embodiment of the present invention;
FIG. 5 is a graph illustrating curve shape adjustment under a global view with diagonal assistance provided in accordance with an embodiment of the present invention;
FIG. 6 is a thermodynamic diagram of a predicted distortion distribution of a patient's visual field provided by an embodiment of the present invention;
fig. 7 is a view distortion cluster diffusion or transition trend vector diagram provided by the embodiment of the invention.
Detailed Description
Reference will now be made in detail to the exemplary embodiments, examples of which are illustrated in the accompanying drawings. When the following description refers to the accompanying drawings, like numbers in different drawings represent the same or similar elements unless otherwise indicated. The embodiments described in the following exemplary embodiments do not represent all embodiments consistent with the present invention. Rather, they are merely examples of apparatus and methods consistent with certain aspects of the invention, as detailed in the appended claims.
Example 1:
as shown in fig. 1, an abnormal visual field data evaluation system provided by the embodiment of the present application includes:
the system comprises an information input unit, an information query unit, a visual field distortion measurement unit and a data persistence unit;
the information entry unit: inputting information according to the actual condition of the patient, including the name, sex, birth year and month, diagnosis and treatment card number, the attending doctor, the eye disease, the past medical history, other eye disease examination result images and other disease notes of the patient;
the information inquiry unit: inputting the name, age and diagnosis and treatment card number information of a patient, and carrying out fuzzy query or accurate query;
the field distortion measurement unit: based on a dragging spline family of QtCharts, each grid line forming the square table independently forms a spline curve, and a user can change the shape of each spline curve by moving the position of a control point on the spline curve through human-computer interaction, so that the whole Amsler square table accurately edits dynamic areas of shapes and colors of all parts; the grid lines include: horizontal grid lines and vertical grid lines; the lower left corner of the dynamic area is used as a coordinate origin, the right side is the positive direction of an x axis, and the upward side is the positive direction of a y axis; setting a plurality of control points on the grid line, wherein the control points are arranged on the grid line at equal intervals, and the positions of the control points are changed by a user in a mode of controlling movement or mouse pressing and dragging by a point-by-point direction key; the specific method for controlling the movement by the point-by-point direction key comprises the following steps:
the control points of the grid lines can move towards any direction, and the control points move for a single time to fix the step pitch;
selecting a currently used control point through up, down, left and right direction keys, confirming the selected control point by using an enter key, and displaying the selected control point in an amplifying and flickering mode in an enhanced mode; if the current control point is located in the user visual field distortion area, the user moves the position of the control point through the up-down left-right direction keys, the step distance moved by the control point is adjusted by pressing the up-down left-right direction keys each time, the control point needing to be moved is traversed, the position of each control point is adjusted by using the up-down direction keys, after the current control point is adjusted, esc is pressed to exit from the state of adjusting the position, and the next control point is selected through the up-down left-right direction keys; the mode of controlling the movement by the point-by-point direction key is completed by the user;
the mouse is dragged in a pressing mode: the control points of the grid lines can move in any direction, the user needs to describe the position where deformation occurs, the assistant can select which curves to adjust the shape by watching the copied second screen, and whether the curve conforms to the actual situation or not is fed back according to the change of the assistant to the curve shape, so that the assistant can make proper adjustment:
the specific method for pressing and dragging the mouse comprises the following steps: after the mouse selects the control point and presses down, the control point can move to any direction;
the grid background, grid lines, control points and fixation points in the Amsler grid table are all provided with a color adjusting function; the size of the Amsler grid table is as follows: 10cm × 10cm, table densities set to 20 × 20, 10 × 10, and 5 × 5; in order to compensate the measurement precision lost due to the reduction of the density of the table, a low-density grid table is used for measuring by using low-density tables in different areas for multiple times in a traversing measurement mode of translating a certain step length along the specified direction, and finally, the measurement results are subjected to complementary integration;
because the visual field blind spot areas and the sizes are different, the fixation point originally positioned in the center of the Amsler grid table is probably just positioned in the visual field blind spot area, and for the problem, the specific solution provided is as follows:
adjusting the size of the fixation point;
as shown in fig. 3, table diagonal hiding and displaying and table diagonal width adjustment: selecting a diagonal line for displaying the whole table, and adjusting the width of the diagonal line of the table according to different discriminative power;
the close observation of the dense table during the measurement process causes visual fatigue, and a specific solution is given to the problem that:
as shown in fig. 4 and 5, the local view is switched with the global view: dragging and deforming the grid lines through a plurality of control points on one grid line each time, namely, the grid line is in an activated state, and other grid lines are in an inactivated state, namely, the grid lines are kept in a static state and have no control points; under the global view, all grid lines are displayed on the picture, and under the local view, other grid lines except the currently activated grid line and the table frame line are in a hidden state;
the method of immersive measurement for presenting an interface for isometric zooming in relative to a user: the side length of the whole Amsler square table displayed on the display screen is kept to be 1: 3, and the center of the Amsler square table is exactly on the same horizontal plane with the sight line of human eyes;
in order to utilize the physiological characteristics of human eyes such as 'super-sharpness', the method is given as follows: hiding and displaying grid lines, adjusting the sizes of control points and flickering the control points, and the specific method comprises the following steps:
dragging a certain control point, and then flashing the control point at an adjustable frequency while following the moving position of the mouse pointer while keeping other control points still;
the control points on the grid line enter a flashing state one by one according to the arrangement sequence, and only one control point enters the flashing state at the same time; when the first control point flickers, the position of the first control point is adjusted by using a direction key, the first control point performs step displacement in the direction every time the direction key is pressed, when the first control point is considered to be located at a proper position, an enter key is pressed to fix the first control point, the next control point is enabled to flicker, and the positions of the control points are adjusted one by one in sequence;
the visual field distortion measuring unit gives a function of marking patterns in the dynamic area aiming at visual field blind spots, dim and fuzzy users, and the specific method comprises the following steps:
after the user selects the pattern used by the mark, the shape of the mouse pointer is automatically switched to the pattern, and the parameters of the pattern comprise: size, shape, color; dragging the mouse, wherein the pattern moves to different areas of the dynamic area along with the mouse and shields grid lines and control points of the area; when a user thinks that the pattern is just moved to the area where the blind spot is located, the size of the pattern can be adjusted through a mouse wheel until the area where the blind spot is located is just shielded, a right mouse button is clicked to 'stamp' the pattern on the area where the blind spot is located, and the visual field distortion measuring unit automatically marks the pattern and places the pattern on the topmost layer of the Amsler square table;
visual field abnormality evaluation unit:
(1) giving various evaluated indicators to the measurement result of the visual field distortion measurement unit, including: the number of blind spots/dim-down/fuzzy areas of the visual field of a patient; the area of each blind spot/dim-light/fuzzy area of the visual field of the patient accounts for the proportion of the Amsler table area; the maximum/minimum area of the blind spot/dim/fuzzy area of the visual field of the patient; fourthly, scoring the blind spots/dim/fuzzy degree of the visual field of the patient; the distorted field of vision of the patient accounts for the area proportion of the Amsler table; sixthly, the cluster number of the visual field distortion area of the patient is counted; seventhly, grading the distortion degree of each region of the distorted visual field of the patient; eighthly, scoring the total degree of distortion of the visual field of the patient;
the specific scoring method for scoring the blind spots/dim-light/fuzzy degree of the visual field comprises the following steps: the disease area of the patient with the most serious disease is the largest and is used as 0 grade, the undetected disease area is used as 100 grade, and then the position of the newly detected disease area of the patient is graded from 0 grade to 100 grade; dividing the actual measurement blind spot area of the new patient by the disease area of the most serious patient, and expressing the score by area ratio percentage;
the most severe definition of the condition is: the total area of the disease condition is the largest;
the specific calculation method of the cluster number of the visual field distortion region of the patient comprises the following steps: for a certain measurement result, because the position of a sampling point on a spline curve is moved, the position of the sampling point on the whole curve is possibly changed, so that according to a certain sampling frequency, the displacement of the sampling points can be obtained, a threshold value k is set, if the displacement is smaller than k, the point is regarded as not distorted, a sign that no distortion occurs is made, and if the displacement is larger than k, a sign that distortion occurs is made; traversing the whole table, and communicating continuous acquisition points with the distortion generation marks to form a plurality of areas, wherein the areas are distortion areas, and each single distortion area is called a distortion area cluster; finding each individual warping area by means of edge detection and contour detection in similar image processing; the threshold k is one tenth of the width of each grid in the Amsler table; in actual use, the most used square grids are 10 multiplied by 10, so that one tenth of small square grid side length in a 10 multiplied by 10 density table is adopted, namely 1 mm; the next cell width at 5 × 5 density is 2 cm;
as shown in fig. 6, the specific calculation method for the distortion degree score of each region of the distorted visual field of the patient includes: performing curve fitting on all grid lines in a twisting area one by using a curve fitting method, dividing a curve obtained by fitting each grid line into a plurality of sections of sub-curves according to different convexities and concavities, wherein the bending degree of each sub-curve is represented by the rotation angle of tangent vectors of the curve sections at two end points relative to the arc length, the bending degree of the grid lines is represented by the average bending degree of all sub-curves forming the line, and the twisting area is represented by the average bending degree of all grid lines in the area; dividing the measured average bending degree of the visual field distortion region of a new patient by the average bending degree of the distortion region of the worst patient, and expressing the fraction by the bending degree ratio percentage;
the specific calculation method of the patient visual field distortion overall degree score comprises the following steps: (ii) the mean of all of said patient field distortion individual zone distortion scores;
(2) after the same patient measures for multiple times and obtains multiple measurement results of different time nodes, automatically comparing, analyzing and evaluating indexes of the two adjacent measurement result graphs of the time nodes:
diffusion or transfer of trend vectors of each blind point/dim/fuzzy area of a visual field;
secondly, the visual field distorts each cluster of diffusion or transfer trend vectors;
each blind spot/dim/blurred region of the field of view spreads or shifts a trend vector: each blind spot/dim/blurred region of the field of view spreads or shifts a trend vector: the blind spot marker region would be saved as: a data structure of center coordinates, type and size, wherein the size of the blind spot is expressed in terms of the occupied area; between two adjacent measurement results, the parameters of the blind spot marking region measured last time are consistent with the parameters of the blind spot marking region measured this time, and the condition of the patient is regarded as unchanged; if the blind spot size variation quantity is within the threshold value n, the blind spot size variation quantity is regarded as the occurrence of blind spot area transfer to point to the subsequent blind spot center from the original center; m is 3cm, n is 3cm2；
As shown in fig. 7, the field of view distorts the respective cluster diffusion or transfer trend vectors: the warp field would be saved as: a data structure of center coordinates, type and size, wherein the size of the warp field is expressed in terms of occupied area; between two adjacent measurement results, the parameters of the distortion region measured last time are consistent with the parameters of the distortion region measured this time, and the condition of the patient is considered to be unchanged; if the distance between the measured distortion region and the center coordinate of the current distortion region is within a threshold value i, and the size variation of the blind spot is within a threshold value j, if the measured distortion region exists, the measured distortion region is regarded as the distortion region transfer, so that the original center points to the center of the subsequent distortion region; i is 3cm, and j is 3cm2；
(3) With the increasing number of patients measured and the number of test cases accumulated, an index for macroscopic data analysis evaluation is also given:
the distortion degree of the average visual field of a patient, the blind spot/dim/fuzzy degree of the average visual field;
measuring a visual field distortion degree change curve and a visual field blind spot/dim-down/fuzzy degree change curve for the same patient for multiple times;
thirdly, distributing the visual field distortion degree, visual field blind spot/dim/fuzzy degree of the patients with the same type of symptoms;
the data persistence unit: each measurement is reliably saved for later review or statistical analysis.
Example 2:
the system for evaluating abnormal visual field data as shown in fig. 1 comprises:
the system comprises an information input unit, an information query unit, a visual field distortion measurement unit and a data persistence unit;
an information entry unit: before use, the information is input according to the actual condition of the patient, including the name, sex, birth year and month, diagnosis and treatment card number, the treating doctor, the patient's eye, the past medical history, other eye examination result graphs (including but not limited to OCT scan, routine examination result graph and the like) and other disease notes (such as vision condition, whether cataract is suffered, whether surgical history exists and the like). The system can record each item of information of each patient, when the same patient uses the software for testing for many times, only the name or the diagnosis and treatment card number and the like are input from the second time, the system automatically searches in the database according to the name or the diagnosis and treatment card number, and pushes the similar existing user information to the foreground for the user to directly select, thereby avoiding the trouble of repeatedly inputting all the information of the patient. The system database automatically integrates and saves the results of multiple measurements of the patient.
An information inquiry unit: the information of the name, the age, the diagnosis and treatment card number and the like of the patient can be input for fuzzy query or accurate query. The query result is displayed on the user interface in a paging list form; the inquired fields comprise basic information input by the patient, a previous measurement result graph of the patient, evaluation parameter indexes of the previous measurement result of the patient, a thermal simulation graph of abnormal visual field conditions of the patient, a distorted visual field transition trend graph, a blind visual field transition trend graph, a comprehensive disease development trend graph and the like of the patient generated according to previous measurement results.
Visual field distortion measuring unit:
(1) the Amsler square table innovatively uses a dragging style strip curve family based on QtCharts on the formation of the square table, each grid line forming the square table independently forms a spline curve, a user can change the shape of each strip curve by moving the position of a control point on the spline curve through man-machine interaction, and the change range of the position of the control point can be accurate to a pixel level, so that the whole Amsler square table is changed into a dynamic area with the pixel level and the accurate editing of the shape, the color and the like of each part from a previous static background picture serving as a reference object, and the simulation of the visual field distortion condition far exceeding the hand drawing precision is realized. Secondly, because the shape of the spline curve is always a smooth curve, and is not an irregular figure possibly comprising a plurality of sections of different broken lines when the spline curve is drawn by hands, and the abnormal vision caused by the pathological changes (including macular edema, macular hole and the like) generated by the macular region is reflected on the Amsler table as a region with smoothly changing shape (such as pincushion distortion, barrel distortion and the like), the measurement mode is more in line with the physiological structure characteristics of human eyes. The lower left corner of the dynamic area is used as the origin of coordinates, the right side is the positive direction of an x axis, the upward side is the positive direction of a y axis, elements such as points, lines, blocks and the like in the dynamic area correspond to parameters such as respective coordinates, lengths, widths, areas and the like in software, and the accurate quantifiable characteristic of the software is fully embodied. For each horizontal grid line, a plurality of control points are arranged on the grid line, the control points are transversely arranged on the grid line at equal intervals, and a user can change the positions of the control points in a mode of controlling movement or mouse pressing and dragging through a point-by-point direction key; the specific method for controlling the movement by the point-by-point direction key comprises the following steps: the control points of the grid lines can move towards any direction, and the control points move for a single time to fix the step pitch; the control point is displaced in a certain range (the coordinate is changed), and the mode of controlling the movement by the direction key point by point can be automatically completed by the patient; under the mode that the mouse is pressed and dragged, a patient needs to pay attention to the position of a mouse pointer dispersedly, because the control point can be selected only when the mouse pointer moves to the position near a certain control point and presses a left button of the mouse, and the control point can move along with the position of the mouse under the condition that the left button is kept pressed, the patient can move along with the position of the mouse if the patient operates by himself in the process, therefore, the operation is finished by an assistant when watching a copied second screen, at the moment, the patient only needs to describe the position where deformation occurs to enable the assistant to select which curves to carry out shape adjustment, and whether the curves meet the actual conditions or not is fed back according to the change of the curve shapes by the assistant, and therefore the assistant can make proper adjustment. Due to the characteristics of the spline curve, the change of the coordinate position of a certain point on the curve affects the shape of the whole curve, and particularly, the curve segment near the point has larger deformation compared with other areas, and the deformation is gentle. The vertical grid lines are also true. By means of the mode that the control points are dragged to scan the whole grid table point by point, line and area array, a user can realize accurate control over each curve shape, and therefore the combination simulates the situation of a very rich deformed back view.
(2) In the aspect of changing the position of the control point, in view of the fact that the sight line of the patient is shielded in the operation process by using a touch pen or finger touch, the curve shape is not judged by the patient easily, and the measurement result is greatly interfered, so that the following two control modes are designed by the software: the moving mode is controlled by a point-by-point direction key: selecting a currently used control point through up, down, left and right direction keys, confirming the selected control point by using an enter key, and displaying the selected control point in an amplifying and flickering mode in an enhanced mode; if the current control point is located in the user visual field distortion area, the user moves the position of the control point through the up-down left-right direction keys, the up-down left-right direction keys are pressed each time, the moving step distance of the control point is adjusted, the control point needing to be moved is traversed, the up-down direction key is used for adjusting the position of each control point, after the current control point is adjusted, esc is pressed to quit the state of adjusting the position, and the next control point is selected through the up-down left-right direction keys.
Secondly, the mouse is dragged in a mode of: the position of the control point is changed by moving the mouse pointer to a certain control point position, pressing down and dragging the mouse. After the mouse selects the control point and presses down, the control point can move to any direction; the positions of all control points are adjusted through the method, so that the shape of the whole Amsler table grid line is adjusted.
(3) In the aspect of controlling the density of the Amsler grid table, the Amsler grid table originally having the density of 20 multiplied by 20 grids but only having the size of 10cm multiplied by 10cm is denser to the actual sense organ of people, and ordinary people with normal vision and no eye disease are still difficult to clearly distinguish the change of the grid line shape by only using the residual light under the condition of watching the central fixation point of the table at a single sight, and are not to mention that the middle-aged and elderly people suffering from the diseases have reduced attention focusing ability and relatively reduced visual ability. To address this issue, the software has devised a number of table density options, including but not limited to using grid tables of 20 × 20, 10 × 10, 5 × 5, etc. density, and tables with smaller grid densities can be viewed as tables with larger grid densities with the remainder of the other grid lines hidden. In actual use, the patient can select a grid table which can easily distinguish the change of the grid line shape for testing. Meanwhile, in order to compensate the measurement precision lost due to density reduction, a traversal measurement mode that the low-density grid table translates a certain step length along the designated direction is designed, so that the actual traversal density of the grid area can reach or even exceed the original 20 x 20 grid density by using the low-density grid tables in different areas for testing for many times without increasing the load of judging curve deformation of a patient every time, and finally, the measurement results are subjected to complementary integration, so that the purpose of accurate measurement and evaluation is better achieved.
(4) Because the blind spot areas of the visual fields of different patients are different in size, the fixation point originally positioned in the center of the Amsler grid table may be just positioned in the blind spot areas of the visual fields of some patients, so that the patients cannot accurately observe the fixation point, and the visual line of the patients is kept challenging during measurement. Therefore, the size of the fixation point can be adjusted according to different human eye sensitivity degrees, the diagonal line of the whole table can be selected and displayed for a patient with a visual field blind point just at the fixation point, the diagonal line width of the table can be adjusted according to different discrimination of the patient, although the patient cannot see the fixation point in the center of the table, the human brain can simulate an intersection point of the two diagonal lines for the patient in vision through the two visible diagonal lines which are mostly not shielded by the blind point, and the patient can achieve the same effect as long as the patient 'watches' the point.
(5) Complex visual information brought by close-distance observation of a dense form is a burden which is difficult for an ophthalmologic patient to effectively process, and further, the patient is required to intensively observe the shape change of one grid line in the complex form, which is difficult, so that the patient is easy to generate visual fatigue quickly in the test process, and the test cannot be effectively finished. Aiming at the problem, a local view and global view switching function is designed. In the process of measuring the visual field distortion, a user can drag and deform the grid line through a plurality of control points on one grid line each time, the grid line is called to be in an activated state at the moment, other grid lines are kept static at the moment, and the grid line is called to be in an inactivated state without control points on the curve. After the shape of the grid line is adjusted, the user can switch the adjacent grid lines in sequence or switch other grid lines with shapes to be adjusted at random, at this time, the corresponding grid line is activated, and other grid lines are in an inactivated state. In the global view, all grid lines are displayed on the screen, and in the local view, other grid lines except the currently activated grid line and the table border line are hidden. Under the local view, only one grid line is displayed in the table, and other areas are blank, so that high contrast is formed, the processing load of the brain of a patient on complex visual information formed by distinguishing the shape change of a single grid line in a dense table is effectively reduced, and the accurate judgment of a tester on the curve shape is facilitated. The measurement method of observing only one grid line at a time, scanning in sequence and combining for multiple times is provided innovatively, so that the shape of each grid line is adjusted more accurately, the effect of sand gathering and tower formation is realized, and the optimization of the global measurement result is promoted by the accumulation of the optimization of local measurement results.
(6) Because the traditional Amsler grid table requires the table size to be 10cm multiplied by 10cm, and the table is placed on the sight line of a patient at a position which is about 30cm away from the eyes, the method can ensure that the table area is exactly positioned in the central area of the macular vision of the patient, and the observation angle of the patient is 20 degrees, namely the upper and lower viewing angles and the left and right viewing angles. However, the traditional Amsler meter is mostly used for qualitative judgment in practice, and when the Amsler meter is used for quantitative measurement, under the measurement environment, the Amsler meter is interfered by other objects around the meter and is easily affected by fatigue caused by long-time close observation of the electronic equipment screen by human eyes, and an immersion type measurement scheme for enlarging a software presentation interface at an equal ratio relative to a patient is provided. When the scheme is used for measurement, a display screen with enough large size or a combination of a projector and a curtain is firstly arranged, the scene color behind the display screen is ensured to be single, no redundant interference exists, then a patient sits on the adjustable lifting chair with the backrest and can be adjusted to a comfortable posture that the front can be kept by eyes, and a neck support can be arranged to help the patient keep the head posture if necessary. In order to ensure that the table area is located exactly in the center of the patient's visual field, the side length of the entire table displayed on the display screen should be kept at a distance of 1: 3, the center of the table is just on the same horizontal plane with the sight of human eyes, and after the position of the screen, the size of the table and the distance between the seat and the screen are fixed, the sight of patients with different heights can be adjusted by adjusting the lifting of the seat. Through the operation, the patient can be in an immersive measuring environment, the pressure for distinguishing the small-range curve deformation of the patient is reduced, and the measuring error caused by the fact that the original grid lines are not in the accurate positions and are misjudged to be in the accurate positions due to insufficient resolution of the patient's eyes during small-scale observation is reduced through geometric amplification.
(7) Due to the physiological characteristics of human eyes, the "super-sharpness" of human eyes is ten times sharper than that of human eyes, i.e. the human eyes are extremely sensitive to the phenomenon of misalignment of visual objects, for example, the points arranged on a straight line are slightly shifted. Foreign countries have special measurement software developed for the human eye feature, Reichert foreee PHP, and the software is already put into commercial use at present. Several functional modes are designed, and a series of extended functions including the software functions can be realized, which are respectively as follows: hiding and displaying grid lines, adjusting the size of control points, flashing the control points and the like. By hiding the original grid lines and frames, leaving control points and fixation points, and setting a local display view, only the control point corresponding to a certain activated grid line will be displayed on the screen. For this view, two measurement modes are designed: firstly, a user uses a mouse to press and drag a certain control point according to the method described in the foregoing, then the point flickers at an adjustable frequency while following the moving position of a mouse pointer, and other control points are kept still, because the flicking point is obvious relative to the static point, the position comparison between the current control point and other control points of the grid line where the current control point is located is formed, based on the principle of human eyes 'super-sharpness', a patient can more easily distinguish whether the control points are regularly arranged on a straight line in the mode, and finally the control points are located on the same straight line in the eyes of the patient through point-by-point position adjustment;
for each grid line in the grid, the control point on the grid line does not need to be pressed and dragged by a mouse, but enters a flashing state one by one according to the arrangement sequence, only one point enters the flashing state at the same time, when the first control point flashes, the patient can simply use a direction key to realize the position adjustment of the control point, when the direction key is pressed once, the control point performs displacement with small step distance in the direction, when the patient thinks that the control point is positioned at the proper position, the patient presses a carriage return key to fix the control point, and the next control point starts flashing to sequentially adjust the position of the control point one by one. No matter which measurement mode is used, the accurate coordinate of each control point can be finally obtained by measuring the complete grid table in a point-by-point, line-by-line and area array scanning mode, the Amsler table shape seen in the eyes of a patient can be restored by displaying the originally hidden grid line or directly carrying out curve fitting on a series of control point coordinates at the moment, and the position coordinate array of the control point can also be used as an independent test index for analysis. In addition, in order to adapt to the sensitivity of different human eyes to the flicker of the control points, the software is provided with a function of adjusting the size of the control points, and can be used for patients with poor resolution to use larger control points.
(8) The original Amsler checkerboard is designed as a black line with white background or a white line with black background, and the color matching is mainly because the Amsler checkerboard at that time is only used for qualitative research, has almost no requirement on measurement accuracy, and lacks of various popular electronic devices which can display rich color matching nowadays. According to related researches, the sensitivity of different human eyes to the same color is different, so that the color matching cannot guarantee that all testers can feel obvious contrast. Aiming at the problem, the color adjusting function is set for each component element in the dynamic area of the Amsler grid table, including a grid background, grid lines, control points, a fixation point and the like, and a combination with bright color contrast including red, black, yellow, green and the like is set for selection, so that a patient can select a color combination which is most easy to judge curve shape change or control point arrangement neatness degree in the actual measuring process, and therefore personalized and refined measuring effects are achieved.
(9) When a correct testing position relation is formed between a patient and a display screen, a part of an Amsler square table area may be an area which cannot be seen or is dull or blurred in color and luster in the eyes of the patient, which is specifically shown in the way that some areas in an Amsler square table dynamic area seen in the eyes of the patient are originally white bottom black lines, but the eyes of the patient are completely black or are very dull or blurred in lines, the existence of the abnormal visual areas brings great inconvenience to the life of the patient, and the existence of different symptoms is likely to correspond to lesions of different positions and different degrees of the eyeground. In addition, because these symptoms often coexist with the visual field distortion, when the visual field distortion is measured, these areas are likely to block part of control points and grid lines in the eyes of the patient, and hinder the measurement mode of point-by-point, line-by-line and area array scanning. To address this problem, a function was devised that can mark patterns in the dynamic area of the Amsler grid. When the mouse is used, after a patient selects a pattern (including the size, the shape, the color and the like) used by the mark, the shape of the mouse pointer is automatically switched to the pattern, and the shape, the color, the size and the like of the mouse pointer are consistent. The patient (assistant) can drag the mouse to enable the mouse pointer to float above the table area in a pattern mode to be marked, at the moment, the pattern moves to different areas on the table along with the movement of the position of the mouse pointer and shields grid lines and control points of the area, and when the patient thinks that the pattern just moves to the area where the blind spot of the patient is located, the size of the pattern can be adjusted through the mouse wheel until the abnormal visual field area is just shielded (the small pattern can be used for carrying out irregular expansion on the area later). Then clicking the right button on the Amsler form area "stamps" the pattern on the form area (similar to the stamping operation in daily life), the system automatically places the marker pattern on the topmost layer of the form view, with the control points and grid lines within this area naturally occluded, simulating the actual vision in the patient's eye. This effectively remedies the repeated mark-first-erase defects in other software. In order to make the measurement process simpler, the functions of withdrawing and canceling the marked patterns individually (similar to the retracting and advancing in the word) and clearing the marked patterns are also designed, so that the defect that all the marked patterns can be erased only by one key is overcome, and the patient can be helped to trace the abnormal area of the visual field more quickly and accurately.
Visual field abnormality evaluation unit:
(1) giving various evaluated indicators to the measurement result of the visual field distortion measurement unit, including: the number of blind spots/dim-down/fuzzy areas of the visual field of a patient; the area of each blind spot/dim-light/fuzzy area of the visual field of the patient accounts for the proportion of the Amsler table area; the maximum/minimum area of the blind spot/dim/fuzzy area of the visual field of the patient; fourthly, scoring the blind spots/dim/fuzzy degree of the visual field of the patient; the distorted field of vision of the patient accounts for the area proportion of the Amsler table; sixthly, the cluster number of the visual field distortion area of the patient is counted; seventhly, grading the distortion degree of each region of the distorted visual field of the patient; eighthly, scoring the total degree of distortion of the visual field of the patient;
the specific scoring method for scoring the blind spots/dim-light/fuzzy degree of the visual field comprises the following steps: the disease area of the patient with the most serious disease is the largest and is used as 0 grade, the undetected disease area is used as 100 grade, and then the position of the newly detected disease area of the patient is graded from 0 grade to 100 grade; dividing the actual measurement blind spot area of the new patient by the disease area of the most serious patient, and expressing the score by area ratio percentage;
the most severe definition of the condition is: the total area of the disease condition is the largest;
the specific calculation method of the cluster number of the visual field distortion region of the patient comprises the following steps: for a certain measurement result, because the position of a sampling point on a spline curve is moved, the position of the sampling point on the whole curve is possibly changed, so that according to a certain sampling frequency, the displacement of the sampling points can be obtained, a threshold value k is set, if the displacement is smaller than k, the point is regarded as not distorted, a sign that no distortion occurs is made, and if the displacement is larger than k, a sign that distortion occurs is made; traversing the whole table, and communicating continuous acquisition points with the distortion generation marks to form a plurality of areas, wherein the areas are distortion areas, and each single distortion area is called a distortion area cluster; finding each individual warping area by means of edge detection and contour detection in similar image processing; the threshold k is one tenth of the width of each grid in the Amsler table; in actual use, the most used square grids are 10 multiplied by 10, so that one tenth of small square grid side length in a 10 multiplied by 10 density table is adopted, namely 1 mm;
the specific calculation method for the distortion degree scores of the visual field distortion regions of the patient comprises the following steps: performing curve fitting on all grid lines in a twisting area one by using a curve fitting method, dividing a curve obtained by fitting each grid line into a plurality of sections of sub-curves according to different convexities and concavities, wherein the bending degree of each sub-curve is represented by the rotation angle of tangent vectors of the curve sections at two end points relative to the arc length, the bending degree of the grid lines is represented by the average bending degree of all sub-curves forming the line, and the twisting area is represented by the average bending degree of all grid lines in the area; dividing the measured average bending degree of the visual field distortion region of a new patient by the average bending degree of the distortion region of the worst patient, and expressing the fraction by the bending degree ratio percentage;
the specific calculation method of the patient visual field distortion overall degree score comprises the following steps: (ii) the mean of all of said patient field distortion individual zone distortion scores;
(2) after the same patient measures for multiple times and obtains multiple measurement results of different time nodes, automatically comparing, analyzing and evaluating indexes of the two adjacent measurement result graphs of the time nodes:
diffusion or transfer of trend vectors of each blind point/dim/fuzzy area of a visual field;
secondly, the visual field distorts each cluster of diffusion or transfer trend vectors;
each blind spot/dim/blurred region of the field of view spreads or shifts a trend vector: each blind spot/dim/blurred region of the field of view spreads or shifts a trend vector: the blind spot marker region would be saved as: a data structure of center coordinates, type and size, wherein the size of the blind spot is expressed in terms of the occupied area; between two adjacent measurement results, the parameters of the blind spot marking region measured last time are consistent with the parameters of the blind spot marking region measured this time, and the condition of the patient is regarded as unchanged; if the blind spot size variation quantity is within the threshold value n, the blind spot size variation quantity is regarded as the occurrence of blind spot area transfer to point to the subsequent blind spot center from the original center; m is 3cm, n is 3cm2；
The field of view distorts the respective cluster diffusion or transfer trend vectors: the warp field would be saved as: a data structure of center coordinates, type and size, wherein the size of the warp field is expressed in terms of occupied area; between two adjacent measurement results, the parameters of the distortion region measured last time are consistent with the parameters of the distortion region measured this time, and the condition of the patient is considered to be unchanged; if the distance between the measured distortion region and the center coordinate of the current distortion region is within a threshold value i, and the size variation of the blind spot is within a threshold value j, if the measured distortion region exists, the measured distortion region is regarded as the distortion region transfer, so that the original center points to the center of the subsequent distortion region; i is 3cm, and j is 3cm2；
(3) With the increasing number of patients measured and the number of test cases accumulated, an index for macroscopic data analysis evaluation is also given:
the distortion degree of the average visual field of a patient, the blind spot/dim/fuzzy degree of the average visual field;
measuring a visual field distortion degree change curve and a visual field blind spot/dim-down/fuzzy degree change curve for the same patient for multiple times;
thirdly, distributing the visual field distortion degree, visual field blind spot/dim/fuzzy degree of the patients with the same type of symptoms;
a data persistence unit: since the condition of a patient may change over time, it is important to reliably store each measurement in time for later review or statistical analysis.
(1) A 'center-periphery type' data persistence mode is designed. The center uses a high-performance central database server, and the periphery is provided with a plurality of measuring software terminals. After each measurement on each terminal, the system can generate two identical test results, one of which is visually stored in a folder visible to the user, the other of which is stored in a local database in a hidden data manner, and access control is set to prevent the user from deleting the test results by mistake. After the equipment is connected to the network, the system automatically uploads the data which is not synchronized to the remote data server in the database, so that multiple redundant data storage is formed, and the reliable persistence of the data is ensured.
(2) Except generating a diagram and measuring and evaluating indexes, the system automatically stores the positions of all control points under a certain measuring state, the sizes, the shapes and the positions of all blind points/dim/fuzzy areas in a binary data mode, and can automatically read the last measured last state for field recovery when software is returned next time after unexpected exit in the middle of the test, thereby saving the trouble of repeated tests.
It is to be understood that although the terms first, second, third, etc. may be used herein to describe various information, these information should not be limited to these terms. These terms are only used to distinguish one type of information from another. For example, first information may also be referred to as second information, and similarly, second information may also be referred to as first information, without departing from the scope of the present invention. The word "if" as used herein may be interpreted as "at … …" or "when … …" or "in response to a determination", depending on the context.
While this specification contains many specific implementation details, these should not be construed as limitations on the scope of any invention or of what may be claimed, but rather as descriptions of features specific to particular embodiments of particular inventions. Certain features that are described in this specification in the context of separate embodiments can also be implemented in combination in a single embodiment. In other instances, features described in connection with one embodiment may be implemented as discrete components or in any suitable subcombination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a subcombination or variation of a subcombination.
Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. In some cases, multitasking and parallel processing may be advantageous. Moreover, the separation of various system modules and components in the embodiments described above should not be understood as requiring such separation in all embodiments, and it should be understood that the described program components and systems can generally be integrated together in a single software product or packaged into multiple software products.
Thus, particular embodiments of the subject matter have been described. Other embodiments are within the scope of the following claims. In some cases, the actions recited in the claims can be performed in a different order and still achieve desirable results. Further, the processes depicted in the accompanying figures do not necessarily require the particular order shown, or sequential order, to achieve desirable results. In some implementations, multitasking and parallel processing may be advantageous.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present invention should be included in the scope of the present invention.

Claims (10)

1. A visual field abnormality data evaluation system, comprising: the system comprises an information input unit, an information query unit, a visual field distortion measurement unit, a visual field abnormity evaluation unit and a data persistence unit;
the information entry unit: inputting information according to the actual condition of the patient, including the name, sex, birth year and month, diagnosis and treatment card number, the attending doctor, the eye disease, the past medical history, other eye disease examination result images and other disease notes of the patient;
the information inquiry unit: inputting the name, age and diagnosis and treatment card number information of a patient, and carrying out fuzzy query or accurate query;
the field distortion measurement unit: based on a dragging spline family of QtCharts, each grid line forming the square table independently forms a spline curve, and a user can change the shape of each spline curve by moving the position of a control point on the spline curve through human-computer interaction, so that the whole Amsler square table accurately edits dynamic areas of shapes and colors of all parts; the grid lines include: horizontal grid lines and vertical grid lines; the lower left corner of the dynamic area is used as a coordinate origin, the right side is the positive direction of an x axis, and the upward side is the positive direction of a y axis; setting a plurality of control points on the grid line, wherein the control points are arranged on the grid line at equal intervals, and the positions of the control points are changed by a user in a mode of controlling movement or mouse pressing and dragging by a point-by-point direction key; in the mode of controlling the movement by the direction key point by point: the control points of the grid lines can move towards any direction, and the control points move for a single time to fix the step pitch; the mouse is dragged in a pressing mode: the control points of the grid lines can move towards any direction;
visual field abnormality evaluation unit: giving various evaluated indicators to the measurement result of the visual field distortion measurement unit, including: number of blind/dim/fuzzy areas of the patient's visual field; the area of each patient visual field blind spot/dim/fuzzy area accounts for the ratio of Amsler table area; patient visual field blind spot/dim/fuzzy area maximum/minimum area; fourthly, scoring the blind spots/dim/fuzzy degree of the visual field of the patient; the proportion of the distorted visual field of the patient in the Amsler table area; patient field of view distortion zone cluster number; the distortion degree of each region of the visual field of the patient is scored; patient visual field distortion overall degree score;
the data persistence unit: each measurement is reliably saved for later review or statistical analysis.
2. The system for evaluating the abnormal visual field data according to claim 1, wherein the abnormal visual field data evaluating unit further gives an index for performing automatic comparative analysis evaluation on the measurement result graphs adjacent to the two time nodes after the same patient has measured a plurality of times and obtained a plurality of measurement results of different time nodes:
each blind spot/dim/fuzzy area of the field of view diffuses or transfers a trend vector;
the field of view distorts the respective cluster spread or shift trend vector.
3. The system for visual field abnormality data evaluation according to claim 1, wherein said visual field abnormality evaluation unit further gives an index of macroscopic data analysis evaluation as the number of measured patients and the number of accumulated test cases increase:
the patient's average visual field distortion level, average visual field blind spot/dim-out/blurry level;
measuring a visual field distortion degree change curve, a visual field blind spot/dim-light/fuzzy degree change curve for the same patient for multiple times;
the same type of symptom patient has distorted visual field, blind spot/dim/fuzzy degree distribution map of visual field.
4. The visual field abnormality data evaluation system according to claim 1, wherein the patient visual field blind spot/dim-out/blur degree score is scored by: the disease area of the patient with the most serious disease is the largest and is used as 0 grade, the undetected disease area is used as 100 grade, and then the position of the newly detected disease area of the patient is graded from 0 grade to 100 grade; dividing the actual measurement blind spot area of the new patient by the disease area of the most serious patient, and expressing the score by area ratio percentage;
the most severe definition of the condition is: the area of the total disease area is the largest.
5. The system for evaluating abnormal visual field data according to claim 1, wherein the specific calculation method of the cluster number of the distorted visual field areas of the patient is as follows: for a certain measurement result, because the position of a sampling point on a spline curve is moved, the position of the sampling point on the whole curve is possibly changed, so that according to a certain sampling frequency, the displacement of the sampling points can be obtained, a threshold value k is set, if the displacement is smaller than k, the point is regarded as not distorted, a sign that no distortion occurs is made, and if the displacement is larger than k, a sign that distortion occurs is made; traversing the whole table, and communicating continuous acquisition points with the distortion generation marks to form a plurality of areas, wherein the areas are distortion areas, and each single distortion area is called a distortion area cluster; each individual warp field is found by means similar to edge detection, contour detection in image processing.
6. The system for visual field abnormality data evaluation according to claim 5, wherein k is one tenth of the width of each cell in the Amsler table.
7. The system for assessing abnormal visual field data of claim 5, wherein the score for the distortion degree of each region of the patient's visual field distortion is calculated by: performing curve fitting on all grid lines in a twisting area one by using a curve fitting method, dividing a curve obtained by fitting each grid line into a plurality of sections of sub-curves according to different convexities and concavities, wherein the bending degree of each sub-curve is represented by the rotation angle of tangent vectors of the curve sections at two end points relative to the arc length, the bending degree of the grid lines is represented by the average bending degree of all sub-curves forming the line, and the twisting area is represented by the average bending degree of all grid lines in the area; the average curvature of the newly-received patient's distorted visual field was divided by the average curvature of the most-severe patient's distorted visual field, and the fraction was expressed as percent curvature.
8. The system for assessing abnormal visual field data of claim 7, wherein the patient's overall visual field distortion score is calculated by: the mean of the distortion scores for all the patient fields of view distortion for each region.
9. The system for visual field abnormality data evaluation according to claim 1, wherein each blind spot/dim-out/blurred region of said visual field is diffused or shifted by a trend vector: the blind spot marking area is stored as a data structure with the center coordinate, the type and the size, wherein the size of the blind spot is represented by the occupied area; between two adjacent measurement results, the parameters of the blind spot marking region measured last time are consistent with the parameters of the blind spot marking region measured this time, and the condition of the patient is regarded as unchanged; if the blind spot size variation quantity is within the threshold value n, the blind spot size variation quantity is regarded as the occurrence of blind spot area transfer to point to the subsequent blind spot center from the original center; m is 3cm, n is 3cm2。
10. The system for visual field abnormality data evaluation according to claim 1, wherein said visual field distortion clusters spread or shift trend vectors: the distortion area is stored as a data structure with the center coordinate, the type and the size, wherein the size of the distortion area is expressed by the occupied area; between two adjacent measurement results, the parameters of the distortion region measured last time are consistent with the parameters of the distortion region measured this time, and the condition of the patient is considered to be unchanged; if the distance between the data structure and the center coordinate of the current distortion region is not consistent with the threshold value i, the same type data structure with the blind spot size variation within the threshold value j is searched in the previous distortion region measurement, and if the data structure existsThen it is considered that the warp field shift has occurred to point from the original center to the center of the subsequent warp field; i is 3cm, and j is 3cm2。
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