CN1395902A - 光学相干层析x射线摄影法角膜测绘设备 - Google Patents

光学相干层析x射线摄影法角膜测绘设备 Download PDF

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CN1395902A
CN1395902A CN02102862A CN02102862A CN1395902A CN 1395902 A CN1395902 A CN 1395902A CN 02102862 A CN02102862 A CN 02102862A CN 02102862 A CN02102862 A CN 02102862A CN 1395902 A CN1395902 A CN 1395902A
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T·赫尔穆思
J·魏
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Carl Zeiss AG
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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Abstract

光学相干层析X射线摄影法(″OCT″)角膜测绘仪包含：(a)由改变参考光路装置构成的OCT装置；(b)对0CT装置的取样光进行光栅扫描的光栅扫描器；(c)用于将该扫描器的取样光传输到眼睛和将从眼底反射的取样光通过扫描器传输到OCT装置的曲面镜；以及(d)耦合到扫描器、改变装置、以及OCT装置的参考和取样干涉输出的分析器，用于从光栅点处的参考和取样干涉输出确定角膜图样。

Description

光学相干层析X射线摄影法角膜测绘设备
本发明涉及一种角膜测绘装置，更具体地说，涉及一种光学相干层析X射线摄影法角膜测绘装置。
众所周知，屈光术按其主要目的就是一种通过切割角膜来校正眼屈光不正以改变角膜屈光度的手术过程。手术中控制角膜形状需要一种精确的方法来测量从顶点到边缘(limbus)的前部角膜曲率。目前，测量角膜中心曲率通常使用角膜曲率计，为了更精确地测量角膜外形，通常使用光角膜镜或视频角膜镜。
通用的角膜外形测量装置大多是以浦拉西多盘为基础的视频角膜镜。在此种装置中，使一系列同心环成形在锥形壳上致使从角膜反射的图象在空间实际平坦。然后，分析这些环的形状以确定角膜外形。这种先有技术装置在M.G.Townsley的题为″确定入眼角膜外形的新设备和方法″(Contacto，11(4)，1967，pp，72-81)一文已有描述。这种视频角膜镜有下列缺点：(a)由角膜半径小(～8mm)，在角膜上能分辨的环的数目有限(一般，能被测量的外形限制在角膜上直径范围从0.8到11mm的区域)；(b)在环与环之间不能获得信息，以及(c)由于使用了环，在与眼外科显微镜一起使用时，协调测量(in-linemeasurement)非常困难。S.B.Hannush，S.L.Crawford，G.O.Waring III，M.C.Gemmill，M，J，Lynn和A.Nizam在Arch Ophthalmol(v01107，Aug，1989，pp1235-1239)上发表的题为″角膜曲率计，光角膜镜以及分度钢，球上的角膜模型的精确度″的文中给出了这些先有技术方法和装置的比较。
最近PAR微型系统公司研制出另一种角膜外形测量装置。该装置应用网格摄影测量学来测量角膜外形。在该装置中，将栅图(gridpattern)投影到角膜上。然后从斜角观察该栅图并使其成象。最后，利用被投影的栅图图象和与其几何形状有关的信息计算出栅图中每一个离散点的角膜高度。M，W.Bertlin在J.Cataract Refract Surg(Vol19，SuppLement，1993，PP 188-192)上发表的题为″手术内光栅摄影测量学(Intrao Perative raster photogrammetry)PAR角膜外形系统″一文中描述了该装置。因为通过成象光学只能分辨被投影的栅图图象中有限个点，故在这种装置中角膜外形测量受损害。
按进一步所了解的，由于后面角膜表面贡献约占整个角膜屈光度的-14％，故在某些情况下，单单前面角膜外形不能提供用在屈光手术过程中的足够信息。为此，获得具有现行的角膜外形测量装置所不能提供的精度的角膜外形测量变得更加重要。
最近，已公开了一种新的眼科测量装置-光学相干层析X射线摄影法(″OCT″)装置，它优于上述的先有技术眼科测量装置。OCT装置基于白光干涉量度学原理使用短的相干光源用于区域测量。近来已有人提出在几种眼科应用中使用OCT。例如，J.A.Izatt，M.R.Hee，E.A.Swanson，C，P，Lin，D.Huang，J.S.Schuman，C.A.Puliafito和J.G.Fujimoto在已提交出版的题为″用OCT在(Vivo)中的前眼微米级分辨成象″一文预印本[1994，PP 1-24(″Izatt等引证)]中已作出这样的提议。该预印本公开了一种使用光纤技术和超发光激光二极管光源的OCT装置，将该OCT装置与裂隙灯生物显微镜面接，用于以10～20μm的空间分辨率对眼内结构成象。该预印本公开了使用OCT装置以提供对下列部分直接微米级分辨率测量：(a)眼轮廓尺寸、光学散射、角膜内结构；(b)前角范围；(c)虹膜；(d)眼珠水晶体。该预印本进一步公开了使用OCT装置测量(a)前房深度，定义为沿视轴从后角膜表面到水晶体前膜片的距离；(b)角膜前后表面的曲率半径；(c)角膜折射率；以及(d)诸如厚度之类的角膜尺寸。该预印本还进一步公开了使用价廉的二极管激光源和纤维光学仪器的OCT装置是可与现有的眼科仪器兼容的。最后，该预印本对OCT潜在的临床应用作了下述建议：(a)提供整个前房截面图用以说明角膜、前角区域和虹膜的病症，以及用以发现和监视眼内物质或肿瘤；(b)测量前房深度、角膜曲率和角膜折射率；以及(c)提供示出角膜厚度变化和角膜基质内散射分布的高分辨率图象用以对角膜病症作定量分析。
上述OCT装置有两个主要缺点。上述仪器第一个主要缺点是获得上述数据的几秒时间对于角膜体内测量来说太长了，因为眼睛迅速扫视运动将干扰体内测量。事实上，实际为了防止扫视运动的干扰，获取数据时间需要小于0.1秒。
上述仪器的第二个主要缺点是OCT信号的信噪比由反向散射光的散粒噪声确定，该散粒噪声取决于被检测光子的平均数。该被检测光子数可通过使用较亮的OCT光束或通过对每个取样点使用较长的积分时间来增加，这些方法都有问题。例如，在人眼角膜处OCT光束的最大允许功率受限制并由ANSI标准规定。第二，对每个取样点使用较长的积分时间意味着对给定数目的取样点获取(数据)时间较长，从而加重了上面讨论的数据获取问题。
鉴于此，在本领域中需要一种解决上面所发现的种种问题，并为重建三维角膜结构提供快速数据获取和低噪声的角膜测绘装置。
本发明的一个实施例含有一种通过为重建三维角膜结构提供快速数据获取和低噪声来解决本领域中上面所发现问题的光学相干层析X射线摄影法(OCT)角膜测绘装置。更具体地说，本发明第一方面的实施例是含有下列装置的OCT角膜测绘设备：(a)含有改变参考光路装置的OCT装置，(b)用于对来自OCT装置的取样光学输出进行光栅扫描的光栅扫描装置；(c)用于将来自光栅扫描装置的取样光学输出传送到眼睛和将从眼后反射出的取样光学输出通过该光栅扫描装置传送到该OCT装置的曲面镜装置；以及(d)与光栅扫描装置、改变装置以及来自OCT装置的参考光和取样光干涉输出相耦合的分析装置，用于使(i)光栅扫描装置将取样光学输出移到光栅中的点；(ii)改变装置在每一个点的预定量上改变参考光路的长度；以及(iii)从光栅中每一个点的参考光和取样光干涉输出确定角膜图。
本发明第二方面的一个实施例是含有下列装置的OCT角膜测绘设备：(a)含有改变参考光路长度装置的OCT装置；(b)用于对来自眼睛上方的OCT装置的取样光学输出进行光栅扫描和将从眼后反射出的取样光学输出传输到该OCT装置的光栅扫描装置；以及(c)与光栅扫描装置、改变装置以及来自OCT装置的参考光和取样光干涉输出相耦合的分析装置，用于使(i)光栅扫描装置将取样光学输出移到光栅中的点上，(ii)改变装置在每一个点的予定量上改变参考光路的长度，(iii)改变装置响应在一个或多个点处获得的参考光和取样光干涉输出而改变参考光路的长度，以及(IV)从光栅各点处的参考光和取样光的干涉输出确定角膜图。
图1以图示形式表示含有光学相干层析X射线摄影法″OCT″角膜测绘设备的本发明第一实施例；
图2图示了用于装配图1中所示第一实施例的OCT装置的纤维光学
实施例；
图3图示了用于装配图1中所示OCT装置的螺旋镜；
图4图示了由图3中所示螺旋镜提供的作为时间函数的光程长度；
图5图示了含有OCT角膜测绘设备的本发明第二实施例；以及
图6图示了角膜测绘OCT扫描图样。
为便于理解，不同图中相同的元件标以同样的数码。
根据本发明，通过减少取样体积而使所发明的角膜测绘设备的数据获取时间减少，以致于与不属于角膜的眼睛前房的其它部分相比所扫描的角膜体积较小。
图1图示了含有光学相干层析X射线摄影法(″OCT″)角膜测绘设备100的本发明第一实施例。如图1中所示，OCT角膜测绘设备100包含OCT干涉仪1。OCT取样光束是单模光纤250中的OCT干涉仪1的输出。来自单模光纤250的OCT取样光束输出经准直透镜3准直并经反射镜4偏转照射到扫描镜5。然后由扫描镜5将OCT取样光束反射到扫描镜6，再由扫描镜6将其反射到曲面镜7。然后由曲面镜7将OCT取样光束反射到眼睛8上。
图2图示了OCT干涉仪1的纤维光学实施例。如图2所示，OCT干涉仪1包含CW辐射源220，例如一个其输出的中心(波长)基本在850nm的高能发光激光二极管。将辐射源220的输出耦合到光纤230并由50/50耦合器240分成两束。分别将来自50/50耦合器240的输出耦合到光纤250和270。光纤270的输出经由透镜280成像到螺旋参考镜290，光纤250的输出如上所述直接照射到眼睛8上。然后，将从眼睛8反射的辐射耦合回到光纤250，并由50/50耦合器240将其与从螺旋参考镜290反射并耦合回光纤270的辐射相叠加。将来自50/50耦合器240的叠加辐射输出耦合到光纤265。正如已知的，如果光程差小于辐射源220的相干长度，则从物体(眼睛8)反射的辐射与从螺旋参考镜290反射的辐射之间存在干涉。如图3所示，通过本领域众所周知的普通技术装置(未示出)使螺旋参考镜290基本匀速旋转，结果，随由光电探测器275产生的探测器信号的周期变化检测到该干涉，该周期变化的频率与螺旋参考镜290的旋转频率相等。螺旋参考镜290的螺旋表面由下式表述：
              Z＝h/2π其中h是螺旋表面的阶高，是水平(azimuthal)旋转角。众所周知，当螺旋参考镜290旋转时，OCT干涉仪1的参考臂长是周期性变化的。图4图示了由螺旋参考镜290旋转所产生的作为时间函数的光程(opt-ical path length)变化。根据本发明，选择螺旋表面的高度以使由OCT干涉仪1的参考臂的光程变化所产生的深度扫描大约为角膜的厚度。这样减小了扫描体积，从而减少了为测绘角膜所需的数据获取时间。根据本发明，使用螺旋参考镜是优越的，因为它能旋转得非常快，从而能实现短的数据获取时间。
正如图2所示：(a)将光电探测器275的输出作为输入施加到解调器285解调；(b)将解调器285的输出作为输入施加于模/数转换器295(A/D295)以转换为数字信号，以及(c)将A/D295的数字信号输出作为输入施加于计算机210用于分析。根据本发明，一旦从物体(眼睛8)反射出的辐射与从螺旋参考镜290反射出的辐射间的光程差大于辐射源220的相干长度光电探测器275的干涉信号输出即消失。
再参照图1，为提供OCT光束的横向扫描，垂直安置扫描仪镜组5和6，该扫描仪镜组安置在一对用于扫描的电流计(未示出)上。该对扫描电流计和旋转螺旋参考镜290的电动机以本领域普通技术人员熟知的方式在计算机210的控制下运行。这给计算机210提供了信息使其能从该装置的几何条件确定三维坐标；扫描仪镜组5和6提供光栅扫描，螺旋参考镜290提供深度扫描。
根据本发明，如图1所示，选择镜7的半径使扫描光束的主光线总能通过眼睛8角膜的曲率中心15。当来自光纤250的OCT取样光束输出被扫描仪镜组5和6横向扫描时，从50/50耦合器240到眼睛8前面的虚曲线71的光程对扫描仪镜6的所有位置都是恒定值。另外，该恒定的光线长度等于50/50耦合器240与螺旋参考镜290的内部位置291即螺旋参考镜290的高点间的光学距离。再有，虚曲线72描绘了内部位置292即螺旋镜290的低点的等光程曲线。在由扫描仪镜组5和6提供的每一个横向位置，使螺旋参考镜290旋转360度以提供2h距离，即虚曲线71和72间的距离以上的深度扫描。在深度扫描期间，由计算机210接收的OCT信号提供用于对各个横向位置上的角膜结构定位的数据。由此可很容易理解，根据本发明由于采用了螺旋镜已缩短了数据获取时间并将深度扫描降至等于2h的距离。根据本发明，将2h调整为观测角膜厚度所需的最小距离。
根据本发明，使用位于眼睛8虹膜共轭位置的CCD摄影机115监测眼睛8。如图1所示，红外光源80的红外光照射眼睛8。红外光源80通过例如用红外滤光片对白炽灯进行滤光获得。照射眼睛8虹膜的红外光通过曲面镜7中的槽口滤光片20被透镜135成象在CCD115上。根据本发明，槽口滤光片20反射OCT取样光束波长的辐射，例如，波长约等于850nm，反射率约为90％(透射率约为10％)，并透过照射眼睛8的红外光。曲面镜7剩余部分对OCT取样光束波长的辐射的反射率也约为90％。由CCD摄影机115产生的图象示出眼睛8和OCT取样光束在虹膜和角膜顶点上的扫描轨迹。OCT取样光束扫描轨迹图象由被眼睛8反射并透过槽口滤光片20的辐射引起。由于CCD摄影机115对波长为850nm左右的辐射非常灵敏，故即使反射的OCT取样光束的透射性小，也能对扫描轨迹成象。图6图示了由OCT角膜测绘设备100所产生的扫描图样。图6示出OCT取样光束扫描轨迹300-350，虹膜360，以及瞳孔370。因为从瞳孔370的反射非常少，CCD图象显示瞳孔370是暗的并被明亮的虹膜360所包围。另外，OCT取样光束扫描轨迹300-350的图象展示了扫描轨迹通过对应于瞳孔370(除了角膜顶)区域的暗的部分和通过对应于虹膜360区域的明亮部分。结果，可人工改变设备100的位置使OCT取样光束扫描轨迹通过瞳孔370的中心。再有，可用计算机210分析由CCD摄影机115产生的图象以通过边缘检测确定瞳孔370的中心并相应调整扫描轨迹的位置。
应深度扫描期间数据获取的要求，计算机210通过检测不同信号强度最大值在横向扫描点识别角膜的不同位置。根据本发明，扫描仪镜组5和6根据计算机210的指令提供角膜的光栅即横向OCT扫描，OCT干涉仪1根据计算机210给螺旋参考镜290的指令提供角膜的深度OCT扫描。由计算机单元210分析该结果以获得角膜外形测量，诸如(a)前角膜表面轮廓，(b)后角膜表面轮廓，以及(c)角膜厚度。这些数据可用来例如在屈光手术过程中在线监测角膜的折射率或拟合接触透镜等。在本发明第一方面的一个实施例中，将阈值输入计算机210用于识别对应于预定的角膜表面的信号最大值的目的。然后，计算机210使具有大于最大值电平的信号与预定表面对应，并从光栅扫描中OCT取样光束的位置获得空间中表面的空间坐标，和从深度扫描中螺旋参考镜290的位置获得表面深度坐标。将这些空间值储存在计算机210中。从在深度扫描期间由后、前角膜表面产生的信号峰值间的空间差以及熟知的角膜光学特性例如折射率等，可确定角膜厚度。当光栅扫描完成时，计算机210进行该表面的空间坐标拟合以提供后、前角膜表面轮廓。然后，用该表面轮廓来提供角膜后、前表面曲率的测量，以及由此测量角膜折射率。
图5图示了本发明的第二个实施例，它含有OCT角膜测绘设备500。如图5所示，OCT角膜测绘设备500含有CW辐射源220，例如具有中心(波长)基本在850nm输出的高能发光激光二极管。直接将辐射源220的输出射到分束器540。分束器540将该输出分束成直射到后向反射镜550的参考光束541和直射到扫描仪装置的取样光束542，该扫描仪装置由垂直安置的，由电流计驱动的扫描仪镜组565和566组成，该扫描仪镜组安置在一对电流计上(未示出)。扫描仪电动机565和566在计算机210以本领域普通技术人员熟知的方式控制下运转。由扫描仪镜组565和566组成的光栅扫描仪位于扫描仪透镜31的后焦面中。这提供了远心光学结构，而扫描取样光束542的主光线在不同扫描位置均平行。另外，该远心光学结构保证角膜上扫描长度在Z方面即沿图5中箭头1000的方向上与角膜无关。然而，对于光栅扫描的″等路径长度表面″是一个平面，它由图5中虚线571表示。这在平面571不适合角膜几何条件而导致大于为确定角膜图所需要的扫描体积和数据获取时间方面是不利的。根据本发明，通过在光栅扫描的不同位置改变参考光束541的路径长度来减小扫描体积。这通过移动后向反射镜550来改变作为OCT取样光束542扫描角的函数的参考光束541的路径长度来完成。如图5所示，后向反射镜550由电流扫描器532来移动。例如将杆535固定到电流扫描器532和后向反射镜550。当电流扫描器532被驱动时(以下述方式)，杆535旋转，后向反射镜550沿箭头10/0所示方向移动。由于电流扫描器532所需位移小，后向反射镜550的随后移动基本上是沿直线。结果，根据本发明第二方面的最佳实施例，电流扫描器532的运动将由虚线571所示的平面改变为具有基本等于角膜半径的半径的球面，该半径为8mm左右。
再如图5所示，参考光束541从后向反射镜550射向螺旋参考镜290。在由扫描镜组565和566提供的每一个横向位置，螺旋镜290旋转360度以在上面讨论的关于图1所示的实施例100的方式提供大于2h距离的深度扫描。螺旋参考镜290通过该领域普通技术人员熟知的装置(未示出)以基本恒定的速度旋转。参考光束541从螺旋参考镜290反射并通过分束器540与来自被眼睛8反射的取样光束542的辐射叠加。该叠加辐射由光电探测器275检测。光电探测器275的输出被解调器285解调，解调器285的已解调输出由模/数转换器295(A/D295)转换为数字信号，将A/D295的输出施加到计算机210作为其输入用于分析。
在取样光束542由扫描器镜组565和566作横向扫描期间，螺旋镜290旋转预定次数，例如n次。一对驱动扫描器镜组565和566的扫描电流计和一个使螺旋参考镜290旋转的电动机在计算机210以本领域普通技术人员熟知的方式控制下运行。根据本发明的一个最佳实施例，OCT数据由计算机210同步采集以致于例如在一次横向扫描过程中发生了由螺旋参考镜290的n次旋转提供的n次深度扫描。由计算机210接收的来自检测器275的OCT信号被实时优先分析。通过以上述关于OCT角膜测绘设备100的方式对由计算机210接收的OCT信号的峰值进行分析确定不同角膜结构的坐标。
如上面已描述的，在光栅或横向扫描中在预定的点作深度扫描。在横向扫描中的一个点处作深度扫描期间，特别的信号峰值测出特别的角膜结构的位置，在横向扫描的一个点处的该特别角膜结构的深度取决于参考光束541和取样光束542间的路径长度差。然而，由于角膜的曲面形状，该路径长度差作为扫描角度的函数变化。根据本发明第二方面，在横向扫描期间，计算机210通过检测信号峰值来确定在横向扫描例如角膜前表面中第一点处的特别角膜结构的深度。然后，计算机210对该第一个点处的前表面深度和沿着该横向扫描前点处的前表面深度进行比较。将这两个沿着横向扫描相邻点处的前表面深度差用来移动后向反射镜550使其沿角膜曲面形状行驶。使计算机210将在两个相邻点处前表面深度差的负数通过滤波器555施加给电流扫描器532作为输入信号来实现该跟踪。电流扫描器532响应该信号移动后向反射镜550使其跟踪角膜表面进行深度扫描。结果，产生恒定路径长度差表面即虚线571自动适应在调查中的角膜表面的作用。以这种方式并根据本发明，缩短了深度扫描数据获取时间。滤波器555用来避免电流扫描器532振动并可作为本领域普通技术人员熟知的PI-控制器被安装。
最后，如图5所示，用CCD摄影机115以类似于图1所示的实施例100的方式监测眼睛8。特别是，用来自红外光源80的红外光照射眼睛8，该红外光源可通过例如用红外滤光片对白炽灯进行过滤而获得。从眼睛8反射的红外光通过槽口滤光片575由透镜537成象在CCD115上。根据本发明，槽口滤光片575反射照射眼睛的红外光，透射OCT光束波长，例如，该波长基本等于850……。
本领域技术人员将认识到前面所叙述的仅为说明和描述起见而提供。如此，没打算详尽或将本发明限于所公开的严谨形式。例如，根据上述教导所作改进和变化是可能的，而这些改进和变化仍在本发明的精神范围内。因此应将所附的权利要求书理解为要覆盖所有这些落在本发明实际范围和精神内的改进和变化。

Claims (8)

1.一种光学相干层析X射线摄影法角膜测绘设备，它包括：
由改变参考光束路径长度装置组成的光学相干层析X射线摄影装置；
用于对来自光学相干层析X射线摄影装置的取样光学输出进行光栅扫描并将从眼后反射出的取样光学输出传输到光学相干层析X射线摄影装置的光栅扫描装置；以及
耦合到光栅扫描装置、改变装置、和来自光学相干层析X射线摄影装置的参考和取样干涉输出的分析装置，用于使：光栅扫描装置将取样光学输出移到光栅中的点上；改变装置在每一个点处预定数量上改变参考光束路径的长度；改变装置响应从一个或多个点获得的参考和取样干涉输出改变参考光束路径的长度；以及从光栅中点处的参考和取样干涉输出确定角膜图样。
2.如权利要求1所述的光学相干层析X射线摄影法角膜测绘设备，其特征在于所述改变装置包含安置在参考光束路径中的螺旋参考镜。
3.如权利要求1所述的光学相干层析X射线摄影法角膜测绘设备，其特征在于所述改变装置还包括安置在参考光束路径中的可动反射装置。
4.如权利要求1所述的光学相干层析X射线摄影法角膜测绘设备，其特征在于可移动反射装置包含后向反射镜，以及改变装置还包含用于移动该后向反射镜装置的电流计装置。
5.如权利要求1所述的光学相干层析X射线摄影法角膜测绘设备，其特征在于光栅扫描装置包含垂直安装的镜组。
6.如权利要求1所述的光学相干层析X射线摄影法角膜测绘设备，其特征在于还包括：
用红外辐射照射眼睛的装置，
用于检测该红外辐射的装置，以及
响应来自该检测装置的输出，用于显示眼睛图象的装置。
7.如权利要求1所述的光学相干层析X射线摄影法角膜测绘设备，其特征在于该分析装置包含用于下列作用的装置：检测一个或最大的参考和取样干涉输出；将该一个或最大的输出与一个或多个角膜表面相联系；以及提供该一个或多个表面的轮廓图样。
8.如权利要求7所述的光学相干层析X射线摄影法角膜测绘设备，其特征在于该分析装置还包含有用于确定该一个或多个表面中至少两个表面间距离的装置。
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