JP2000083903A - Ophthalmologic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To facilitate the measurement of form change quantity by calculating change quantity between a first eye ground observation image unless a fluid is injected from an injection nozzle to the cornea and the second one when the fluid with a fixed pressure is injected at the time of obtaining the eye ground observation image by means of scanning and illuminating an eye ground through the use of a laser beam spot. SOLUTION: When form change quantity for estimating the change of a lesion from now on is measured the eye ground is scanned and illuminated by the laser beam spot from a diode laser 80 at first and the concavity, volume and inclination of an optic nerve mamilla are obtained based on a scanning reflection light flux together with an optic nerve mamilla observation image and are displayed in a display means 206. Then, eye drops anesthesia is executed in an eye to be examined E, a doughnut-shaped pad 61 is fitted to the tip of the injection nozzle 55 and it is pressurized against the circumference of the eye to be examined. In this state, the compression fluid is injected from the injection nozzle 55, various kinds of data of the optic nerve mamilla obtained from image information at the time of injection and also the ratio and change quantity between the concavity diameter of the optic nerve mamilla and the diameter of the optic nerve mamilla are obtained and they are displayed in the display means 206.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a fundus examination apparatus which can grasp the plane and depth of the fundus and can be used, for example, for ophthalmic examination of glaucoma.

[0002]

2. Description of the Related Art The examination of glaucoma, which often leads to blindness, is performed by measuring intraocular pressure, morphological changes of the optic papilla by observation of the fundus, defects in the nerve fiber layer, and the inner diameter of the optic papilla relative to the diameter dimension (D). The ratio of the concave diameter dimension (C) (C /
It is said that the measurement of D) is effective, and in the precise measurement of the optic disc, only a few mmHg intraocular pressure increases,
It is said that the depression becomes larger. In order to reduce the burden on the subject and the examiner at the time of measurement, an apparatus having a composite function has appeared. For example, in Japanese Patent Application Laid-Open No. 7-148118, an intraocular pressure measurement, a fundus observation image, and a fundus measurement value (C / D) ) Are described.

[0003] However, these devices measure and observe the current disease of the eye to be inspected, and cannot measure the amount of morphological change for estimating how the disease will change in the future.

[0004]

SUMMARY OF THE INVENTION It is an object of the present invention to provide an ophthalmologic apparatus for measuring the amount of morphological change for estimating how the form of the optic disc will change in the future as the intraocular pressure rises. is there.

[0005]

An ophthalmologic apparatus according to the present invention for achieving the above object has a scanning optical system for scanning and illuminating a fundus with a laser beam spot. In an ophthalmologic apparatus for assembling an observation image, an ejection nozzle that ejects a fluid toward a cornea of an eye to be examined, a fluid supply unit that supplies a fluid at a constant pressure to the ejection nozzle, and a fluid is ejected from the ejection nozzle to the cornea of the eye to be examined. The gist is that a calculation means is provided for calculating the amount of change in a predetermined portion between the first fundus observation image when not performed and the second fundus observation image when a constant-pressure fluid is ejected.

Further, a projection optical system for projecting a light beam toward the cornea of the eye to be inspected, an ejection nozzle for ejecting a fluid toward the cornea, a fluid supply means for supplying a fluid to the ejection nozzle, and an ejection from the ejection nozzle A detection optical system that causes a light receiving element to receive a light beam reflected from the cornea in a deformed state by the fluid that has been deformed, and an intraocular pressure measurement system that measures an intraocular pressure value based on an output signal from the light receiving element, and a laser beam. A scanning optical system that scans and illuminates the fundus with a spot, and a laser beam scanning fundus observation system that assembles a fundus observation image based on a scanning reflected light beam of each part of the fundus,
The first fundus observation image by the laser beam scanning type fundus observation system when the fluid is not ejected from the ejection nozzle to the cornea of the eye using the fluid supply unit, and the laser beam scanning method when the fluid of a constant pressure is ejected. It is a gist of the present invention to provide a calculating means for calculating an amount of change in a predetermined portion from a second fundus observation image by the fundus observation system.

[0007] It is another object of the present invention to provide a flexible resin for sealing a fluid to be injected between the injection nozzle and the periphery of the subject's eye at the tip of the injection nozzle.

[0008] Further, it is the gist that a predetermined portion of the first fundus observation image and the second fundus observation image is an optic disc.

[0009]

The ophthalmologic apparatus having the above-described configuration captures a fundus oculi observation image before fluid ejection and a fundus oculi observation image by constant-pressure fluid ejection that presses the eyeball, and determines the amount of change in the two fundus oculi observation images at a predetermined site. Since there is a calculating means for calculating, a transition due to an increase in intraocular pressure can be grasped from clinical data or numerical simulation.

In an ophthalmologic apparatus equipped with an intraocular pressure measurement system and a laser beam scanning type assertion observation system, a compressed fluid is generated by using a fluid supply unit of the tonometry system. There is no provision.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of an ophthalmologic apparatus according to the present invention will be described below with reference to the drawings. The method of measuring an intraocular pressure value according to the present embodiment includes determining a corneal curvature radius before fluid ejection at a plurality of predetermined positions of the cornea, and a corneal curvature radius when a fluid of a constant pressure is ejected, and determining a plurality of previously determined corneas. The method of deriving the corresponding intraocular pressure value based on the correlation table of the intraocular pressure value corresponding to the corneal curvature radius before the injection at the predetermined position and the injection state at the predetermined position is adopted.

In FIG. 1, a measuring optical system 1 of an intraocular pressure measuring system is shown.
Reference numeral 00 denotes a projection optical system 10 for projecting a plurality of annular light beams onto the cornea C of the eye E to be inspected, a detection optical system 20 for photographing reflected light beams of the annular light beams from the cornea C, and an alignment projection optical system for projecting an alignment light beam on the cornea. 30, a fixation optical system 40 for fixing the eye E to be examined. The projection optical system 10 includes a truncated-cone member 50 having an outer shape of a truncated cone, and a light source 11 that illuminates the truncated-cone member 50. The photographing optical system 20 includes a Hough mirror 21, an imaging lens 22, a dust filter 23, and a CCD.
A camera 24 is provided. The alignment optical system 30
LED 31 for irradiating infrared light, collimator lens 32,
An alignment beam is provided to the cornea C through the first communication hole 54 from the outer wall 52 of the truncated cone member 51 toward the cylindrical cavity 53.
An objective lens 88 of a scanning optical system 150 of a laser beam scanning type fundus observation system to be described later is fixed to the truncated conical member main body 51, and the periphery of the objective lens 88 is sealed so that fluid ejected to the cornea does not flow to other than the ejection nozzle. Have been. Further, the first communication hole 54 is similarly closed by a transparent cylindrical member 56 so that the fluid ejected to the cornea does not flow out of the ejection nozzle 55. The fixation optical system 40 is red L
ED 41, pinhole 42, fixation stop 43 for limiting the amount of light of red LED 41, fixation collimator lens 44,
A half mirror 45 is provided.

Next, a ring group for projecting a plurality of annular light beams onto the cornea of the truncated cone member 50 of the projection optical system 10 will be described. Before the processing, the truncated conical member body 51 is a transparent body. However, the outer wall 52 of the truncated conical member body 51 is opaquely white-painted, and thereafter, is matted black from above. Central cylindrical bore 5
After the inner wall 57 of No. 3 is painted in black and black, the ring group 5
8 is engraved. The luminous flux reflected by the white painted surface by the illumination light from the light source 11 passes through the first ring group 58 to form an annular luminous flux on the cornea C.

A plate 59 made of a transparent material is adhered to the eye to be examined of the truncated cone body 51, and an injection nozzle 55 is provided at the center. Also, the truncated cone member body 5
The second communication hole 6 extends from the first outer wall 52 toward the cylindrical bore 53.
0 is provided and communicated with the fluid supply means shown in FIG. In the present embodiment, the injection nozzle 55 has a hole having a diameter of 2.2 mm at the center.

The reflected images of the plurality of annular light beams projected on the cornea are transmitted through the transparent plate 59 and the ejection nozzle 55, and the objective lens 88, the half mirror 21, the imaging lens 22, and the imaging lens 22, CCD through dust filter 23
An image is formed on the camera 24.

Next, the fluid supply means will be described. FIG. 2 shows a pneumatic circuit 70 of the fluid supply means. The pneumatic circuit 70 includes an air compressor 71, a first electromagnetic on-off valve 72, a reservoir 73 for storing air at a constant pressure, and a second electromagnetic on-off circuit. Pressure detector 7 for detecting pressure in valve 74 and reservoir 73
5. A control circuit 76 is provided. If the electric signal from the pressure detector 75 is lower than the set pressure, the control circuit 76 supplies a signal to open the first solenoid on-off valve until the pressure reaches the set pressure, and supplies the compressed air of the pressure generator 71 to the reservoir 73. In the present embodiment, the set pressure was 18 mmHg when measuring the intraocular pressure and 200 mmHg when photographing the fundus observation image.

Next, measurement of intraocular pressure will be described. Cornea C
The alignment light beam reflected by the light source forms an image on a CCD camera 24 via a half mirror 21, an image forming lens 22, and a dustproof filter 23 shown in FIG. Although not shown, a visual axis alignment alignment index image based on the infrared light emitted from the LED 31 is formed on the CCD camera 24. Also CC
A reticle image that forms the visual axis allowable range is projected on the D camera 24, and the examiner operates the apparatus main body so that the index image falls within the visual axis allowable range mark. When the alignment is completed, the push button on the left side of the switch 200 is pressed. The calculating means 201 inputs image information of the CCD camera 24 of the photographing optical system 20 to the first image memory 203 via the frame grabber substrate 202. Next, the calculating means 201
Is supplied to the control circuit 76 of the pneumatic circuit 70 shown in FIG.
(A signal line is not shown). The compressed fluid flows into the cylindrical bore 53 of the truncated conical member main body 51 and is jetted from the jet nozzle 55 toward the cornea C. Next, the arithmetic means 201 converts the image information of the deformed state of the cornea C into the frame grabber substrate 2 about 50 msec after the injection.
2 is input to the second image memory 204 through FIG.
Is sent to the control circuit 76 to stop the supply of fluid by stopping the energization of the second solenoid valve 74. A pressure sensor for detecting the fluid pressure in the cylindrical bore 53 of the truncated cone member body 51 is provided, and the fluid pressure is set at a set pressure (18 mmH).
When g) is reached, the image information may be input to the second image memory 204 via the frame grabber substrate 202.

Into the correlation table memory 205, intraocular pressure values corresponding to corneal curvature radii at a plurality of predetermined positions of the cornea C before deformation and in a deformed state by fluid ejection are input based on clinical tests and simulations. The calculating means 201 is provided with the first
The corneal curvature radius at a plurality of predetermined positions is obtained from the memory 203 and the second image memory 204, and the corresponding intraocular pressure value is derived from the correlation table memory 205 to calculate the average value. The plurality of intraocular pressure values and the average value are displayed on the display unit 206 so as to be superimposed on the topography during fluid ejection. In this embodiment, a plurality of predetermined positions are set at a radius of 1.5 mm from the vertex of the cornea C.
Were set at four points, up, down, left, and right on the same circumference.

Next, the scanning optical system 150 of the laser beam scanning type fundus observation system will be described. 80 is a diode laser having an output of 4.25 mW at 780 nm,
The laser beam is guided by an optical fiber 81, reflected by a beam splitter 82, transmitted through a dichroic beam splitter 83, a collimator lens 84, and a focus lens 85, and horizontally scanned by a galvanometer, which is a first optical deflector 86. Subsequently, the light is scanned in the vertical direction by a galvanometer as the second optical deflector 87, passes through the objective lens 88, forms an image in the eyeball of the eye E, and scans the retinal surface. The reflected beam from the retinal surface is
And the second optical deflector 87 and the first optical deflector 86
The light is reflected by the first photodetector 90 through the focus lens 85, the lorimeter lens 84, the dichroic beam splitter 83, the beam splitter 82, and the pinhole 89. The light beam reflected by the laser beam is reflected by the dichroic beam splitter 83.
And is received by the second photodetector 91 for fundus fluorescence. Further, the focus lens 85 automatically moves upward. In this embodiment, 256 pixels 655 each in the vertical and horizontal directions
After scanning the fundus of 36 points, the focal plane is shifted backward by 32 by the movement of the focus lens 85, and data of a total of 2,000,000 points or more is obtained by well-known image processing together with the observation image of the optic disc and the optic disc recession. And the volume and inclination are displayed on the display means 206. In the present embodiment, when imaging a normal optic disc, the central push button of the switch 200 is pressed.

Next, when taking an image of the optic papilla when the eyeball is compressed, an ophthalmic anesthesia is applied to the eye E to be examined, and a donut-shaped flexible tip is provided at the tip of the injection nozzle 55 so that the injected compressed fluid does not leak outside. A suitable resin pad 61 is attached and pressed around the eye to be examined. In this embodiment, the pad 61 uses urethane rubber. Next, the right push button of the switch 200 is pressed. The arithmetic means 201 converts the image of the normal optic disc into the first memory 20 via the frame grabber board 202.
3 is input. After the photographing, the arithmetic means 201 sends a predetermined signal to the control circuit 76 of the pneumatic circuit 70 shown in FIG. 2 (signal lines are not shown). The control circuit 76 includes a reservoir 73
Pressure 200m higher than the tonometry set value 18mmHg
Set to mHg. When the set value is reached, the second solenoid valve 74 is energized, and the reservoir 73 is connected via the second solenoid valve 74.
Is injected from the injection nozzle 55 when flowing into the second communication hole 60 of the truncated conical member main body 51. In this embodiment,
About three seconds after pressing the right button of the switch 200, an image of the optic disc is input to the second memory 204 via the frame grabber substrate 202. In addition, the truncated cone member 51
A pressure sensor for detecting the fluid pressure in the cylindrical bore 53 may be provided, and an image of the optic disc may be input when the fluid pressure reaches a set value (200 mmHg).

The arithmetic means 201 is provided for the first image memory 20
From the second and second image memories 203, the ratio between the optic disc recession diameter and the optic disc diameter and the amount of change (rate) are obtained and displayed on the display means 206. For example, if the ratio between the optic disc recession diameter and the optic disc increases from 0.4 to 0.6, the change amount is 0.2 and the change rate increases by 50%. In addition, the image before the eyeball compression and the compressed image are superimposed and displayed on the display unit 206 by the known image processing. From this result, the transition due to the increase in intraocular pressure can be grasped from clinical data or numerical simulation.

In the present invention, it is needless to say that the amount of change in the optic nerve fiber layer can be changed by using the above-described injection nozzle and fluid supply means in an apparatus for measuring the thickness of the optic nerve fiber layer which has recently been used for diagnosis of glaucoma. No.

[0023]

As is apparent from the above description, in the ophthalmologic apparatus having the structure according to the present invention, the image of the optic papilla before the ejection of the fluid at a constant pressure that applies a load to the eye to be examined and the image of the optic disc when the ejection is performed And an arithmetic means for calculating the ratio of the optic disc diameter and the concave diameter and the amount of change from each image is provided, so that the transition due to an increase in intraocular pressure can be grasped from clinical data or a numerical simulation.

Further, an ophthalmologic apparatus having an intraocular pressure measurement system and a laser beam scanning type fundus observation system is a device which is used by one fluid supply means at the time of measuring the intraocular pressure and at the time of photographing the fundus observation image by pressing the eyeball. Is cheaper.

[Brief description of the drawings]

FIG. 1 is a diagram schematically showing a structure of an ophthalmologic apparatus as one embodiment of the present invention.

FIG. 2 is a diagram showing a pneumatic circuit of a fluid supply unit as one embodiment of the present invention.

[Explanation of symbols]

 Eye to be inspected E Cornea C 50 Truncated cone member 55 Injection nozzle 70 Pneumatic circuit 80 Diode laser 88 Objective lens 90 First photodetector 91 Second photodetector 100 Measurement optical system of intraocular pressure measurement system 150 Laser beam scanning fundus observation System scanning optical system 200 switch 201 computing means 203 first image memory 204 second image memory

Claims (4)

[Claims] 1. An ophthalmologic apparatus having a scanning optical system for scanning and illuminating a fundus of a laser beam onto a fundus and assembling a fundus observation image based on a scanning reflected light beam of each part of the fundus, injects a fluid toward a cornea of an eye to be examined. An ejection nozzle, fluid supply means for supplying a constant pressure fluid to the ejection nozzle, and ejecting a first fundus observation image and the constant pressure fluid when the fluid is not ejected from the ejection nozzle to the cornea of the subject's eye. An ophthalmologic apparatus, comprising: calculating means for calculating an amount of change in a predetermined portion between the second fundus observation image and the second fundus observation image. 2. A projection optical system for projecting a light beam toward a cornea of an eye to be examined, an ejection nozzle for ejecting a fluid toward the cornea, a fluid supply unit for supplying a fluid to the ejection nozzle, and A detection optical system that causes a light receiving element to receive a reflected light beam from the cornea in a deformed state by the ejected fluid, and an intraocular pressure measurement system that measures an intraocular pressure value based on an output signal from the light receiving element; An ophthalmologic apparatus having a scanning optical system that scans and irradiates a laser beam spot onto the fundus, and a laser beam scanning fundus observation system that assembles a fundus observation image based on a scanning reflected light beam of each part of the fundus; By using the first fundus observation image by the laser beam scanning type fundus observation system when the fluid is not ejected from the ejection nozzle to the cornea of the eye to be examined, and when a fluid of a constant pressure is ejected An ophthalmologic apparatus, further comprising a calculating means for calculating an amount of change in a predetermined portion from a second fundus observation image by the laser beam scanning type fundus observation system. 3. A flexible resin for sealing the fluid to be ejected is provided between the ejection nozzle and the periphery of the subject's eye at the tip of the ejection nozzle.
The ophthalmic apparatus according to any of the preceding claims. 4. The ophthalmologic apparatus according to claim 1, wherein predetermined portions of the first fundus observation image and the second fundus observation image are optic discs.