JP2008154950A - Fundus image processing device, ophthalmography device and program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide technologies capable of precisely reflecting the result of specification on the computation of indexes such as a C/D ratio when a target region is specified while observing a stereoscopically visible stereoscopic fundus image consisting of a pair of left and right fundus images. <P>SOLUTION: An operator's dominant eye is assumed to be the right eye. The fundus image processing device 1 comprises a display part 151 for displaying the stereoscopic fundus image GLR consisting of a pair of left and right fundus images GL and GR, and an operating part 152 for the operator to specify the target region such as an optic papilla region or a depressed region based on the displayed stereoscopic fundus image GLR. A position specifying part 12 specifies a region on the fundus image GR (the fundus image on the dominant eye side) corresponding to the target region specified by the operator. A control part 10 displays the fundus image GR on the display part 151, and displays image information, such as the image of the outer edge of the papilla or the image of the outer edge of the depressed region, expressing the region specified by the position specifying part 12 on the fundus image GR. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a fundus image processing apparatus that processes a fundus image, a fundus imaging apparatus that captures and displays a fundus image, and a program that controls a computer that processes the fundus image, and particularly displays an analysis result of the fundus image. It is about technology.

  Glaucoma is a disease in which the optic nerve is damaged for some reason and the visual field is lost, and is known as one of the main causes of blindness. In glaucoma, the optic disc is depressed due to an increase in intraocular pressure, which results in the loss of blood supply to the optic nerve cell and the death of the optic nerve cell, and a visual field defect without an increase in intraocular pressure. There is a thing. Even in the latter case (normal tension glaucoma), depression occurs in the optic nerve head.

  In view of such a phenomenon, as an index for diagnosing glaucoma, a C / D ratio reflecting the depressed state of the optic disc has been widely used. In recent years, the R / D ratio has also been used.

  The C / D ratio (cup-to-disc ratio) is defined as the ratio of the diameter of the outer edge of the optic disc capped region to the diameter of the outer edge of the optic disc (disc). The The ratio of diameters in the vertical direction (body axis direction of the subject) is called a vertical C / D ratio, and the ratio of diameters in the horizontal direction (direction perpendicular to the body axis direction) is called a horizontal C / D ratio. Yes (see, for example, Patent Document 1).

  The R / D ratio (rim-to-disc ratio) is defined as the ratio of the width of the rim region to the measurement position of the width and the nipple diameter passing through the nipple center. Here, the rim region means a region existing between the outer edge of the optic nerve head and the outer edge of the depression of the optic nerve head. The R / D ratio can be defined for each radial line group passing through the nipple center.

  In recent years, various methods for analyzing a fundus image to obtain a C / D ratio have been developed (see, for example, Patent Document 1). This conventional method acquires a pair of right and left fundus images (stereo fundus images) using a stereoscopic fundus camera, performs stereo matching processing on the stereo fundus image, and generates three-dimensional data. A three-dimensional image and a planar image based on the above are displayed. The operator manually designates the optic disc area on the displayed three-dimensional image or planar image. The recessed area is automatically designated by image analysis.

JP-A-11-151206

  According to such a conventional technique, the C / D ratio can be automatically calculated, but there is a disadvantage that the R / D ratio cannot be obtained automatically.

  Also, according to such a conventional technique, the position of the optic nerve head region or the like is designated on the image obtained by performing the stereo matching process on the stereo fundus image, and the C / D ratio is obtained based on the designated position. Therefore, the C / D ratio may be calculated based on a position different from the position designated by the operator due to an error caused by the stereo matching process. This seems to be a particular problem when determining the R / D ratio for a large number of regions of the fundus.

  In the diagnosis using the conventional stereoscopic fundus camera, the stereoscopic form of the fundus is provided to the operator by alternately shielding the left and right eyes of the operator while alternately displaying the left and right integral fundus images. It was supposed to be recognized. When this technology is used, the stereoscopic fundus image is recognized three-dimensionally only in the brain of the operator based on the parallax between the left and right eyes when the left and right fundus images are viewed, and is flat on the display screen. Only a typical image is displayed. Therefore, there is a possibility that the optic disc region is designated at a position different from the position intended by the operator.

  This invention was made to solve the above problems, and when an operator designates a region of interest such as an optic disc region or a recessed region while observing a fundus image that can be viewed stereoscopically, It is an object of the present invention to provide a fundus image processing apparatus, a fundus imaging apparatus, and a program capable of accurately reflecting the designation result in calculation of an index such as a C / D ratio or an R / D ratio.

  In order to achieve the above object, the invention according to claim 1 is based on display means for displaying a stereoscopic fundus image comprising a pair of left and right fundus images and being stereoscopically visible, and the displayed stereoscopic fundus image. An operation unit for designating a region of interest on the fundus, a specifying unit for identifying a region on one or both fundus images of the pair of left and right fundus images corresponding to the designated region of interest, and the one or both A fundus image processing apparatus comprising: control means for causing the display means to display the fundus image on the displayed fundus image and displaying image information representing the position of the identified part on the displayed fundus image. is there.

  The invention according to claim 2 is the fundus image processing apparatus according to claim 1, wherein the storage means stores the dominant eye information representing the dominant eye of the observer who observes the displayed stereoscopic fundus image. The specifying means specifies the corresponding part on the fundus image on the dominant eye side of the observer indicated in the dominant eye information among the pair of right and left fundus images, and the control means includes the dominant hand The fundus image on the eye side is displayed on the display means, and the image information is displayed on the fundus image on the dominant eye side.

  The invention according to claim 3 is the fundus image processing apparatus according to claim 1, further comprising selection operation means for selecting one or both of the pair of left and right fundus images, wherein the specifying means is The corresponding portion on the selected one or both fundus images of the pair of left and right fundus images is specified, and the control unit displays the one or both fundus images on the display unit, The image information is displayed on the one or both fundus images.

  The invention according to claim 4 is the fundus image processing apparatus according to claim 1, wherein the specifying means designates an outer edge of the optic nerve head region and an outer edge of the recessed region as the attention site. Sometimes, a region on one or both fundus images of the pair of left and right fundus images corresponding to the outer edge of the designated optic disc region and the outer edge of the recessed region is specified, and the specified depression Computation means for calculating the ratio of the diameter of the part corresponding to the outer edge of the concave area and the diameter of the part corresponding to the outer edge of the optic nerve head area to obtain the C / D ratio of the fundus is further provided. And

  The invention according to claim 5 is the fundus image processing apparatus according to claim 1, wherein the specifying means designates an outer edge of the optic disc area and an outer edge of the recessed area as the attention site. Sometimes, a region on one or both fundus images of the pair of left and right fundus images corresponding to the outer edge of the designated optic disc area and the outer edge of the recessed region is specified, and the specified optic nerve Calculate the ratio of the width of the rim region sandwiched between the portion corresponding to the outer edge of the nipple region and the portion corresponding to the outer edge of the recessed region, and the diameter of the portion corresponding to the outer edge of the optic nerve region, It further comprises a calculation means for obtaining the R / D ratio of the fundus.

  According to the sixth aspect of the present invention, an imaging unit configured to capture a stereoscopic fundus image that includes a pair of left and right fundus images and is stereoscopically visible, and displays the captured stereoscopic fundus image so as to be stereoscopically visible. Display means, operation means for designating a region of interest on the fundus based on the displayed stereoscopic fundus image, and one or both fundus images of the pair of left and right fundus images corresponding to the designated region of interest Identification means for identifying the upper part, and control means for causing the display means to display the one or both fundus images and displaying image information representing the position of the identified part on the displayed fundus image And a fundus imaging apparatus.

  According to the seventh aspect of the present invention, there is provided display means for displaying a stereoscopically recognizable stereoscopic fundus image comprising a pair of left and right fundus images, and designating a region of interest on the fundus based on the displayed stereoscopic fundus image And a computer comprising: an operating means for functioning as a specifying means for specifying a part on one or both fundus images of the pair of left and right fundus images corresponding to the designated region of interest; A program that causes both fundus images to be displayed on the display unit and functions as a control unit that displays image information representing the position of the specified region on the displayed fundus image.

  According to the present invention, when an observer of a three-dimensional fundus image designates a region of interest, the region on the fundus image corresponding to the region of interest is specified, and image information representing the position of the specific region is displayed on the fundus image. be able to.

  Therefore, as compared with the conventional configuration using image processing such as stereo matching as described in Patent Document 1, the position of the target region designated while observing a stereoscopic fundus image is calculated using the C / D ratio, It is possible to accurately reflect the calculation of the index such as the R / D ratio.

  In particular, according to the second aspect of the present invention, a part corresponding to the attention part is specified in the fundus image on the dominant eye side of the observer, and the image representing the position of the specific part on the fundus image on the dominant eye side Since the information acts to be displayed, the image information is displayed on the fundus image on the side having no parallax (small parallax) with respect to the stereoscopic fundus image observed in the binocular viewing state. Therefore, when an observer observing a stereoscopic fundus image designates a site of interest, the designation result can be accurately reflected in the calculation of indices such as the C / D ratio and R / D ratio.

  An example of a preferred embodiment of a fundus image processing apparatus, a fundus imaging apparatus, and a program according to the present invention will be described in detail with reference to the drawings.

[Constitution]
An example of the configuration of the fundus image processing apparatus according to this embodiment is shown in FIGS. The fundus image processing apparatus 1 is connected to the ophthalmologic image database 2000 via a communication line such as a LAN (Local Area Network).

  The ophthalmic image database 2000 is a filing system that manages image data of images in the ophthalmic field. For example, a large-capacity storage device that stores digital image data and database software that manages data stored in the large-capacity storage device Including. The ophthalmic image database 2000 may include a filing system for other purposes such as an electronic medical record, in addition to a filing system for image data.

  Image data stored in the ophthalmic image database 2000 is acquired by the stereoscopic fundus camera 1000. Although only one stereoscopic fundus camera is shown in FIG. 1, it is possible to install two or more stereoscopic fundus cameras.

  The stereoscopic fundus camera 1000 is an apparatus that captures a stereoscopic fundus image that includes a pair of left and right fundus images (see, for example, Japanese Patent Laid-Open No. 5-15499), and is an example of the “imaging unit” of the present invention. It functions.

  The stereoscopic fundus camera 1000 includes an illumination optical system that irradiates illumination light toward the fundus and a left and right imaging optical system that guides fundus reflection light of the illumination light. Each of the left and right photographing optical systems is provided with a light receiving element such as a CCD (Charge Coupled Devices) image sensor. Each light receiving element converts the received light into an electrical signal. The stereoscopic fundus camera 1000 transmits to the ophthalmic image database 2000 image data G composed of a pair of left and right image data (digital data) GL and GR based on electrical signals generated by the left and right light receiving elements.

  Hereinafter, the fundus image may be identified with the image data. Therefore, the symbol GL represents the fundus image taken by the left photographing optical system and its image data, and the symbol GR represents the fundus image taken by the right photographing optical system and its image data. A symbol G represents a pair of left and right fundus images GL and GR, and also represents the image data GL and GR.

  The image data G of the fundus image is associated with information such as patient information such as the patient ID and patient name of the patient to be imaged, the imaging date and time, the imaging magnification, and various imaging conditions such as left and right eyes, and is stored in the ophthalmic image database 2000. Saved. The operator of the fundus image processing apparatus 1 can read and observe a desired fundus image of a desired patient by designating a patient ID, a patient name, and the like.

  When the fundus image is a monochrome image, the image data G of the fundus image is data in which the coordinate value of the pixel forming the fundus image is associated with the luminance value of each pixel. When the fundus image is a color image, the image data G is data in which the coordinate values of the pixels forming the fundus image are associated with the RGB values (R value, G value, B value) of each pixel.

  Note that the fundus image processing apparatus according to the present invention is not limited to the configuration for reading the captured image stored in the ophthalmic image database 2000, and for example, directly receives an image captured by the stereoscopic fundus camera 1000. There may be. In addition, the fundus image processing apparatus according to the present invention may include a drive device that reads image data G recorded on a medium (recording medium) such as a CD-R or a DVD-R.

[Hardware configuration]
A hardware configuration of the fundus image processing apparatus 1 according to this embodiment will be described. The fundus image processing apparatus 1 includes, for example, a general-purpose computer. As shown in FIG. 2, the fundus image processing apparatus 1 includes a microprocessor 200, a RAM 201, a nonvolatile storage device 202, a display 203, a keyboard 204, a mouse 205, and a communication interface (I / F) 206. .

  The microprocessor 200 is configured by an arbitrary microprocessor such as a CPU (Central Processing Unit) or an MPU (Micro Processing Unit) that executes various arithmetic processes and control processes.

  A RAM (Random Access Memory) 201 is a volatile storage device, and a program and data being executed by the microprocessor 200 are expanded.

  The nonvolatile storage device 202 includes a storage device (external storage device) such as a hard disk drive (Hard Disk Drive) or a ROM (Read Only Memory). The non-volatile storage device 202 stores a program P in advance. The microprocessor 200 executes processing characteristic of this embodiment by developing the program P on the RAM 201. In addition, image data G of the fundus image received from the ophthalmologic image database 2000 is stored in the nonvolatile storage device 202 (particularly, a hard disk drive). The program P corresponds to an example of the “program” of the present invention.

  When the computer constituting the fundus image processing apparatus 1 constitutes a client server system (Client-Server System) client, the program P is stored in the server, and the program P is appropriately called to execute the processing. May be.

  In addition, the fundus image processing apparatus 1 includes a display 203, a keyboard 204, and a mouse 205 as in a normal computer.

  The display 203 includes an arbitrary display device such as an LCD (Liquid Crystal Display) or a CRT (Cathode Ray Tube) display. The display 203 constitutes the display unit 151 shown in FIG. The display unit 151 corresponds to an example of the “display unit” of the present invention.

  The keyboard 204 and the mouse 205 are used as input devices for inputting various types of information based on information such as images and screens displayed on the display 203, and as operation devices for instructing execution of a desired operation. Used. The keyboard 204 and the mouse 205 constitute the operation unit 152 shown in FIG. Note that the operation unit 152 is not limited to a keyboard or a mouse, and may include a trackball, a joystick, a dedicated control panel, and the like.

  The operation unit 152 corresponds to an example of “operation means” and “selection operation means” of the present invention. In this embodiment, the same operation unit 152 constitutes both the operation means and the selection operation means. However, the operation means and the selection operation means can be separately constructed. The selection operation means will be described in the [Modification] section.

  The communication interface 206 performs data communication with other devices such as the ophthalmic image database 2000 via a communication line such as a LAN. The communication interface 206 includes a network adapter such as a LAN card, for example. Further, in the case where connection to a WAN (Wide Area Network) such as the Internet is possible, a communication device such as a modem for the connection is provided in the communication interface 206.

[Control system configuration]
Next, the configuration of the control system of the fundus image processing apparatus 1 will be described with reference to FIG. The fundus image processing apparatus 1 includes a control unit 10, an image reception unit 11, a storage unit 14, an image analysis unit 13, and a user interface 15.

(Control part)
The control unit 10 functions as the center of the control system of the fundus image processing apparatus 1. The control unit 10 includes a microprocessor 200 that operates based on the program P. The control unit 10 performs operation control of each unit of the fundus image processing apparatus 1 and various arithmetic processes. Details of these processes will be described later. The control unit 10 functions as an example of the “control unit” of the present invention.

  Further, the control unit 10 associates the position on the fundus image with the position of information in the graph information of the R / D ratio described later. That is, when a position on the fundus image is designated, the control unit 10 specifies information in the graph information corresponding to the designated position. Further, when information in the graph information is designated, a position on the fundus image corresponding to the designated information is specified.

  Further, the control unit 10 displays various display screens, fundus images, and information on the display unit 151 (display 203). In particular, the control unit 10 executes processing such as changing the display mode of the information in the graph information identified as described above and the position on the fundus image. The specific processing content of the control unit 10 will be described later.

(Image reception department)
For example, the image receiving unit 11 transmits information such as a patient ID specified by an operator of the fundus image processing apparatus 1 and a photographing date and time to the ophthalmic image database 2000, and the fundus transmitted from the ophthalmic image database 2000 based on this information. The image data G of the image is received and input to the control unit 10. The control unit 10 causes the storage unit 14 to store the image data G input from the image receiving unit 11. The image receiving unit 11 includes a communication interface 206.

  As described above, when the image data G is received directly from the stereoscopic fundus camera 1000, the image receiving unit 11 includes a connection interface with the stereoscopic fundus camera 1000.

(Location identification part)
The position specifying unit 12 operates in response to the operator designating a region of interest on the fundus based on the three-dimensional fundus image displayed on the display unit 151, and in one or both of the left and right pair of fundus images GL and GR. The site corresponding to the site of interest is specified. The position specifying unit 12 functions as an example of the “specifying unit” of the present invention, and includes the microprocessor 200 and the like. Specific contents of the processing executed by the position specifying unit 12 will be described later.

(Image Analysis Department)
The image analysis unit 13 performs various types of analysis processing based on the image data G of the fundus image, and includes a microprocessor 200 and the like. The image analysis unit 13 calculates the C / D ratio and R / D ratio of the fundus and functions as an example of the “calculation unit” of the present invention.

  The image analysis unit 13 includes an R / D ratio calculation unit 131, an average value calculation unit 132, a C / D ratio calculation unit 133, an area calculation unit 134, and an area ratio calculation unit 135. Hereinafter, each of these units 131 to 135 will be described.

(R / D ratio calculator)
The R / D ratio calculation unit 131 analyzes the image data G of the fundus image and obtains the value of the R / D ratio. The processing of the R / D ratio calculation unit 131 will be described more specifically. In order to calculate the R / D ratio, as described above, the outer edge of the region corresponding to the optic nerve head (optic nerve head region) in the fundus image and the region corresponding to the rim (rim region) are determined. There is a need. Note that the rim region is defined as a region sandwiched between the outer edge of the optic nerve head region and the outer edge of the recessed region, so that the outer edge of the optic nerve region and the outer edge of the recessed region need to be determined. A method for determining these conditions will be described later.

  Reference is now made to FIG. FIG. 3 shows an example of a fundus image based on the image data G (also represented by the symbol G). Symbol D indicates the outer edge of the optic disc region, and symbol C indicates the outer edge of the recessed region. The symbol O indicates the center position of the optic disc area. The center position O is defined as the center position of the circle, the center position of the ellipse (intersection position of the major axis and the minor axis), and the center of gravity position, respectively, when the outer edge of the optic disc area is circular, elliptical, or otherwise. can do.

  The R / D ratio calculation unit 131 sets a measurement site on a straight line passing through the center position O at a predetermined angular interval. As an example, the R / D ratio calculation unit 131 sets 72 measurement sites at intervals of 5 degrees: for example, the left side of the fundus image G is 0 degrees, 0 degrees clockwise, 5 degrees, 10 degrees,. -The direction of 345 degrees, 350 degrees, and 355 degrees is set as the measurement site. Each measurement site is set to i = 1 to 72.

  Next, the R / D ratio calculation unit 131 obtains the rim region width φR (i) and the outer edge D diameter (optic nerve head diameter) φD (i) of each measurement site i. A specific example of this process will be described. As a first example, φR (i) can be calculated by acquiring the number of pixels lined up in the width direction of the rim region and multiplying this number by a distance per pixel (known). As a second example, when a distance (metric) is set on the fundus image G in advance, the width of the rim region can be obtained using this metric. The optic nerve head diameter φD (i) can be similarly calculated.

  Subsequently, for each measurement site i, the R / D ratio calculation unit 131 calculates the R / D ratio by dividing the rim region width φR (i) by the optic disc diameter φD (i): measurement site i R / D ratio R / D (i) = φR (i) / φD (i). Thereby, a plurality of (here 72) R / D ratio values are obtained.

(Average value calculator)
The average value calculation unit 132 calculates an average value of two or more values among the values of the plurality of R / D ratios R / D (i) obtained by the R / D ratio calculation unit 131. The average value to be calculated is, for example, the average value of the R / D ratio in the measurement region (i = 13 to 25) included in the range corresponding to 11:00 to 1 o'clock in the optic disc area, or 5 to 7 o'clock. An area that is important in diagnosis using the R / D ratio, such as an average value of the R / D ratio in the measurement region (i = 49 to 61) included in the corresponding range, is calculated. Further, an average value may be calculated for the measurement site included in the range manually designated by the operator of the fundus image processing apparatus 1.

(C / D ratio calculator)
The C / D ratio calculation unit 133 analyzes the image data G of the fundus image and obtains a C / D ratio value. The processing of the C / D ratio calculation unit 133 will be described more specifically. In order to calculate the C / D ratio, as described above, it is necessary to determine the outer edge of the optic disc area and the outer edge of the recessed area in the fundus image. A method for determining these conditions will be described later.

  Reference is now made to FIGS. First, the first calculation method of the C / D ratio will be described with reference to FIG. In this first calculation method, the maximum diameter ΨC (v) of the outer edge C of the recessed area and the maximum diameter ΨD (v) of the outer edge D of the optic nerve head area are obtained, and these ratios are defined as the C / D ratio. C / D (v1) = ΨC (v) / ΨD (v). Here, each maximum diameter ΨC (v) and ΨD (v) represents the maximum diameter in the vertical direction. The maximum diameter ΨD (v) passes through the center position O of the outer edge D of the optic nerve head region (when the shape of the outer edge is a circle, an ellipse, or left-right symmetry).

  Next, the second calculation method of the C / D ratio will be described with reference to FIG. In this second calculation method, the maximum diameter ΨC (v) of the outer edge C of the recessed area and the diameter ΩD (v) of the outer edge D of the optic papilla area passing through the measurement site of the maximum diameter ΨC (v) are calculated. C / D (v2) = ΨC (v) / ΩD (v) which is obtained and defined as the C / D ratio. Here, the maximum diameter ΨC (v) and the diameter ΩD (v) represent the diameter in the vertical direction. The maximum diameter ΩD (v) generally does not pass through the center position O of the outer edge D of the optic nerve head region.

  In the above, the C / D value in the vertical direction (that is, the vertical C / D ratio) C / D (v1) and C / D (v2) are defined, but the C / D ratio in the horizontal direction (that is, the horizontal direction) C / D ratio) can be defined similarly: C / D (h1) = ΨC (h) / ΨD (h); C / D (h2) = ΨC (h) / ΩD (h).

(Area calculation part)
The area calculation unit 134 analyzes the image data G of the fundus image and calculates the area S (D) of the optic disc area and the area S (R) of the rim area. Further, the area calculation unit 134 calculates the area S (C) of the recessed area. Here, the area S (D) of the optic nerve head region is the area of the region surrounded by the outer edge D of the optic nerve head region. Further, the area S (C) of the recessed area is an area of the area surrounded by the outer edge C of the recessed area. Further, the area S (R) of the rim region is an area obtained by subtracting the area S (C) of the recessed region from the area S (D) of the optic nerve head: S (R) = S (D) − S (C).

  A specific example of a method for calculating the areas S (D), S (C), and S (R) will be described. As a first calculation method, there is a method using Green's theorem. Green's theorem is a widely used formula for determining the area of a region surrounded by a closed curve. As a second calculation method, the area can be obtained by counting the number of pixels included in the area measurement target region and multiplying this number of pixels by the area per pixel (assumed to be known).

(Area ratio calculator)
The area ratio calculation unit 135 calculates a predetermined area ratio based on the areas S (D), S (C), and S (R) obtained by the area calculation unit 134. The area ratio to be calculated is, for example, the area ratio (R / D area ratio) S (R / D) = S (R) / S (D) between the rim area and the optic nerve head area, and the recessed area and the optic nerve. Area ratio with the nipple region (C / D area ratio) S (C / D) = S (C) / S (D).

(Memory part)
The storage unit 14 stores various types of information such as image data G of the fundus image and dominant eye information 141, and includes a nonvolatile storage device 202 (particularly, a hard disk drive). The control unit 10 performs a process of writing information to the storage unit 14 and a process of reading information stored in the storage unit 14.

  The dominant eye information 141 is information representing the dominant eye of the operator of the fundus image processing apparatus 1. The dominant eye information 141 records, for example, the letter “L” when the operator's dominant eye is the left eye, and the letter “R” when the dominant eye is the right eye. Here, the dominant eye (dominant eye) means the eye on the side to be used mainly in the binocular vision state with the left and right eyes.

  When a plurality of operators use the fundus image processing apparatus 1, information indicating the dominant eye of each operator is associated with identification information (ID, name, etc.) of the operator and recorded in the dominant eye information 141. The operator inputs his / her identification information when using the fundus image processing apparatus 1. The control unit 10 selects information representing the dominant eye associated with the input identification information. A method of using the dominant eye information 141 will be described later.

(User interface)
The user interface 15 is a user interface (User Interface) of the fundus image processing apparatus 1. The user interface 15 is provided with the display unit 151 and the operation unit 152 described above. In this embodiment, the display means and the operation means are configured separately, but a user interface such as a touch panel display in which these are integrated can also be applied.

[Usage form]
A usage pattern of the fundus image processing apparatus 1 having the above configuration will be described. The flowchart shown in FIG. 6 represents an example of the usage pattern of the fundus image processing apparatus 1. 7 to 14 show examples of display screens displayed in this usage pattern. In addition, the control part 10 performs the display process of these display screens.

(Step 0: Select dominant eye)
This step 0 is performed as necessary when there are a plurality of operators using the fundus image processing apparatus 1. The operator operates the operation unit 152 as necessary to input his / her identification information. The control unit 10 selects information representing the dominant eye associated with the input identification information from the dominant eye information 141 and sends the selected information to the position specifying unit 12. Hereinafter, it is assumed that the dominant eye of the operator is the right eye.

(Step 1: Patient selection)
The operator performs a predetermined operation to display the menu screen 3000 shown in FIG. When the mouse 205 is operated and the patient button 3001 is clicked, a patient list screen 3100 shown in FIG. 8 is displayed. A patient list display unit 3101 of the patient list screen 3100 displays a list of patient IDs. The operator operates the scroll bar, the previous button 3102, the next button 3103, and the like with the mouse 205, and clicks and selects a desired patient ID. Then, by clicking the patient selection button 3104, the selected patient (ID) is confirmed.

(Step 2: Selection of fundus image)
When a patient is selected, the control unit 10 displays a list of fundus images acquired in the past for this patient (fundus image list screen; not shown). Examples of the fundus image list screen include those that display thumbnail images such as thumbnails of the fundus image side by side, those that display a list of fundus image shooting dates, and those that sequentially display the fundus image in a slide show format. Any display form capable of selecting an image can be adopted. In addition to the fundus image, various types of information attached to the fundus image, such as the examination date and time and the right and left eyes can be displayed together.

  The operator operates the operation unit 152 to select a desired fundus image. When the fundus image is selected, the operator clicks the 3D button 3002 on the menu screen 3000 in FIG. 7, for example. The 3D button 3002 is operated when observing a fundus image captured by a stereoscopic fundus camera as in this embodiment.

(Step 3: Setting the optical value of the eyeball)
When the fundus image is selected, an eyeball optical value setting screen 3200 shown in FIG. 9 is displayed. The correction mode setting unit 3201 displays a list for selecting an eyeball optical correction mode. Here, a mode using the eyeball optical value of the model eye (Mode 1), a mode using the eyeball optical value of the eye to be examined (Mode 2), and a mode using only the refractive power of the eye to be examined are displayed. Yes. The operator operates the mouse 205 to select a desired mode.

  When the mode using the eyeball optical value of the model eye is selected, the eyeball optical value of the model eye stored in advance is automatically set. The eyeball optical values set here are, for example, standard values of the Gullstrand model eye: refractive power = 0 (D), radius of curvature of cornea = 7.7 (mm), axial length = 2.38 (mm) .

  When a mode using the eyeball optical value of the eye to be examined is selected, an eyeball optical value input unit 3202 shown in FIG. 9 is displayed in the eyeball optical value setting screen 3200. The eyeball optical value input unit 3202 inputs an input space for inputting refractive power, a check box for selecting the presence or absence of a correction lens, an input space for inputting the radius of curvature of the cornea, and an axial length. Input space. The operator operates the keyboard 204 and the mouse 205 to input these values.

  When a mode using only the refractive power of the eye to be examined is selected, an eyeball optical value input unit 3202 shown in FIG. 10 is displayed in the eyeball optical value setting screen 3200. In the eyeball optical value input unit 3202, the input space for the radius of curvature and the input space for the axial length are invalid (that is, a state in which no input is accepted). The operator operates the keyboard 204 and the mouse 205 to input refractive power and select the presence / absence of a correction lens.

  The operator clicks an OK button 3203 shown in FIGS. 9 and 10 to determine the eyeball optical value to be used. When the OK button 3203 is clicked, the eyeball optical value at that time is set as a correction value.

  When the mode using the eyeball optical value of the eye to be examined or the mode using only the refractive power is selected, when the OK button 3203 is clicked without inputting the necessary value, the control unit 10 determines the necessary value. Pop up a dialog with a message instructing you to enter Thereby, a necessary value can be surely input, and in some cases, a mode can be changed.

(Step 4: Alignment of left and right fundus images)
When the setting of the eyeball optical value is completed, the left and right fundus images of the stereoscopic fundus image are aligned. This step 4 is necessary only when a three-dimensional fundus image is used.

  When the setting of the eyeball optical system is completed, a fundus image alignment screen 3300 shown in FIG. 11 is displayed. The fundus image alignment screen 3300 is a screen for aligning the left and right fundus images of the stereoscopic fundus image.

  On the fundus image alignment screen 3300, a fundus image GL photographed by the left photographing optical system of the stereoscopic fundus camera and a fundus image GR photographed by the right photographing optical system are displayed side by side. The operator inputs alignment frames FL and FR to the left and right fundus images GL and GR, respectively. The positions and sizes of the frames FL and FR are adjusted by dragging the mouse 205, for example.

  Note that the frames FL and FR are set so as to include regions corresponding to the optic nerve head in the fundus images GL and GR, respectively. When the setting of the frames FL and FR is completed, the operator clicks an OK button 3301 to determine the frames FL and FR.

(Step 5: Designation of optic disc area)
When the OK button 3301 is clicked, the control unit 10 extracts image areas surrounded by the frames FL and FR from the left and right fundus images GL and GR, respectively. Image regions extracted from the left and right fundus images GL and GR are also represented by the fundus images GL and GR.

  The control unit 10 displays the extracted left and right fundus images GL and GR on the display unit 151 in a stereoscopically viewable manner. For example, the following stereoscopic display modes are available.

  First, there is a method in which an operator puts on glasses for stereoscopic viewing and alternately displays the left and right fundus images GL and GR at predetermined time intervals. The stereoscopic glasses operate so as to alternately shield the left and right visual fields of the operator at predetermined time intervals. This shielding operation can be realized by, for example, a configuration using polarized light or a configuration using a liquid crystal shutter. The switching interval between the left and right fundus images GL and GR and the switching interval between the left and right visual field shields are the same (synchronized). That is, when the left fundus image GL is displayed on the display unit 151, the right visual field is blocked, and when the right fundus image GR is displayed, the left visual field is blocked. Note that the left and right switching intervals are set to be sufficiently short. As a result, the operator visually recognizes the left fundus image GL with only the left eye and visually recognizes the right fundus image GR with only the right eye, and the left and right can be switched at a sufficiently high speed. The fundus can be grasped in three dimensions.

  It is also possible to use a general-purpose display that displays an image in a stereoscopic manner.

  If necessary, the operator moves the display positions of the fundus images GL and GR so that the image area corresponding to the optic nerve head is located near the center of the screen, for example, by dragging the mouse 205.

  Thus, in a state where the left and right fundus images GL and GR are stereoscopically viewed, the operator operates the operation unit 152 to designate the optic disc region. The symbol D in the fundus image display screen 3400 shown in FIG. 12 represents the optic nerve head region (outer edge) designated on the stereoscopic fundus image GLR obtained by alternately displaying the left and right fundus images GL and GR. . The stereoscopic fundus image GLR is actually an image that is recognized only in the brain of an operator who visually recognizes the left and right fundus images GL and GR alternately.

  A specific example of the designation mode of the optic nerve head region D will be described. The operator finds a position corresponding to the outer edge of the optic disc while observing the stereoscopic fundus image GLR, and inputs a plurality of points on the position by clicking the mouse 205.

  The position specifying unit 12 specifies the position on the right fundus image GR (the fundus image on the dominant eye side of the operator) corresponding to the position of each of the plurality of input points. The position on the fundus image GR that the operator's dominant eye visually recognizes is considered to be the same as the position on the stereoscopic fundus image GLR. Considering this, the position specifying unit 12 in this embodiment sets the position of the point input by the operator as the position on the fundus image GR as it is.

  The control unit 10 calculates an equation of an ellipse that passes through the positions (or the positions in the vicinity thereof) of a plurality of points on the fundus image GR specified by the position specifying unit 12. The control unit 10 displays this ellipse on the three-dimensional fundus image GLR (on each fundus image GL, GR). The optic disc area D of FIG. 12 shows this ellipse.

  In addition, the designation | designated aspect of the optic disc area | region D is not limited to this. For example, a closed curve passing through a plurality of points input on a position corresponding to the outer edge of the optic disc may be obtained and displayed. The closed curve may be a curve that can be differentiated at an arbitrary position, or may be a curve that cannot be differentiated at a certain position. Specifically, a spline curve, a Bezier curve, or the like can be used.

(Step 6: Specifying the recessed area)
When the designation of the optic disc area D is completed, the operator designates a recessed area in the optic disc area D. Designation of the recessed area can be performed by the same operation as in the optic nerve head area D.

  As in the case of the optic disc area, the position specifying unit 12 specifies a position on the fundus image GR corresponding to the recessed area (input positions of a plurality of points) designated on the stereoscopic fundus image GLR by the operator. The control unit 10 obtains a closed curve that passes through the positions of the plurality of points (or positions in the vicinity thereof) on the identified fundus image GR. The control unit 10 sets the closed curve indicating the designated part of the outer edge of the recessed area on the stereoscopic fundus image GLR (the respective fundus images GL, On the GR).

  The recessed area C shown in FIG. 12 is represented by a smooth closed curve passing through a plurality of points input by the operator, unlike the optic disc area D approximated by an ellipse. Although an approximate ellipse can be used for the recessed area, the method shown in FIG. 12 is considered desirable in order to more accurately reflect the shape of the recessed area.

  A two-dimensional coordinate system (xy coordinate system) is set in advance for each fundus image GL, GR. The control unit 10 acquires the coordinate value of the optic disc area D specified in step 5 and the coordinate value of the recessed area C specified in step 6.

(Step 7: Calculation of C / D ratio)
When the optic disc region D and the recessed region C are specified in the stereoscopic fundus image GLR, the C / D ratio calculation unit 133 of the image analysis unit 13 determines the optic disc region (outer edge) D specified by the position specifying unit 12. And the vertical C / D ratio C / D (v1), C / D (v2), and horizontal C / D as described above D ratios C / D (h1) and C / D (h2) are calculated, respectively.

(Step 8: Calculation of R / D ratio)
Further, the R / D ratio calculation unit 131 of the image analysis unit 13 includes a part corresponding to the optic nerve head region (outer edge) D specified by the position specifying unit 12 and a part corresponding to the depressed region (outer edge) C. Based on the above, a plurality of R / D ratios R / D (i) are calculated as described above (for example, 72 at intervals of 5 degrees).

  In addition, the average value calculation unit 132 includes an average value of R / D ratios in a measurement part included in a range corresponding to 5:00 to 7:00 in the optic nerve head region D and a measurement part included in a range corresponding to 11:00 to 1:00. The average value of the R / D ratio at is calculated.

(Step 9: Calculation of area and area ratio)
In addition, the area calculation unit 134 of the image analysis unit 13 is based on the part corresponding to the optic papilla region (outer edge) D specified by the position specifying unit 12 and the part corresponding to the depressed region (outer edge) C. As described above, the area S (D) of the optic nerve head area, the area S (C) of the recessed area, and the area S (R) of the rim area are calculated.

  Further, the area ratio calculation unit 135 calculates the C / D area ratio S (C / D) and R / D based on these areas S (D), S (C), and S (R) as described above. The area ratio S (R / D) is calculated.

(Step 10: Display of measurement results)
The control unit 10 performs C / D (v1), C / D (v2), C / D (h1), C / D (h2) calculated in step 7 and R / C calculated in step 8. D (i) and the areas S (D), S (C), S (R) and area ratios S (C / D), S (R / D) calculated in step 10 are represented by the fundus image GR. Display with

  A measurement result display screen 3500 shown in FIG. 13 represents an example of a screen that displays these values together with the fundus oculi image GR. At the bottom of the measurement result display screen 3500, a plurality of operation buttons 3530 for performing various processes are provided. The operator can perform a desired operation by selectively clicking a desired operation button.

  The symbol D (i) in the measurement result display screen 3500 represents the optic disc diameter for a certain i (for example, i = 1 to 72), and the symbol R (i) represents the width of the rim region at this i. Yes. The length of the optic disc diameter D (i) corresponds to the aforementioned optic disc diameter φD (i) (see FIG. 3). The length of the rim region width R (i) corresponds to the rim region width φR (i) described above. Therefore, the ratio of the length of the rim region width R (i) to the length of the optic disc diameter D (i) corresponds to the R / D ratio R / D (i) at i.

  Symbol C (v) represents the maximum diameter of the recessed region C in the vertical direction, and symbol D (V) represents the maximum diameter of the optic disc region D in the vertical direction. The length of the maximum diameter C (v) in the vertical direction of the recessed area C corresponds to the maximum diameter (outer edge) ΨC (v) of the recessed area (see FIG. 4). The length of the maximum diameter D (V) in the vertical direction of the optic nerve head region D corresponds to the maximum diameter (outer edge) ΨD (v) of the aforementioned optic nerve head region. Therefore, the ratio between the length of the maximum diameter C (v) of the recessed area C and the length of the maximum diameter D (V) of the optic nerve head area D is the first C / D ratio C / D (v1) in the vertical direction. ).

  Further, the symbol D (v) represents the vertical diameter of the optic papilla region D passing through the maximum vertical diameter C (v) of the recessed region C. The length of the diameter D (v) corresponds to the (outer edge) diameter ΩD (v) of the optic nerve region described above. Therefore, the ratio between the length of the maximum diameter C (v) of the recessed area C and the length of the diameter D (v) of the optic nerve head area D is the second C / D ratio C / D (v2) in the vertical direction. It corresponds to.

  Symbol C (h) represents the maximum diameter of the recessed region C in the horizontal direction, and symbol D (H) represents the maximum diameter of the optic nerve head region D in the horizontal direction. The length of the maximum horizontal diameter C (h) of the recessed region C corresponds to the maximum diameter (outer edge) ψC (h) of the recessed region described above. Further, the length of the horizontal maximum diameter D (H) of the optic nerve head region D corresponds to the maximum diameter (outer edge) ΨD (h) of the above-mentioned optic nerve head region. Therefore, the ratio between the length of the maximum diameter C (h) of the recessed area C and the length of the maximum diameter D (H) of the optic nerve head area D is the first C / D ratio C / D (h1) in the horizontal direction. ).

  Further, the symbol D (h) represents the horizontal diameter of the optic papilla region D that passes through the maximum horizontal diameter C (h) of the recessed region C. The length of the diameter D (h) corresponds to the (outer edge) diameter ΩD (h) of the optic milk region described above. Therefore, the ratio between the length of the maximum diameter C (h) of the recessed region C and the length of the diameter D (h) of the optic disc region D is the second horizontal C / D ratio C / D (h2). It corresponds to.

  On the fundus image GR of the measurement result display screen 3500, an image representing the outer edge D of the optic nerve head region (papillary outer edge image) and an image representing the outer edge C of the recessed region (recessed outer edge image), as well as the width R of the rim region. An image representing (i) and at least one of diameters D (i), D (v), D (V), D (h), D (H), C (v), and C (h) An image to be represented (linear image) or the like is displayed.

  The nipple outer edge image and the recessed outer edge image represent the position of the region on the fundus image GR specified by the position specifying unit 12 based on the outer edge D of the optic nerve head region and the outer edge C of the recessed region specified by the operator. This is an image and corresponds to an example of “image information” of the present invention.

  The measurement value display unit 3510 of the measurement result display screen 3500 displays the eyeball optical value input in step 3, the measurement value calculated in the calculation processing in steps 7 to 9, and the like. More specifically, the measurement value display unit 3510 displays the following information: refractive power of the subject eye (Refractive Error [D]), average corneal curvature (Mean Corne Curve [mm]), Axial length (Axial Length [mm]), area of optic disc area D (Disc Area [mm2]), area of recessed area C (Cup Area [mm2]), area of rim area (Rim Area [mm2]) , The area ratio between the recessed area C and the optic nerve head area D (C / D Area Ratio), the area ratio between the rim area and the optic nerve head area D (R / D Area Ratio), the first vertical C / D ratio ( Vertical C / D Ratio 1), second vertical C / D ratio (Vertical C / D Ratio 2), first water Flat C / D ratio (Horizontal C / D Ratio 1), second horizontal C / D ratio (Horizontal C / D Ratio 2).

  In the “R / D Ratio” field of the measurement value display unit 3510, any one of the plurality of R / D ratios R / D (i) calculated in Step 8 is displayed. An example of the display mode of the R / D value will be described. First, the operator designates a desired position in the optic disc region D by clicking the mouse 205 or the like. The control unit 10 specifies the measurement position (angle) of the R / D ratio that is closest to the designated position. The control unit 10 displays an image (linear image) indicating the specified measurement position on the fundus image GR. In addition, the control unit 10 acquires the R / D ratio measurement result R / D (i) at the specified measurement position from the R / D ratio calculation unit 131 and causes the measurement value display unit 3510 to display the measurement result. According to such a display mode, it is possible to easily grasp the value of the R / D ratio at the measurement position closest to the position arbitrarily designated by the operator.

  When the operator designates a desired histogram in an R / D ratio graph 3520 described later by clicking the mouse 205 or the like, the control unit 10 performs the R corresponding to the designated histogram in the same manner as described above. The value of the / D ratio is displayed on the measurement value display unit 3510. It should be noted that this function may be omitted when the R / D ratio value is displayed beside each histogram as described later.

  Next, a display mode of graph information representing values of a plurality of R / D ratios R / D (i) will be described. The R / D ratio graph 3520 of the measurement result display screen 3500 is a graph in which the R / D ratios R / D (i) calculated in Step 8 are displayed in a histogram.

  A character string displayed beside each histogram will be described (only the uppermost histogram will be described). The character string “@ 000” indicates that this histogram represents the value of the R / D ratio at a position (left position) at an angle of 0 degrees. The character string “0.216” represents the R / D ratio value indicated by the histogram. In FIG. 13, 72 histograms are arranged and displayed at intervals of 5 degrees. In this way, the control unit 10 operates to display the plurality of R / D ratio values R / D ratio (i) in association with the corresponding histogram.

  Here, the histogram of the predetermined range is displayed in a display mode different from the other histograms. In FIG. 13, histograms in the ranges of 60 to 120 degrees and 240 to 300 degrees are displayed in different display modes. As a display mode of this histogram, for example, the display color can be changed (that is, color-coded display), the display density can be changed, or the display pattern (design) can be changed. In general, the control unit 10 operates to classify a plurality of R / D ratio values R / D (i) into two or more ranges and display a plurality of histograms in a display mode for each classification.

  The display result of the measurement result will be further described with reference to FIG. The measurement result display screen 3600 shown in FIG. 14 is different from the case of FIG. 13 in which a plurality of designated positions are approximated by an ellipse, and is a closed curve such as a spline curve passing through a plurality of points input on a position corresponding to the outer edge of the optic disc. It is an example of a display screen in the case of using (see the description of step 5).

  On the fundus image GR of the measurement result display screen 3600, an image representing the outer edge D of the optic nerve head region, an image representing the outer edge C of the recessed region, an image representing the width R (i) of the rim region, and a diameter D ( i), D (v), D (V), D (h), D (H), C (v), and an image (linear image) representing at least one of C (h) are displayed. Is done.

  On the measurement result display screen 3600, scale images 3640v and 3640h representing the distance on the fundus image GR are displayed. The scale image 3640v represents the distance in the vertical direction. The scale image 3640h represents the distance in the horizontal direction. The operator can change the display position of each of the scale images 3640v and 3640h by a drag operation of the mouse 205. Thereby, the length of a desired part on the stereoscopic fundus image GLR and the distance between two points can be measured.

  On the fundus image GR of the measurement result display screen 3600, image information representing the distribution of the plurality of R / D ratio values R / D (i) calculated in step 8 is displayed. This image information represents at least the positional distribution of the value of the R / D ratio, and also represents the magnitude of the value of the R / D ratio.

  This image information is displayed on the optic disc area (outer edge) R in particular. First, the position on the optic nerve head region D corresponding to the measurement site where the R / D ratio value R / D (i) is equal to or less than the predetermined threshold is displayed in a display mode different from the other positions. In this display mode, image information of a display color, display density, or display pattern different from other positions is displayed. Moreover, you may make it display the linear image of the thickness different from another position.

  In FIG. 14, R / D ratio = 0.1 is applied as a predetermined threshold, and image information d1 is displayed at a position on the optic disc region D corresponding to a range of angles 305 degrees to 325 degrees, and the angle Image information d2 is displayed at a position corresponding to a measurement position of 340 degrees.

  In FIG. 14, the image information d3 is displayed at a position on the optic disc region D corresponding to 11:00 to 1 o'clock, and the image information d4 is displayed at a position corresponding to 5 o'clock to 7 o'clock.

  Furthermore, the display aspect regarding a R / D ratio graph is demonstrated, referring FIG. The histogram included in the R / D ratio graph 3620 shown in FIG. 14 includes the R / D ratio value R / D (i) equal to or less than a predetermined threshold (= 0.1) and a predetermined range (11:00 to 1 o'clock). (A range corresponding to 5 o'clock to 7 o'clock) and those other than that. Here, the former is given priority for those that are equal to or smaller than the predetermined threshold and are included in the predetermined range.

  The control unit 10 displays these three classifications in different display modes. For example, a histogram below a predetermined threshold is displayed in red, a histogram included in a predetermined range is displayed in yellow, and other histograms are displayed in green. Here, reference numerals 3620a and 3620b indicate histograms having a predetermined threshold value or less. Thus, by changing the display mode of the histogram, the operator can easily grasp the histogram (measurement position) to be noted.

  A mark display field in which a mark (for example, a black circle) indicating that the R / D ratio value R / D (i) is equal to or less than a predetermined threshold is displayed at a further horizontal position of the character string next to the R / D ratio graph 3620. 3650 is provided. The control unit 10 extracts the R / D ratio value R / D (i) that is equal to or less than the predetermined threshold value, and displays the mark in the corresponding column in the mark display column 3650. Thereby, the operator can easily grasp a particularly noteworthy histogram (measurement position), that is, a measurement position having a small R / D ratio.

  In a further horizontal position of the mark display field 3650, another mark display field 3660 for displaying a mark (star) indicating the range of the preset measurement position is provided. The display of the mark in the mark display field 3660 is executed by the control unit 10. In FIG. 14, marks are displayed at measurement positions in a range corresponding to 11:00 to 1 o'clock and measurement positions in a range corresponding to 5 o'clock to 7 o'clock. As a result, it is possible to easily grasp the measurement region of the attention range set in advance. The mark displayed in the mark display field 3660 corresponds to an example of designated part information representing a part of a fundus image designated in advance. It should be noted that the part for displaying the designated part information may be a default part or may be designated manually by the operator.

  In each range where the R / D ratio value R / D (i) is less than or equal to a predetermined threshold value, a mark 3670 indicating the measurement position having the smallest value within the range is displayed at the right end of the screen. In FIG. 14, marks 3670 are displayed at a measurement position with an angle of 315 degrees and a measurement position with an angle of 340 degrees.

  Further, a mark 3680 indicating the measurement position having the smallest value among all the calculated R / D ratio values R / D (i) is also displayed at the right end of the screen. In FIG. 14, the character string “Min” is displayed as the mark 3680.

  Next, display control in which the fundus image GR and the R / D ratio graph 3620 are linked will be described. First, when the operator designates a position on the fundus image GR by clicking the mouse 205 or the like, the control unit 10 obtains a measurement position of the R / D ratio that is closest to the designated position. And the control part 10 changes the display mode of the histogram corresponding to the calculated | required measurement position. For example, the display mode is changed by inverting the display color or changing it to a predetermined display color.

  On the other hand, when the operator designates a histogram in the R / D ratio graph 3620 by clicking the mouse 205 or the like, position information representing a position on the fundus image GR corresponding to the designated histogram is displayed. As this position information, image information such as a dot-like image indicating the position or an image on a line can be used. When a plurality of histograms are designated, for example, linear image information indicating the designated range can be displayed.

  Finally, the average value of the R / D ratio will be described. When the operator designates a range on the fundus image GR by dragging the mouse 205 or the like (R / D ratio measurement region range), the control unit 10 specifies a measurement region included in the designated range. The average value calculator 132 calculates the average value of the R / D ratio values R / D (i) calculated by the R / D ratio calculator 131 for the specified measurement site. The control unit 10 displays the calculated average value on the measurement result display screen 3600.

  When the operator designates a histogram in the R / D ratio graph 3620 by clicking the mouse 205 or the like, the average value computing unit 132 calculates the R calculated by the R / D ratio computing unit 131 for the designated measurement site. The average value of the values / D ratio R / D (i) is calculated. The control unit 10 displays the calculated average value on the measurement result display screen 3600.

[Action / Effect]
The operation and effect of the fundus image processing apparatus 1 as described above will be described.

  The fundus image processing apparatus 1 includes a display unit 151 that displays a three-dimensional fundus image GLR including a pair of left and right fundus images GL and GR, and a region of interest such as an optic nerve head region and a recessed region based on the displayed three-dimensional fundus image GLR. Is provided with an operation unit 152 for the operator to specify. Further, the position specifying unit 12 operates to specify a part on the fundus image GR (or the fundus image GL; the same applies hereinafter) corresponding to the target part designated by the operator, and the control unit 10 displays the fundus image GR. The information is displayed on the part 151 and image information (such as a nipple outer edge image and a recessed outer edge image) indicating the position of the part specified by the position specifying unit 12 is displayed on the fundus image GR.

  Thus, according to the fundus image processing apparatus 1, when the operator designates a region of interest based on the stereoscopic fundus image GLR, the region on the fundus image GR corresponding to the region of interest is identified, and the position of this specific region is determined. The represented image information can be displayed on the fundus oculi image GR. Therefore, as compared to the conventional configuration using image processing such as stereo matching as described in Patent Document 1, the position of the attention site designated by the operator (observer) is observed while observing a stereoscopic fundus image. / D ratio, R / D ratio, and other indicators can be accurately reflected.

  In particular, in the fundus image processing apparatus 1, a region corresponding to the region of interest is identified for the fundus image GR on the dominant eye side of the operator, and image information indicating the position of the specific region is displayed on the fundus image GR on the dominant eye side. Therefore, image information is displayed on the fundus image GR on the side having no parallax (at least with a small parallax) with respect to the stereoscopic fundus image GLR that the operator observes in a pseudo binocular viewing state. Become. Therefore, according to the fundus image processing apparatus 1, when an operator designates a target region while observing a stereoscopic fundus image, the designation result is used to calculate an index such as a C / D ratio or an R / D ratio. It can be reflected with high accuracy.

[Modification]
A modification of the fundus image processing apparatus 1 according to this embodiment will be described.

  In the above embodiment, the dominant eye information representing the dominant eye of the operator is stored in advance, and the fundus image is selectively used based on the dominant eye information. It is also possible to select one or both of the GRs and use the selected fundus image.

  A usage pattern when this configuration is applied will be briefly described. First, instead of Step 0 described above, the operator operates the operation unit 152 to arbitrarily select one or both of the left and right fundus images GL and GR. At this time, for example, only the fundus image on the dominant eye side can be selected as in the above-described embodiment, or only the fundus image on the side of the eye with good vision can be selected. It is also possible to specify both right and left fundus images. It is the same about the usage pattern after step 1.

  According to such a modification, there is an advantage that the operator can make a diagnosis by selectively using the fundus image on the desired side. The operation unit 152 in this modification corresponds to an example of “selection operation means” in the present invention.

  In the above embodiment, diagnosis is performed using only one of the left and right pair of fundus images. However, both left and right fundus images GL and GR can be used. In this case, as for the fundus image on the dominant eye side, the position of the attention area designated on the stereoscopic fundus image GLR can be used as it is, as in the above embodiment. On the other hand, for the fundus image on the side opposite to the dominant eye, the position specifying unit 12 performs the correction in consideration of the parallax of the left and right eyes, the imaging magnification, and the like, as in the past, so Identify the site. As a result, the position of the site of interest designated while observing a stereoscopic fundus image can be accurately reflected in the calculation of indices such as the C / D ratio and R / D ratio.

  In the above embodiment, the optic disc area and the recessed area are considered as the attention site designated by the operator while observing the stereoscopic fundus image GLR. For example, the systematic attention site of the fundus such as the macula, blood vessel It is possible to designate an arbitrary site of interest according to the examination content or the like, such as a site of interest on the blood vessel such as a branching position or a bent site.

  In the above embodiment, histograms of measurement results of a plurality of R / D ratios are displayed as graph information, but graph information of other forms can be displayed. For example, a graph in which measurement results of a plurality of R / D ratios are plotted, a line graph formed by connecting a plurality of R / D ratio measurement results, and the like can be displayed.

  In the above-described embodiment, the measurement results of a plurality of R / D ratios are classified into those that are equal to or less than a predetermined threshold value, those that correspond to parts that are designated in advance, etc., but any other classification is possible. It can be carried out.

  In addition, it is possible to configure so that the outer edge of the optic disc area and the outer edge of the recessed area that have been set can be appropriately corrected. For example, the position of the outer edge can be corrected by dragging with the mouse 205 a part of the outer edge that has already been set and displayed. When the position of the outer edge is corrected, the C / D ratio, the R / D ratio, the area, the area ratio, and the like can be calculated again based on the new outer edge position, and the calculation result can be displayed. . In addition, graph information and image information can be obtained and displayed again. Note that such correction is started by clicking the correction button among the operation buttons 3530 and 3630 shown in FIGS.

  In the above embodiment, the image information is displayed on the fundus image and the graph information is displayed. However, the graph information need not be displayed.

  In the above embodiment, the operator manually designates both the outer edge of the optic disc area and the outer edge of the recessed area, but only one of these is designated manually, It is also possible to configure so as to be automatically specified by an arbitrary method similar to the conventional method.

<About fundus photography device>
Similar to the stereoscopic fundus camera 1000 of the above-described embodiment, the fundus imaging apparatus according to the present invention captures a stereoscopic fundus image that is composed of a pair of left and right fundus images of the eye to be examined and can be viewed stereoscopically, and outputs image data (digital data). And a computer having a function of the fundus image processing apparatus 1 according to the above embodiment.

  The configuration for capturing the image data by capturing a pair of left and right fundus images functions as the “imaging means” of the present invention. The display means, operation means, identification means, and control means of the fundus imaging apparatus according to the present invention can be configured in the same manner as in the above embodiment.

<About the program>
A program according to the present invention includes a display unit configured to display a stereoscopic fundus image that includes a pair of left and right fundus images, and an operation unit that designates a region of interest on the fundus based on the displayed stereoscopic fundus image. It is a computer program which controls a computer provided with. Specifically, the program according to the present invention is a computer program that causes such a computer to function as the above-described fundus image processing apparatus 1 (see the description of the above embodiment for the function).

  The program according to the present invention can be recorded on any recording medium that can be read by a drive device of a computer. For example, a recording medium such as an optical disk, a magneto-optical disk (CD-ROM / DVD-RAM / DVD-ROM / MO, etc.), a magnetic storage medium (hard disk / floppy (registered trademark) disk / ZIP, etc.) can be used. is there. It can also be stored in a storage device such as a hard disk drive or memory. Further, this program can be transmitted through a network such as the Internet or a LAN.

It is a schematic block diagram showing an example of composition of a suitable embodiment of a fundus image processing device concerning this invention. It is a schematic block diagram showing an example of composition of a suitable embodiment of a fundus image processing device concerning this invention. It is a schematic explanatory drawing for demonstrating an example of the measurement aspect of R / D ratio by suitable embodiment of the fundus image processing apparatus concerning this invention. It is a schematic explanatory drawing for demonstrating an example of the measurement aspect of C / D ratio by suitable embodiment of the fundus image processing apparatus concerning this invention. It is a schematic explanatory drawing for demonstrating an example of the measurement aspect of C / D ratio by suitable embodiment of the fundus image processing apparatus concerning this invention. It is a flowchart showing an example of the usage pattern of suitable embodiment of the fundus image processing apparatus according to the present invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention. It is the schematic showing an example of the display screen displayed by suitable embodiment of the fundus image processing apparatus concerning this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Fundus image processing apparatus 10 Control part 11 Image reception part 12 Position specification part 13 Image analysis part 131 R / D ratio calculation part 132 Average value calculation part 133 C / D ratio calculation part 134 Area calculation part 135 Area ratio calculation part 14 Memory | storage Unit 141 dominant eye information 15 user interface 151 display unit 152 operation unit 200 microprocessor 201 RAM
202 Nonvolatile storage device 203 Display 204 Keyboard 205 Mouse 206 Communication interface 1000 Fundus photographing device 2000 Stereo fundus camera P Program

Claims (7)

Display means for displaying a three-dimensional fundus image that includes a pair of left and right fundus images and is stereoscopically visible;
Operating means for designating a region of interest in the fundus based on the displayed stereoscopic fundus image;
A specifying means for specifying a part on one or both fundus images of the pair of left and right fundus images corresponding to the designated attention site;
Control means for causing the display means to display the one or both fundus images and displaying image information representing the position of the specified part on the displayed fundus image;
A fundus image processing apparatus comprising: Storage means for storing dominant eye information representing the dominant eye of an observer observing the displayed stereoscopic fundus image;
The specifying unit specifies the corresponding part on the fundus image on the dominant eye side of the observer shown in the dominant eye information among the pair of right and left fundus images,
The control unit displays the fundus image on the dominant eye side on the display unit, and displays the image information on the fundus image on the dominant eye side.
The fundus image processing apparatus according to claim 1. A selection operation means for selecting one or both of the left and right pair of fundus images,
The specifying means specifies the corresponding part on the selected one or both fundus images of the pair of left and right fundus images,
The control unit displays the one or both fundus images on the display unit and displays the image information on the one or both fundus images.
The fundus image processing apparatus according to claim 1. When the outer edge of the optic nerve head region and the outer edge of the recessed region are designated as the region of interest, the specifying means corresponds to each of the outer edge of the designated optic nerve head region and the outer edge of the recessed region, Identify a region on one or both fundus images of a pair of left and right fundus images,
Calculating means for calculating a ratio of a diameter of a portion corresponding to the outer edge of the identified recessed region and a diameter of a portion corresponding to the outer edge of the optic nerve head region to obtain a C / D ratio of the fundus In addition,
The fundus image processing apparatus according to claim 1. When the outer edge of the optic nerve head region and the outer edge of the recessed region are designated as the region of interest, the specifying means corresponds to each of the outer edge of the designated optic nerve head region and the outer edge of the recessed region, Identify a region on one or both fundus images of a pair of left and right fundus images,
The width of the rim region sandwiched between the portion corresponding to the outer edge of the identified optic disc region and the portion corresponding to the outer edge of the recessed region, and the diameter of the portion corresponding to the outer edge of the optic disc region A calculation means for calculating a ratio to obtain an R / D ratio of the fundus;
The fundus image processing apparatus according to claim 1. Photographing means for photographing a three-dimensional fundus image that includes a pair of right and left fundus images and is stereoscopically visible;
Display means for displaying the photographed stereoscopic fundus image in a three-dimensionally recognizable manner;
Operating means for designating a region of interest in the fundus based on the displayed stereoscopic fundus image;
A specifying means for specifying a part on one or both fundus images of the pair of left and right fundus images corresponding to the designated attention site;
Control means for causing the display means to display the one or both fundus images and displaying image information representing the position of the specified part on the displayed fundus image;
A fundus photographing apparatus comprising: Display means for displaying a three-dimensional fundus image that includes a pair of left and right fundus images and is stereoscopically visible;
Operating means for designating a region of interest in the fundus based on the displayed stereoscopic fundus image;
A computer comprising
Function as a specifying means for specifying a part on one or both fundus images of the pair of left and right fundus images corresponding to the designated attention site;
Causing the one or both fundus images to be displayed on the display means, and functioning as control means for displaying image information representing the position of the identified part on the displayed fundus image;
A program characterized by that.

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