JP2020179272A - Ophthalmologic apparatus - Google Patents

Abstract

To provide an ophthalmologic apparatus capable of reducing fatigue and stress applied to a subject.SOLUTION: An ophthalmologic apparatus according to an embodiment can acquire data on eyes in a binocular vision state. The ophthalmologic apparatus comprises a data acquisition section, a visual fixation system, and a control section. The data acquisition section includes an optical system for acquiring data on the eyes. The visual fixation system presents a left-eye fixation target to the left eye and a right-eye fixation target to the right eye. The control section concurrently executes control of the data acquisition section for acquiring the data and control of the visual fixation system for moving the left-eye fixation target and the right-eye fixation target according to the same pattern.SELECTED DRAWING: Figure 3

Description

The present invention relates to an ophthalmic apparatus.

The ophthalmologic apparatus includes an ophthalmologic imaging apparatus for obtaining an image of the eye to be inspected and an ophthalmologic measuring apparatus for measuring the characteristics of the eye to be inspected.

Examples of ophthalmologic imaging devices include an optical coherence tomography that obtains tomographic images using optical coherence tomography (OCT), a fundus camera that photographs the fundus, and an image of the fundus by laser scanning using a cofocal optical system. There is a scanning laser ophthalmoscope (SLO) and the like.

Examples of ophthalmic measuring devices include an ophthalmic refraction tester (refractometer, keratometer) that measures the refractive characteristics of the eye to be inspected, an tonometer, a specular microscope that obtains corneal characteristics (corneal thickness, cell distribution, etc.), and the like. There is a wave front analyzer that obtains refractive error information of the eye to be inspected using a Hartmann-Shack sensor.

Many ophthalmic devices are provided with a configuration for presenting a fixation target to the eye to be inspected (or a companion eye). The fixation target has a function of guiding the line of sight in order to acquire data of a desired portion of the eye to be inspected and a function of fixing the eye to be inspected during the acquisition of data.

Japanese Unexamined Patent Publication No. 2014-200680

In a conventional ophthalmic apparatus, an image is taken while the subject is staring at a stationary fixation target. On the other hand, some photographs and the like take several seconds or longer, and the subject is required to stare at the fixation target all the time during the imaging and the like. However, it is unnatural to keep staring at a stationary fixation target, which may cause fatigue and stress to the subject. This problem is considered to be particularly noticeable for children, the elderly and people with low vision.

An object of the present invention is to provide an ophthalmic apparatus capable of photographing and measuring an eye to be inspected in a natural state.

The ophthalmic apparatus of the embodiment can acquire eye data in a binocular vision state, and includes a data acquisition unit, a fixation system, and a control unit. The data acquisition unit includes an optical system for acquiring eye data. The fixation system presents the left eye fixation target to the left eye and the right eye fixation target to the right eye. The control unit controls the data acquisition unit for acquiring data and the fixation system for moving the left-eye fixation target and the right-eye fixation target according to the same pattern in parallel. Run.

According to the ophthalmic apparatus according to the embodiment, it is possible to photograph and measure the eye to be inspected in a natural state.

The schematic which shows the example of the structure of the ophthalmic apparatus which concerns on embodiment. The schematic which shows the example of the structure of the ophthalmic apparatus which concerns on embodiment. The schematic which shows the example of the structure of the ophthalmic apparatus which concerns on embodiment. The flowchart which shows the example of the operation of the ophthalmic apparatus which concerns on embodiment. The flowchart which shows the example of the operation of the ophthalmic apparatus which concerns on embodiment. The flowchart which shows the example of the operation of the ophthalmic apparatus which concerns on embodiment.

Embodiments of the present invention will be described in detail with reference to the drawings. The ophthalmic apparatus according to one embodiment includes an optical coherence tomography (OCT) and a fundus camera as elements for acquiring data of the eye to be inspected. Here, instead of or in addition to the fundus camera, a scanning laser ophthalmoscope (SLO), a slit lamp microscope, a microscope for ophthalmic surgery, an anterior ocular segment photographing camera and the like may be provided. Swept source OCT is applied in the following examples, but other types of OCT (spectral domain OCT, time domain OCT, unfuss OCT, polarized OCT, etc.) may be applied.

<Constitution>
As shown in FIG. 1, the ophthalmic apparatus 1 includes a fundus camera unit 2, an OCT unit 100, and an arithmetic control unit 200. The fundus camera unit 2 is provided with an optical system and a mechanism for acquiring a frontal image of the eye to be inspected. The OCT unit 100 is provided with a part of an optical system and a mechanism for executing OCT. The other part of the optical system and mechanism for performing OCT is provided in the fundus camera unit 2. The arithmetic and control unit 200 includes one or more processors that execute various arithmetic operations and controls. In addition to these, any element such as a member for supporting the subject's face (jaw holder, forehead pad, etc.) and a lens unit for switching the target part of OCT (for example, an attachment for anterior segment OCT). Or unit may be provided in the ophthalmic apparatus 1.

In the present specification, the "processor" is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an ASIC (Application Specific Integrated Circuit), a programmable logic device (for example, a SPLD (Simple Program)), a programmable logic device (for example, a SPLD) It means a circuit such as Programmable Logic Device) and FPGA (Field Programmable Gate Array). The processor realizes the function according to the embodiment by reading and executing a program stored in a storage circuit or a storage device, for example.

<Fundus camera unit 2>
The fundus camera unit 2 is provided with an optical system for photographing the fundus Ef of the eye to be inspected E. The acquired image of the fundus Ef (called a fundus image, a fundus photograph, etc.) is a front image such as an observation image, a photographed image, or the like. The observed image is obtained by photographing a moving image using near infrared light. The captured image is a still image using flash light.

The fundus camera unit 2 includes an illumination optical system 10 and a photographing optical system 30. The illumination optical system 10 irradiates the eye E to be inspected with illumination light. The photographing optical system 30 detects the return light of the illumination light from the eye E to be inspected. The measurement light from the OCT unit 100 is guided to the eye E to be inspected through the optical path in the fundus camera unit 2, and the return light is guided to the OCT unit 100 through the same optical path.

The light (observation illumination light) output from the observation light source 11 of the illumination optical system 10 is reflected by the reflection mirror 12 having a curved reflecting surface, passes through the condenser lens 13, and passes through the visible cut filter 14. It becomes near infrared light. Further, the observation illumination light is once focused in the vicinity of the photographing light source 15, reflected by the mirror 16, and passes through the relay lenses 17, 18, the diaphragm 19, and the relay lens 20. Then, the observation illumination light is reflected by the peripheral portion of the perforated mirror 21 (the region around the perforated portion), passes through the dichroic mirror 46, is refracted by the objective lens 22, and is the eye to be inspected E (fundus Ef or anterior eye). Department) is illuminated. The return light of the observation illumination light from the eye E to be inspected is refracted by the objective lens 22, passes through the dichroic mirror 46, passes through the hole formed in the central region of the perforated mirror 21, and passes through the dichroic mirror 55. , It is reflected by the mirror 32 via the photographing focusing lens 31. Further, this return light passes through the half mirror 33A, is reflected by the dichroic mirror 33, and is imaged on the light receiving surface of the image sensor 35 by the condenser lens 34. The image sensor 35 detects the return light at a predetermined frame rate. The focus of the photographing optical system 30 is adjusted so as to match the fundus Ef or the anterior segment of the eye.

The light output from the photographing light source 15 (photographing illumination light) is applied to the fundus Ef through the same path as the observation illumination light. The return light of the photographing illumination light from the eye E to be examined is guided to the dichroic mirror 33 through the same path as the return light of the observation illumination light, passes through the dichroic mirror 33, is reflected by the mirror 36, and is reflected by the condenser lens 37. An image is formed on the light receiving surface of the image sensor 38.

The LCD (Liquid Crystal Display) 39 displays a fixation target and a visual acuity measurement target. A part of the light flux output from the LCD 39 is reflected by the half mirror 33A, reflected by the mirror 32, passes through the photographing focusing lens 31 and the dichroic mirror 55, and passes through the hole portion of the perforated mirror 21. The luminous flux that has passed through the hole of the perforated mirror 21 passes through the dichroic mirror 46, is refracted by the objective lens 22, and is projected onto the fundus Ef.

By changing the display position of the fixation target on the screen of the LCD 39, the fixation position of the eye E to be inspected can be changed. Examples of the fixation position include the fixation position for acquiring an image centered on the macula, the fixation position for acquiring an image centered on the optic nerve head, and the space between the macula and the optic nerve head. There is a fixation position for acquiring an image centered on the center of the fundus, and a fixation position for acquiring an image of a portion (peripheral portion of the fundus) far away from the macula. A GUI (Graphical User Interface) or the like for designating at least one of such typical fixation positions can be provided. In addition, a GUI or the like for manually moving the fixation position (display position of the fixation target) can be provided.

The configuration for presenting the movable fixation target to the eye E is not limited to a display device such as an LCD. For example, a movable fixation target can be generated by selectively lighting a plurality of light sources in a light source array (light emitting diode (LED) array or the like). In addition, a movable fixation target can be generated by one or more movable light sources.

The alignment optical system 50 generates an alignment index used for alignment of the optical system with respect to the eye E to be inspected. The alignment light output from the LED 51 passes through the diaphragms 52 and 53 and the relay lens 54, is reflected by the dichroic mirror 55, and passes through the hole portion of the perforated mirror 21. The light that has passed through the hole of the perforated mirror 21 passes through the dichroic mirror 46 and is projected onto the eye E to be inspected by the objective lens 22. The corneal reflected light of the alignment light is guided to the image sensor 35 through the same path as the return light of the observation illumination light. Manual alignment and auto alignment can be executed based on the received light image (alignment index image).

The focus optical system 60 generates a split index used for focus adjustment with respect to the eye E to be inspected. The focus optical system 60 is moved along the optical path (illumination optical path) of the illumination optical system 10 in conjunction with the movement of the photographing focusing lens 31 along the optical path (photographing optical path) of the photographing optical system 30. The reflection rod 67 is removable with respect to the illumination optical path. When adjusting the focus, the reflecting surface of the reflecting rod 67 is inclined and arranged in the illumination optical path. The focus light output from the LED 61 passes through the relay lens 62, is separated into two luminous fluxes by the split index plate 63, passes through the two-hole diaphragm 64, is reflected by the mirror 65, and is reflected by the condensing lens 66. Once imaged on the reflecting surface of, it is reflected. Further, the focus light passes through the relay lens 20, is reflected by the perforated mirror 21, passes through the dichroic mirror 46, is refracted by the objective lens 22, and is projected onto the fundus Ef. The fundus reflected light of the focus light is guided to the image sensor 35 through the same path as the corneal reflected light of the alignment light. Manual alignment and auto alignment can be executed based on the received light image (split index image).

The diopter correction lenses 70 and 71 can be selectively inserted into the photographing optical path between the perforated mirror 21 and the dichroic mirror 55. The diopter correction lens 70 is a plus lens (convex lens) for correcting high-intensity hyperopia. The diopter correction lens 71 is a minus lens (concave lens) for correcting high myopia.

The dichroic mirror 46 synthesizes a fundus photography optical path and an OCT optical path. The dichroic mirror 46 reflects light in the wavelength band used for OCT and transmits light for fundus photography. The optical path for OCT is provided with a collimator lens unit 40, an optical path length changing unit 41, an optical scanner 42, an OCT focusing lens 43, a mirror 44, and a relay lens 45 in this order from the OCT unit 100 side.

The optical path length changing unit 41 is movable in the direction of the arrow shown in FIG. 1, and changes the length of the optical path for OCT. This change in the optical path length is used for correcting the optical path length according to the axial length and adjusting the interference state. The optical path length changing unit 41 includes a corner cube and a mechanism for moving the corner cube.

The optical scanner 42 is arranged at a position optically conjugate with the pupil of the eye E to be inspected. The optical scanner 42 deflects the measurement light LS passing through the optical path for OCT. The optical scanner 42 is, for example, a galvano scanner capable of two-dimensional scanning.

The OCT focusing lens 43 is moved along the optical path of the measurement light LS in order to adjust the focus of the optical system for OCT. The movement of the photographing focusing lens 31, the movement of the focus optical system 60, and the movement of the OCT focusing lens 43 can be controlled in a coordinated manner.

<OCT unit 100>
As illustrated in FIG. 2, the OCT unit 100 is provided with an optical system for performing Swept Source OCT. This optical system divides the light from the variable wavelength light source (wavelength sweep type light source) into the measurement light and the reference light, and causes the return light of the measurement light from the eye E to be inspected to interfere with the reference light passing through the reference optical path. It includes an interfering optical system that generates interfering light and detects this interfering light. The detection result (detection signal) obtained by the interference optical system is a signal showing the spectrum of the interference light, and is sent to the arithmetic control unit 200.

The light source unit 101 includes, for example, a near-infrared wavelength tunable laser that changes the wavelength of emitted light at high speed. The light L0 output from the light source unit 101 is guided by the optical fiber 102 to the polarization controller 103, and its polarization state is adjusted. Further, the optical L0 is guided by the optical fiber 104 to the fiber coupler 105 and divided into the measurement optical LS and the reference optical LR.

The reference light LR is guided by the optical fiber 110 to the collimator 111, converted into a parallel light flux, and guided to the corner cube 114 via the optical path length correction member 112 and the dispersion compensation member 113. The optical path length correction member 112 acts to match the optical path length of the reference light LR with the optical path length of the measurement light LS. The dispersion compensating member 113 acts to match the dispersion characteristics between the reference light LR and the measurement light LS. The corner cube 114 is movable in the incident direction of the reference light LR, thereby changing the optical path length of the reference light LR.

The reference light LR that has passed through the corner cube 114 is converted from a parallel light flux to a focused light beam by the collimator 116 via the dispersion compensating member 113 and the optical path length correction member 112, and is incident on the optical fiber 117. The reference light LR incident on the optical fiber 117 is guided by the polarization controller 118 to adjust its polarization state, is guided to the attenuator 120 by the optical fiber 119 to adjust the amount of light, and is guided to the fiber coupler 122 by the optical fiber 121. Be taken.

On the other hand, the measurement optical LS generated by the fiber coupler 105 is guided by the optical fiber 127 and converted into a parallel light beam by the collimator lens unit 40, and the optical path length changing unit 41, the optical scanner 42, the OCT focusing lens 43, and the mirror 44 The light is reflected by the dichroic mirror 46 via the relay lens 45, is refracted by the objective lens 22, and is incident on the eye E to be inspected. The measurement light LS is scattered and reflected at various depth positions of the eye E to be inspected. The return light of the measurement light LS from the eye E to be inspected travels in the same direction as the outward path in the opposite direction, is guided to the fiber coupler 105, and reaches the fiber coupler 122 via the optical fiber 128.

The fiber coupler 122 combines (interferes with) the measurement light LS incidented through the optical fiber 128 and the reference light LR incidented via the optical fiber 121 to generate interference light. The fiber coupler 122 generates a pair of interference light LCs by branching the interference light at a predetermined branching ratio (for example, 1: 1). The pair of interference light LCs are guided to the detector 125 through optical fibers 123 and 124, respectively.

The detector 125 is, for example, a balanced photodiode. The balanced photodiode has a pair of photodetectors that detect each pair of interference light LCs, and outputs the difference between the detection results by these. The detector 125 sends this output (detection signal) to the DAQ (Data Acquisition System) 130.

A clock KC is supplied to the DAQ 130 from the light source unit 101. The clock KC is generated in the light source unit 101 in synchronization with the output timing of each wavelength swept within a predetermined wavelength range by the tunable light source. The light source unit 101 optically delays one of the two branched lights obtained by branching the light L0 of each output wavelength, and then sets the clock KC based on the result of detecting the combined light. Generate. The DAQ 130 samples the detection signal input from the detector 125 based on the clock KC. The DAQ 130 sends the sampling result of the detection signal from the detector 125 to the arithmetic control unit 200.

In this example, in order to change the length of the optical path length changing unit 41 for changing the length of the optical path (measurement optical path, measurement arm) of the measurement light LS and the length of the optical path (reference optical path, reference arm) of the reference light LR. Although both corner cubes 114 are provided, only one of the optical path length changing portion 41 and the corner cube 114 may be provided. Further, it is also possible to change the difference between the measured optical path length and the reference optical path length by using an optical member other than these.

<Control system>
FIG. 3 shows a configuration example of the control system of the ophthalmic apparatus 1. The control unit 210, the image forming unit 220, and the data processing unit 230 are provided in the arithmetic control unit 200.

<Control unit 210>
The control unit 210 executes various controls. The control unit 210 includes a main control unit 211 and a storage unit 212.

<Main control unit 211>
The main control unit 211 includes a processor and controls each unit (including the elements shown in FIGS. 1 to 3) of the ophthalmic apparatus 1. The photographing focusing lens 31 is moved by the photographing focusing drive unit (not shown), and the OCT focusing lens is moved by the OCT focusing drive unit. Further, the reference drive unit 114A moves the corner cube 114.

The moving mechanism 150, for example, moves at least the fundus camera unit 2 three-dimensionally. In a typical example, the moving mechanism 150 includes an x stage that can move in the x direction (horizontal direction), an x moving mechanism that moves the x stage, a y stage that can move in the y direction (vertical direction), and y. It includes a y-moving mechanism that moves the stage, a z-stage that can move in the z-direction (depth direction), and a z-moving mechanism that moves the z-stage. Each moving mechanism includes an actuator such as a pulse motor and is controlled by the main control unit 211.

The main control unit 211 controls the LCD 39. For example, the main control unit 211 displays the fixation target at a preset position on the screen of the LCD 39. Further, the main control unit 211 can gradually change the display position of the fixation target displayed on the LCD 39 (that is, the fixation target can be moved). The display position and movement mode of the fixation target are set manually or automatically. Manual setting is performed using, for example, a GUI. The automatic setting is performed, for example, by the movement pattern setting unit 231 described later.

<Memory unit 212>
The storage unit 212 stores various types of data. The data stored in the storage unit 212 includes an OCT image, a fundus image, and eye examination information. The eye test information includes subject information such as patient ID and name, left eye / right eye identification information, electronic medical record information, and the like.

<Image forming unit 220>
The image forming unit 220 forms an image based on the output (sampling result of the detection signal) from the DAQ 130. For example, the image forming unit 220 performs signal processing on the spectrum distribution based on the sampling result for each A line to form a reflection intensity profile for each A line, and images these A line profiles as in the conventional swept source OCT. And arrange it along the scan line. The signal processing includes noise removal (noise reduction), filter processing, FFT (Fast Fourier Transform), and the like.

<Data processing unit 230>
The data processing unit 230 performs image processing and analysis processing on the image formed by the image forming unit 220. For example, the data processing unit 230 creates three-dimensional image data (stack data, volume data, etc.) based on raster scan data, renders three-dimensional image data, corrects an image, and performs image analysis based on an analysis application. The data processing unit 230 includes a movement pattern setting unit 231 and a motion detection unit 232.

<Movement pattern setting unit 231>
The movement pattern setting unit 231 sets the movement pattern of the fixation target. The movement pattern represents one of a route through which the fixation target is moved, information equivalent thereto, information for deriving the target, information corresponding thereto, information related thereto, and the like.

As a typical example, the movement pattern includes the shape, orientation, size, movement direction, movement speed, etc. of the movement path of the fixation target. Examples of shapes include circular, rectangular, spiral, linear, and random shapes. The orientation of the shape may be set when the shape has asymmetry. The direction of movement can be set, for example: clockwise, counterclockwise, or a combination of these in the case of a circle, rectangle, or spiral; in the case of a spiral, the direction away from the center or the center. The approaching direction, a combination of these, etc. can be set; in the case of a linear shape, the direction from the first end to the second end, the direction from the second end to the first end, a combination thereof (for example, the first end). (Round trip between the end and the second end) etc. can be set. The moving speed can be selected from options such as low speed, medium speed, and high speed. Further, a desired moving speed may be set, or the moving speed may be adjustable.

When a movement pattern (for example, one or more of shape, shape orientation, size, movement direction, movement speed, etc.) is specified using the user interface 240 (GUI, etc.), the user can use the movement pattern setting unit 231 to perform the movement pattern. Set the movement pattern corresponding to the specified content.

It is possible to set a movement pattern by referring to medical information such as an electronic medical record. For example, when a movement pattern actually applied in shooting or the like is recorded in an electronic medical record or the like, the movement pattern setting unit 231 reads a movement pattern applied in the past from the electronic medical record of the subject, and this movement pattern Can be set as the movement pattern for this shooting. As another example, when the correspondence information in which the predetermined information (for example, the disease name) is associated with the movement pattern is created in advance, the movement pattern setting unit 231 performs the diagnosis name (disease) from the electronic medical record of the subject. The name) can be read out, and the movement pattern corresponding to this diagnosis name can be obtained from the corresponding information.

Preliminary shooting can be performed to determine the movement pattern applied to the shooting. For example, the main control unit 211 causes the ophthalmologic apparatus 1 to perform OCT of the fundus Ef while controlling the LCD 39 so as to move the fixation target according to one or more movement patterns. When two or more movement patterns are applied, OCT of the fundus Ef is executed while applying these movement patterns in sequence.

The movement pattern setting unit 231 evaluates the data collected by such preliminary OCT or an image based on the data. In a typical example, the movement pattern setting unit 231 can perform one or more of noise evaluation, image quality evaluation, contrast evaluation, sharpness evaluation, graininess evaluation, and the like.

The movement pattern setting unit 231 determines whether or not the result of this evaluation is included in the allowable range. For example, the movement pattern setting unit 231 determines whether or not the value (evaluation value) calculated by the evaluation process exceeds a predetermined threshold value. When the evaluation result is included in the permissible range, the movement pattern setting unit 231 sets the movement pattern applied in the preliminary OCT (the movement pattern applied at the time of data collection) as the movement pattern for the main shooting. When the evaluation result is not included in the permissible range (when none of the movement patterns of 1 or more is appropriate), for example, the mode shifts to the mode for manually setting the movement pattern.

It is possible to combine any two or more of the above movement pattern setting modes (manual setting mode, medical information reference mode, preliminary imaging mode, etc.), or to execute any two or more in sequence.

An example thereof will be described. First, the movement pattern setting unit 231 determines whether or not the medical information reference mode can be executed. For example, the movement pattern setting unit 231 determines whether or not predetermined information (movement pattern applied in the past, etc.) is recorded in an electronic medical record or the like.

When the predetermined information is recorded in an electronic medical record or the like, the movement pattern is set by the medical information reference mode. In order to confirm whether or not this movement pattern is appropriate, a preliminary shooting mode using this movement pattern can be executed.

If the predetermined information is not recorded in the electronic medical record or the like, the mode shifts to the preliminary shooting mode. When an appropriate movement pattern is determined by the preliminary shooting mode, this movement pattern is adopted. If an appropriate movement pattern is not determined by the preliminary shooting mode, the mode shifts to the manual setting mode.

The combination and order of the movement pattern setting modes (manual setting mode, medical information reference mode, preliminary imaging mode, etc.) are not limited to the above examples.

<Motion detection unit 232>
The motion detection unit 232 detects the motion of the eye E to be inspected. The method for detecting the movement of the eye E to be inspected is arbitrary.

For example, the motion detection unit 232 can obtain the motion (change in position with time) of the eye E to be inspected by analyzing the moving image of the eye E to be inspected. An example of this moving image is an observation image of the anterior segment of the eye or the fundus Ef. The motion detection unit 232 identifies a predetermined region (pupil region, pupil center, iris region, iris center, macula region, optic disc region, lesion region, laser treatment spot, etc.) in each frame of the moving image, and a plurality of frames. By comparing the positions of the predetermined regions in the above, the movement of the eye E to be inspected can be detected. This process is also used in conventional auto-alignment and tracking.

In another example, a projection optical system that projects a light flux onto the cornea or fundus Ef of the eye E to be inspected, and a detection optical system that detects the reflected light flux with an area sensor or the like are provided. The motion detection unit 232 can detect the motion of the eye E to be inspected by the time course of the detection position of the reflected light flux by the detection optical system. The method for detecting the movement of the eye E to be inspected is not limited to these.

<User interface 240>
The user interface 240 includes a display unit 241 and an operation unit 242. The display unit 241 includes a display device 3. The operation unit 242 includes various operation devices and input devices. The user interface 240 may include a device such as a touch panel in which a display function and an operation function are integrated. It is also possible to build embodiments that do not include at least a portion of the user interface 240. For example, the display device may be an external device connected to an ophthalmic device.

<motion>
The operation of the ophthalmic apparatus 1 will be described.

<First operation example>
A first operation example is shown in FIG. Examples of this operation include parallel control of OCT scanning and movement of the fixation target.

(S1: Setting the movement pattern of the fixation target)
First, the movement pattern setting unit 231 sets the movement pattern of the fixation target. This process is executed as described above.

(S2: Start of presentation of fixation target)
The main control unit 211 starts presenting the fixation target by controlling the LCD 39. For example, the main control unit 211 displays the fixation target at the initial position (pixel position of the LCD 39) based on the movement pattern set in step S1. Alternatively, the main control unit 211 displays the fixation target at a preset position for alignment or the like in step S3.

(S3: Alignment / focus adjustment)
The main control unit 211 controls the alignment optical system 50 to project alignment indexes (two alignment bright spots) onto the eye E to be inspected. As in the past, auto alignment or manual alignment is performed. Further, the main control unit 211 controls the focus optical system 60 to project the split index onto the fundus Ef. As in the past, auto-focusing or manual focusing is performed.

Further, as the optimization of the imaging conditions, it is possible to adjust the optical path length of the measurement optical path, adjust the polarization state of the measurement light LS, adjust the amount of light of the measurement light LS, adjust the focus of the measurement optical path, and the like. After the optimization is completed, the examiner (or the ophthalmic apparatus 1) can confirm whether or not a problem such as flare contamination has occurred in the observation image.

(S4: Start shooting)
The examiner or the main control unit 211 gives an instruction to start imaging (OCT, fundus imaging, etc.). The examiner can perform an operation for instructing the start of photographing by using, for example, the user interface 240. Further, the main control unit 211 receives, for example, the completion of alignment and focus adjustment, the completion of optimization of shooting conditions, or the fact that there is no problem such as flare mixing or the problem is solved. It is possible to generate an instruction to start shooting.

When the instruction to start shooting is given, the main control unit 211 executes the control of step S5A and the control of step S5B at an arbitrary timing. For example, the main control unit 211 can start step S5A and step S5B at the same time. Alternatively, the main control unit 211 can start one of steps S5A and S5B and then start the other at a predetermined timing.

(S5A: Start of movement of fixation target)
The main control unit 211 starts moving the fixation target according to the movement pattern set in step S1.

(S5B: Start of OCT scan)
The main control unit 211 starts scanning the fundus Ef using OCT by controlling the OCT unit 100, the optical scanner 42, and the like. This scan may be a relatively long time scan, such as a raster scan (three-dimensional scan), OCT angiography (OCT angiography), or OCT blood flow measurement.

(S6A: Completion of movement of fixation target)
The main control unit 211 completes the movement of the fixation target at a predetermined timing. The predetermined timing is based on, for example, the examiner's instruction, the completion of the OCT scan, and the like.

(S6B: Completion of OCT scan)
The main control unit 211 completes the OCT scan at a predetermined timing. The predetermined timing is based on, for example, the examiner's instruction, the completion of the movement of the fixation target, and the like.

The main control unit 211 can finish the movement of the fixation target and the OCT scan at the same time. Alternatively, the main control unit 211 can finish one of the fixation target movement and the OCT scan, and then finish the other at a predetermined timing.

With such control, the movement of the fixation target and the OCT scan are performed in parallel. Here, executing two (or three or more) controls in parallel means that at least a part of the period in which one control is executed overlaps with at least a part of the period in which the other control is executed. Means. In this example, the main control unit 211 executes both controls so that at least a part of the period during which the movement of the fixation target is executed and at least a part of the period during which the OCT scan is executed overlap.

(S7: Formation of OCT image)
The image forming unit 220 forms an image of the fundus Ef based on the data collected by the movement of the fixation target and the parallel control of the OCT scan. In addition, the data processing unit 230 can process the image formed by the image forming unit 220.

The image formed in step S7 may be, for example, volume data representing a three-dimensional region of the fundus Ef, a rendered image thereof, an angiographic image (angiogram) of the fundus Ef, a blood flow image of the fundus Ef, or the like.

<Second operation example>
A second operation example is shown in FIG. Examples of this operation include parallel control of OCT scanning, movement of the fixation target, and tracking using the movement mechanism 150.

(S1 to S4)
Steps S1 to S4 are executed in the same manner as, for example, in the first operation example.

When the instruction to start imaging in step S4 is given, the main control unit 211 executes OCT scan control, movement control of the fixation target, and tracking control using the movement mechanism 150 at an arbitrary timing. For example, the main control unit 211 can start two or three of these three controls at the same time. Alternatively, the main control unit 211 starts the first control of these three controls, starts the second control at a predetermined timing thereafter, and starts the third control at a predetermined timing thereafter. be able to. In FIG. 5, the OCT scan control and the fixation target movement control are collectively referred to as step S15A, and the tracking control is referred to as step S15B.

(S15A: Movement of fixation target / start of OCT scan)
The main control unit 211 starts the movement of the fixation target according to the movement pattern set in step S1 at a predetermined timing, and starts the OCT scan at a predetermined timing. The start of the movement of the fixation target is the same as in step S5A of the first operation example, and the start of the OCT scan is the same as in step S5B.

(S15B: Start of tracking by moving mechanism)
The main control unit 211 starts tracking by the moving mechanism 150 at a predetermined timing. The first processing example of tracking according to this example is, for example, acquisition of a moving image of the eye E to be inspected, detection of the movement of the eye E to be inspected by the motion detection unit 232, and a movement mechanism 150 according to the detected movement. Including control. The main control unit 211 causes the fundus camera unit 2 to acquire an infrared observation image, and causes the fundus camera unit 2 to follow the movement of the eye E to be inspected substantially in real time by the motion detection unit 232 (in other words). The movement mechanism 150 is controlled (so as to cancel the displacement of the eye E to be inspected). According to the first processing example, the optical system can be made to follow the movement of the eye E to be inspected in substantially real time.

A second processing example of tracking according to this example includes, for example, control of the movement mechanism 150 based on the movement pattern set in step S1. The main control unit 211 controls the movement mechanism 150 so that the fundus camera unit 2 follows the movement of the eye E to be inspected in the line-of-sight direction according to the movement pattern set in step S1. The second processing example is based on the premise that the eye E to be inspected follows a moving fixation target.

The first processing example and the second processing example may be combined. For example, while executing the second processing example, the displacement between the proper line-of-sight direction and the actual orientation (position) of the eye E to be inspected is obtained, and when this displacement exceeds the predetermined threshold value, the first processing example is executed. can do.

(S16A: Movement of fixation target / completion of OCT scan)
The main control unit 211 completes the movement of the fixation target at a predetermined timing, as in step S6A of the first operation example. Further, the main control unit 211 completes the OCT scan at a predetermined timing as in step S6B of the first operation example.

(S16B: Completion of tracking by the moving mechanism)
The main control unit 211 completes tracking by the moving mechanism 150 at a predetermined timing. The predetermined timing is based on, for example, the examiner's instruction, the completion of the movement of the fixation target, the completion of the OCT scan, and the like.

By such control, the movement of the fixation target, the OCT scan, and the tracking by the movement mechanism 150 are executed in parallel. In this example, at least a part of the period during which the fixation target is moved, at least a part of the period during which the OCT scan is performed, and at least a part of the period during which the tracking by the movement mechanism 150 is performed overlap. The main control unit 211 executes three controls so as to do so.

(S7: Formation of OCT image)
The image forming unit 220 forms an image of the fundus Ef based on the data collected by the movement of the fixation target and the parallel control of the OCT scan and the tracking. This process is executed in the same manner as in step S7 of the first operation example.

<Third operation example>
A third operation example is shown in FIG. Examples of this operation include parallel control of OCT scanning, movement of the fixation target, and tracking using the optical scanner 42.

(S1 to S4)
Steps S1 to S4 are executed in the same manner as, for example, in the first operation example.

When the instruction to start imaging in step S4 is given, the main control unit 211 executes OCT scan control, fixation target movement control, and tracking control using the optical scanner 42 at arbitrary timings. For example, the main control unit 211 can start two or three of these three controls at the same time. Alternatively, the main control unit 211 starts the first control of these three controls, starts the second control at a predetermined timing thereafter, and starts the third control at a predetermined timing thereafter. be able to. In FIG. 6, the OCT scan control and the fixation target movement control are collectively referred to as step S25A, and the tracking control is referred to as step S25B.

(S25A: Movement of fixation target / start of OCT scan)
The main control unit 211 starts the movement of the fixation target according to the movement pattern set in step S1 at a predetermined timing, and starts the OCT scan at a predetermined timing. The start of the movement of the fixation target is the same as in step S5A of the first operation example, and the start of the OCT scan is the same as in step S5B.

(S25B: Start of tracking by optical scanner)
The main control unit 211 starts tracking by the optical scanner 42 at a predetermined timing. The first processing example of tracking according to this example is, for example, acquisition of a moving image of the eye E to be inspected, detection of the movement of the eye E to be inspected by the motion detection unit 232, and an optical scanner 42 according to the detected movement. Including control. The main control unit 211 causes the fundus camera unit 2 to acquire an infrared observation image, and causes the motion detection unit 232 to follow the projection position of the measurement light LS to the movement of the eye E to be inspected detected in substantially real time ( In other words, the optical scanner 42 is controlled (so as to cancel the displacement of the eye E to be inspected). According to the first processing example, the projection position of the measurement light LS can be made to follow the movement of the eye E to be inspected in substantially real time.

A second processing example of tracking according to this example includes, for example, control of the optical scanner 42 based on the movement pattern set in step S1. The main control unit 211 controls the optical scanner 42 so that the projection position of the measurement light LS follows the movement of the eye E to be inspected in the line-of-sight direction according to the movement pattern set in step S1. The second processing example is based on the premise that the eye E to be inspected follows a moving fixation target.

The first processing example and the second processing example may be combined. For example, while executing the second processing example, the displacement between the proper line-of-sight direction and the actual orientation (position) of the eye E to be inspected is obtained, and when this displacement exceeds the predetermined threshold value, the first processing example is executed. can do.

(S26A: Movement of fixation target / completion of OCT scan)
The main control unit 211 completes the movement of the fixation target at a predetermined timing, as in step S6A of the first operation example. Further, the main control unit 211 completes the OCT scan at a predetermined timing as in step S6B of the first operation example.

(S26B: Completion of tracking by optical scanner)
The main control unit 211 completes tracking by the optical scanner 42 at a predetermined timing. The predetermined timing is based on, for example, the examiner's instruction, the completion of the movement of the fixation target, the completion of the OCT scan, and the like.

By such control, the movement of the fixation target, the OCT scan, and the tracking by the optical scanner 42 are executed in parallel. In this example, at least a part of the period during which the fixation target movement is executed, at least a part of the period during which the OCT scan is performed, and at least a part of the period during which the tracking by the optical scanner 42 is executed overlap. The main control unit 211 executes three controls so as to do so.

(S7: Formation of OCT image)
The image forming unit 220 forms an image of the fundus Ef based on the data collected by the movement of the fixation target and the parallel control of the OCT scan and the tracking. This process is executed in the same manner as in step S7 of the first operation example.

<Action / effect>
The operation and effect of the ophthalmic apparatus according to the embodiment will be described.

The ophthalmic apparatus of the embodiment includes a data acquisition unit, a fixation system, and a control unit. The data acquisition unit includes an optical system for acquiring data of the eye to be inspected. In the above example, the data acquisition unit includes an optical system for executing OCT and an image forming unit 220. The fixation system presents an fixation target to the eye to be inspected. In the above example, the fixation system includes an LCD 39 and an element for guiding the light output from the LCD 39 to the eye E to be inspected. The control unit executes the control of the data acquisition unit for acquiring the data of the eye to be inspected and the control of the fixation system for moving the fixation target in parallel. In the above example, the control unit includes a main control unit 211.

With such an ophthalmic device, it is possible to perform imaging and measurement while moving the fixation target, so that it is in a natural state as compared with a conventional ophthalmology device that requires a stationary fixation target. It is possible to take and measure the eye to be inspected. Thereby, for example, fatigue and stress given to the subject can be reduced.

The ophthalmic apparatus of the embodiment may include a tracking function. The tracking function can be realized, for example, by using a moving mechanism that moves the optical system of the data acquisition unit. In the above example, the moving mechanism 150 moves the optical system. Further, the control unit controls the data acquisition unit for acquiring the data of the eye to be inspected, the control of the fixation system for moving the fixation target, and the control of the movement mechanism for moving the optical system. Can be run in parallel.

In one example, the ophthalmic apparatus of the embodiment may include a detector that detects the movement of the eye to be inspected. In the above example, the detection unit includes a motion detection unit 232. Further, the control unit can control the movement mechanism according to the movement of the eye to be inspected detected by the detection unit.

In another example, the control unit controls the fixation system so as to move the fixation target according to a predetermined movement pattern (predetermined pattern), and also controls the movement mechanism based on the predetermined movement pattern. can do.

It is also possible to realize a tracking function by using an optical scanner. The optical scanner scans the eye to be inspected with the light from the light source. In the above example, an optical scanner 42 for scanning the eye E to be inspected with the light from the light source unit 101 (measurement light LS) is used.

In one example, the ophthalmic apparatus of the embodiment may include a detector that detects the movement of the eye to be inspected. Further, the control unit controls the optical system according to the movement of the eye to be inspected detected by the detection unit in the control of the data acquisition unit for acquiring the data of the eye to be inspected. As a result, the correction of the scan position is executed in substantially real time according to the movement of the eye to be inspected. For example, when the scan of the eye to be inspected is executed with a preset scan pattern, it is possible to correct a series of scan positions according to the scan pattern according to the movement of the eye to be inspected.

In another example, the control unit controls the fixation system so as to move the fixation target according to a predetermined pattern, and in the control of the data acquisition unit for acquiring the data of the eye to be inspected, the predetermined pattern. It is possible to perform control of the optical system based on.

With the above functions, it is possible to take and measure the eye to be inspected in a natural state, and to take and measure an appropriate position by tracking according to the movement of the eye to be inspected and / or the movement of the fixation target. It becomes possible.

The ophthalmic apparatus of the embodiment may include a function (setting unit) for setting a movement pattern of the fixation target. In the above example, the setting unit includes a movement pattern setting unit 231. Further, the control unit can control the fixation system so as to move the fixation target according to the movement pattern set by the setting unit. The movement pattern set by the setting unit can be used as the above-mentioned predetermined pattern.

Examples of the method of setting the movement pattern of the fixation target include a method of manually setting by the examiner, a method of setting by referring to medical information such as an electronic medical record, and a preliminary photographing (preliminary) for setting the movement pattern. There is a method of setting using measurement), an arbitrary combination of these, and the like.

Preliminary imaging (preliminary measurement) is performed prior to main imaging (main measurement), which includes parallel control of the data acquisition unit and the fixation system (and tracking). In the specific example, the control unit causes the data acquisition unit to acquire preliminary data while executing control of the fixation system so as to move the fixation target according to one or more patterns. The setting unit can set the movement pattern based on the acquired preliminary data.

By providing the movement pattern setting function illustrated above, it is possible to use the movement pattern of the fixation target according to the subject and the eye to be inspected. That is, when the fixation target moves, the pattern (shape, orientation, size, movement direction, movement speed, etc.) that makes it easy to follow the fixation target is considered to be different for each subject and each eye. Therefore, according to an ophthalmic apparatus capable of setting the movement pattern of the fixation target, a movement pattern suitable for each subject and each eye (for example, natural movement that is considered to cause less fatigue and stress to the subject). Pattern) can be applied.

The embodiments described above are merely examples of the present invention. A person who intends to carry out the present invention can arbitrarily make modifications (omission, replacement, addition, etc.) within the scope of the gist of the present invention.

In the operation examples shown in FIGS. 4 to 6, the movement of the fixation target is started after the start of imaging (measurement), but the timing at which the movement of the fixation target is started is not limited to that after the start of imaging. For example, the fixation target can be moved while performing preparatory operations such as alignment, focus adjustment, and optimization of shooting conditions. By doing so, it is possible to practice how to move the eye to be inspected according to the movement pattern of the fixation target, and to encourage the subject to become accustomed to the movement pattern.

Before the main shooting (main measurement), it is possible to practice how to move the eye to be inspected by moving the fixation target in a predetermined pattern. Further, it is possible to perform preliminary imaging (preliminary measurement) while performing tracking and repeating the movement of the fixation target a predetermined number of times in a predetermined pattern in response to a predetermined trigger. As a specific example, after starting tracking and blink detection processing, the fixation target is moved three times along a circular orbit (clockwise or counterclockwise) in response to the detection of blinking of the eye to be inspected. While doing so, it is possible to photograph the fundus, which substantially makes a circular motion. By evaluating the data obtained by such preliminary imaging (preliminary measurement), it is possible to determine whether or not the guidance of the line of sight by the fixation target is appropriate. Depending on the result of this determination, it is possible to practice how to move the eye to be inspected again, change the movement pattern for the practice, and start the main shooting (main measurement).

By predicting the movement pattern of the eye to be inspected, it is possible to set the movement pattern of the fixation target and the tracking pattern. The movement pattern of the eye to be inspected can be predicted based on, for example, the data acquired by the movement detection unit 232.

When imaging or measurement is performed in a binocular vision state, the fixation target can be presented to both eyes of the subject. At this time, it is possible to control the left-eye fixation target and the right-eye fixation target to move according to the same pattern. Such an operation is realized, for example, by synchronous control of a display device for displaying the left-eye fixation target and a display device for displaying the right-eye fixation target. According to this function, shooting and measurement can be performed in a natural binocular vision state.

1 Ophthalmic device 39 LCD
42 Optical scanner 100 OCT unit 101 Light source unit 211 Main control unit 220 Image forming unit 231 Movement pattern setting unit 232 Motion detection unit

Claims (5)

It is an ophthalmic device that can acquire eye data in binocular vision.
A data acquisition unit that includes an optical system for acquiring eye data,
An fixation system that presents a left eye fixation target to the left eye and a right eye fixation target to the right eye,
The control of the data acquisition unit for acquiring the data and the control of the fixation system for moving the fixation target for the left eye and the fixation target for the right eye according to the same pattern are performed in parallel. An ophthalmic device equipped with a control unit that executes data. The fixation system includes a first display device for displaying the left-eye fixation target and a second display device for displaying the right-eye fixation target.
The control unit is characterized in that the left-eye fixation target and the right-eye fixation target are moved according to the same pattern by synchronous control of the first display device and the second display device. The ophthalmic apparatus according to claim 1. The ophthalmologic apparatus according to claim 1 or 2, further comprising a setting unit for setting the pattern in which the left eye fixation target and the right eye fixation target are moved. The setting unit is characterized in that the setting unit sets the pattern in which the left eye fixation target and the right eye fixation target are moved based on the prediction of the eye movement pattern of the subject. The ophthalmic apparatus according to any one of 1-3. Further including means for performing a preparatory operation for acquiring the data by the data acquisition unit.
The control unit according to any one of claims 1 to 4, wherein the control unit executes other control of the fixation system for moving the fixation target according to the pattern in parallel with the preparation operation. The ophthalmic device described.