JP2021194117A - Ultrasonic eyeball measurement support instrument and ultrasonic measuring device using the same - Google Patents

Abstract

To provide an ultrasonic eyeball measurement support instrument that can cope with an arbitrary position of an eyeball and can enhance accuracy of ultrasonic measurement, and allows a change with time of parameters related to an eyeball such as a pupil size to be measured, and to provide an ultrasonic eyeball measuring device using the support instrument.SOLUTION: The ultrasonic eyeball measurement support instrument includes a light blocking body for covering an eyelid of an object person whose eyeball is measured, and a probe holding mechanism capable of fixing and holding an ultrasonic probe to the light blocking body in a predetermined position state. The instrument may include light blocking body mounting means for fixing the light blocking body to the face or the head, and a light source that can emit visible light so as to be substantially orthogonal to a longitudinal direction of the ultrasonic probe may be attached inside the light blocking body in a state that the ultrasonic probe is fixed and held to the light blocking body.SELECTED DRAWING: Figure 6

Description

The present invention is an ultrasonic measurement support for an eyeball used to create an eyeball image by ultrasonic measurement and to monitor eyeball-related parameters such as pupil size and intraocular pressure, and their changes over time easily and with high accuracy. The present invention relates to a tool and an ultrasonic measuring device for an eyeball using the tool.

In medical practice, it is common practice to examine pupillary light reflexes such as pupillary light reflex and dilated pupils in order to obtain findings such as the degree, cause, and site of consciousness disorder, and simple findings on the cranial nerves.
For the light reflex, which changes the size of the pupil according to the intensity of light, the light reflex has been visually confirmed by using a penlight. However, in order to obtain information such as miosis, mydriasis, and differences in left and right pupil sizes as the basis for diagnosis of cause and focal localization, index of severity, prognosis prediction, and judgment of surgery / treatment indication, the pupil There is a need for a measuring device that can measure the size accurately and easily.

In recent years, an infrared pupillometer that obtains an infrared image using infrared reflection and calculates the pupil diameter based on the image has been generally used.
The portable infrared pupillometer irradiates the eyes with infrared rays, detects the infrared rays reflected from the iris by the built-in camera with a sensor, and calculates the diameter and area of the pupil based on the obtained reflected image. (Non-Patent Document 1: Merlin D et.al “Portable Infrared Pupillometry: A Review” www.anesthesia-analgesia.org June 2015, Vol.120 No.6 pp1242-1253).

In Japanese Patent Application Laid-Open No. 2000-300500 (Patent Document 1), as a device for obtaining an eyeball image for measuring the size of a pupil by light reflex for the purpose of inspecting stress and dementia, a visible light emitting means, an infrared light emitting means, and the like. A holding means including an eyeball imaging means, which is composed of a pupil-shaped frame for holding each component in order to prevent each component of these means from being displaced by a movement of the head, and an eyeball obtained by the eyeball imaging means. A pupil measuring device including an image pickup signal processing means for calculating the size of the pupil and the position of the pupil or the center position of the pupil from an image has been proposed.

In order to observe the light reflex, it is necessary to shine light on the eye. Therefore, when the measurement subject is in a closed eye state due to clouding of consciousness or trauma, it is necessary to forcibly open the eyelids in order to irradiate the pupil with light. Patent 6111492 (Patent Document 2) includes an apparatus main body composed of temporal regions arranged so as to sandwich the temporal region of a measurement target person from both left and right sides, and a pair of photographing units provided on the apparatus main body. The photographing unit has an irradiation unit that irradiates visible light and infrared light toward the pupil of the measurement target person, and a camera unit that captures an image of the pupil, and is worn by the measurement target person. , A pupil diameter measurement support device has been proposed in which a gap is formed between both eyes of a measurement target and the front part of the main body of the device so that a finger can be inserted to open the eyelids. With the measurement support device attached to the subject's head, the measurer can open the subject's eyelids, observe the light reflex, and capture a pupil image.

In the infrared pupillometer used in Non-Patent Document 1, it is necessary for the measurer to grasp a measuring instrument provided with an infrared irradiation unit and a built-in camera, and to point the camera at the eyeball to take an image. Therefore, when it is desired to monitor the change of the pupil size with time, it is necessary to hold the measuring instrument and continue the imaging, and there is also a problem that the imaging point shifts due to the movement of the subject.

In this regard, according to the portable pupil measuring device proposed in Patent Document 1, the image pickup camera, the infrared light emitting means, and the visible light emitting means can be fixed to the head of the subject by the eyeglass type frame. The measurer does not have to keep holding the pupil measuring device.

Further, according to the measurement support device of Patent Document 2, even when measuring the light reflex of a patient with eyes closed, it is possible to measure the light reflex while wearing it on the head of the subject.

On the other hand, as a method for measuring the pupil size, in addition to a method of taking an infrared image and measuring the pupil size based on the obtained image, the pupil image is visualized and the pupil diameter is measured by using ultrasonic imaging. There are also reports.
For example, Ashot e. Sargsyan et. Al, "Ultrasonic evaluation of pupillary light reflex" Crit Ultrasound J (2009) 1: 53-57 (Non-Patent Document 2) contains PLR (pupilary light reflex) and ultrasonic images. It is reported that it was used and evaluated. Here, as shown in FIG. 1, an ultrasonic probe 1 capable of transmitting ultrasonic waves and receiving echoes is grasped and applied to the eyelids 6 of a subject to obtain an ultrasonic image.

Further, in Japanese Patent Application Laid-Open No. 2019-518549 (Patent Document 3), the size and / or pupil of the subject's pupil is described even when the subject's eyes are closed as in the clinical evaluation of a coma patient. Devices and methods that can evaluate reflection have been proposed. Specifically, it is a device provided with a light source configured to pass light toward the vitreous cavity and a detector for detecting a part of transmitted light emitted from the pupil. The detector enables detection of pupil contour and / or pupil shape by near-infrared photography.
Further, Patent Document 3 uses a step of irradiating the subject's eye with induced light through the subject's closed eye, thereby inducing pupillary reflex, and an ultrasonic trasducer of the eye to obtain ultrasonic output. Based on the step of irradiating the subject's eye with ultrasound and the measurements performed on the ultrasound output obtained in response to inducing pupillary light reflex, the subject's pupil and / or pupil. A measurement method is disclosed that includes a step of determining the size of the reflection. Specifically, there is an explanation that a device in which an attachment element configured so that an ultrasonic transducer can be attached is arranged on the front surface of the spectacle frame is used, but there is no disclosure about the specific configuration.

Japanese Unexamined Patent Publication No. 2000-300500 Japanese Patent No. 6111492 Japanese Unexamined Patent Publication No. 2019-518549

Merlin D et.al “Portable Infrared Pupillometry: A Review” www.anesthesia-analgesia.org June 2015, Vol.120 No.6 pp1242-1253) Ashot e.Sargsyan et.al, “Ultrasonic evaluation of pupillary light reflex” Crit Ultrasound J (2009) 1: 53-57

Since it is necessary to irradiate the eyeball with infrared rays in order to obtain a pupil image by infrared reflection, it is forcibly to measure the pupil of a patient with impaired consciousness or a patient with closed eyes such as general anesthesia. You need to open your eyelids.
If it is desired to monitor changes in pupil size, it is practically difficult to monitor changes in pupil size over time because it is necessary to open the eyelids for each measurement.

With the method using ultrasonic waves, it is possible to create an eyeball image even when the eyes are closed.
However, since the ultrasonic image of the eyeball is formed based on the echo at the interface of the eyeball tissue, it is effective when the ultrasonic wave does not pass through the pupil due to a slight difference in eye movement, angle, and position. Pupil image cannot be obtained. Therefore, in the fixed device, the error due to the position fluctuation of the eyeball becomes larger, and the information obtained from the monitoring is insufficient in terms of accuracy.

The present invention has been made in view of such circumstances, and an object thereof is to be able to cope with an arbitrary position of an eyeball, to improve the accuracy of ultrasonic measurement, and to have a pupil size. It is an object of the present invention to provide an ultrasonic measurement support tool for an eyeball, which enables measurement of changes in parameters related to the eyeball such as, and an ultrasonic measurement device for the eyeball using the support tool.

That is, the ultrasonic measurement support tool for the eyeball of the present invention performs eyeball measurement by an ultrasonic measuring device that abuts an ultrasonic probe on the eyelid and generates an ultrasonic image of the eyeball by transmitting and receiving ultrasonic waves from the ultrasonic probe. It is a supporting device and has a light-shielding body that covers the eyelids of the subject whose eyeball is measured; and a probe holding mechanism that can fix and hold the ultrasonic probe in a predetermined position on the light-shielding body.

It is preferable that the light-shielding body is provided with an insertion port into which the ultrasonic probe can be inserted, and the probe holding mechanism is a locking means for locking the ultrasonic probe to the insertion port. Further, it is preferable that a locking receiving portion into which the locking convex portion attached to the ultrasonic probe can be inserted is provided on the peripheral edge of the insertion port.

The measurement support tool may further include a light-shielding body wearing means for fixing the light-shielding body to the face or the head. The light-shielding body may be a goggle-type light-shielding body.

A gel-like substance that fills the gap between the tip of the ultrasonic probe and the eyelid, which is fixedly held by the light-shielding body, may be attached to the eyelid contact portion of the light-shielding body.

Further, a light source capable of irradiating visible light so as to be substantially orthogonal to the longitudinal direction of the ultrasonic probe while the ultrasonic probe is fixedly held by the light-shielding body may be attached to the light-shielding body. ..

The present invention relates to the above-mentioned measurement support tool of the present invention; an ultrasonic probe fixedly held in a predetermined position by the measurement support tool; and processing an ultrasonic output signal from the ultrasonic probe to image a pupil and / or an eyeball. Also includes an ultrasonic measuring device for an eyeball provided with a signal processing means for producing the above; and a display means for capturing an image of the pupil created by the signal processing means.

The signal processing means may have a means capable of calculating and outputting at least one eyeball-related parameter selected from the group consisting of pupil size, intraocular pressure parameter and optic nerve parameter.

Since the ultrasonic measurement support tool for the eyeball of the present invention can stably hold the probe for ultrasonic measurement, it is possible to reduce the labor of the measurer in measuring the time-dependent change of the parameter applied to the eyeball.
Further, by using the ultrasonic measurement support tool of the present invention, it is possible to hold the ultrasonic measurement probe at an appropriate position with respect to an arbitrary position of the eyeball, and therefore, the pupil diameter at an arbitrary position of the eyeball. Can be measured.
Furthermore, if a light source for irradiating visible light is provided in the light-shielded body, the line of sight of the subject who can freely move the eyeball under consciousness can be stabilized, so that the subject can be continuously affected. It is possible to measure changes in the pupil diameter.

It is a schematic diagram for demonstrating the ultrasonic wave measurement method of an eyeball. It is a schematic diagram which shows the structure of the ultrasonic measurement support tool of the eyeball of 1st Embodiment. It is a schematic diagram which shows an example of the ultrasonic probe used for the ultrasonic measurement support tool of the eyeball of 1st Embodiment. It is a figure for demonstrating the measurement method using the ultrasonic measurement support tool of 1st Embodiment. It is a figure which shows the other embodiment of the locking means. It is a schematic diagram which shows the state which attached the ultrasonic measurement support tool of 2nd Embodiment. It is a schematic diagram which shows the state which attached the ultrasonic measurement support tool of 2nd Embodiment. It is a block diagram which shows the structure of one Embodiment of the ultrasonic wave measuring apparatus of the eyeball parameter of this invention. It is a flow figure explaining the operation of the ultrasonic wave measuring apparatus of the eyeball parameter of this invention.

[Eyeball ultrasonic measurement support tool]
The ultrasonic measurement support tool for the eyeball of the present invention supports eyeball measurement by an ultrasonic measuring device that abuts an ultrasonic probe on the upper eyelid and generates an ultrasonic image of the eyeball by transmitting and receiving ultrasonic waves from the ultrasonic probe. A light-shielding body that covers the eyelids of a subject whose eyeball state is measured; and a probe holding mechanism that can fix and hold the ultrasonic probe in a predetermined position on the light-shielding body.

The probe holding mechanism is configured to have a structure in which the light-shielding body and the ultrasonic probe can be unlockably locked. For example, the probe holding mechanism includes a light-shielding body having a probe insertion port and a locking means that can be locked to the insertion port. Combination with ultrasonic probe; Examples thereof include a combination having a structure in which a probe insertion port provided in a light-shielding body and an ultrasonic probe can be locked to each other.

<First Embodiment>
The measurement support tool of the first embodiment includes a cup-shaped light-shielding body 11 having a probe insertion port through which an ultrasonic probe can be inserted, and is an ultrasonic probe provided with a locking means that can be locked to the probe insertion port. It is used in combination with.

FIG. 2 is a perspective view showing the configuration of the cup-shaped measurement support tool 10 using the cup-shaped light-shielding body 11, and FIG. 3 shows an ultrasonic probe 20 provided with a locking means for the cup-shaped light-shielding body 11. There is. FIG. 4 shows a method of using the measurement support tool 10, that is, a state in which the ultrasonic probe 20 is held in a predetermined position by the measurement support tool 10.

The cup-shaped light-shielding body 11 is usually made of a plastic molded body or a black-painted aluminum or stainless steel molded body because it is lightweight and has excellent durability. The light-shielding body 11 has a role of blocking external light in order to prevent light reflection of the pupil by visible light from the outside. Therefore, the shading body 11 is usually black.

The light-shielding body 11 may have a size that can stably hold and fix the ultrasonic probe, and is not particularly limited, but may be such that it can cover not only the orbital part but also the lower part of the orbital part and the cheekbone part. .. Specifically, the diameter (major diameter in the case of an ellipse) of the opening 12a of the light-shielding body 11 is about 10 to 15 cm, preferably about 11 to 14 cm.
The probe insertion port 13 is inserted from the forehead side so that the ultrasonic probe 20 is slightly tilted with respect to the eyeball with the light-shielding body 11 placed on the face with the eyeball portion as the center. , It is opened on the curved surface on the forehead side from the top of the cup-shaped shading body. The shape and size of the probe insertion port 13 depend on the size and shape of the ultrasonic probe 20 to be inserted (particularly, the ultrasonic sensor portion of the probe tip 20a). From the size and shape of the ultrasonic probe normally used, a rectangular shape of 2 cm × 4 cm to 5 cm × 8 cm is preferable.

A gel-like sheet 14 is detachably attached to the opening 12a on the eyelid contact side of the light-shielding body 11, and the tip 20a of the ultrasonic probe 20 inserted into the light-shielding body 11 hits the gel-like sheet 14. You can come in contact with it.
The gel-like sheet 14 used here may be any as long as it can transmit ultrasonic waves, but a hydrogel sheet is preferably used. The gel-like sheet 14 is deformable so as to follow the movement of the eyelid and fill the space between the eyelid and the probe tip 20a, and has a role of removing an air portion to which ultrasonic waves are not propagated. This makes it possible to set an appropriate distance for creating ultrasonic imaging as the distance between the probe 20 and the eyeball. The gel-like sheet 14 also serves as a cushioning material between the probe tip 20a and the eyelid, and is useful for protecting the probe tip 20a and protecting the eyeball.
Further, by covering the entire opening 12a with the flexible gel-like sheet 14, it is possible to eliminate the gap between the face and the peripheral edge of the light-shielding body 11 and prevent light from leaking into the light-shielding body 11.

In the ultrasonic probe 20 used in combination with such a measurement support device, as shown in FIG. 3, the locking portion support 22 on which the swingable claw 21 serving as the locking portion is projected is the ultrasonic probe 20. It is attached to the grip portion 20b of.

The locking portion support 22 is composed of a ring-shaped object that is slidable in the longitudinal direction of the grip portion 20b of the probe (in the direction of the arrow A in FIG. 3) and has a stopper (not shown).
When an ultrasonic probe 20 having a claw 21 as a locking portion is inserted into the probe insertion port 13, the claw 21 is closed and inserted into the light-shielding body 11 at the time of insertion, and after insertion, the claw 21 is inserted inside the light-shielding body 11. When it is in the open state, it is fixed to the insertion slot 13. As shown in FIG. 4, the measurement support tool in which the ultrasonic probe 20 having the locking portion 21 is fixedly held has the tip 20a of the ultrasonic probe 20 on the upper eyelid of the subject whose eyeball state is measured. , It is placed and used so as to be in contact with the gel-like sheet 14. By deforming the gel-like sheet 14 along the orbital part, the lower part of the orbital part, and the cheekbone part of the subject, the light-shielding body 11 can be placed on the face of the subject without any gap.

By sliding the locking portion support 22 up and down along the longitudinal direction of the grip portion (direction of the arrow A in FIG. 3), the tip 20a of the ultrasonic probe 20 abuts on the gel-like sheet 14 without a gap. Can be adjusted. Further, by moving the probe 20 from the jaw side (or forehead side) of the subject to the forehead side (or jaw side) in the locked state at the insertion port 13, the probe 20 is moved in the direction of the arrow B in FIG. You can adjust the tilt angle of.

In FIG. 4, reference numeral 15 denotes an LED light source (visible light light source) that serves as a marker for fixing the viewpoint. The LED light source used here irradiates visible light, and specifically, a red LED, a blue LED, a green LED, and various light LEDs in combination thereof can be used.

The LED light source 15 is provided at a position perpendicular to the jaw side of the subject with respect to the longitudinal direction of the ultrasonic probe 20 in a state where the ultrasonic probe 20 is in contact with the eyelids. By irradiating the subject with visible light, the viewpoint of the subject can be guided, so it is possible to measure the pupil diameter of not only unconscious patients such as under anesthesia but also conscious patients. can. Furthermore, by irradiating visible light from below the face (chin side), the viewpoint (pupil) can be guided downward, so ultrasonic sensors 20a that abut on the upper eyelid make ultrasonic waves based on changes in pupil size. The amount of output can be increased. In addition, as a result of the light contraction by visible light, the pupil size in normal times (when not stimulated) can be contracted, so the rate of change when measuring the change in pupil size in response to stimulation increases, and the measurement accuracy Will be higher.

The tip 20a of the ultrasonic probe 20 is an ultrasonic sensor that is an array of elements (vibration elements, piezoelectric elements) that vibrate with voltage, and the reflected echo is transmitted to the grip portion (body) 20b to change the voltage (electricity). It has a built-in transducer that can be converted into a signal). By applying a voltage to such a probe 20, ultrasonic waves are transmitted, and ultrasonic waves are generated by mechanically vibrating the ultrasonic vibrator provided at the tip, and the ultrasonic waves are radiated to the subject. The emitted ultrasonic waves propagate in the living body and are reflected one after another on the discontinuity surface of the acoustic impedance during propagation. The ultrasonic probe 20 receives the reflected wave and converts it into a voltage. The reflected echo can be converted into a voltage change (electric signal).

Since the ultrasonic probe 20 is fixedly held in a state of being in contact with a predetermined position of the eyelid, the measurer can measure without grasping the ultrasonic probe 20.
Further, by placing the cup-shaped light-shielding body on the eyelid of the subject, it is possible to support the probe 20 in a fixed positional relationship between the tip 20a and the pupil, so that the echo wave at the same position can be supported. A pupil image can be generated based on. Therefore, it is possible to monitor changes in pupil size over time, which was difficult in the past due to large errors due to camera shake and the like.

In the measurement support tool 10, the gel-like sheet 14 is provided in the entire opening 12a of the light-shielding body 11, but for example, when the gel-like sheet is attached to the tip 20a of the ultrasonic probe 20. The gel-like sheet that covers the entire opening 12a may not be provided. Instead, a sealing material such as a rubber ring is provided on the peripheral edge of the light-shielding body 11 which is the eyelid contact portion so that there is no gap between the peripheral edge of the opening 12a of the light-shielding body 11 and the face of the subject. It may just be done.

Further, in the measurement support tool 10, the ultrasonic probe uses a locking portion composed of claws 21 as a locking structure, but the locking structure is not limited to the claws, and other locking structures such as keys, pins, and latches are used. May be.

The locking portion constituting the locking structure may be provided on at least one of the ultrasonic probe and the probe insertion port. For example, a locking receiving portion into which the locking convex portion attached to the ultrasonic probe can be inserted may be provided on the peripheral edge of the insertion port.

Further, the locking structure as a probe holding mechanism capable of fixing and holding the ultrasonic probe in a predetermined position may have a fastening structure such as screwing in order to stably fix the locked state. ..
FIG. 5 is a diagram showing an embodiment of a locking structure that can be screwed.

A locking receiving portion 16 having a locking hole 16a is projected on two opposite sides of the rectangular probe insertion port 13'. As shown in FIG. 5, the ultrasonic probe 20'used in combination with this has a ring 22'as a locking portion support in which a screw 23 is projected as a locking portion.
After inserting the ultrasonic probe 20'into the probe insertion port 13'and inserting the screw 23 into the locking hole 16a to adjust the position of the probe tip 20'a so as to have a predetermined tilt angle with respect to the eyeball. The ultrasonic probe 20'can be fixedly held to the light-shielding body by screwing with a nut.

In the measurement support tool of the first embodiment, a cup-shaped light-shielding body is used as the light-shielding body, but the shape of the light-shielding body is not limited to the cup type. The shape and configuration may be such that the ultrasonic probe can be stably fixed and held and can be placed on the face of the subject. Further, the light-shielding body may have a shape that covers not only one eye but also both eyes.

Further, in the above embodiment, the tilt angle of the ultrasonic probe is adjusted by moving the ultrasonic probe with the ultrasonic probe inserted, but it is adjusted to at least one of the ultrasonic probe and the probe insertion port. , An insertion angle adjusting means (for example, bellows) capable of changing the tilt angle of the held ultrasonic probe may be provided.

[Second Embodiment]
The measurement support tool of the second embodiment is provided with a light-shielding body mounting means capable of mounting the light-shielding body on the face or head of the subject so that the light-shielding body can be stably fixed to the face. ..
Examples of the means for attaching the light-shielding body include a fixing band for fixing the light-shielding body to the head, a hook-shaped member that can lock the light-shielding body to the auricle of the subject, and a spectacle-shaped frame to which the light-shielding body can be attached. Be done. The light-shielding body mounting means may be configured separately from the light-shielding body, or may be integrally configured with the light-shielding body.

6 and 7 show a state in which the goggle-type measurement support tool 30 to which the fixing band 36 as a light-shielding body wearing means is attached to the goggle-type light-shielding body 31 is attached to the head.
In the goggle-type measurement support tool 30, as a probe holding mechanism, the goggle-type light-shielding body 31 has the locking structure shown in FIG. 5, and the ultrasonic probe 20'with the screw-type locking portion 23. Are used in combination.

A probe insertion port 33 into which the ultrasonic probe 20'can be inserted is provided on the spherical surface corresponding to one eye (right eye in FIG. 6) of the goggle type light-shielding body 31. On the two opposite sides of the rectangular probe insertion port 33, a locking receiving portion having a locking hole is provided so as to project.

The goggle-type light-shielding body 31 as described above is attached and fixed to the head of the subject with the fixing band 36. In this state, the screw 23 attached to the ultrasonic probe 20'is inserted, and the ultrasonic probe 20'is inserted into the goggle type light-shielding body 31. Since the locking hole 16a has a size that allows the screw 23 to be loosely inserted, the tilt angle of the ultrasonic probe 20'is set so that the ultrasonic sensor 20a is slightly tilted from the horizontal with respect to the eyeball with the screw 23 inserted. It may be adjusted so as to be in contact with the.
After the position and angle of the tip of the ultrasonic probe are brought into contact with the eyelid so that there is no gap, the ultrasonic probe 20'is fixed by tightening the screw 23 with a nut.
As described above, the measurement support tool 30 can be attached and fixed to the head of the subject, and the ultrasonic probe 20'can be held in a predetermined position.

Therefore, by using the measurement support tool of the second embodiment, the relative position of the ultrasonic probe 20'with respect to the eyeball can be fixed even when the head of the subject may move. Therefore, it is useful as a support tool used for eyeball measurement in the case of surgery in which the head may be moved upward or upside down, or in the case where general anesthesia cannot be applied and the subject may move.

In the case of the goggle-type light-shielding body, the light-shielding body mounting means is not limited to the fixing band attached to the side portion of the goggle-type light-shielding body as a separate body. It may be formed integrally with the light-shielding body. For example, a goggle-type light-shielding body may be integrally attached to a helmet that covers the entire head.

[Ultrasonic measuring device for eyeball]
Next, an ultrasonic measuring device system for an eyeball using the measurement support tool of the present invention will be described.
The eyeball measuring device system of the present invention is the measurement support tool of the present invention; the ultrasonic probe fixedly held in a predetermined position by the measurement support tool; the ultrasonic output signal from the ultrasonic probe is processed to process the pupil and the pupil. / Or a signal processing means for creating an eyeball image; a display means for displaying the pupil and / or the eyeball image created by the signal processing means is provided.

FIG. 8 is a block diagram showing a configuration of an eyeball measuring device system.
The ultrasonic probe and the signal processing unit may be connected so as to be able to transmit and receive an electric signal or a radio wave signal, may be connected by wire or wirelessly, or may be integrally configured. May be good.

The frequency of the ultrasonic wave used is 2 to 60 MHz, preferably 5 to 50 MHz, more preferably 10 to 30 MHz. Such high frequency ultrasonic waves do not propagate in the air. The higher the frequency, the higher the distance resolution, but the greater the attenuation. That is, with a high-frequency probe, it is easy to obtain a clear image, but the reach is short. The pupil is measured by abutting the probe on the eyelid, and since the thickness of the eyelid and the distance to the pupil are at most about 20 mm, high-frequency ultrasonic waves in the above range can be used.
The lower the frequency, the deeper the ultrasonic beam propagates and better spatial resolution is achieved in the far field. The exact frequency used is defined based on the required resolution.

The signal processing unit acquires an electric signal or a radio wave signal output from the ultrasonic probe, processes the acquired signal to generate an image, and further performs various operations according to a set arithmetic program.
Specifically, the signal processing unit is composed of a transmission / reception circuit, a B mode processing circuit, an M mode processing circuit, a Doppler processing circuit, an image generation circuit, a communication circuit, an arithmetic processing circuit, and the like.

The measuring device of the present invention preferably includes a storage unit for storing data and a program necessary for arithmetic processing of the signal processing unit. Specifically, it includes a program that calculates and outputs eyeball-related parameters based on the generated pupil image. A part or all of the program and data stored in the storage unit may be downloaded by communication via electronic debt work, or may be provided with a storage circuit via a portable storage medium such as an optical disk.

The image generation circuit generates an ultrasonic image of the eye from the received signal. When the M-mode processing circuit is provided, the time-dependent change of the generated image can be generated as a video.
The arithmetic processing circuit calculates eyeball-related parameters according to the data and the program stored in the storage unit. Here, the eyeball-related parameters include parameters related to pupil size, intraocular pressure parameters, optic nerve parameters, and the like.

The parameters related to the pupil size include, in addition to the pupil diameter, the maximum diameter and the minimum diameter of the pupil, the change in the pupil size, the rate of change, the rate of change, and the like.
The pupil size corresponds to the pupil diameter (horizontal diameter or vertical diameter), the pupil area, etc., but usually refers to the pupil diameter. "Pupil diameter" refers to the size / diameter of a hole located in the center of the iris of the eye where light is struck by the retina. The pupil diameter can be calculated based on the edge position of the pupil obtained based on the anterior eye portion image stored in the memory.

In addition, when the measured pupil image is temporarily stored in the storage unit, the signal processing unit also displays the time-dependent change data of the pupil size, specifically, the graph, chart, etc. of the pupil size. It can be calculated and output as a size parameter.

Optic nerve parameters include the width of the optic nerve. Since the optic nerve is also imaged in the ultrasonic image of the eyeball, the width of the optic nerve can be measured.
Examples of the intraocular pressure parameter include intraocular pressure and changes in intraocular pressure. By measuring the change in the width of the optic nerve, the change in intraocular pressure can be calculated.

The display unit is a display, and specifically, is composed of a general display output device such as a liquid crystal display or an organic EL display, and is connected to the signal processing unit by wire or wirelessly. It may be a terminal device or a tablet-type personal computer in which a display unit, a signal processing unit, and a storage unit are integrally formed.

The display unit can display the ultrasonic image generated by the signal processing unit on the screen. Further, the signal processing result (calculation processing result) is displayed according to the signal processing content (calculation processing content) of the signal processing unit.

A method of measuring and generating an eyeball image and an eyeball parameter using an ultrasonic measuring device for an eyeball having the above configuration will be described with reference to FIG.

The ultrasonic probe is fixedly held at a predetermined angle on the measurement support tool of the present invention, and the measurement support tool is placed on the subject's face so that the tip of the ultrasonic probe is in a predetermined position with respect to the subject's eyeball. In the case of the measurement support tool of the second embodiment, the measurement support tool is mounted and fixed to the head of the subject by the light-shielding body mounting means.

In such a state, the ultrasonic probe periodically or continuously sends ultrasonic waves to the eyelids of the subject. The ultrasonic waves pass through the eyelids, and by the time they reach the iris, they receive the transmitted reflected waves at the interface, and the piezoelectric element converts them into electrical signals.

The signal processing unit acquires an electric signal that is an output from the ultrasonic probe (step # 1 in FIG. 9). Then, based on the acquired electrical signal, an ultrasonic image of the eye is generated (step # 2 in FIG. 9) and displayed (step # 2'in FIG. 9).

Further, when the video creation program is installed in the storage unit, it is possible to display a video showing the change over time of the ultrasonic image of the eye (step # 2 in FIG. 9).
Since ultrasonic images depend on interfacial reflections with foreign media (cornea, crystalline lens, liquid eye chamber, etc.), the sharpness of the image is affected by the color of the iris compared to the image of an infrared camera. Hard to receive. In addition, ultrasonic measurement is advantageous in that it does not require the eye to be opened as compared with the measurement using infrared rays, so that the risk of corneal dryness and damage associated with maintaining the eye open can be reduced.

When a program for calculating eyeball-related parameters is stored in the storage unit, the signal processing unit determines the pupil size parameters such as the pupil diameter and the type of arithmetic program based on the generated image. , Intraocular pressure parameters, optic nerve parameters, etc. may be calculated (step # 3 in FIG. 9) and displayed (step # 3'in FIG. 9).

As described above, by using the measurement support tool of the present invention, the ultrasonic probe can be fixedly held in a predetermined position with respect to the eyeball, so that the measurer can simply operate the interface of the measuring device. An ultrasound image can be obtained. Furthermore, unlike during surgery, it is not necessary to perform any treatment on the ultrasonic probe or the subject when measuring ultrasonic waves in the pupil and eyeball of a patient who is under anesthesia and in a closed eye state. Moreover, since the ultrasonic sensor can be fixedly held in a predetermined position with respect to the eyeball, an error due to camera shake or the like may occur even when monitoring changes in the eyeball state over time or when acquiring and measuring pupil data at predetermined time intervals. Can be avoided. When the measurement support tool is equipped with an LED light source for fixing the viewpoint, the viewpoint can be fixed, so that the accuracy of monitoring changes in the pupil over time is high. In addition, since the viewpoint can be fixed, it is possible to measure the pupil diameter of a conscious patient.

Further, by using the measurement support tool of the second embodiment, the relative position of the probe with respect to the eyeball can be fixed even when the head of the subject may move. Therefore, in the case of surgery that may move the head up or down (for example, prostate surgery with robot assistance), or if general anesthesia cannot be applied and the subject may move. However, it is possible to monitor changes over time. Furthermore, in the case of surgery that may move the head up and down, it is possible to measure the pupil size and intraocular pressure together, so it is not only for the purpose of direct measurement of the eyeball image. It can also be used to monitor intraocular pressure depending on the surgical position.

The measurement support tool of the present invention is useful for simplifying ultrasonic measurement of the eyeball and improving the measurement accuracy. Furthermore, it enables easy and highly accurate monitoring of changes over time in the eyeball, intraocular pressure, optic nerve, and the like. Therefore, the ultrasonic measuring device for the eyeball using the measurement support tool of the present invention can be used not only for ultrasonic measurement of the eyeball but also for grasping the patient's condition such as pain, consciousness state, and change in intraocular pressure during surgery. ..
Further, since the change in the pupil diameter can correspond not only to the miotic reaction typified by the light reflex but also to the dilated reaction of the pupil, which has been attracting attention in recent pain research and stress research, the present invention. It can also be used as these research tools by using the measurement support tool of.

1 Ultrasonic probe 2 Signal processing unit 3 Display unit 4 Storage unit 5 Sensor unit 6 Eyelid 10 Cup-type measurement support tool 11 Cup-shaped light-shielding body 12a Opening 13, 13'Probe insertion port 14 Gel-like sheet 15 LED light source 20, 20 ′ Ultrasonic probe 20a Ultrasonic sensor 20b Grip part 21 Claw (locking part)
22, 22'Locking part support 30 Goggles-type measurement support tool 31 Goggles-type light-shielding body 33 Probe insertion port 36 Fixing band (light-shielding body mounting means)

Claims (9)

An instrument that supports eyeball measurement with an ultrasonic measuring device that abuts an ultrasonic probe on the eyelids and generates an ultrasonic image of the eyeball by transmitting and receiving ultrasonic waves from the ultrasonic probe.
A light-shielding body that covers the eyelids of a subject whose eyeball is measured; and an ultrasonic measurement support tool for an eyeball that has a probe holding mechanism capable of fixing and holding the ultrasonic probe in a predetermined position on the light-shielding body. The light-shielding body is provided with an insertion port into which the ultrasonic probe can be inserted.
The ultrasonic measurement support tool for an eyeball according to claim 1, wherein the probe holding mechanism is a locking means for locking the ultrasonic probe to the insertion port. The ultrasonic measurement support tool for an eyeball according to claim 2, wherein a locking receiving portion into which a locking convex portion attached to the ultrasonic probe can be inserted is provided on the peripheral edge of the insertion port. The ultrasonic measurement support tool for an eyeball according to any one of claims 1 to 3, further comprising a light-shielding body wearing means for fixing the light-shielding body to the face or the head. The ultrasonic measurement support tool for an eyeball according to claim 4, wherein the light-shielding body is a goggle-type light-shielding body. 6. Ultrasound measurement support tool for the eyelids. Claims 1 to 1 in which a light source capable of irradiating visible light so as to be substantially orthogonal to the longitudinal direction of the ultrasonic probe while the ultrasonic probe is fixedly held by the light-shielding body is attached to the light-shielding body. The measurement support tool according to any one of 6. The ultrasonic measurement support tool according to any one of claims 1 to 7.
An ultrasonic probe that is fixedly held in a predetermined position by the measurement support tool;
A signal processing means for processing an ultrasonic output signal from the ultrasonic probe to create a pupil and / or eyeball image; and a display means for imaging a pupil image created by the signal processing means. Ultrasound measuring device. The ultrasonic measuring device for an eyeball according to claim 8, wherein the signal processing means has a means capable of calculating and outputting at least one eyeball-related parameter selected from the group consisting of a pupil size, an intraocular pressure parameter, and an optic nerve parameter. ..

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