JP2022075732A - Ophthalmologic apparatus and ophthalmologic information processing program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a novel technique for specifying causes of not improving a result of subjective examination.

SOLUTION: An ophthalmologic apparatus includes an edema specification part and a measured value correction part. The edema specification part specifies edema in a fundus oculi based on data of the fundus oculi of a subject's eye collected by using optical coherence tomography. The measured value correction part corrects a measured value of refractive power of the subject's eye based on an axial length in a macular area, a distance from a retinal pigment epithelial layer to an inner limiting membrane at the site of the edema specified by the edema specification part, and a retinal thickness of the macular area.

SELECTED DRAWING: Figure 4

COPYRIGHT: (C)2022,JPO&INPIT

Description

The present invention relates to an ophthalmic apparatus and an ophthalmic information processing program.

Ophthalmic devices that can perform multiple tests and measurements on the eye to be inspected are known. Examinations and measurements for the eye to be inspected include subjective examinations and objective measurements. The subjective test obtains the result based on the response from the subject. Objective measurement obtains information about the eye to be inspected mainly by using a physical method without referring to the response from the subject.

For example, Patent Document 1 discloses an ophthalmic apparatus capable of measuring the refractive power of an eye to be inspected and measuring using optical coherence tomography. This ophthalmic apparatus projects a ring-shaped measurement light beam onto the eye to be inspected and detects the return light to acquire a measured value of the refractive power of the eye to be inspected. The ophthalmic appliance can provide information for determining the reliability of the measured value of the refractive power of the eye to be inspected by acquiring a tomographic image at the incident position of the light beam for measurement on the retina.

Japanese Unexamined Patent Publication No. 2017-136216

If the result of the subjective examination does not improve even though the refraction is corrected for the eye to be inspected, various causes can be considered. If the cause is in the anterior segment of the eye to be inspected, it is possible that the refraction of the light incident in the eye is not sufficient and the light is not focused on the retina. If the cause is in the posterior part of the eye to be inspected, it is possible that there is a disease in the retina and the light focused on the retina cannot be taken in. In addition, it is possible that the cause is in the nervous system or the brain.

In such cases, it is desirable that the ophthalmic appliance can provide information to identify the cause.

However, since the conventional method grasps the morphology of the fundus at the incident position of the light beam for measurement, it is necessary to identify whether the cause of the improvement in the result of the subjective examination is in the anterior eye or the posterior eye. It is difficult to provide information on.

The present invention has been made in view of such circumstances, and an object of the present invention is to provide a new technique for identifying a cause in which the result of a subjective test is not improved.

The first aspect of some embodiments is an edema-specific portion that identifies edema in the fundus based on data on the fundus of the eye to be examined collected using optical coheren stromography, and an axial length in the macula and said above. A measurement value correction unit that corrects the measured value of the refractive power of the eye to be inspected based on the distance from the retinal pigment epithelial layer to the inner border membrane and the macular retina thickness at the edema site specified by the edema specific part. Is an ophthalmic device, including.

In the ophthalmic apparatus according to the second aspect of some embodiments, in the first aspect, the axial length, which is the distance from the corneal apex to the internal limiting membrane, is AL _ILM , the retinal film thickness of the retinal region is RT, and the retinal thickness of the retinal region is RT. When the height of the edema is MET and the converted refractive index in the eye is n, the measured value correction unit adds the correction value γ1 obtained by the following formula (A) to the measured value to obtain the measured value. To correct.

In the ophthalmic apparatus according to the third aspect of some embodiments, in the first aspect, the axial length, which is the distance from the corneal apex to the internal limiting membrane, is AL _ILM , the retinal film thickness of the retinal region is RT, and the retinal thickness of the retinal region is RT. When the height of the edema is MET and the intraocular conversion refractive index is n, the measured value correction unit adds the correction value γ1 obtained by the following formulas (B) and (C) to the measured value. This corrects the measured value.

The ophthalmic apparatus according to the fourth aspect of some embodiments includes a display control unit that causes the display means to display the measured value corrected by the measured value correction unit in any one of the first to third aspects.

A fifth aspect of some embodiments is a edema-specific step of identifying edema in the fundus based on data on the fundus of the eye to be examined collected using optical coheren stromography, and the axial length in the macula and said. A measurement value correction step that corrects the measured value of the refractive power of the eye to be inspected based on the distance from the retinal pigment epithelial layer to the inner border membrane and the macular retina thickness at the site of the edema identified in the edema identification step. Is an ophthalmologic information processing program that causes a computer to execute.

In the ophthalmologic information processing program according to the sixth aspect of some embodiments, the axial length, which is the distance from the corneal apex to the internal limiting membrane, is AL _ILM , the retinal thickness of the retinal region is RT, and the height of edema in the luteal region is high. When the value is MET and the intraocular conversion refractive index is n, the measured value correction step corrects the measured value by adding the correction value γ1 obtained by the following formula (D) to the measured value. ..

In the ophthalmologic information processing program according to the seventh aspect of some embodiments, the axial length, which is the distance from the corneal apex to the internal limiting membrane, is AL _ILM , the retinal thickness of the retinal region is RT, and the height of edema in the luteal region is high. When the value is MET and the intraocular conversion refractive index is n, the measured value correction step is performed by adding the correction value γ1 obtained by the following equations (E) and (F) to the measured value. Correct the measured value.

The ophthalmic information processing program according to some embodiments includes, in any one of the fifth to seventh aspects, a display control step for causing the display means to display the measured value corrected in the measured value correction step.

INDUSTRIAL APPLICABILITY According to the present invention, it becomes possible to provide a new technique for identifying a cause in which the result of a subjective test is not improved.

It is a schematic diagram which shows the structural example of the optical system of the ophthalmic apparatus which concerns on embodiment. It is a schematic diagram which shows the structural example of the optical system of the ophthalmic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the processing system of the ophthalmic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the processing system of the ophthalmic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the operation of the ophthalmologic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the operation of the ophthalmologic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the operation of the ophthalmologic apparatus which concerns on embodiment. It is a schematic diagram which shows the flow of the operation example of the ophthalmologic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the operation of the ophthalmologic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the operation of the ophthalmologic apparatus which concerns on embodiment. It is a schematic diagram for demonstrating the operation of the ophthalmic apparatus which concerns on the modification of embodiment.

An example of an ophthalmic apparatus and an embodiment of an ophthalmic information processing program according to the present invention will be described in detail with reference to the drawings. In addition, the description contents of the document cited in this specification and arbitrary known techniques can be incorporated into the following embodiments.

The ophthalmic apparatus according to the embodiment has a function of an ophthalmic information processing apparatus. The function of the ophthalmic information processing apparatus is realized by a computer that executes processing according to the ophthalmic information processing program. The ophthalmic information processing apparatus includes a processor and a storage unit in which the ophthalmic information processing program is stored in advance, and the processor executes processing according to the ophthalmic information processing program read from the storage unit to obtain the ophthalmic information processing apparatus. Realize the function.

The ophthalmic apparatus according to the embodiment can perform measurement of refractive power (ref measurement) and measurement and imaging using optical coherence tomography (hereinafter referred to as OCT).

Hereinafter, in the embodiment, the case where the swept source type OCT method is used in the measurement using OCT will be described in particular, but for an ophthalmic apparatus using another type (for example, spectral domain type) OCT, It is also possible to apply the configuration according to the embodiment.

The ophthalmic apparatus according to some embodiments further includes a subjective test optical system for performing a subjective test and an objective measurement system for performing other objective measurements.

The subjective test is a measurement method for acquiring information by using the response from the subject. The subjective test includes a subjective refraction measurement such as a distance test, a near test, a contrast test, and a glare test, and a visual field test.

Objective measurement is a measurement method for acquiring information about an eye to be inspected mainly by using a physical method without referring to a response from the subject. Objective measurement includes measurement for acquiring the characteristics of the eye to be inspected and photographing for acquiring an image of the eye to be inspected. Other objective measurements include kerato measurement, intraocular pressure measurement, fundus photography and the like.

Hereinafter, the fundus conjugate position is a position optically coupled to the fundus of the eye to be inspected in a state where the alignment is completed, and means a position optically coupled to the fundus of the eye to be inspected or its vicinity thereof. Similarly, the pupil-coupled position is a position that is optically coupled to the pupil of the eye to be inspected in the state where the alignment is completed, and means a position that is optically coupled to or in the vicinity of the pupil of the eye to be inspected. ..

The ophthalmologic apparatus according to the embodiment generates abnormality degree information indicating the degree of abnormality of the fundus based on a predetermined interlayer distance in the fundus and standard data (normal eye data) acquired by using OCT. The ophthalmic apparatus displays the measured value of the refractive power of the eye to be inspected acquired by the measurement of the refractive power and the generated abnormality degree information on the same screen of the display means. The ophthalmologic apparatus according to some embodiments identifies edema in the fundus (eg, yellow spot) using OCT and corrects and corrects the measured power of the optometric eye according to the identified edema morphology. The measured value is displayed on the display means. In some embodiments, the corrected measurement is displayed on the display means when observing the morphology of the fundus in detail based on the above abnormality degree information. In some embodiments, the measured value of the refractive power of the eye to be inspected obtained by the measurement of the refractive power and the corrected measured value are displayed on the same screen of the display means.

<Composition of optical system>
FIG. 1 shows a configuration example of an optical system of an ophthalmic apparatus according to an embodiment. The ophthalmic apparatus 1000 according to the embodiment includes an optical system for observing the eye E to be inspected, an optical system for inspecting the eye E to be inspected, and a dichroic mirror for wavelength-separating the optical paths of these optical systems. An anterior eye portion observation system 5 is provided as an optical system for observing the eye E to be inspected. An OCT optical system and a ref measurement optical system (refractive power measurement optical system) are provided as an optical system for inspecting the eye E to be inspected.

The ophthalmic apparatus 1000 includes a Z alignment system 1, an XY alignment system 2, a kerato measurement system 3, a fixative projection system 4, an anterior ocular segment observation system 5, a reflex measurement projection system 6, a reflex measurement light receiving system 7, and an OCT optical system 8. including. In the following, for example, the anterior segment observation system 5 uses light of 940 nm to 1000 nm, and the reflex measurement optical system (ref measurement projection system 6, reflex measurement light receiving system 7) uses light of 830 nm to 880 nm, and the fixation projection system is used. It is assumed that 4 uses light of 400 nm to 700 nm, and OCT optical system 8 uses light of 1000 nm to 1100 nm.

(Anterior eye observation system 5)
The anterior eye portion observation system 5 captures a moving image of the anterior segment of the eye to be inspected E. In the optical system via the anterior eye portion observation system 5, the image pickup surface of the image pickup element 59 is arranged at the pupil conjugate position. The anterior eye portion illumination light source 50 irradiates the anterior segment of the eye E to be inspected with illumination light (for example, infrared light). The light reflected by the anterior segment of the eye E to be inspected passes through the objective lens 51, passes through the dichroic mirror 52, passes through the hole formed in the diaphragm (teressen diaphragm) 53, and passes through the half mirror 23. , Passes through the relay lenses 55 and 56, and passes through the dichroic mirror 76. The dichroic mirror 52 synthesizes (separates) the optical path of the reflex measurement optical system and the optical path of the anterior ocular segment observation system 5. In the dichroic mirror 52, the optical path synthesis surface that synthesizes these optical paths is arranged so as to be inclined with respect to the optical axis of the objective lens 51. The light transmitted through the dichroic mirror 76 is imaged on the image pickup surface of the image pickup element 59 (area sensor) by the image pickup lens 58. The image pickup device 59 performs image pickup and signal output at a predetermined rate. The output (video signal) of the image pickup device 59 is input to the processing unit 9 described later. The processing unit 9 displays the front eye portion image E'based on this video signal on the display screen 10a of the display unit 10 described later. The anterior segment image E'is, for example, an infrared moving image.

(Z alignment system 1)
The Z alignment system 1 projects light (infrared light) for alignment in the optical axis direction (front-back direction, Z direction) of the anterior eye portion observation system 5 onto the eye E to be inspected. The light output from the Z alignment light source 11 is projected onto the corneal Cr of the eye E to be inspected, reflected by the cornea Cr, and imaged on the sensor surface of the line sensor 13 by the imaging lens 12. When the position of the apex of the cornea changes in the optical axis direction of the anterior ocular segment observation system 5, the projection position of light on the sensor surface of the line sensor 13 changes. The processing unit 9 obtains the position of the corneal apex of the eye E to be inspected based on the light projection position on the sensor surface of the line sensor 13, and controls the mechanism for moving the optical system based on this to execute Z alignment.

(XY alignment system 2)
The XY alignment system 2 emits light (infrared light) for alignment in a direction orthogonal to the optical axis of the anterior segment observation system 5 (horizontal direction (X direction), vertical direction (Y direction)). Irradiate to. The XY alignment system 2 includes an XY alignment light source 21 and a collimator lens 22 provided in an optical path branched from the optical path of the anterior eye observation system 5 by a half mirror 23. The light output from the XY alignment light source 21 passes through the collimator lens 22, is reflected by the half mirror 23, and is projected onto the eye E to be inspected through the anterior eye observation system 5. The reflected light from the corneal Cr of the eye E to be inspected is guided to the image pickup device 59 through the anterior ocular segment observation system 5.

The image (bright spot image) Br based on this reflected light is included in the anterior eye portion image E'. The processing unit 9 displays the front eye portion image E'including the bright spot image Br and the alignment mark AL on the display screen of the display unit. When manually performing XY alignment, the user operates the optical system so as to guide the bright spot image Br in the alignment mark AL. When the alignment is automatically performed, the processing unit 9 controls a mechanism for moving the optical system so that the displacement of the bright spot image Br with respect to the alignment mark AL is cancelled.

(Kerato measurement system 3)
The kerato measurement system 3 projects a ring-shaped luminous flux (infrared light) for measuring the shape of the corneal Cr of the eye E to be inspected onto the corneal Cr. The kerato plate 31 is arranged between the objective lens 51 and the eye E to be inspected. A keratling light source 32 is provided on the back surface side (objective lens 51 side) of the kerato plate 31. By illuminating the kerato plate 31 with the light from the keratling light source 32, a ring-shaped luminous flux (arc-shaped or circumferential-shaped measurement pattern) is projected onto the corneal Cr of the eye E to be inspected. The reflected light (keratling image) from the corneal Cr of the eye E to be inspected is detected by the image pickup device 59 together with the anterior eye portion image E'. The processing unit 9 calculates a corneal shape parameter representing the shape of the corneal Cr by performing a known calculation based on this keratling image.

(Ref measurement projection system 6, reflex measurement light receiving system 7)
The reflex measurement optical system includes a reflex measurement projection system 6 and a reflex measurement light receiving system 7 used for refractive power measurement. The reflex measurement projection system 6 projects a luminous flux for measuring refractive power (for example, a ring-shaped luminous flux) (infrared light) onto the fundus Ef. The reflex measurement light receiving system 7 receives the return light of this luminous flux from the eye E to be inspected. The reflex measurement projection system 6 is provided in an optical path branched by a perforated prism 65 provided in the optical path of the reflex measurement light receiving system 7. The hole formed in the hole prism 65 is arranged at the pupil conjugate position. In the optical system via the reflex measurement light receiving system 7, the image pickup surface of the image pickup element 59 is arranged at the fundus conjugate position.

In some embodiments, the ref measurement light source 61 is an SLD (Superluminescent Diode) light source, which is a high-intensity light source. The reflex measurement light source 61 is movable in the optical axis direction. The reflex measurement light source 61 is arranged at the fundus conjugate position. The light output from the reflex measurement light source 61 passes through the relay lens 62 and is incident on the conical surface of the conical prism 63. The light incident on the conical surface is deflected and emitted from the bottom surface of the conical prism 63. The light emitted from the bottom surface of the conical prism 63 passes through the translucent portion formed in a ring shape on the ring diaphragm 64. The light (ring-shaped luminous flux) that has passed through the translucent portion of the ring diaphragm 64 is reflected by the reflecting surface formed around the hole portion of the perforated prism 65, passes through the rotary prism 66, and is reflected by the dichroic mirror 67. Ru. The light reflected by the dichroic mirror 67 is reflected by the dichroic mirror 52, passes through the objective lens 51, and is projected onto the eye E to be inspected. The rotary prism 66 is used for averaging the light amount distribution of the ring-shaped luminous flux with respect to the blood vessel or the diseased part of the fundus Ef and reducing the speckle noise caused by the light source.

The return light of the ring-shaped luminous flux projected on the fundus Ef passes through the objective lens 51 and is reflected by the dichroic mirror 52 and the dichroic mirror 67. The return light reflected by the dichroic mirror 67 passes through the rotary prism 66, passes through the hole portion of the perforated prism 65, passes through the relay lens 71, is reflected by the reflection mirror 72, and is reflected by the relay lens 73 and the focusing lens. Pass through 74. The focusing lens 74 can move along the optical axis of the reflex measurement light receiving system 7. The light that has passed through the focusing lens 74 is reflected by the reflection mirror 75, reflected by the dichroic mirror 76, and imaged on the image pickup surface of the image pickup element 59 by the image pickup lens 58. The processing unit 9 calculates the refractive power value of the eye E to be inspected by performing a known calculation based on the output from the image sensor 59. For example, the refractive power value includes spherical power, astigmatic power and astigmatic axis angle, or equivalent spherical power.

(Fixation projection system 4)
The OCT optical system 8, which will be described later, is provided in an optical path whose wavelength is separated from the optical path of the reflex measurement optical system by the dichroic mirror 67. The fixative projection system 4 is provided in the optical path branched from the optical path of the OCT optical system 8 by the dichroic mirror 83.

The fixative projection system 4 presents the fixative to the eye E to be inspected. A fixative unit 40 is arranged in the optical path of the fixative projection system 4. The fixative unit 40 can move along the optical path of the fixative projection system 4 under the control of the processing unit 9 described later. The fixative unit 40 includes a liquid crystal panel 41.

The liquid crystal panel 41, which is controlled by the processing unit 9, displays a pattern representing a fixative. By changing the display position of the pattern on the screen of the liquid crystal panel 41, the fixative position of the eye E to be inspected can be changed. The fixative position of the eye E to be inspected includes a position for acquiring an image centered on the macula of the fundus Ef, a position for acquiring an image centered on the optic disc, and a position between the macula and the optic disc. There is a position for acquiring an image centered on the center of the fundus between the two. It is possible to arbitrarily change the display position of the pattern representing the fixative. Instead of the liquid crystal panel 41, a transmissive optotype chart on which an optotype or the like is printed on a film or the like and a light source for illumination that illuminates the optotype chart may be provided.

The light from the liquid crystal panel 41 passes through the relay lens 42, passes through the dichroic mirror 83, passes through the relay lens 82, is reflected by the reflection mirror 81, is transmitted through the dichroic mirror 67, and is reflected by the dichroic mirror 52. .. The light reflected by the dichroic mirror 52 passes through the objective lens 51 and is projected onto the fundus Ef. In some embodiments, each of the liquid crystal panel 41 and the relay lens 42 can move independently in the optical axis direction.

(OCT optical system 8)
The OCT optical system 8 is an optical system for performing OCT measurement. The position of the focusing lens 87 is adjusted so that the end face of the optical fiber f1 is coupled to the imaging site (fundus Ef or anterior ocular segment) and the optical system based on the result of the reflex measurement performed before the OCT measurement. ..

The OCT optical system 8 is provided in an optical path whose wavelength is separated from the optical path of the reflex measurement optical system by a dichroic mirror 67. The optical path of the fixative projection system 4 is coupled to the optical path of the OCT optical system 8 by the dichroic mirror 83. Thereby, the optical axes of the OCT optical system 8 and the fixative projection system 4 can be coaxially coupled.

The OCT optical system 8 includes an OCT unit 100. As shown in FIG. 2, in the OCT unit 100, the OCT light source 101 is a wavelength sweep type (wavelength scanning type) light source capable of sweeping (scanning) the wavelength of emitted light, similar to a general swept source type OCT device. Consists of including. The wavelength sweep type light source is configured to include a laser light source including a resonator. The OCT light source 101 changes the output wavelength with time in a near-infrared wavelength band that cannot be visually recognized by the human eye.

As illustrated in FIG. 2, the OCT unit 100 is provided with an optical system for performing a swept source OCT. This optical system includes an interference optical system. This interference optical system has a function of dividing the light from the wavelength variable light source (wavelength sweep type light source) into the measurement light and the reference light, and the return light of the measurement light from the eye E to be inspected and the reference light via the reference light path. It has a function of generating interference light by superimposing the light and a function of detecting the interference light. The detection result (detection signal) of the interference light obtained by the interference optical system is a signal showing the spectrum of the interference light and is sent to the processing unit 9.

The OCT light source 101 includes, for example, a near-infrared wavelength tunable laser that changes the wavelength of emitted light (wavelength range of 1000 nm to 1100 nm) at high speed. The light L0 output from the OCT light source 101 is guided to the polarization controller 103 by the optical fiber 102, and its polarization state is adjusted. The light L0 whose polarization state has been adjusted is guided by the optical fiber 104 to the fiber coupler 105 and divided into the measurement light LS and the reference light LR.

The reference light LR is guided to the collimator 111 by the optical fiber 110, converted into a parallel light flux, passes through the optical path length correction member 112 and the dispersion compensation member 113, and is guided to the corner cube 114. 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 measured 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 luminous flux to a focused luminous flux by a collimator 116 via a dispersion compensating member 113 and an 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.

On the other hand, the measurement light LS generated by the fiber coupler 105 is guided by the optical fiber f1 and converted into a parallel light flux by the collimator lens unit 89, and passes through the optical scanner 88, the focusing lens 87, the relay lens 85, and the reflection mirror 84. Then, it is reflected by the dichroic mirror 83.

The optical scanner 88 deflects the measurement light LS one-dimensionally or two-dimensionally. The optical scanner 88 includes, for example, a first galvano mirror and a second galvano mirror. The first galvano mirror deflects the measurement light LS so as to scan the imaging site (fundibular Ef or anterior eye portion) in the horizontal direction orthogonal to the optical axis of the OCT optical system 8. The second galvano mirror deflects the measurement light LS deflected by the first galvano mirror so as to scan the imaging region in the direction perpendicular to the optical axis of the OCT optical system 8. Examples of the scanning mode of the measured optical LS by the optical scanner 88 include horizontal scan, vertical scan, cross scan, radial scan, circular scan, concentric circular scan, and spiral scan.

The measurement light LS reflected by the dichroic mirror 83 passes through the relay lens 82, is reflected by the reflection mirror 81, is transmitted through the dichroic mirror 67, is reflected by the dichroic mirror 52, is reflected by the objective lens 51, and is reflected by the objective lens 51. Incident to. 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 incident via the optical fiber 128 and the reference light LR incident 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 the optical fibers 123 and 124, respectively.

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

A clock KC is supplied to the DAQ 130 from the OCT light source 101. The clock KC is generated in the OCT light source 101 in synchronization with the output timing of each wavelength swept within a predetermined wavelength range by the tunable light source. The OCT light source 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 these combined lights. 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 processing unit 220 of the processing unit 9. The arithmetic processing unit 220 forms a reflection intensity profile in each A line by, for example, performing a Fourier transform or the like on the spectral distribution based on the sampling data for each series of wavelength scans (for each A line). Further, the arithmetic processing unit 220 forms image data by imaging the reflection intensity profile of each A line.

In this example, the corner cube 114 for changing the length of the optical path (reference optical path, reference arm) of the reference optical path LR is provided, but the measured optical path length and the reference optical path length are provided by using an optical member other than these. It is also possible to change the difference with.

The processing unit 9 calculates a refractive power value from the measurement results obtained by using the reflex measurement optical system, and based on the calculated refractive power value, the fundus Ef, the reflex measurement light source 61, and the image pickup element 59 are coupled. The reflex measurement light source 61 and the focusing lens 74 are moved to the respective positions in the optical axis direction. In some embodiments, the processing unit 9 moves the focusing lens 87 of the OCT optical system 8 in the optical axis direction in conjunction with the movement of the focusing lens 74. In some embodiments, the processing unit 9 moves the liquid crystal panel 41 (fixation unit 40) in the optical axis direction in conjunction with the movement of the reflex measurement light source 61 and the focusing lens 74.

<Processing system configuration>
The configuration of the processing system of the ophthalmic apparatus 1000 will be described. An example of the functional configuration of the processing system of the ophthalmic apparatus 1000 is shown in FIGS. 3 and 4. FIG. 3 shows an example of a functional block diagram of the processing system of the ophthalmic apparatus 1000. FIG. 4 shows an example of a functional block diagram of the data processing unit 223.

The processing unit 9 controls each unit of the ophthalmic apparatus 1000. Further, the processing unit 9 can execute various arithmetic processes. The processing unit 9 includes a processor. Processor functions include, 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 , FPGA (Field Processor Gate Array)) and the like. The processing unit 9 realizes the function according to the embodiment by reading and executing, for example, a program stored in a storage circuit or a storage device.

The processing unit 9 is an example of the "ophthalmology information processing apparatus" according to the embodiment. That is, the program for realizing the function of the processing unit 9 is an example of the "ophthalmology information processing program" according to the embodiment.

The processing unit 9 includes a control unit 210 and an arithmetic processing unit 220. Further, the ophthalmic apparatus 1000 includes a moving mechanism 200, a display unit 270, an operation unit 280, and a communication unit 290.

The moving mechanism 200 includes a Z alignment system 1, an XY alignment system 2, a kerato measurement system 3, a fixative projection system 4, an anterior segment observation system 5, a reflex measurement projection system 6, a reflex measurement light receiving system 7, an OCT optical system 8, and the like. It is a mechanism for moving the head portion in which the optical system of the above is housed in the front-back and left-right directions. For example, the moving mechanism 200 is provided with an actuator that generates a driving force for moving the head portion and a transmission mechanism that transmits the driving force. The actuator is composed of, for example, a pulse motor. The transmission mechanism is composed of, for example, a combination of gears or a rack and pinion. The control unit 210 (main control unit 211) controls the moving mechanism 200 by sending a control signal to the actuator.

(Control unit 210)
The control unit 210 includes a processor and controls each unit of the ophthalmologic device. The control unit 210 includes a main control unit 211 and a storage unit 212. A computer program for controlling the ophthalmologic device is stored in the storage unit 212 in advance. The computer program includes a light source control program, a detector control program, an optical scanner control program, an optical system control program, an arithmetic processing program, a user interface program, and the like. When the main control unit 211 operates according to such a computer program, the control unit 210 executes the control process.

The main control unit 211 performs various controls of the ophthalmic apparatus as a measurement control unit. The control for the Z alignment system 1 includes the control of the Z alignment light source 11 and the control of the line sensor 13. The control of the Z alignment light source 11 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. The control of the line sensor 13 includes exposure adjustment, gain adjustment, detection rate adjustment, and the like of the detection element. As a result, the Z alignment light source 11 is switched between lighting and non-lighting, and the amount of light is changed. The main control unit 211 captures the signal detected by the line sensor 13, and determines the projection position of the light with respect to the line sensor 13 based on the captured signal. The main control unit 211 obtains the position of the corneal apex of the eye E to be inspected based on the specified projection position, and controls the movement mechanism 200 based on this to move the head unit in the front-rear direction (Z alignment).

The control for the XY alignment system 2 includes the control of the XY alignment light source 21 and the like. The control of the XY alignment light source 21 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. As a result, the XY alignment light source 21 is switched between lighting and non-lighting, and the amount of light is changed. The main control unit 211 captures the signal detected by the image pickup device 59, and determines the position of the bright spot image based on the return light of the light from the XY alignment light source 21 based on the captured signal. The main control unit 211 controls the movement mechanism 200 so that the displacement from the position of the bright spot image Br with respect to a predetermined target position (for example, the center position of the alignment mark AL) is canceled, and moves the head unit in the left-right / up-down direction. Move (XY alignment).

The control for the kerato measurement system 3 includes the control of the keratling light source 32 and the like. The control of the keratling light source 32 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. As a result, the lighting and non-lighting of the keratling light source 32 are switched, and the amount of light is changed. The main control unit 211 causes the arithmetic processing unit 220 to perform a known calculation on the keratling image detected by the image sensor 59. As a result, the corneal shape parameter of the eye E to be inspected is obtained.

Controls for the fixative projection system 4 include control of the liquid crystal panel 41 and movement control of the fixative unit 40. The control of the liquid crystal panel 41 includes turning on / off the display of the fixative and switching the display position of the fixative.

For example, the fixative projection system 4 is provided with a moving mechanism for moving the liquid crystal panel 41 (or the fixative unit 40) in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 211 controls the moving mechanism by sending a control signal to the actuator, and at least moves the liquid crystal panel 41 in the optical axis direction. As a result, the position of the liquid crystal panel 41 is adjusted so that the liquid crystal panel 41 and the fundus Ef are optically conjugate.

The control for the anterior eye portion observation system 5 includes the control of the anterior eye portion illumination light source 50, the control of the image pickup element 59, and the like. The control of the anterior eye illumination light source 50 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. As a result, the lighting of the frontal eye illumination light source 50 can be switched between lighting and non-lighting, and the amount of light can be changed. The control of the image pickup element 59 includes exposure adjustment, gain adjustment, detection rate adjustment, and the like of the image pickup element 59. The main control unit 211 captures the signal detected by the image pickup device 59, and causes the arithmetic processing unit 220 to perform processing such as forming an image based on the captured signal.

The control for the reflex measurement projection system 6 includes the control of the reflex measurement light source 61, the control of the rotary prism 66, and the like. The control of the reflex measurement light source 61 includes turning on / off the light source, adjusting the amount of light, adjusting the aperture, and the like. As a result, the lighting of the reflex measurement light source 61 can be switched between lighting and non-lighting, and the amount of light can be changed. For example, the reflex measurement projection system 6 includes a moving mechanism that moves the reflex measurement light source 61 in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 211 controls the movement mechanism by sending a control signal to the actuator, and moves the reflex measurement light source 61 in the optical axis direction. Control of the rotary prism 66 includes rotation control of the rotary prism 66 and the like. For example, a rotation mechanism for rotating the rotary prism 66 is provided, and the main control unit 211 rotates the rotary prism 66 by controlling this rotation mechanism.

The control for the reflex measurement light receiving system 7 includes the control of the focusing lens 74 and the like. Control of the focusing lens 74 includes control of movement of the focusing lens 74 in the optical axis direction. For example, the reflex measurement light receiving system 7 includes a moving mechanism that moves the focusing lens 74 in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 211 controls the moving mechanism by sending a control signal to the actuator, and moves the focusing lens 74 in the optical axis direction. The main control unit 211 illuminates the reflex measurement light source 61 and the focusing lens 74, for example, according to the refractive power of the eye E to be inspected so that the reflex measurement light source 61, the fundus Ef, and the image pickup element 59 are optically coupled. It can be moved in the axial direction.

The control for the OCT optical system 8 includes the control of the OCT light source 101, the control of the optical scanner 88, the control of the focusing lens 87, the control of the corner cube 114, the control of the detector 125, the control of the DAQ 130, and the like. The control of the OCT light source 101 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. The control of the optical scanner 88 includes control of the scanning position, scanning range and scanning speed by the first galvano mirror, control of the scanning position, scanning range and scanning speed by the second galvano mirror and the like.

To control the in-focus lens 87, control the movement of the in-focus lens 87 in the optical axis direction, control the movement of the in-focus lens 87 to the in-focus reference position corresponding to the imaging region, and the movement range corresponding to the imaging region (focus). There is movement control within the focal range). For example, the OCT optical system 8 includes a moving mechanism that moves the focusing lens 87 in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 211 controls the moving mechanism by sending a control signal to the actuator, and moves the focusing lens 87 in the optical axis direction. In some embodiments, the ophthalmic apparatus is provided with a holding member that holds the focusing lenses 74 and 87 and a drive unit that drives the holding member. The main control unit 211 controls the movement of the focusing lenses 74 and 87 by controlling the drive unit. For example, the main control unit 211 may move the focusing lens 87 in conjunction with the movement of the focusing lens 74, and then move only the focusing lens 87 based on the intensity of the interference signal.

The control of the corner cube 114 includes movement control along the optical path of the corner cube 114. For example, the OCT optical system 8 includes a moving mechanism that moves the corner cube 114 in a direction along an optical path. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 211 controls the movement mechanism by sending a control signal to the actuator, and moves the corner cube 114 in the direction along the optical path. The control of the detector 125 includes exposure adjustment, gain adjustment, detection rate adjustment, and the like of the detection element. The main control unit 211 samples the signal detected by the detector 125 by the DAQ 130, and causes the arithmetic processing unit 220 (image forming unit 222) to perform processing such as image formation based on the sampled signal.

Further, as a display control unit, the main control unit 211 can be used as a display control unit for measuring values of refractive power calculated by the eye refractive power calculation unit 221, tomographic images formed by the image forming unit 222, and processing results of the data processing unit 223 described later. The corresponding information is displayed on the display unit 270. As the processing result of the data processing unit 223, the intraocular distance calculated by the intraocular distance calculation unit 231, the abnormality degree information generated by the analysis unit 232, the measured value of the refractive power corrected by the measured value correction unit 233, and the like are obtained. be.

Further, the main control unit 211 performs a process of writing data to the storage unit 212 and a process of reading data from the storage unit 212.

(Memory unit 212)
The storage unit 212 stores various data. The data stored in the storage unit 212 includes, for example, measurement results of objective measurement, measurement results of OCT measurement, image data of tomographic image, image data of anterior segment image, eye information to be inspected, standard data, and the like. The eye test information includes information related to the test eye such as left eye / right eye identification information.

Standard data is statistically derived from a large number of normal eye measurement data and is called normal eye data (normalative data) or the like. Standard data includes the intraocular distance in the normal eye and the predetermined interlayer distance of the fundus. The intraocular distance includes the axial length (distance from the apex of the cornea to the internal limiting membrane), corneal thickness, anterior chamber depth, lens thickness, vitreous cavity length, retinal film thickness, choroidal film thickness, and the like. Within a given interlayer distance of the fundus, the retinal thickness (Retinal Pickness), internal limiting membrane (Inner Limiting Membrane), nerve fiber layer, ganglion cell layer, inner retinal layer, inner granule layer, outer plexiform layer, outer plexiform layer, outer limiting membrane. There are arbitrary two interlayer distances such as the granular layer, the outer limiting membrane, the photoreceptor layer, and the retinal pigment epithelium. Macular retina thickness is the distance between the internal limiting membrane and the retinal pigment epithelial layer in the macula (eg, within a predetermined range from the fovea centralis).

Further, various programs and data for operating the ophthalmic apparatus are stored in the storage unit 212.

(Arithmetic processing unit 220)
The arithmetic processing unit 220 includes an eye refractive power calculation unit 221, an image forming unit 222, and a data processing unit 223.

(Eye Refractive Power Calculation Unit 221)
The eye refractive power calculation unit 221 receives a ring image (pattern image) obtained by receiving the return light of the ring-shaped luminous flux (ring-shaped measurement pattern) projected on the fundus Ef by the reflex measurement projection system 6 by the image pickup element 59. ) Is analyzed. For example, the optical power calculation unit 221 obtains the position of the center of gravity of the ring image from the brightness distribution in the image in which the obtained ring image is drawn, and obtains the brightness distribution along a plurality of scanning directions radially extending from the position of the center of gravity. , The ring image is specified from this brightness distribution. Subsequently, the optical power calculation unit 221 obtains an approximate ellipse of the specified ring image, and by substituting the major axis and the minor axis of the approximate ellipse into a known equation, the spherical power, the astigmatic power, and the astigmatic axis angle (refraction). Force value) is calculated. Alternatively, the eye refractive power calculation unit 221 can obtain the parameter of the eye refractive power based on the deformation and displacement of the ring image with respect to the reference pattern.

The refractive index calculation unit 221 is based on the difference between the wavelength region of the light (near infrared light) projected on the fundus Ef by the refraction measurement projection system 6 and the wavelength region of the light (visible light) used in the subjective examination. It is possible to obtain the refraction force value (measured value of the refraction force). In the subjective test, the image obtained by visible light near the surface of the retina (specifically, the internal limiting membrane) is recognized and the orientation of the Randolt ring, for example, is determined. Reflected light is detected. If the refractive power from the cornea to the inner border membrane is α, the refractive power from the cornea to the retinal pigment epithelial layer is β, and the correction value corresponding to the above difference in the wavelength region is γ, the eye has no disease in the retina. On the other hand, the correction value γ is obtained so that (α-β-γ) representing the difference between the measured value of the refractive power and the test value of the subjective test becomes 0. The eye refractive power calculation unit 221 obtains the measured value of the refractive power of the eye E to be inspected by adding the correction value γ to the refractive power value obtained as described above.

Further, the eye refractive power calculation unit 221 calculates the corneal refractive power, the corneal astigmatism degree, and the corneal astigmatism axis angle based on the keratling image acquired by the anterior eye portion observation system 5. For example, the optical power calculation unit 221 calculates the corneal radius of curvature of the strong main meridian and the weak main meridian on the anterior surface of the cornea by analyzing the keratling image, and calculates the above parameters based on the corneal radius of curvature.

(Image forming unit 222)
The image forming unit 222 forms the image data of the tomographic image of the fundus Ef based on the signal detected by the detector 115. That is, the image forming unit 222 forms the image data of the eye E to be inspected based on the detection result of the interference light LC by the interference optical system. This processing includes processing such as filtering processing and FFT (Fast Fourier Transform), as in the case of the conventional spectral domain type OCT. The image data acquired in this way is a data set containing a group of image data formed by imaging a reflection intensity profile in a plurality of A lines (paths of each measured light LS in the eye E to be inspected). be.

In order to improve the image quality, it is possible to superimpose (add and average) a plurality of data sets collected by repeating scanning with the same pattern multiple times.

(Data processing unit 223)
The data processing unit 223 performs various data processing (image processing) and analysis processing on the tomographic image formed by the image forming unit 222. For example, the data processing unit 223 executes correction processing such as image brightness correction and dispersion correction. Further, the data processing unit 223 performs various image processing and analysis processing on the image (anterior eye portion image and the like) obtained by using the anterior eye portion observation system 5.

The data processing unit 223 can form volume data (voxel data) of the eye E to be inspected by executing known image processing such as interpolation processing for interpolating pixels between tomographic images. When displaying an image based on volume data, the data processing unit 223 performs rendering processing on the volume data to form a pseudo three-dimensional image when viewed from a specific line-of-sight direction.

The data processing unit 223 includes an intraocular distance calculation unit 231, an analysis unit 232, and a measured value correction unit 233.

(Intraocular distance calculation unit 231)
The intraocular distance calculation unit 231 obtains one or more intraocular distances in the eye E to be inspected based on the detection result of the interference light LC obtained by the OCT optical system 8. The intraocular distance of 1 or more includes the axial length (distance from the apex of the cornea to the internal limiting membrane). In some embodiments, the intraocular distance calculation unit 231 obtains one or more intraocular distances based on the data obtained by 3D scanning by the OCT optical system 8. In some embodiments, the intraocular distance calculation unit 231 analyzes the detection result of the interference light LC obtained by the OCT optical system 8 to detect the interference light corresponding to a predetermined portion in the eye (interference signal). ) Is specified, and the above-mentioned intraocular distance is obtained based on the distance between the specified peak positions. The intraocular distance calculation unit 231 according to some embodiments further obtains the corneal thickness, the anterior chamber depth, the crystalline lens thickness, the vitreous cavity length, the retina film thickness, the choroidal film thickness, and the like.

(Analysis unit 232)
The analysis unit 232 obtains a predetermined interlayer distance in the fundus based on the detection result of the interference light LC obtained by the OCT optical system 8, and an abnormality indicating the degree of abnormality of the fundus based on the obtained interlayer distance and standard data. Generate degree information. The analysis unit 232 includes a layer region identification unit 232A, an edema identification unit 232B, a layer thickness calculation unit 232C, a comparison unit 232D, and an abnormality degree information generation unit 232E.

(Layer area identification unit 232A)
The layer region specifying unit 232A identifies a layer region corresponding to a predetermined layer structure of the fundus Ef based on the detection result of the interference light LC obtained by the OCT optical system 8. In some embodiments, the layer region identification unit 232A identifies a layer region corresponding to a predetermined layer tissue of the fundus Ef by analyzing the three-dimensional data collected by 3D scanning by the OCT optical system 8. In some embodiments, the layer region identification unit 232A performs a segmentation process on the tomographic image of the fundus Ef formed by the image forming unit 222 based on the detection result of the interference light LC obtained by the OCT optical system 8. By applying, a layer area corresponding to a predetermined layer structure is specified. Segmentation is generally performed based on the luminance value of an OCT image (two-dimensional tomographic image, three-dimensional image, etc.). Each layered tissue of the fundus Ef has a characteristic reflectance, and the image region of the layered tissue also has a characteristic luminance value. In segmentation, a target image area is specified based on such characteristic luminance values.

The layer region specifying portion 232A includes an inner limiting membrane, a nerve fiber layer, a ganglion cell layer, an inner plexiform layer, an inner granule layer, an outer plexiform layer, an outer granular membrane, an outer boundary membrane, a photoreceptor layer, and a retina. It is possible to identify the pigment epithelial layer (Retinal Pigment Epithelium) and the like.

(Edema specific part 232B)
The edema identification portion 232B identifies edema in the fundus Ef (particularly the macula) based on the detection result of the interference light LC obtained by the OCT optical system 8. The edema specifying portion 232B can specify the position and morphology (outer shape, shape) of the edema in the fundus Ef. The edema identification unit 232B identifies edema in the fundus Ef based on the detection result of the interference light LC obtained by the OCT optical system 8. The edema identification portion 232B can identify edema based on the distance between the internal limiting membrane identified by the layer region identification portion 232A and the retinal pigment epithelial layer. In some embodiments, the edema identifying portion 232B identifies edema based on a change in the distance in the B scan direction between the internal limiting membrane and the retinal pigment epithelial layer identified by the layer region identifying portion 232A. In some embodiments, the edema identification unit 232B identifies edema in the fundus Ef by analyzing 3D data collected by 3D scanning with OCT optical system 8. In some embodiments, the edema identification unit 232B performs a segmentation process on the tomographic image of the fundus Ef formed by the image forming unit 222 based on the detection result of the interference light LC obtained by the OCT optical system 8. Identify edema by this.

(Layer thickness calculation unit 232C)
The layer thickness calculation unit 232C calculates the thickness (interlayer distance) of the layer region specified by the layer region identification unit 232A. The layer thickness calculation unit 232C can calculate the thickness at a plurality of positions of the layer region specified by the layer region identification unit 232A and output these statistical values (average value, median value, etc.). The thickness of the layered region is measured, for example, as the distance between the upper surface (the surface on the surface side of the fundus) and the lower surface (the surface on the deep side of the fundus) of the layered region. This distance is measured, for example, along the Z direction.

The layer thickness calculation unit 232C can determine at least the retina thickness of the macula and the height of edema in the macula. The macular retina thickness and the height of edema in the macula are obtained as the average value of the values obtained from the A scan results at the representative positions in the macula or from the A scan results at two or more positions in the macula. Or something.

(Comparison unit 232D)
The comparison unit 232D compares the thickness of the layer region calculated by the layer thickness calculation unit 232C with the standard data stored in the storage unit 212. Further, when the standard data includes the thickness of the layer region at a plurality of positions in the eye, the comparison unit 232D stores the thickness of the layer region calculated by the layer thickness calculation unit 232C for each position and the storage unit 212. It is possible to compare the standard data with the standard data and store the comparison result in the storage unit 212 in correspondence with each position.

(Abnormality information generation unit 232E)
The abnormality degree information generation unit 232E generates a retinal index (abnormality degree information) indicating the degree of abnormality of the retina (fundus) based on the comparison result obtained by the comparison unit 232D. The retinal index is information indicating the degree of retinal abnormality, no retinal abnormality, and retinal abnormality.

FIG. 5 schematically shows an example of the retinal index according to the embodiment.

The abnormality degree information generation unit 232E calculates the retinal index according to the difference between the standard data and the thickness of the layer region calculated by the layer thickness calculation unit 232C. The abnormality degree information generation unit 232E outputs "10" indicating that there is no abnormality in the retina as a retina index when the difference between the standard data and the calculated macular retina thickness is equal to or less than a predetermined threshold value. The abnormality degree information generation unit 232E sets a retinal index of any of "1" to "9" indicating that there is an abnormality in the retina when the difference between the standard data and the calculated macular retina thickness is larger than a predetermined threshold value. Is output as. The abnormality degree information generation unit 232E can output the retinal index so that the numerical value gradually decreases as the difference between the standard data and the calculated macular retina thickness increases.

(Measured value correction unit 233)
The measured value correction unit 233 corrects the measured value of the refractive power of the eye to be inspected E calculated by the eye refractive power calculation unit 221 according to the morphology of the edema specified by the edema identification unit 232B. Specifically, the measured value correction unit 233 corrects the measured value of the refractive power of the eye to be inspected E calculated by the eye refractive power calculation unit 221 according to the height of the edema in the yellow spot. In some embodiments, the measured value correction unit 233 corrects the measured value of the refractive power of the eye E to be inspected according to the height of the identified edema when the edema is identified by the edema specifying unit 232B.

6A and 6B show an explanatory diagram of the operation of the measured value correction unit 233 according to the embodiment. FIG. 6A shows an explanatory diagram of the refractive power value of the eye to be inspected E calculated by the optical power calculation unit 221. FIG. 6B shows an explanatory diagram of the correction value of the refractive power value of the eye E to be inspected, which is corrected by the measurement value correction unit 233. 6A and 6 schematically show the tomographic structure of the fundus Ef.

As described above, the eye refractive power calculation unit 221 obtains the refractive power value based on the near-infrared light reflected by the retinal pigment epithelial layer RPE. Since the subjective test value is obtained by recognizing an image obtained by visible light near the internal limiting membrane ILM, the ocular refractive power calculation unit 221 may use the refractive power value calculated as described above in the yellow spot portion. A value to which the correction value γ corresponding to the distance between the internal limiting membrane ILM and the retinal pigment epithelial layer RPE (yellow spot network thickness RT) is applied is output as a measured value of the refractive power value.

On the other hand, the measured value correction unit 233 further applies the correction value γ1 corresponding to the height of edema in the macula to the measured value obtained by applying the correction value γ as shown in FIG. 6A. ..

Specifically, as shown in FIG. 6B, the measured value correction unit 233 corrects the above measured value in consideration of the height MET of the edema in the macula. The axial length, which is the distance from the apex of the cornea to the internal limiting membrane, is AL _ILM , the retina thickness of the macula is RT, the height of edema in the macula is MET (Macular Edema Stickness), and the intraocular conversion refractive index is n. Then, the correction value γ1 is expressed by the following equation.

The correction value γ1 may be determined from the measured value as shown in the equation (1), or may be determined by using a constant value constant or a function of the refractive power. In some embodiments, the constant value const is expressed by the following equation.

In this case, the correction value γ1 is expressed by the following equation.

The measured value correction unit 233 adds the correction value γ1 represented by the formula (1) or the formula (3) to the measured value of the refractive power obtained by the eye refractive power calculation unit 221 to obtain the refractive power of the eye E to be inspected. Correct the measured value.

(Display unit 270, operation unit 280)
The display unit 270, as a user interface unit, displays information under the control of the control unit 210. The display unit 270 includes the display unit 10 shown in FIG. 1 and the like.

The operation unit 280 is used as a user interface unit to operate the ophthalmologic device. The operation unit 280 includes various hardware keys (joysticks, buttons, switches, etc.) provided in the ophthalmic apparatus. Further, the operation unit 280 may include various software keys (buttons, icons, menus, etc.) displayed on the touch panel type display screen 10a.

At least a part of the display unit 270 and the operation unit 280 may be integrally configured. As a typical example thereof, there is a touch panel type display screen 10a.

(Communication unit 290)
The communication unit 290 has a function for communicating with an external device (not shown). The communication unit 290 includes a communication interface according to the connection form with the external device. An example of an external device is a spectacle lens measuring device for measuring the optical characteristics of a lens. The spectacle lens measuring device measures the power of the spectacle lens worn by the subject, and inputs this measurement data to the ophthalmic device 1000. Further, the external device may be an arbitrary ophthalmic device, a device (reader) for reading information from a recording medium, a device (writer) for writing information on a recording medium, or the like. Further, the external device may be a hospital information system (HIS) server, a DICOM (Digital Imaging and Communication in Medicine) server, a doctor terminal, a mobile terminal, a personal terminal, a cloud server, or the like. The communication unit 290 may be provided in, for example, the processing unit 9.

The reflex measurement optical system (refraction measurement projection system 6 and reflex measurement light receiving system 7) and the ocular refractive power calculation unit 221 are examples of the “refractive power measurement unit” according to the embodiment. The OCT optical system 8 is an example of the “data collection unit” according to the embodiment. The control unit 210 (main control unit 211) is an example of a “display control unit”.

<Operation example>
The operation of the ophthalmic apparatus 1000 according to the embodiment will be described.

FIG. 7 shows an example of the operation of the ophthalmic apparatus 1000. FIG. 7 shows a flow chart of an operation example of the ophthalmic apparatus 1000. The storage unit 212 stores a computer program for realizing the process shown in FIG. 7. The main control unit 211 executes the process shown in FIG. 7 by operating according to this computer program. Here, it is assumed that the information of the subject is stored in the storage unit 212 in advance.

(S1: Alignment)
The ophthalmic apparatus 1000 performs alignment when the examiner performs a predetermined operation on the operation unit 280 with the subject's face fixed to the face receiving portion (not shown).

Specifically, the main control unit 211 turns on the Z alignment light source 11 and the XY alignment light source 21. Further, the main control unit 211 turns on the front eye portion illumination light source 50. The processing unit 9 acquires an image pickup signal of the front eye portion image on the image pickup surface of the image pickup element 59, and causes the display unit 270 to display the front eye portion image. After that, the optical system shown in FIG. 1 is moved to the inspection position of the eye E to be inspected. The inspection position is a position where the inspection of the eye E to be inspected can be performed within sufficient accuracy. The eye E to be inspected is placed at the examination position via the above-mentioned alignment (alignment by the Z alignment system 1 and the XY alignment system 2 and the anterior eye observation system 5). The movement of the optical system is executed by the control unit 210 according to an operation or instruction by the user or an instruction by the control unit 210. That is, the movement of the optical system to the examination position of the eye E to be inspected and the preparation for performing the objective measurement are performed.

Further, the main control unit 211 moves the reflex measurement light source 61, the focusing lens 74, and the fixative unit 40 (liquid crystal panel 41) to the position of the origin (for example, the position corresponding to 0D) along the respective optical axes. Move it.

The kerato measurement may be executed after the alignment in step S1 is completed. In this case, the main control unit 211 causes the liquid crystal panel 41 to display a pattern indicating the fixative at the display position corresponding to the desired fixative position. As a result, the eye E to be inspected is gazed at a desired fixative position. After that, the main control unit 211 turns on the keratling light source 32. When light is output from the keratling light source 32, a ring-shaped light flux for measuring the shape of the cornea is projected onto the cornea Cr of the eye E to be inspected. The ocular refractive power calculation unit 221 calculates the corneal radius of curvature by performing arithmetic processing on the image acquired by the image pickup element 59, and the corneal refractive power, corneal astigmatism, and corneal astigmatism are calculated from the calculated corneal radius of curvature. Calculate the axis angle. In the control unit 210, the calculated corneal refractive power and the like are stored in the storage unit 212.

The operation of the ophthalmic apparatus 1000 shifts to step S2 by the instruction from the main control unit 211 or the user's operation or instruction to the operation unit 280.

(S2: Measurement of refractive power)
In the refractive power measurement, the main control unit 211 projects a ring-shaped measurement pattern luminous flux for measuring the refractive power onto the eye E to be inspected as described above. A ring image based on the return light of the measurement pattern luminous flux from the eye E to be inspected is formed on the image pickup surface of the image pickup element 59. The main control unit 211 determines whether or not a ring image based on the return light from the fundus Ef detected by the image sensor 59 could be acquired. For example, the main control unit 211 detects the position (pixel) of the edge of the image based on the return light detected by the image sensor 59, and whether the width of the image (difference between the outer diameter and the inner diameter) is equal to or more than a predetermined value. Judge whether or not. Alternatively, the main control unit 211 determines whether or not a ring image can be acquired by determining whether or not a ring can be formed based on a point (image) having a predetermined height (ring diameter) or more. May be good.

When it is determined that the ring image can be obtained, the optical power calculation unit 221 analyzes the ring image based on the return light of the measurement pattern luminous flux projected on the eye E to be inspected by a known method, and analyzes the provisional spherical power S and the tentative spherical power S. A tentative astigmatic power C is obtained. Based on the obtained temporary spherical power S and astigmatic power C, the main control unit 211 sets the reflex measurement light source 61, the focusing lens 74, and the fixative unit 40 (liquid crystal panel 41) into equivalent spherical power (S + C / 2). Move to the position of (the position corresponding to the temporary far point). The main control unit 211 further moves the fixative unit 40 (liquid crystal panel 41) from that position to the cloud fog position, and then controls the reflex measurement projection system 6 and the reflex measurement light receiving system 7 as the main measurement to obtain a ring image. Get it again. The main control unit 211 causes the eye refractive power calculation unit 221 to calculate the spherical power, the astigmatic power, and the astigmatic axis angle from the analysis result of the ring image obtained in the same manner as described above and the movement amount of the focusing lens 74. As described above, the optical power calculation unit 221 corresponds to the distance between the internal limiting membrane ILM and the retinal pigment epithelial layer RPE in the macula (macula retina thickness RT) with respect to the calculated power value. The measured value of the refractive power value is acquired by applying the correction value γ.

Further, the eye refractive power calculation unit 221 obtains a position corresponding to the far point of the eye E to be inspected (a position corresponding to the far point obtained by this measurement) from the obtained spherical power and astigmatic power. The main control unit 211 moves the liquid crystal panel 41 to a position corresponding to the obtained far point. In the control unit 210, the position of the focusing lens 74, the calculated spherical power, and the like are stored in the storage unit 212. The operation of the ophthalmic apparatus 1000 shifts to step S3 by the instruction from the main control unit 211 or the user's operation or instruction to the operation unit 280.

When it is determined that the ring image cannot be acquired, the main control unit 211 considers the possibility of an intensified refractive error eye and sets the reflex measurement light source 61 and the focusing lens 74 on the minus power side (for example, in a preset step). -10D), move to the plus frequency side (for example, + 10D). The main control unit 211 detects the ring image at each position by controlling the reflex measurement light receiving system 7. When it is determined that the ring image cannot be acquired even after that, the main control unit 211 executes a predetermined measurement error process. At this time, the operation of the ophthalmic apparatus 1000 may shift to step S3. In the control unit 210, information indicating that the reflex measurement result was not obtained is stored in the storage unit 212.

(S3: OCT measurement)
First, the main control unit 211 moves the fixative unit 40 (liquid crystal panel 41) from the cloud fog position to the in-focus position. In some embodiments, the in-focus position maximizes the intensity of the interference signal or the like from the position of the equivalent spherical power (S + C / 2) specified in step S4, or the position of the equivalent spherical power (S + C / 2). It is a position adjusted so as to be.

Subsequently, the main control unit 211 turns on the OCT light source 101 and controls the optical scanner 88 to scan a predetermined portion (the portion including the macula) of the fundus Ef with the measurement light LS. For example, the detection signal obtained by scanning the measurement light LS is sent to the image forming unit 222. The image forming unit 222 forms a tomographic image of the fundus Ef from the obtained detection signal.

(S4: Calculate the interlayer distance)
Next, the main control unit 211 causes the layer area specifying unit 232A to specify a predetermined layer region in the fundus based on the scan data acquired in step S3. Similarly, the main control unit 211 causes the edema identification unit 232B to perform the edema identification process in the macula based on the scan data acquired in step S3. The main control unit 211 causes the layer thickness calculation unit 232C to calculate at least a predetermined interlayer distance such as the thickness of the macula retina.

(S5: Calculate the retinal index)
The main control unit 211 causes the comparison unit 232D to compare the macular network thickness calculated in step S4 with the standard data stored in the storage unit 212, and based on the comparison result, sets the retinal index to the abnormality degree information generation unit 232E. To generate. The anomaly degree information generation unit 232E generates a retinal index, for example, as shown in FIG.

(S6: Display)
The main control unit 211 displays the measured value of the refractive power value to which the correction value γ acquired in step S2 is applied and the retinal index calculated in step S5 on the same screen of the display unit 270.

FIG. 8 shows a display example in step S6 according to the embodiment.

The main control unit 211 causes the display unit 270 to display the anterior eye portion image IMG1 acquired by the anterior eye portion observation system 5 in real time. Further, the main control unit 211 superimposes and displays the measured values of the refractive power values of the right eye and the left eye of the subject, the retinal index, and the tomographic image on the anterior eye portion image IMG1.

Specifically, the main control unit 211 superimposes the measured value RA of the refractive power of the right eye of the subject, the retinal index RID of the right eye, and the tomographic image RIMG of the fundus of the right eye on the anterior eye image IMG1. To display. The retinal index RID is generated based on the interlayer distance of the fundus obtained by the OCT scan performed when the measured value RA was obtained. The tomographic image RIMG is generated by an OCT scan performed when the measured value RA is obtained. Similarly, the main control unit 211 superimposes the measured value LA of the refractive power of the left eye of the subject, the retinal index LID of the left eye, and the tomographic image LIMG of the fundus of the left eye on the anterior eye image IMG1 and displays it. Let me. The retinal index LID is generated based on the interlayer distance of the fundus obtained by the OCT scan performed when the measured value LA was obtained. The tomographic image LIMG is generated by an OCT scan performed when the measured LA was acquired.

By displaying the measured value of the refractive power and the retinal index on the display unit 270, when it is determined that the refractive power value is abnormal, it can be easily determined whether or not the cause is in the fundus. Will be.

(S7: Enlarged display?)
Subsequently, the main control unit 211 determines whether or not to magnify and display the tomographic image displayed in step S6. For example, the main control unit 211 performs a predetermined operation on the operation unit 280 when the examiner or the like who has seen the measured value, the retinal index, or the tomographic image displayed in step S6 wants to check the morphology of the fundus in detail. By determining whether or not the tomographic image is enlarged, it is determined whether or not the tomographic image is enlarged.

When it is determined that the tomographic image is enlarged (S7: Y), the operation of the ophthalmologic apparatus 1000 shifts to step S8. When it is determined that the tomographic image is not enlarged (S7: N), the operation of the ophthalmologic apparatus 1000 is completed (end).

(S8: Correct the measured refractive power)
When it is determined in step S7 that the tomographic image is to be magnified (S7: Y), the main control unit 211 causes the measured value correction unit 233 to correct the measured value of the refractive power of the eye E to be inspected acquired in step S2. Between steps S3 and S8, the intraocular distance calculation unit 231 calculates the axial length of the eye to be inspected E. In step S8, the measured value correction unit 233 corrects the measured value of the refractive power acquired in step S2 by using the correction value γ1 represented by the equation (1).

(S9: Display)
The main control unit 211 enlarges and displays the tomographic image specified in step S7, and displays the measured value of the refractive power acquired in step S2 and the corrected value of the measured value obtained in step S8. Display on the same screen of 270.

FIG. 9 shows a display example in step S9 according to the embodiment.

The main control unit 211 causes the display unit 270 to display the tomographic image LIMG in which the tomographic image specified in step S7 is magnified by a predetermined magnification. Further, the main control unit 211 displays the measured value LA of the refractive power acquired in step S2 and the measured value LA1 corrected in step S8 on the same screen of the display unit 270.

By displaying the measured value LA and the corrected measured value LA1 on the display unit 270 together with the tomographic image LIMG, it is easy to determine whether or not the abnormality of the refractive power value is caused by the morphology in the fundus (particularly the macula). It becomes possible to judge.

This completes the operation of the ophthalmic apparatus 1000 (end).

As described above, according to the embodiment, when the measured value of the refractive power and the retinal index are displayed on the display unit 270 and the refractive power value is determined to be abnormal, the cause is the fundus. It becomes possible to easily determine whether or not there is. In addition, by displaying the measured value and the corrected measured value on the display unit 270 together with the tomographic image, it is easy to determine whether or not the abnormality of the refractive power value is caused by the morphology in the fundus (particularly the macula). It becomes possible to judge.

<Modification example>
In the above embodiment, the case where the abnormality degree information generation unit 232E generates a retinal index that changes stepwise according to the difference between the acquired refractive power value and the standard data has been described, but the configuration according to the embodiment has been described. Is not limited to this.

For example, the main control unit according to the modified example of the embodiment may change the display color of the retinal index stepwise according to the difference between the acquired refractive power value and the standard data.

FIG. 10 schematically shows an example of the number of retinal indexes according to the modified example of the embodiment.

The main control unit according to the modification changes the display color of the retinal index according to the difference (that is, the degree of abnormality) between the acquired refractive power value and the standard data, and causes the display unit 270 to display the color. For example, when the retinal index is "8" to "10", it is displayed in green, when the retinal index is "4" to "7", it is displayed in yellow, and when the retinal index is "1" to "3". Is displayed in green.

According to this modification, the display color of the retina index displayed on the display unit 270 is changed according to the degree of abnormality of the retina, so that it is possible to prevent oversight and call attention by the examiner or the like. Become.

It is also possible to notify the degree of abnormality of the retina by mere color output or sound output.

[Action / Effect]
The operation and effect of the ophthalmic apparatus according to the embodiment will be described.

The ophthalmic apparatus (1000) according to some embodiments includes a refractive power measuring unit (refraction measurement projection system 6, reflex measurement light receiving system 7, and ocular refractive power calculation unit 221) and a data acquisition unit (OCT optical system 8). , A storage unit (212), an analysis unit (232), an abnormality degree information generation unit (232E), and a display control unit (control unit 210, main control unit 211). The refractive power measuring unit acquires the measured value of the refractive power of the eye to be inspected (E). The data collection unit collects data on the fundus (Ef) of the eye to be inspected using optical coherence tomography. The storage unit stores in advance standard data including a predetermined interlayer distance in the fundus of a normal eye. The analysis unit calculates a predetermined interlayer distance based on the data of the fundus. The abnormality degree information generation unit generates abnormality degree information indicating the abnormality degree of the fundus based on a predetermined interlayer distance calculated by the analysis unit and standard data. The display control unit displays the measured value of the refractive power acquired by the refractive power measuring unit and the abnormality degree information on the same screen of the display means (display unit 270).

According to such a configuration, the measured value of the refractive power of the eye to be inspected acquired by the refractive power measuring unit and the abnormality degree information indicating the degree of abnormality of the fundus based on the standard data and the predetermined interlayer distance in the fundus are displayed. Since it is displayed on the same screen of the means, when it is determined that the refractive power value is abnormal, it becomes possible to easily determine whether or not the cause is in the fundus of the eye.

In the ophthalmic apparatus according to some embodiments, the abnormality degree information generation unit generates abnormality degree information corresponding to the difference between the standard data and the predetermined interlayer distance calculated by the analysis unit.

According to such a configuration, the degree of abnormality of the fundus can be expressed by a simple process, so that the degree of abnormality of the fundus can be easily determined when the refractive power value is determined to be abnormal. Become.

The ophthalmic apparatus according to some embodiments includes an image forming unit (222) that forms a tomographic image of the fundus based on the data of the fundus, and the display control unit includes a tomographic image formed by the image forming unit and an optical power. The measured value and the abnormality degree information are displayed on the same screen of the display means.

According to such a configuration, when it is determined that the refractive power value is abnormal, it is possible to easily determine whether or not the cause is in the fundus while looking at the tomographic image or the like.

In an ophthalmic apparatus according to some embodiments, the predetermined interlayer distance is the distance between the retinal pigment epithelial layer and the internal limiting membrane.

According to such a configuration, abnormality degree information can be generated based on the distance between the retinal pigment epithelial layer and the internal limiting membrane. Therefore, when the refractive power value is determined to be abnormal, the abnormality degree information can be generated. It becomes possible to easily determine whether or not the cause is in the retina.

The ophthalmologic apparatus according to some embodiments measures the edema specific part (232B) that identifies edema in the fundus based on the data of the fundus and the measured value of the refractive force according to the morphology of the edema specified by the edema specific part. The display control unit includes the measurement value correction unit (233) to be corrected, and causes the display means to display the measurement value corrected by the measurement value correction unit.

According to such a configuration, the edema in the fundus of the eye was identified, the measured value of the refractive power was corrected according to the identified edema morphology, and the corrected measured value was displayed on the display means. When it is determined that the force value is abnormal, it becomes possible to easily determine whether or not the cause is edema.

The ophthalmic apparatus (1000) according to some embodiments includes a refractive power measuring unit (ref measurement projection system 6, reflex measurement light receiving system 7, and eye refractive power calculation unit 221) and a data acquisition unit (OCT optical system 8). , A edema specifying unit (232B), a measured value correction unit (233), and a display control unit (control unit 210, main control unit 211). The refractive power measuring unit acquires the measured value of the refractive power of the eye to be inspected (E). The data collection unit collects data on the fundus (Ef) of the eye to be inspected using optical coherence tomography. The edema identification site identifies edema in the fundus based on the data of the fundus. The measured value correction unit corrects the measured value of the refractive power according to the morphology of the edema specified by the edema specific portion. The display control unit causes the display means (display unit 270) to display the measured value corrected by the measured value correction unit.

With such a configuration, edema is identified based on the data collected using optical coherence stromography, and the measured power of refraction of the subject eye is corrected and corrected according to the identified edema morphology. Since the measured value is displayed on the display means, when it is determined that the refractive power value is abnormal, it becomes possible to easily determine whether or not the cause is edema.

In the ophthalmic apparatus according to some embodiments, the measurement correction unit is the axial length in the macula and the distance from the retinal pigment epithelial layer to the internal limiting membrane and the macular retina at the site of edema identified by the edema specific area. Correct the measurement based on the thickness.

According to such a configuration, the measured value of the refractive power is corrected based on the axial length in the macula, the distance from the retinal pigment epithelial layer to the internal limiting membrane, and the thickness of the retina in the macula. It is possible to obtain the refractive power value including the influence with high accuracy.

In the ophthalmic apparatus according to some embodiments, the display control unit displays the measured value of the refractive power acquired by the refractive power measuring unit and the measured value corrected by the measured value correction unit on the same screen of the display means. ..

According to such a configuration, the measured value of the refractive power of the eye to be inspected and the corrected measured value are displayed on the same screen of the display means, so that the influence of edema can be easily determined. ..

The ophthalmic information processing program according to some embodiments causes a computer to execute an analysis step, an abnormality degree information generation step, and a display control step. The analysis step calculates a predetermined interlayer distance in the fundus based on the data of the fundus (Ef) of the eye to be inspected (E) collected using the optical coherence source graph. The abnormality degree information generation step generates abnormality degree information indicating the degree of abnormality of the fundus based on the standard data including the predetermined interlayer distance calculated in the analysis step and the predetermined interlayer distance in the fundus of a normal eye. In the display control step, the measured value of the refractive power of the eye to be inspected and the abnormality degree information are displayed on the same screen of the display means (display unit 270).

According to such a program, the measured value of the refractive power of the eye to be inspected and the abnormality degree information indicating the abnormality degree of the fundus based on the standard data and the predetermined interlayer distance in the fundus are displayed on the same screen of the display means. Therefore, when it is determined that the refractive power value is abnormal, it becomes possible to easily determine whether or not the cause is in the fundus.

In the ophthalmic information processing program according to some embodiments, the anomaly degree information generation step generates anomaly degree information corresponding to the difference between the standard data and the predetermined interlayer distance calculated in the analysis step.

According to such a program, the degree of abnormality of the fundus can be expressed by a simple process, so that the degree of abnormality of the fundus can be easily determined when the refractive power value is determined to be abnormal. Become.

The ophthalmologic information processing program according to some embodiments includes an image forming step of forming a tomographic image of the fundus based on the data of the fundus, and a display control step is a tomographic image formed in the image forming step, a refractive power. The measured value and the abnormality degree information are displayed on the same screen of the display means.

According to such a program, when it is determined that the refractive power value is abnormal, it is possible to easily determine whether or not the cause is in the fundus while looking at the tomographic image or the like.

In an ophthalmic information processing program according to some embodiments, the predetermined interlayer distance is the distance between the retinal pigment epithelial layer and the internal limiting membrane.

Such a program can generate anomalous degree information based on the distance between the retinal pigment epithelial layer and the internal limiting membrane, so that if the refractive power value is determined to be abnormal, it can be generated. It becomes possible to easily determine whether or not the cause is in the retina.

The ophthalmic information processing program according to some embodiments corrects the measured value of the refractive force according to the edema identification step for identifying the edema in the fundus based on the data of the fundus and the edema form identified in the edema identification step. Including the measured value correction step to be performed, the display control step causes the display means to display the measured value corrected in the measured value correction step.

According to such a program, the edema in the fundus was identified, the measured value of the refractive power was corrected according to the identified edema morphology, and the corrected measured value was displayed on the display means. When it is determined that the force value is abnormal, it becomes possible to easily determine whether or not the cause is edema.

The ophthalmic information processing program according to some embodiments causes a computer to perform an edema identification step, a measured value correction step, and a display control step. The edema identification step identifies edema in the fundus based on the fundus (Ef) data of the eye to be inspected (E) collected using optical coherence tomography. The measured value correction step corrects the measured value of the refractive power of the eye to be inspected according to the morphology of the edema identified in the edema specifying step. The display control step causes the display means (display unit 270) to display the measured value corrected in the measured value correction step.

According to such a program, edema is identified based on the data collected using optical coherence stromography, and the measured power of the optometric eye is corrected and corrected according to the morphology of the identified edema. Since the measured value is displayed on the display means, when it is determined that the refractive power value is abnormal, it becomes possible to easily determine whether or not the cause is edema.

In an ophthalmic information processing program according to some embodiments, the measurement correction step is the axial length in the macula and the distance from the retinal pigment epithelial layer to the internal limiting membrane and the macula at the site of edema identified in the macula identification step. The measured value is corrected based on the thickness of the retina.

According to such a program, the measurement value of the refractive power was corrected based on the axial length in the macula, the distance from the retinal pigment epithelial layer to the internal limiting membrane, and the macular network thickness, so that the measured value of the refractive power was corrected. It is possible to obtain the refractive power value including the influence with high accuracy.

In the ophthalmic information processing program according to some embodiments, the display control step displays the measured value of the refractive power and the measured value corrected in the measured value correction step on the same screen of the display means.

According to such a program, the measured value of the refractive power of the eye to be inspected and the corrected measured value are displayed on the same screen of the display means, so that the influence of edema can be easily determined. ..

<Others>
The embodiments shown above are merely examples for carrying out the present invention. A person who intends to carry out the present invention can make arbitrary modifications, omissions, additions, etc. within the scope of the gist of the present invention.

In the above embodiment or a modification thereof, the case where the measured value of the refractive power is acquired by projecting light onto the eye to be inspected has been described, but the configuration of the ophthalmic apparatus according to the embodiment is not limited to this. .. The ophthalmic apparatus according to the embodiment may acquire a measured value of the refractive power based on the wavefront aberration acquired by using a known wavefront sensor.

1 Z alignment system 2 XY alignment system 3 kerato measurement system 4 fixation projection system 5 anterior eye observation system 6 ref measurement projection system 7 reflex measurement light receiving system 8 OCT optical system 9 processing unit 210 control unit 211 main control unit 220 arithmetic processing Part 221 Eye refractive power calculation part 222 Image formation part 223 Data processing part 231 Intraocular distance calculation part 232 Analysis part 232A Layer area identification part 232B Edema identification part 232C Layer thickness calculation part 232D Comparison part 232E Abnormality information generation part 233 Measured value Correction unit 1000 Ophthalmic device

Claims (8)

An edema specific part that identifies edema in the fundus based on data on the fundus of the eye to be inspected collected using optical coherence tomography.
The measured value of the refractive power of the eye to be inspected is determined based on the axial length in the macula, the distance from the retinal pigment epithelial layer to the internal limiting membrane in the edema site identified by the edema specific part, and the macular network thickness. The measured value correction unit to be corrected and
Including ophthalmic equipment. The above- _mentioned The ophthalmic apparatus according to claim 1, wherein the measured value correction unit corrects the measured value by adding the correction value γ1 obtained by the following formula (A) to the measured value.

The above- _mentioned The ophthalmology according to claim 1, wherein the measured value correction unit corrects the measured value by adding the correction value γ1 obtained by the following formulas (B) and (C) to the measured value. Device.

The ophthalmic apparatus according to any one of claims 1 to 3, further comprising a display control unit for displaying the measured value corrected by the measured value correction unit on the display means. An edema identification step that identifies edema in the fundus based on fundus data of the eye to be inspected collected using optical coherence tomography.
The measured value of the refractive power of the eye to be inspected is determined based on the axial length in the macula, the distance from the retinal pigment epithelial layer to the internal limiting membrane at the site of edema identified in the edema identification step, and the thickness of the macula network. The measured value correction step to be corrected and
An ophthalmic information processing program that causes a computer to execute. The above- _mentioned The ophthalmic information processing program according to claim 5, wherein the measured value correction step corrects the measured value by adding the correction value γ1 obtained by the following formula (D) to the measured value.

The above- _mentioned The ophthalmology according to claim 5, wherein the measured value correction step corrects the measured value by adding the correction value γ1 obtained by the following formulas (E) and (F) to the measured value. Information processing program.

The ophthalmic information processing program according to any one of claims 5 to 7, wherein the display control step for displaying the measured value corrected in the measured value correction step is included in the display means.

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