JP2022087264A - Ophthalmologic system, ophthalmologic information processor, program, and recording medium - Google Patents

Abstract

PROBLEM TO BE SOLVED: To effectively use a slit lamp microscope.

SOLUTION: An ophthalmologic system acquires a front image by imaging an anterior eye part and collects a plurality of images by imaging the anterior eye part using slit light to form a three dimensional image on the basis of the collected images. The ophthalmologic system performs registration between the front image and the three dimensional image. When receiving input from a user to designate an attention region in the front image, the ophthalmologic system identifies a partial area of the three dimensional image corresponding to the attention region on the basis of a result of the registration and forms a rendering image corresponding to the partial area. The ophthalmologic system further makes display means display the rendering image corresponding to the partial area and the front image and makes an image representing an area corresponding to the rendering image be displayed on the front image.

SELECTED DRAWING: Figure 8

COPYRIGHT: (C)2022,JPO&INPIT

Description

The present invention relates to an ophthalmic system, an ophthalmic information processing apparatus, a program, and a recording medium.

Diagnostic imaging occupies an important position in the field of ophthalmology. In diagnostic imaging, various ophthalmologic imaging devices are used. Ophthalmologic imaging devices include slit lamp microscopes, fundus cameras, scanning laser ophthalmoscopes (SLOs), optical coherence tomography (OCTs), and the like. In addition, various ophthalmologic imaging devices such as reflex meters, keratometers, tonometers, specular microscopes, wavefront analyzers, and microperimeters are also equipped with functions for photographing the anterior segment of the eye and the fundus.

One of the most widely and frequently used devices among these various ophthalmic devices is the slit lamp microscope. A slit lamp microscope is an ophthalmic device for illuminating an eye to be inspected with slit light and observing or photographing an illuminated cross section with a microscope from the side. A slit lamp microscope is generally used for diagnosis of the anterior segment of the eye such as the cornea and the crystalline lens. For example, the doctor observes the entire diagnostic site while moving the illumination field and the focus position by the slit light to determine the presence or absence of an abnormality. In addition, a slit lamp microscope may be used in the prescription of a visual acuity correction device such as confirmation of the fitting state of a contact lens.

By the way, in response to recent advances in information and communication technology, research and development related to telemedicine technology is developing. Telemedicine is the act of providing medical care to a patient in a remote location using information technology such as the Internet. Patent Documents 3 and 4 disclose techniques for operating a medical device from a remote location, and Patent Document 4 discloses techniques for operating a slit lamp microscope from a remote location.

Japanese Unexamined Patent Publication No. 2016-159073 Japanese Unexamined Patent Publication No. 2016-179004 Japanese Unexamined Patent Publication No. 2000-116732 Japanese Unexamined Patent Publication No. 2008-284273

An object of the present invention is to provide an ophthalmic telemedicine technique capable of effectively utilizing a slit lamp microscope.

A first aspect of the exemplary embodiment is a front image acquisition unit that photographs the anterior segment of the eye to be inspected to acquire a front image, and captures the anterior segment with slit light to collect a plurality of images. A slit lamp microscope including an image collecting unit, a three-dimensional image forming unit that forms a three-dimensional image based on the plurality of images, and a registration unit that performs registration between the front image and the three-dimensional image. A user interface that accepts input from the user for designating the region of interest in the front image and a partial region of the three-dimensional image corresponding to the region of interest are specified based on the registration result, and the portion is specified. The front image is a rendering unit that forms a rendered image corresponding to the region, the rendered image corresponding to the partial region, and the front image are displayed on the display means, and the image representing the region corresponding to the rendered image is displayed. It is an ophthalmology system including a display control unit to be displayed on the top.

A second aspect of the exemplary embodiment is a communication unit that receives a three-dimensional image and a frontal image acquired by photographing the anterior segment of the eye to be inspected with a slit lamp microscope, and the frontal image. A registration unit that performs registration between the three-dimensional image, a user interface that accepts input from a user for designating a region of interest in the front image, and the three-dimensional image corresponding to the region of interest. The partial area is specified based on the registration result, the rendering unit forming the rendered image corresponding to the partial area, the rendered image corresponding to the partial area, and the front image are displayed on the display means, and the display means is displayed. An ophthalmic information processing apparatus including a display control unit for displaying an image representing an area corresponding to the rendered image on the front image.

A third aspect of the exemplary embodiment is a step of photographing the anterior segment of the eye to be inspected with a slit lamp microscope and receiving a three-dimensional image and a frontal image acquired via a communication path, and the frontal image and the said. The step of performing registration with the three-dimensional image, the step of accepting input from the user for designating the region of interest in the front image, and the partial region of the three-dimensional image corresponding to the region of interest are described above. The step of forming a rendered image corresponding to the partial region by specifying based on the registration result, and displaying the rendered image and the front image corresponding to the partial region on the display means, and displaying the rendered image on the rendered image. It is a program that causes a computer to execute a step of displaying an image representing a corresponding area on the front image.

A fourth aspect of the exemplary embodiment is a computer-readable non-temporary recording medium on which the program of the third aspect is recorded.

According to the embodiment, it is possible to provide an ophthalmic telemedicine technique capable of effectively utilizing a slit lamp microscope.

It is a schematic diagram which shows an example of the structure of the ophthalmic system which concerns on an exemplary embodiment. It is a schematic diagram which shows an example of the structure of the ophthalmic system which concerns on an exemplary embodiment. It is a schematic diagram which shows an example of the structure of the ophthalmic system which concerns on an exemplary embodiment. It is a schematic diagram which shows an example of the structure of the ophthalmic system which concerns on an exemplary embodiment. It is a schematic diagram for demonstrating an example of the operation of the ophthalmologic system which concerns on an exemplary embodiment. It is a schematic diagram for demonstrating an example of the operation of the ophthalmologic system which concerns on an exemplary embodiment. It is a schematic diagram which shows an example of the structure of the ophthalmic system which concerns on an exemplary embodiment. It is a schematic diagram which shows an example of the structure of the ophthalmic system which concerns on an exemplary embodiment. It is a flowchart which shows an example of the usage form of the ophthalmic system which concerns on an exemplary embodiment. It is a flowchart which shows an example of the usage form of the ophthalmic system which concerns on an exemplary embodiment. It is a flowchart which shows an example of the usage form of the ophthalmic system which concerns on an exemplary embodiment. It is a flowchart which shows an example of the usage form of the ophthalmic system which concerns on an exemplary embodiment. It is a flowchart which shows an example of the usage form of the ophthalmic system which concerns on an exemplary embodiment.

The ophthalmic system, the ophthalmic information processing apparatus, the program, and the recording medium according to the exemplary embodiment will be described in detail with reference to the drawings. It should be noted that any known technique such as the matters disclosed in the cited document can be combined with the embodiment.

The ophthalmologic system of the embodiment is used, for example, for telemedicine using an ophthalmologic imaging device installed in various facilities or a portable ophthalmologic imaging device. In the telemedicine according to the embodiment, at least, the interpretation of the medical image acquired by the ophthalmologic imaging device is performed by a person who performs the interpretation of the medical image in a remote place away from the facility where the ophthalmologic imaging device is installed. This interpreter is typically a specialist such as a doctor or optometrist. The interpreter creates a report on the eye to be inspected by performing the interpretation. In the telemedicine according to the embodiment, a person (assistant) who assists the examination at the facility where the ophthalmologic imaging device is installed may be involved.

Examples of facilities where ophthalmologic imaging equipment is installed include eyeglass stores, medical institutions, health examination venues, examination venues, patients' homes, welfare facilities, public facilities, and examination vehicles.

The ophthalmologic imaging apparatus may be any apparatus used for imaging the eye to be inspected, and has at least a function as a slit lamp microscope. Any of the plurality of ophthalmologic imaging devices included in the ophthalmologic system may include imaging functions (eg, ophthalmologic modalities such as fundus cameras, SLOs, OCTs, etc.) that differ from the slit lamp microscope. Further, the ophthalmologic imaging apparatus may include an application for analyzing measurement data and captured images.

The ophthalmic system of the embodiment may further include an ophthalmic measuring device for measuring the characteristics of the eye to be inspected. Examples of ophthalmic measuring devices include visual acuity test devices (visual acuity display devices, folopters, etc.), eye refraction test devices (refractometers, keratometers, etc.), tonometers, specular microscopes, wavefront analyzers, perimeters, microperimeters, etc. There is.

<Ophthalmology system>
An example of the configuration of the ophthalmic system according to the embodiment will be described. The ophthalmology system 1000 illustrated in FIG. 1 is a communication path (communication line) connecting each of the N facilities (first facility to Nth facility) where ophthalmology imaging is performed, the management server 4000, and the remote terminal 5000 m. It is built using 1100.

Each facility (nth facility: _n = 1 to N, N is an integer of 1 or more) is equipped with an ophthalmologic imaging device 2000-in (in = 1 to _Kn , K _n is an _integer of 1 or more). ing. That is, one or more ophthalmologic imaging devices 2000-in are installed in each facility ( _nth facility). The ophthalmologic imaging apparatus 2000-in constitutes a part of the _{ophthalmology} system 1000. The ophthalmology system 1000 may include an inspection device capable of performing an examination other than ophthalmology.

The _{ophthalmologic} imaging device 2000-in of this example has both a function as an "imaging device" for photographing the eye to be inspected and a function as a "computer" for performing various data processing and communication with an external device. There is. In another example, the photographing device and the computer can be provided separately. In this case, the photographing device and the computer may be configured to be able to communicate with each other. Further, the number of photographing devices and the number of computers are arbitrary, and for example, a single computer and a plurality of photographing devices can be provided.

Further, an information processing device (terminal 3000-n) used by an assistant or a subject is installed in each facility (nth facility). The terminal 3000-n is a computer used in the facility, and may be, for example, a mobile terminal such as a tablet terminal or a smartphone, a server installed in the facility, or the like. Further, the terminal 3000-n may include a wearable device such as a wireless earphone. The terminal 3000-n may be a computer (cloud server or the like) installed outside the facility, as long as it is a computer capable of using the function in the facility.

The ophthalmologic imaging device 2000-in and the terminal 3000- _n communicate with each other using a network constructed in the nth facility (in-facility LAN, etc.), a wide area network (Internet, etc.), and short-range communication technology. It may be configured so that it can be done.

The _{ophthalmologic} imaging apparatus 2000-in may have a function as a communication device such as a server. In this case, the ophthalmologic photographing apparatus 2000-in and the terminal 3000- _n can be configured to directly communicate with each other. As a result, communication between the management server 4000 and the terminal 3000- _n can be performed via the ophthalmologic imaging device 2000-in, so that a function for communicating between the terminal 3000-n and the management server 4000 can be provided. There is no need to provide it.

The management server 4000 is installed in a facility different from any of the first to Nth facilities, for example, in a management center. The management server 4000 can communicate with a remote terminal 5000 m (m = 1 to M, M is an integer of 1 or more) via a network (LAN, wide area network, etc.). Further, the management server 4000 can communicate with at least a part of the _{ophthalmologic} photographing apparatus 2000-in installed in the first to Nth facilities via a wide area network.

The management server 4000 has, for example, a function of relaying communication between the ophthalmologic photographing apparatus 2000-in and a remote terminal 5000 _m , a function of recording the contents of this communication, and an _{ophthalmologic} photographing apparatus 2000-in. It has a function of storing data and information and a function of storing data and information acquired by a remote terminal 5000 m. Further, the management server 4000 may be provided with a data processing function. For example, the management server 4000 is a three-dimensional image forming unit (processor, computer program) for executing a process of forming a three-dimensional image from a plurality of cross-sectional images acquired by an ophthalmologic imaging apparatus 2000-in ( _slit lamp microscope). Etc.) may be included.

The remote terminal 5000 _m includes a computer that can be used for image interpretation and report generation of the image of the eye to be inspected acquired by the ophthalmologic imaging apparatus 2000-in.

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

<Configuration of ophthalmic imaging device>
The configuration of the _{ophthalmologic} imaging apparatus 2000-in will be described. As described above, the ophthalmologic imaging apparatus 2000-in has a function as a _slit lamp microscope. In this example, unless otherwise specified, the ophthalmologic imaging apparatus 2000-in is a _slit lamp microscope.

Here, the direction may be indicated as follows. When the optical system of the slit lamp microscope is placed in front of the eye to be inspected (neutral position), the direction from the lens (objective lens) located closest to the eye to be inspected in the optical system toward the eye to be inspected is forward (or). The depth direction, the depth direction, and the Z direction), and the opposite direction is the rear direction (−Z direction). Further, the horizontal direction orthogonal to the Z direction is defined as the left-right direction (or the lateral direction, ± X direction). Further, the direction orthogonal to both the Z direction and the X direction is defined as the vertical direction (or the vertical direction, ± Y direction). The XYZ coordinate system is defined as, for example, a right-handed system (or a left-handed system).

Further, since the observation and imaging system of the slit lamp microscope can rotate at least in the horizontal direction, the radial direction, which is the direction along the optical axis (observation and imaging optical axis) of the observation and imaging system, is set to the _r1 direction, and the rotation direction is set to the r1 direction. θ _One direction. Similarly, since the illumination system of the slit lamp microscope is rotatable, the radial direction, which is the direction along the optical axis ₍ illumination optical axis) of the illumination system, is the r2 direction, and the rotation direction is the _θ2 direction. For example, the positive direction in the radial direction is the direction from the objective lens toward the eye to be inspected, and the positive direction in the rotation direction is the counterclockwise direction when viewed from above. The rotation direction is defined, for example, with respect to the Z direction (that is, the Z direction is defined as a rotation angle of 0 degrees). When the observation imaging system is placed in the neutral position (that is, when θ ₁ = 0 degrees), the r ₁ direction coincides with the Z direction. Similarly, when the illumination system is located in the neutral position (that is, when θ ₂ = 0 degrees), the r ₂ direction coincides with the Z direction. At least one of the illumination system and the observation imaging system may be rotatable in the vertical direction. In this case as well, the radial direction and the rotational direction are similarly defined.

The appearance configuration of an exemplary slit lamp microscope is shown in FIG. A computer 100 is connected to the slit lamp microscope 1. The computer 100 performs various control processes and arithmetic processes. Instead of providing the computer 100 separately from the microscope main body (housing for storing the optical system and the like), it is also possible to apply a configuration in which a similar computer is mounted on the microscope main body. At least a part of the computer 100 and at least a part of the terminal 3000-n described above may be common.

The slit lamp microscope 1 is placed on the table 2. The base 4 is configured to be three-dimensionally movable via, for example, the moving mechanism unit 3. The base 4 is moved by tilting the operation handle 5. Alternatively, the moving mechanism unit 3 includes an actuator.

A support portion 15 for supporting the observation imaging system 6 and the illumination system 8 is provided on the upper surface of the base 4. A support arm 16 that supports the observation imaging system 6 is attached to the support portion 15 so as to be rotatable in the left-right direction. A support arm 17 that supports the lighting system 8 is rotatably attached to the upper portion of the support arm 16 in the left-right direction. The support arms 16 and 17 are rotatable independently and coaxially with each other.

The observation imaging system 6 is moved by rotating the support arm 16. The lighting system 8 is moved by rotating the support arm 17. Each of the support arms 16 and 17 is rotated by an electrical mechanism. The moving mechanism portion 3 is provided with a mechanism for rotating the support arm 16 and a mechanism for rotating the support arm 17. The observation imaging system 6 can also be moved by manually rotating the support arm 16. Similarly, the lighting system 8 can be moved by manually rotating the support arm 17.

The illumination system 8 irradiates the eye E to be inspected with illumination light. As described above, the lighting system 8 can be rotated in the left-right direction. Further, the lighting system 8 may be configured to be rotatable in the vertical direction. That is, it may be configured so that the elevation angle and the depression angle of the lighting system 8 can be changed. By such a swing operation of the illumination system 8, the projection direction of the illumination light on the eye E to be inspected is changed.

The observation imaging system 6 has a pair of left and right optical systems that guide the return light of the illumination light projected on the eye E to be inspected. This optical system is housed in the lens barrel main body 9. The end of the lens barrel body 9 is the eyepiece portion 9a. The examiner observes the eye E to be inspected by looking into the eyepiece 9a. As described above, the lens barrel body 9 can be rotated in the left-right direction by rotating the support arm 16. Further, the observation imaging system 6 may be configured to be rotatable in the vertical direction. That is, it may be configured so that the elevation angle and the depression angle of the observation imaging system 6 can be changed. By such a swing operation of the observation imaging system 6, the direction in which the eye to be inspected E is imaged can be changed.

A jaw cradle 10 is arranged at a position facing the lens barrel main body 9. The chin cradle 10 is provided with a chin rest portion 10a and a forehead pad 10b for stably arranging the face of the subject.

A magnification operation knob 11 for changing the magnification is arranged on the side surface of the lens barrel main body 9. Further, an image pickup device 13 for photographing the eye E to be inspected is connected to the lens barrel main body 9. The image pickup device 13 includes an image pickup element. The image pickup device is a photoelectric conversion element that detects light and outputs an image signal (electrical signal). The image signal is input to the computer 100. As the image pickup device, for example, a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor is used.

At a position below the illumination system 8, a mirror 12 that reflects the illumination flux output from the illumination system 8 toward the eye E to be inspected is arranged.

Although omitted in FIG. 2, an anterior eye camera 70 for photographing the anterior eye portion of the eye E to be inspected from the front is provided in the vicinity of the mirror 12 (for example, a lower position or an upper position of the mirror 12). (See FIGS. 3 and 4). The anterior eye camera 70 is fixedly arranged or can be moved independently of the movement of the observation imaging system 6 and the illumination system 8. The front eye camera 70 is, for example, a video camera capable of shooting a moving image. Any number of anterior eye cameras 70 may be one or more.

An anterior eye illumination light source for projecting illumination light for taking a picture with the anterior eye camera 70 may be provided. The anterior eye illumination light source may be, for example, an infrared light source or a visible light source. The anterior eye illumination light source is arranged, for example, in the vicinity of the anterior eye camera 70 (for example, a lower position, an upper position, or a lateral position of the anterior eye camera 70). Any number of anterior eye illumination light sources of 1 or more may be provided.

<Composition of optical system>
FIG. 3 shows an example of the configuration of the optical system of the slit lamp microscope 1. As described above, the slit lamp microscope 1 includes an observation imaging system 6 and an illumination system 8.

<Observation photography system 6>
The observation and photographing system 6 includes a pair of left and right optical systems. The left and right optical systems have almost the same configuration. The examiner can observe the eye E to be inspected with binoculars by the left and right optical systems. Note that FIG. 3 shows only one of the left and right optical systems of the observation imaging system 6. The observation imaging system 6 may include only one of the left and right optical systems. Reference numeral O1 indicates the optical axis of the observation imaging system 6.

Each of the left and right optical systems of the observation and photographing system 6 includes an objective lens 31, a variable magnification optical system 32, a beam splitter 34, an imaging lens 35, a prism 36, and an eyepiece lens 37. Here, the beam splitter 34 is provided on one or both of the left and right optical systems. The eyepiece lens 37 is provided in the eyepiece portion 9a. Reference numeral P indicates an image formation position of light guided to the eyepiece lens 37. The reference numeral Ec indicates the cornea of the eye E to be inspected. The symbol Eo indicates the examiner's eye.

The variable magnification optical system 32 includes a plurality of (for example, three) variable magnification lenses 32a, 32b, 32c. In the present embodiment, a plurality of variable magnification lens groups that can be selectively inserted into the optical path of the observation imaging system 6 are provided. These variable magnification lens groups correspond to different magnifications. A magnification lens group arranged in the optical path of the observation imaging system 6 is used as the magnification optical system 32. By selectively inserting the variable magnification lens group in this way, it is possible to change the magnification (angle of view) of the observation image or the captured image of the eye E to be inspected. The change of the magnification, that is, the switching of the variable magnification lens group arranged in the optical path of the observation photographing system 6 is performed by operating the magnification operation knob 11. Further, the magnification can be changed electrically by using a switch (not shown) or the like.

The beam splitter 34 divides an optical path of light traveling along the optical axis O1 into an optical path located on an extension of the optical axis O1 and an optical path orthogonal to the optical axis O1. The light incident on the optical path located on the extension of the optical axis O1 is guided to the examiner's eye Eo via the imaging lens 35, the prism 36, and the eyepiece 37. The prism 36 translates the traveling direction of light upward.

On the other hand, the light incident on the optical path orthogonal to the optical axis O1 is guided to the image pickup element 43 of the image pickup apparatus 13 via the condenser lens 41 and the mirror 42. That is, the observation imaging system 6 guides the return light from the eye E to be examined to the image pickup apparatus 13. The image sensor 43 detects this return light and generates an image signal GS.

The observation imaging system 6 includes a focusing mechanism 40 for changing the focus position. The focusing mechanism 40 moves the objective lens 31 along the optical axis O1. For example, the focusing mechanism 40 transmits a holding member that holds the objective lens 31, a slide mechanism that moves the holding member in the direction of the optical axis O1, an actuator that generates a driving force, and the driving force to the slide mechanism. Includes members and members.

The movement of the objective lens 31 is performed automatically and / or manually. When the objective lens 31 is automatically moved, for example, the computer 100 uses a known focus adjustment method (for example, a phase difference detection method, a contrast detection method, etc.) to determine the focus position based on the return light from the eye E to be inspected. You can ask. Further, the computer 100 can control the actuator so that the objective lens 31 moves along the optical axis O1 to the obtained focus position. On the other hand, when the objective lens 31 is manually moved, the actuator moves the objective lens 31 along the optical axis O1 in response to an operation by the user.

The observation imaging system 6 may include a first focusing lens arranged at a position on the optical axis O1 between the objective lens 31 and the image pickup element 43. In this case, the focusing mechanism 40 changes the focus position of the observation photographing system 6 by moving the first focusing lens along the optical axis O1. For example, the focusing mechanism 40 includes a holding member that holds the first focusing lens, a slide mechanism that moves the holding member in the direction of the optical axis O1, an actuator that generates a driving force, and a slide mechanism that transfers the driving force. Including members to transmit to. Similar to the case of moving the objective lens 31, the movement of the first focusing lens by the focusing mechanism 40 is performed automatically or manually.

Further, the whole (or a part) of the observation imaging system 6 may be configured to be movable along the optical axis O1. In this case, the focusing mechanism 40 changes the focus position of the observation imaging system 6 by moving the entire observation imaging system 6 along the optical axis O1. For example, the focusing mechanism 40 includes a movable stage on which the observation imaging system 6 is mounted, a slide mechanism that moves the movable stage in the direction of the optical axis O1, an actuator that generates a driving force, and a slide mechanism that transfers the driving force. Including members to transmit to. Similar to the case of moving the objective lens 31, the movement of the observation imaging system 6 by the focusing mechanism 40 is performed automatically or manually.

<Lighting system 8>
The illumination system 8 includes an illumination light source 51, a condenser lens 52, a slit forming portion 53, and an objective lens 54. Reference numeral O2 indicates the optical axis of the illumination system 8.

The illumination light source 51 outputs illumination light. The lighting system 8 may be provided with a plurality of light sources. For example, both a light source that outputs constant light (for example, a halogen lamp, a light emitting diode (LED), etc.) and a light source that outputs flash light (for example, a xenon lamp, an LED, etc.) can be provided as the illumination light source 51. Further, a light source for observing the anterior eye portion and a light source for observing the posterior eye portion may be provided separately. For example, the illumination light source 51 includes a visible light source that outputs visible light. The illumination light source 51 may include an infrared light source that outputs infrared light (for example, light having a center wavelength of 800 nm to 1000 nm).

The slit forming portion 53 is used to generate slit light. The slit forming portion 53 has a pair of slit blades. By changing the spacing (slit width) of these slit blades, the width of the generated slit light can be changed.

The illumination system 8 includes a focusing mechanism 50 for changing the focus position of the slit light. The focusing mechanism 50 moves the objective lens 54 along the optical axis O2. For example, the focusing mechanism 50 transmits a holding member that holds the objective lens 54, a slide mechanism that moves the holding member in the direction of the optical axis O1, an actuator that generates a driving force, and the driving force to the slide mechanism. Includes members and members.

The movement of the objective lens 54 is performed automatically and / or manually. When the objective lens 54 is automatically moved, for example, the computer 100 can obtain the focus position by analyzing the image in which the image based on the return light from the eye E to be inspected is drawn. Further, the computer 100 can control the actuator so as to move the objective lens 54 along the optical axis O2 to the obtained focus position. On the other hand, when the objective lens 54 is manually moved, the actuator moves the objective lens 54 along the optical axis O2 in response to an operation by the user.

The illumination system 8 may include a second focusing lens arranged at a position on the optical axis O2 between the objective lens 54 and the slit forming portion 53. In this case, the focusing mechanism 50 changes the focus position of the slit light by moving the second focusing lens along the optical axis O2. For example, the focusing mechanism 50 includes a holding member that holds the second focusing lens, a slide mechanism that moves the holding member in the direction of the optical axis O2, an actuator that generates a driving force, and a slide mechanism that transfers the driving force. Including members to transmit to. Similar to the case of moving the objective lens 54, the movement of the second focusing lens by the focusing mechanism 50 is performed automatically or manually.

Further, the entire (or a part) of the lighting system 8 may be configured to be movable along the optical axis O2. In this case, the focusing mechanism 50 changes the focus position of the slit light by moving the entire illumination system 8 along the optical axis O2. For example, the focusing mechanism 50 uses a movable stage on which the lighting system 8 is mounted, a slide mechanism that moves the movable stage in the direction of the optical axis O2, an actuator that generates a driving force, and this driving force as the slide mechanism. Includes members to transmit. Similar to the case of moving the objective lens 54, the movement of the illumination system 8 by the focusing mechanism 50 is performed automatically or manually.

Although not shown in FIG. 3, a mirror 12 that reflects the illumination flux output from the illumination system 8 toward the eye E to be inspected is arranged on the optical axis O2. Typically, the lighting system 8 and the mirror 12 are configured to rotate integrally.

The slit lamp microscope 1 can take a plurality of images of the eye E to be inspected and acquire a plurality of images while changing the positions of the illumination system 8 and the observation imaging system 6 with respect to the eye E to be inspected. In other words, the slit lamp microscope 1 can acquire a plurality of cross-sectional images of the anterior segment of the eye to be inspected E by photographing the eye to be inspected E a plurality of times while moving the illumination system 8 and the observation and photographing system 6. .. The movement of the illumination system 8 and the observation imaging system 6 for photographing the eye E to be examined a plurality of times may be rotation or translation.

Each of the plurality of cross-sectional images acquired by such control is associated with position information indicating the acquired position (that is, the cross-sectional position). This position information may include, for example, any one or more of the following: the position of the illumination system 8 (rotation position, translation position); the position of the observation imaging system 6 (rotation position, translation position); Position of a cross section in a frontal image of the anterior segment of the eye acquired by the anterior segment camera 70; information obtained based on any one or more of these positions.

The position (that is, the position and / or the angle) of the illumination system 8 and the position (the position and / or the angle) of the observation imaging system 6 can be detected by a position detector including, for example, an encoder. Alternatively, the position of the lighting system 8 and the position of the observation and photographing system 6 can be recognized by the computer 100 that controls the mechanism for moving the lighting system 8 and the observation and photographing system 6. Further, the position of the cross section in the front image of the anterior eye portion of the eye E to be inspected is based on, for example, the front image of the anterior eye portion acquired by the anterior eye portion camera 70 and the position detected by the above-mentioned position detector. Can be asked. Although the details will be described later, a three-dimensional image of the anterior segment can be formed based on such position information and a plurality of cross-sectional images.

It should be noted that the plurality of times of imaging while changing the position of the lighting system 8 and the position of the observation imaging system 6 may be performed when at least one of the illumination system 8 and the observation imaging system 6 is moving. However, it may be performed when at least one of the illumination system 8 and the observation imaging system 6 is stopped. Further, the movement of the illumination system 8 may be continuous or intermittent, and the movement of the observation imaging system 6 may be continuous or intermittent.

The slit lamp microscope 1 can take a plurality of images of the eye E to be inspected and acquire a plurality of images while changing the focus position with respect to the eye E to be inspected. More specifically, the slit lamp microscope 1 photographs the eye E to be inspected a plurality of times while changing at least one of the focus position of the observation imaging system 6 and the focus position of the illumination system 8. It is possible to acquire a plurality of cross-sectional images of a portion.

Position information indicating the acquired position (focus position) is associated with each of the plurality of cross-sectional images acquired by such control. This position information may include, for example, any of the following: control content for the focusing mechanism 40; control content for the focusing mechanism 50; an object moved by the focusing mechanism 40 (for example, the objective lens 31, Position of the first focusing lens or observation imaging system 6); position of the object moved by the focusing mechanism 50 (for example, the objective lens 54, the second focusing lens, or the illumination system 8); these information (control content) , Position) Information obtained based on any one or more.

The control content for the focusing mechanism 40 or 50 can be recognized by, for example, the computer 100 that controls the focusing mechanism 40 or 50. The position of the object moved by the focusing mechanism 40 or 50 can be detected by a position detector including, for example, an encoder. Although the details will be described later, it is possible to form a three-dimensional image of the anterior eye portion based on such control contents and / or position information and a plurality of cross-sectional images.

It should be noted that the plurality of shootings performed while changing the focus position may be performed in parallel with the change of the focus position, or may be performed when the movement of the focus position is stopped. Further, the change of the focus position may be continuous or intermittent.

The above two controls can be combined. For example, the slit lamp microscope 1 photographs the eye E to be examined a plurality of times while changing the position of the illumination system 8, the position of the observation imaging system 6, the focus position of the illumination system 8, and the focus position of the observation imaging system 6. , It is possible to acquire a plurality of cross-sectional images. Each of the plurality of cross-sectional images acquired by such control is associated with position information indicating the acquired position (cross-sectional position and focus position).

<Control system configuration>
The control system of the slit lamp microscope 1 will be described with reference to FIGS. 4 to 6. FIG. 4 shows a configuration example of the control system of the slit lamp microscope 1. The computer 100 may include at least a part of a plurality of elements constituting the control system.

<Control unit 101>
The control unit 101 controls each unit of the slit lamp microscope 1. For example, the control unit 101 includes an observation imaging system 6, an illumination system 8, a moving mechanism 60, an anterior eye camera 70, an image composition unit 120, a display unit 130, a focus position detection unit 150, a scan position detection unit 160, and a communication unit. It controls 170 and so on.

The moving mechanism 60 moves the lighting system 8 and the observation and photographing system 6. The moving mechanism 60 includes, for example, a moving mechanism unit 3, support arms 16 and 17, and a mechanism for moving the support arms 16 and 17. The moving mechanism 60 may be able to move the lighting system 8 and the observation and photographing system 6 independently of each other. This independent movement includes, for example, at least the rotation of the lighting system 8 and the rotation of the observation imaging system 6. Further, this independent movement may include at least one of the translation of the illumination system 8 and the translation of the observation imaging system 6. By such independent movement, the position of the illumination system 8 with respect to the eye to be inspected E (illumination position, illumination angle) can be changed, and the position of the observation imaging system 6 with respect to the eye to be inspected E (observation position, observation angle, imaging). It is possible to change the position (position, shooting angle).

Here, the illumination angle is defined as an angle with respect to the optical axis (illumination optical axis) when the illumination system 8 is arranged at a predetermined reference position (neutral position). Similarly, the observation angle and the imaging angle are defined as, for example, angles with respect to the optical axis (observation imaging optical axis) when the observation imaging system 6 is arranged at a predetermined reference position (neutral position). The reference of the illumination angle and the reference of the observation angle and the shooting angle may be the same or different from each other. As described above, in this example, the observation angle and the shooting angle are expressed by the angle θ ₁ formed by the r ₁ direction with respect to the Z direction, and the illumination angle is the angle θ ₂ formed by the r ₂ direction with respect to the Z direction. It is expressed by.

The moving mechanism 60 may be capable of integrally moving the lighting system 8 and the observation and photographing system 6. This integral movement includes, for example, at least one of translation and rotation. This integrated translation is applicable, for example, to scan the anterior segment of the eye while preserving the illumination and imaging angles. This integral rotation is also applicable, for example, to scan the anterior segment of the eye while varying (continuously or stepwise) between the illumination angle and the imaging angle.

The controls related to the observation imaging system 6 include control of the variable magnification optical system 32, control of the image sensor 43, control of the focusing mechanism 40, control of the moving mechanism 60 for moving the observation imaging system 6, and focus position detection unit 150. Control, control of the scan position detection unit 160, and the like. The control of the variable magnification optical system 32 includes a control for changing the magnification of the macroscopic observation image or the captured image of the eye E to be inspected in response to the operation content of the magnification operation knob 11. The control of the image pickup element 43 includes a control of changing the charge accumulation time, sensitivity, frame rate, etc. of the image pickup element 43, and a control of sending the image signal GS obtained by the image pickup element 43 to the image synthesis unit 120. The control of the focusing mechanism 40 includes a control for changing the focus position of the observation imaging system 6 by the focusing mechanism 40. The control of the movement mechanism 60 includes a control of moving (rotating, translating) the observation imaging system 6. The control of the focus position detection unit 150 includes a control of acquiring a position detected by the focus position detection unit 150 and sending the acquired position to the image composition unit 120. The control of the scan position detection unit 160 includes a control of acquiring a position detected by the scan position detection unit 160 and sending the acquired position to the image composition unit 120.

The controls related to the illumination system 8 include control of the illumination light source 51, control of the slit forming unit 53, control of the focusing mechanism 50, control of the movement mechanism 60 for moving the illumination system 8, and control of the focus position detection unit 150. There is control of the scan position detection unit 160 and the like. The control of the illumination light source 51 includes switching on / off of the illumination light source 51, control of changing the amount of illumination light, and the like. The control of the slit forming unit 53 includes a control of changing the slit width, a control of moving the slit in parallel, a control of rotating the slit, and the like. The control of the focusing mechanism 50 includes a control for changing the focus position (focus position of the illumination system 8) of the slit light by the focusing mechanism 50. The control of the movement mechanism 60 includes a control of moving (rotating, translating) the lighting system 8. The control of the focus position detection unit 150 includes a control of acquiring a position detected by the focus position detection unit 150 and sending the acquired position to the image composition unit 120. The control of the scan position detection unit 160 includes a control of acquiring a position detected by the scan position detection unit 160 and sending the acquired position to the image composition unit 120.

The control unit 101 includes a focusing control unit 101A, a scan control unit 101B, and a storage unit 102.

The focusing control unit 101A executes control of the focus position of the observation and photographing system 6 and control of the focus position of the illumination system 8.

The operation of the focusing control unit 101A will be described with reference to FIG. FIG. 5 schematically shows the focus positions of the observation imaging system 6 and the illumination system 8 with respect to the cornea Ec of the eye E to be inspected. As described above, reference numeral 31 is an objective lens of the observation and photographing system 6, and reference numeral 54 is an objective lens of the illumination system 8. The reference numeral Cf indicates the front surface of the cornea Ec, and the reference numeral Cb indicates the rear surface of the cornea Ec. The reference numeral Cc indicates the position of the center of curvature of the cornea Ec (the anterior surface of the cornea Cf). For example, the rotation axes of the observation imaging system 6 and the illumination system 8 substantially coincide with the curvature center position Cc.

The focusing control unit 101A controls a scan (r scan) in the depth direction (that is, the radial direction in the rotational movement) with respect to the region of interest of the eye E to be inspected. The focusing control unit 101A can control the focusing mechanism 40 and the focusing mechanism 50 in a coordinated manner. For example, the focusing control unit 101A controls the focusing mechanism 40 and the focusing mechanism 50 to observe the positions PS1, PS2, and PS3 in the order of the depth direction (that is, the depth direction in the eye E to be inspected) of the region of interest. The focus position of the shooting system 6 and the focus position of the lighting system 8 are changed. The observation photographing system 6 can photograph the eye E to be inspected at the depth of field corresponding to each focus position. For example, the observation imaging system 6 can acquire an image of the eye E to be inspected at the depth of field PC1 corresponding to the position PS1.

The focusing control unit 101A can alternately execute the control for causing the image pickup apparatus 13 to acquire an image and the above-mentioned linked control. As a result, the focusing control unit 101A can control the acquisition of a plurality of cross-sectional images in the depth direction of the region of interest of the eye E to be inspected. For example, the focusing control unit 101A can control to sequentially acquire an image of a cross section including the position PS1, an image of the cross section including the position PS2, and an image of the cross section including the position PS3.

The scan control unit 101B controls to move the scan position of the eye E to be inspected with respect to the region of interest in the horizontal direction (direction substantially orthogonal to the depth direction). Although detailed description is omitted, the control for moving the scan position in the vertical direction substantially orthogonal to both the horizontal direction and the depth direction can be executed in the same manner.

The operation of the scan control unit 101B will be described with reference to FIG. FIG. 6 schematically shows the focus positions of the observation imaging system 6 and the illumination system 8 with respect to the cornea Ec. In FIG. 6, the same elements and parts as those in FIG. 5 are designated by the same reference numerals, and the description thereof will be omitted as appropriate.

The scan control unit 101B controls scanning (θ scan) in the horizontal direction (that is, the declination direction in the rotational movement) with respect to the region of interest of the eye E to be inspected. The scan control unit 101B controls the moving mechanism 60 so as to link the rotation of the lighting system 8 and the rotation of the observation / photographing system 6, for example. For example, the scan control unit 101B moves the observation imaging system 6 and the illumination system 8 in the order of the horizontal scan positions PS1, PS11, and PS12.

The scan control unit 101B can alternately execute the control of causing the image pickup apparatus 13 to acquire an image and the control of the moving mechanism 60. As a result, the scan control unit 101B can perform control for acquiring a plurality of cross-sectional images arranged in the horizontal direction at the region of interest of the eye E to be inspected. For example, the scan control unit 101B can control to sequentially acquire an image of a cross section including the position PS1, an image of the cross section including the position PS11, and an image of the cross section including the position PS12.

At each of the horizontal positions PS1, PS11, and PS12, the focusing control unit 101A can change the focus position of the observation imaging system 6 and the focus position of the illumination system 8 in the depth direction. Thereby, cross-sectional images can be acquired for each of the positions PS1, PS2, PS3, PS11, PS21, PS31, PS12, PS22, and PS32.

In FIG. 6, although scanning by rotation of the optical system has been described, scanning by translation of the optical system can be performed. For example, in order to image the anterior capsule of the crystalline lens, the observation imaging system 6 is placed at a position where the imaging angle θ ₁ = 0 degrees (neutral position), and the illumination system 8 is placed at a position where the illumination angle θ ₂ ≠ 0 degrees. By integrally moving the observation imaging system 6 and the illumination system 8 in parallel in the arranged state, the anterior capsule of the crystalline lens can be suitably imaged. When photographing the posterior and anterior capsules of the crystalline lens, the observation imaging system 6 is placed at a position where the imaging angle θ ₁ = 0 degrees, and the illumination angle θ ₂ is set to a smaller angle than in the case of anterior capsule imaging. In this state, the posterior capsule and anterior capsule of the crystalline lens can be suitably imaged by integrally moving the observation imaging system 6 and the illumination system 8 in parallel.

It is also possible to perform anterior segment imaging without scanning. For example, the observation imaging system 6 and the illumination system 8 can be arranged (θ ₁ = −θ ₂ ) at positions separated by the same angle in opposite directions with the neutral position in between, and corneal endothelial cells can be imaged. With this arrangement, it is possible to realize a configuration similar to that of a specular microscope.

In parallel with scanning (that is, collection of a plurality of cross-sectional images) by movement (rotation, parallel movement) of the optical system, the front eye portion can be photographed by the front eye portion camera 70. This anterior eye part photography may be a plurality of times of photography, and may be moving image photography. This makes it possible to detect movements and changes in the anterior eye portion during scanning and to perform tracking. It is also possible to take an image of the anterior eye portion when the scan is not performed.

The scan position (cross-sectional position) can be presented together with the front image of the anterior eye portion acquired by the anterior eye portion camera 70. For example, an image representing the scan position can be displayed on the front image. Here, for example, it is possible to obtain the relative position between the front image and the scan position based on the position (known) of the front eye camera 70 and the output from the scan position detection unit 160.

The storage unit 102 stores various computer programs and data. The computer program includes an arithmetic program and a control program for operating the slit lamp microscope 1 according to a predetermined operation mode. The data includes data used in various tests.

Scan information is an example of such data. The scan information includes, for example, control information for moving the observation imaging system 6 and the illumination system 8 to a plurality of scan positions of the region of interest, and the observation imaging system 6 and illumination at a position in one or more depth directions for each scan position. It includes control information for changing the focus position of the system 8. These control information are stored in the storage unit 102 in advance. The control unit 101 individually controls the horizontal scan position by the scan control unit 101B and the focus position control by the focusing control unit 101A by using the computer program and the scan information stored in the storage unit 102. It can be executed on a computer or in a coordinated manner.

The control unit 101 includes a processor, a RAM (Random Access Memory), a ROM (Read Only Memory), a hard disk drive, and the like. A control program is stored in advance in a storage device such as a ROM or a hard disk drive. The operation of the control unit 101 is realized by the cooperation of software such as a control program and hardware such as a processor. The control unit 101 is arranged in the main body of the slit lamp microscope 1 (for example, in the base 4) or in the computer 100.

<Image compositing unit 120>
The image synthesizing unit 120 synthesizes a plurality of cross-sectional images acquired by the image pickup apparatus 13 according to the above control executed by the focusing control unit 101A and / or the scan control unit 101B.

For example, the image synthesizing unit 120 synthesizes a plurality of cross-sectional images acquired by the image pickup apparatus 13 while changing the focus position by the focusing mechanism 40 and the focusing mechanism 50. In this case, the plurality of cross-sectional images are arranged in the depth direction. In other words, the plurality of cross sections depicted by the plurality of cross-section images are arranged in the same plane. The composite image constructed from such a plurality of cross-sectional images is a two-dimensional cross-sectional image having a deeper depth of field (in other words, pan-focus or deep-focus) than the individual cross-sectional images.

The image synthesizing unit 120 can form a three-dimensional image by synthesizing a plurality of (two-dimensional) cross-sectional images in which the cross-sections are not arranged in the same plane. The three-dimensional image means an image (image data) in which the positions of pixels are defined by a three-dimensional coordinate system.

As an example of a three-dimensional image, there is stack data of a plurality of cross-sectional images. The stack data is image data obtained by three-dimensionally arranging a plurality of cross-sectional images obtained at a plurality of scan positions based on the positional relationship of the scan positions. More specifically, the stack data is obtained by expressing (that is, embedding in the same 3D space) a plurality of cross-sectional images originally defined by individual 2D coordinate systems by the same 3D coordinate system. It is the image data to be obtained.

When stack data is formed from a plurality of cross-sectional images acquired by the image pickup apparatus 13 while changing the focus position by the focusing mechanism 40 and the focusing mechanism 50, each of these cross-sectional images is projected onto a cross-section along the Z direction. Can be done. For example, a cross-sectional image taken at an illumination angle θ ₂ ≠ 0 degree can be projected onto a cross-section along the Z direction (for example, an XZ cross-section or a YZ cross-section). As a result, a plurality of projected images parallel to each other can be obtained. The position of each projected image is determined based on the corresponding cross-sectional image. For example, the position of the projected image can be determined so that the predetermined position (for example, the center position) of the corresponding cross-sectional image coincides with the predetermined position (for example, the center position) of the projected image. By embedding a plurality of projected images whose positions are determined in this way in the same three-dimensional space, it is possible to form stack data.

Another example of a 3D image is volume data (also called voxel data). The volume data is image data in which voxels, which are three-dimensional pixels, are three-dimensionally arranged. Volume data is formed, for example, by performing interpolation processing on stack data and making pixels three-dimensional (voxels).

In order to execute such an image composition process, the image composition unit 120 includes an array processing unit 121 and a composition processing unit 122.

The arrangement processing unit 121 transfers an array of a plurality of cross-sectional images acquired by r-scan, θ-scan (rotation of the optical system), or a combination thereof into position information (for example, focus position, etc.) associated with these cross-sectional images. It is possible to specify based on the cross-sectional position) and arrange a plurality of cross-sectional images according to the specified arrangement. Alternatively, the array processing unit 121 associates an array of a plurality of projected images based on a plurality of cross-sectional images obtained by r scan, θ scan (rotation of the optical system), or a combination thereof with these projected images. It can be specified based on position information (for example, focus position, cross-sectional position), and a plurality of projected images can be arranged according to the specified arrangement.

Further, the arrangement processing unit 121 uses an array of a plurality of cross-sectional images acquired by a combination of r-scan and parallel movement of the optical system as position information (for example, focus position, cross-sectional position) associated with these cross-sectional images. Identify based on and place multiple cross-sectional images according to the identified sequence. Alternatively, the array processing unit 121 transfers an array of a plurality of projected images based on a plurality of cross-sectional images acquired by a combination of r-scan and parallel movement of the optical system to the position information (for example, focus) associated with the projected images. It can be specified based on the position (position, cross-sectional position), and a plurality of projected images can be arranged according to the specified arrangement.

For example, the array processing unit 121 receives the focus position (for example, the above-mentioned position information) of the slit light detected by the focus position detection unit 150 from the control unit 101, and receives a plurality of cross-sectional images (or a plurality of projected images). Arrange. Further, the arrangement processing unit 121 receives a plurality of cross-sectional images (or a plurality of cross-sectional images) of the observation imaging system 6 and the illumination system 8 detected by the scan position detection unit 160 (for example, the position information described above) from the control unit 101. (Projection image) is arranged.

The compositing processing unit 122 synthesizes a plurality of cross-sectional images arranged by the array processing unit 121. This image composition process may include, for example, a process of forming stack data, and may further include a process of forming volume data.

By executing such a series of processes, the image synthesizing unit 120 can form a three-dimensional image or a two-dimensional image based on a plurality of cross-sectional images of the anterior eye portion of the eye E to be inspected.

In another example, the image synthesizing unit 120 can synthesize a plurality of cross-sectional images without using the above-mentioned position information. For example, the image synthesizing unit 120 identifies an image area (common area) that depicts a common part in two or more different cross-sectional images by image analysis, and pastes these cross-sectional images so that the specified common areas overlap. Can be matched. When such image analysis is applied, it is not necessary to provide the focus position detection unit 150 or the scan position detection unit 160. However, even if the information obtained by the focus position detection unit 150 and the scan position detection unit 160 is used for "coarse adjustment of the image position" and then "fine adjustment of the image position" by image analysis is performed. good.

At least a part of the functions of the image synthesizing unit 120 may be provided in a device different from that of the slit lamp microscope 1. For example, a computer capable of communicating with the slit lamp microscope 1 can be provided with at least a part of the functions of the image synthesizing unit 120. As a specific example, at least a part of the functions of the image synthesizing unit 120 can be provided in a computer (for example, a terminal 3000-n, a server, etc.) provided in a facility where the slit lamp microscope 1 is installed. Alternatively, at least a part of the functions of the image synthesizing unit 120 can be provided in the management server 4000 or a computer capable of communicating with the management server 4000. As another example, at least a part of the functions of the image synthesizing unit 120 can be provided in the remote terminal 5000 m or a computer capable of communicating with the remote terminal 5000 m.

<Focus position detection unit 150>
The focus position detection unit 150 includes, for example, a first focus position detection unit that detects the focus position of the observation imaging system 6 and a second focus position detection unit that detects the focus position of the illumination system 8. The first focus position detection unit and / or the second focus position detection unit may include, for example, a position sensor such as an encoder or a potentiometer.

Alternatively, the first focus position detection unit includes a processor that obtains the focus position of the observation / photographing system 6 based on the content of the control executed by the focusing control unit 101A on the observation / photographing system 6 (that is, the history of control). But it may be. Similarly, the second focus position detection unit may include a processor that obtains the focus position of the lighting system 8 based on the content of the control executed by the focusing control unit 101A on the lighting system 8 (that is, the control history). good.

<Scan position detection unit 160>
The scan position detection unit 160 includes, for example, a first position detection unit that detects the position of the observation imaging system 6 and a second position detection unit that detects the position of the illumination system 8. The first position detection unit and / or the second position detection unit includes, for example, a position sensor for detecting the position of the base 4 and a rotation angle sensor for detecting the positions of the support arms 16 and 17. ..

Alternatively, the first position detection unit may include a processor that obtains the position of the observation / imaging system 6 based on the content of the control executed by the scan control unit 101B on the observation / imaging system 6 (that is, the history of control). Similarly, the second position detection unit may include a processor that obtains the position of the lighting system 8 based on the content of the control executed by the scan control unit 101B on the lighting system 8 (that is, the history of control).

<Display unit 130>
The display unit 130 displays various information under the control of the control unit 101. For example, the display unit 130 includes a flat panel display such as a liquid crystal display (LCD). The display unit 130 may be provided on the main body of the slit lamp microscope 1 or may be provided on the computer 100.

<Operation unit 140>
The operation unit 140 includes an operation device for operating the slit lamp microscope 1 and an input device for inputting information. The operation unit 140 includes buttons and switches provided in the slit lamp microscope 1 (for example, an operation handle 5, a magnification operation knob 11 and the like), and an operation device (for example, a mouse, a keyboard and the like) provided in the computer 100. Is done. Further, the operation unit 140 may include any operation device or input device such as a trackball, an operation panel, a switch, a button, and a dial.

In FIG. 4, the display unit 130 and the operation unit 140 are shown separately, but at least a part of the display unit 130 and at least a part of the operation unit 140 may be the same device. A specific example is a touch screen.

<Communication unit 170>
The communication unit 170 performs data communication between the slit lamp microscope 1 and another device. The data communication method is arbitrary. For example, the communication unit 170 includes a communication interface compliant with the Internet, a communication interface compliant with a dedicated line, a communication interface compliant with LAN, a communication interface compliant with short-range communication, and the like. The data communication may be wired communication or wireless communication.

The data transmitted / received by the communication unit 170 may be encrypted. In that case, for example, the control unit 101 includes an encryption processing unit that encrypts the transmission data and a decryption processing unit that decodes the received data.

<Management server 4000>
The configuration of the management server 4000 will be described. The management server 4000 illustrated in FIG. 7 includes a control unit 4010, a communication establishment unit 4100, and a communication unit 4200.

<Control unit 4010>
The control unit 4010 executes control of each unit of the management server 4000. The control unit 4010 may be able to execute other arithmetic processing. The control unit 4010 includes a processor. The control unit 4010 may further include a RAM, a ROM, a hard disk drive, a solid state drive, and the like.

The control unit 4010 includes a communication control unit 4011 and a transfer control unit 4012.

The communication control unit 4011 executes control regarding establishment of communication between a plurality of devices including a plurality of ophthalmologic imaging devices 2000-in, a plurality of terminals 3000- _n , and a plurality of remote terminals 5000 m. For example, the communication control unit 4011 sends a control signal for establishing communication to each of two or more devices selected by the selection unit 4120 described later from the plurality of devices included in the ophthalmology system 1000.

The transfer control unit 4012 controls the exchange of information between two or more devices for which communication has been established by the communication establishment unit 4100 (and the communication control unit 4011). For example, the transfer control unit 4012 functions to transfer the information transmitted from one of at least two devices for which communication has been established by the communication establishment unit 4100 (and the communication control unit 4011) to the other device. do.

As a specific example, when communication between the ophthalmologic imaging apparatus 2000-in and the remote terminal _5000m is established, the transfer control unit ₄₀₁₂ may use the information transmitted from the ophthalmologic imaging apparatus 2000-in (for example, the ophthalmologic imaging apparatus 2000-in). The image acquired by 2000-in, the information input to the _{ophthalmologic} photographing apparatus 2000-in, etc.) can be transferred to the remote terminal 5000 _m . On the contrary, the transfer control unit ₄₀₁₂ can transfer the information transmitted from the remote terminal 5000m (for example, the result of specifying the operation mode of the _{ophthalmologic} imaging apparatus 2000-in) to the ophthalmologic imaging apparatus 2000-in.

The transfer control unit 4012 may have a function of processing the information received from the device of the transmission source. In this case, the transfer control unit 4012 can transmit at least one of the received information and the information obtained by the processing process to the transfer destination device.

For example, the transfer control unit 4012 can extract a part of the information transmitted from the ophthalmologic photographing apparatus 2000-in or the like and transmit it to the remote terminal 5000 _m or the like. Further, the information transmitted from the ophthalmologic imaging device 2000-in or the like (for example, the image of the eye to be inspected E) is analyzed by the management server 4000 or another device, and the analysis result (and the original information) is analyzed by the remote terminal 5000 _m or the like. You may send it to.

When a plurality of cross-sectional images are transmitted from the slit lamp microscope 1 ( _ophthalmic imaging device 2000-in), the management server 4000 or another device obtains a three-dimensional image (for example, stack data or volume data) from these cross-sectional images. It is possible to construct and configure the transfer control unit 4012 to transmit the constructed three-dimensional image to the remote terminal 5000 m.

Further, when the stack data is transmitted from the slit lamp microscope 1 ( _ophthalmic imaging apparatus 2000-in), the management server 4000 or another apparatus constructs the volume data from the stack data, and the transfer control unit 4012 constructs the stack data. It is possible to configure the volume data to be transmitted to the remote terminal 5000 m.

The data processing that can be executed by the management server 4000 or another device is not limited to the above example, and may include any data processing.

<Communication establishment unit 4100>
The communication establishment unit 4100 establishes communication between at least two devices selected from a plurality of devices including a plurality of ophthalmologic imaging devices 2000-in, a plurality of terminals 3000- _n , and a plurality of remote terminals 5000 m. Perform the process to do so. In the present embodiment, "establishment of communication" means, for example, (1) establishing one-way communication from a state in which communication is disconnected, and (2) establishing two-way communication from a state in which communication is disconnected. It is a concept including at least one of (3) switching from a state in which only reception is possible to a state in which transmission is possible, and (4) switching from a state in which only transmission is possible to a state in which reception is possible.

Further, the communication establishment unit 4100 can execute a process of disconnecting the established communication. In the present embodiment, "disconnecting communication" means, for example, (1) disconnecting communication from a state in which one-way communication is established, and (2) disconnecting communication from a state in which bidirectional communication is established. (3) Switching from a state where two-way communication is established to one-way communication, (4) Switching from a state where transmission and reception are possible to a state where only reception is possible, (5) A state where transmission and reception are possible It is a concept including at least one of switching from to to a state where only transmission is possible.

Each of the ophthalmologic imaging device 2000-in, the terminal 3000- _n , and the remote terminal 5000 m is used for communication request (call request) for calling another device (its user) and communication between the other two devices. At least one of the communication request (interrupt request) for interrupting can be transmitted to the management server 4000. Call requests and interrupt requests are sent manually or automatically. The management server 4000 (communication unit 4200) receives a communication request transmitted from the ophthalmologic photographing apparatus 2000-in, the terminal 3000- _n , or the remote terminal 5000 m.

In the present embodiment, the communication establishment unit 4100 may include a selection unit 4120. The selection unit 4120 may use the ophthalmologic imaging apparatus 2000-in, the terminal 3000- _n , and the remote terminal, for example, based on a communication request transmitted from the ophthalmologic imaging apparatus 2000-in, the terminal 3000- _n , or the remote terminal 5000m. From 5000 m, one or more devices other than the device that transmitted the communication request are selected.

A specific example of the process executed by the selection unit 4120 will be described. When receiving a communication request from the ophthalmologic imaging apparatus 2000-in or the terminal 3000- _n (for example, a request for interpretation of an image acquired by the ophthalmologic imaging apparatus 2000-in ₎ , the selection unit 4120 may, for example, have a plurality of selection units 4120. Select one of the remote terminals 5000m. The communication establishment unit 4100 establishes communication between the selected remote terminal 5000 m and at least one of the ophthalmologic imaging apparatus 2000-in and the terminal 3000- _n .

The selection of the device according to the communication request is executed, for example, based on the preset attributes. Examples of this attribute include the type of examination (for example, the type of imaging modality, the type of image, the type of disease, the type of candidate disease, etc.), the required degree of specialization / proficiency, and the type of language. In order to realize the process according to this example, the communication establishment unit 4100 may include a storage unit 411 in which the attribute information created in advance is stored. In the attribute information, the attributes of the remote terminal 5000 m and / or its user (doctor) are recorded.

The identification of a doctor is performed, for example, by a pre-assigned doctor ID. Further, the identification of the remote terminal 5000m is performed by, for example, a device ID or a network address assigned in advance. In a typical example, the attribute information includes, as attributes of each doctor, a specialized field (for example, a clinical department, a specialized disease, etc.), a degree of specialization / proficiency, a type of language that can be used, and the like.

When the selection unit 4120 refers to the attribute information, the communication request transmitted from the ophthalmologic imaging apparatus 2000-in, the terminal 3000- _n , or the remote terminal 5000m may include the information regarding the attribute. For example, an image interpretation request (ie, a diagnostic request) transmitted from the ophthalmologic imaging apparatus 2000-in may include any of the following information: (1) information indicating the type of imaging _modality ; (2) image. Information indicating the type of the disease; (3) Information indicating the name of the _disease or the name of the candidate disease; (4) Information indicating the difficulty level of image interpretation; Information indicating the language used.

When such a reading request is received, the selection unit 4120 can select any remote terminal 5000m based on the reading request and the attribute information stored in the storage unit 4110. At this time, the selection unit 4120 collates the information regarding the attributes included in the image interpretation request with the information recorded in the attribute information stored in the storage unit 4110. As a result, the selection unit 4120 selects, for example, a remote terminal 5000 m corresponding to a doctor corresponding to any of the following attributes: (1) a doctor who specializes in the imaging modality; (2) specializes in the image type. (3) A doctor who specializes in the disease (the candidate disease); (4) A doctor who can interpret the difficulty level; (5) A doctor who can use the language.

The correspondence between the doctor and the remote terminal 5000m is made by, for example, the doctor ID input at the time of logging in to the remote terminal 5000m (or the ophthalmology system 1000).

<Communication unit 4200>
The communication unit 4200 performs data communication with another device (for example, any of the ophthalmologic imaging device 2000-in, the terminal 3000- _n , and the remote terminal 5000 m). The data communication method and encryption may be the same as those of the communication unit 170 of the _{ophthalmologic} imaging apparatus 2000-in.

<Remote terminal 5000m>
The configuration of the remote terminal 5000 m will be described. The remote terminal 5000m illustrated in FIG. 8 includes a control unit 5010, a data processing unit 5100, a communication unit 5200, and an operation unit 5300.

<Control unit 5010>
The control unit 5010 controls each unit of the remote terminal 5000 m. The control unit 5010 may be capable of executing other arithmetic processing. The control unit 5010 includes a processor, RAM, ROM, a hard disk drive, a solid state drive, and the like.

The control unit 5010 includes a display control unit 5011. The display control unit 5011 controls the display device 6000 m. The display device 6000 m may be included in the remote terminal 5000 m, or may be a peripheral device connected to the remote terminal 5000 m. The display control unit 5011 causes the display device 6000 m to display an image of the anterior eye portion of the eye to be inspected E. The image of the anterior segment includes a rendered image of a three-dimensional image, a front image, an OCT image, an image showing an analysis result, a slit image, and the like.

The control unit 5010 includes a report creation control unit 5012. The report creation control unit 5012 executes various controls for creating a report regarding the information displayed by the display control unit 5011. For example, the report creation control unit 5012 causes the display device 6000 m to display a screen for creating a report and a graphical user interface (GUI). Further, the report creation control unit 5012 inputs the information input by the user, the image of the anterior eye portion, the analysis data of the image, and the like into a predetermined report template.

<Data processing unit 5100>
The data processing unit 5100 executes various data processing.

For example, the data processing unit 5100 can construct a three-dimensional image (for example, stack data or volume data) from a plurality of cross-sectional images transmitted from the slit lamp microscope 1 ( _ophthalmic imaging apparatus 2000-in). Further, the data processing unit 5100 can construct volume data from the stack data transmitted from the slit lamp microscope 1 ( _ophthalmic imaging apparatus 2000-in).

The data processing unit 5100 includes a registration unit 5105, a partial area designation unit 5110, a rendering unit 5120, and an analysis unit 5130.

The registration unit 5105 performs registration between the front image of the anterior eye portion and the three-dimensional image. As described above, in order to acquire the front image and the three-dimensional image acquired by the anterior eye camera 70 based on the position (known) of the anterior eye camera 70 and the output from the scan position detection unit 160. It is possible to determine the relative position between the position (scan position) to which the scan of is applied. The registration unit 5105 can perform registration between the front image of the anterior eye portion and the three-dimensional image based on this relative position.

In another example, the registration unit 5105 projects a three-dimensional image of the anterior eye portion in the Z direction to construct a frontal image (projection image), and the frontal image and the projection image acquired by the anterior eye portion camera 70 are used. Registration can be done between. The registration unit 5105 of this example executes a process of specifying a feature point in a frontal image acquired by the front eye camera 70 and a process of specifying a feature point in a projection image, and of each other's feature points. Resist between the front image and the projection image so that the positions match. According to this example, it is not necessary to detect the scan position.

The partial area designation unit ₅₁₁₀ designates a partial area of an image transmitted from the ophthalmologic imaging apparatus 2000-in or an image displayed based on the image.

An example of processing that can be executed by the partial area designation unit 5110 will be described. When multiple cross-sectional images of the anterior segment of the eye to be inspected E are obtained using the slit lamp microscope 1 (ophthalmic imaging device 2000-in), the slit lamp microscope 1, the management server 4000, the remote terminal 5000 _m , or another The device forms a three-dimensional image of the anterior segment of the eye E to be inspected. It is assumed that such a three-dimensional image is input to the remote terminal 5000 m. The control unit 5010 stores the three-dimensional image in a storage device such as the hard disk drive or the solid state drive described above.

The display control unit 5011 can display an image based on this three-dimensional image on the display device 6000 m. For example, the control unit 5010 sends a three-dimensional image (for example, stack data or volume data) to the rendering unit 5120. The rendering unit 5120 renders a three-dimensional image to form an image. The display control unit 5011 causes the display device 6000 m to display the image formed by the rendering unit 5120.

A user (doctor) of the remote terminal 5000 m can specify a partial area of the image displayed on the display device 6000 m. This designation operation is performed using the operation unit 5300. For example, the user can specify a desired range of the displayed image using a pointing device.

The partial area designation unit 5110 specifies a partial area of the three-dimensional image corresponding to the partial area of the display image designated by the user. Here, the display image is an image obtained by rendering a three-dimensional image. Therefore, the partial area of the three-dimensional image corresponding to the partial area of the display image is easily specified based on the processing content of this rendering.

Another example will be described. When another image (referred to as a reference image) of the eye E to be inspected has been acquired in the past, a partial area of the three-dimensional image can be specified by using this reference image. The reference image may be, for example, a frontal image acquired by the anterior eye camera 70. Alternatively, the OCT image of the anterior segment of the eye can be used as a reference image.

At least a part of the reference image and at least a part of the three-dimensional image may depict the same part of the eye E to be inspected. Alternatively, it is also possible to further use a wide area image in which both a portion in which at least a part of the reference image is drawn and a part in which at least a part of the three-dimensional image is drawn are drawn. By using such an image, the registration unit 5105 can perform registration between the reference image and the three-dimensional image.

The display control unit 5011 can display the reference image (or wide area image) on the display device 6000 m. The user can specify a partial area of the reference image (or wide area image) by using the operation unit 5300. The partial area designation unit 5110 can designate a partial area of the three-dimensional image based on the partial area of the reference image (or wide area image) designated by the user and the registration result.

Although an example of specifying a partial area of a three-dimensional image based on a user's operation has been described above, the manual specification is not limited to these. On the other hand, the partial area designation unit 5110 may automatically specify the partial area of the three-dimensional image regardless of the user's operation. Such automatic designation may be performed using an artificial intelligence processor.

In one example, the partial area designation unit 5110 designates a partial area of the three-dimensional image by analyzing the front image of the anterior eye portion or by analyzing at least one of the three-dimensional image and the display image based on the three-dimensional image. be able to. For example, the partial area designation unit 5110 applies segmentation to a three-dimensional image or a display image to specify an image area corresponding to a predetermined tissue of the eye E to be inspected, and designates a partial area based on the specified image area. be able to. The predetermined tissue of the eye E to be inspected is determined according to, for example, arbitrary conditions. Examples of this condition include the type of imaging modality, the type of image, and the name of a (candidate) disease.

The rendering unit 5120 applies rendering to the image. For example, the rendering unit 5120 renders the three-dimensional image based on the partial area of the three-dimensional image designated by the partial area designation unit 5110.

Rendering can be arbitrary processing, including, for example, 3D computer graphics. 3D computer graphics is an image with a three-dimensional effect by converting virtual three-dimensional objects (three-dimensional images such as stack data and volume data) in the three-dimensional space defined by the three-dimensional coordinate system into two-dimensional information. It is an arithmetic method to create.

Examples of rendering include volume rendering, maximum projection (MIP), minimum projection (MinIP), surface rendering, multi-section reconstruction (MPR), projection image formation, shadowgram formation, and the like. Further examples of rendering include reproduction of a cross-sectional image obtained by a slit lamp microscope 1, formation of a Scheimpflug image, and the like. Further, the rendering unit 5120 may be able to execute arbitrary processing applied together with such rendering.

The analysis unit 5130 analyzes a three-dimensional image of the anterior eye portion of the eye E to be inspected, a rendered image thereof, a front image, and the like.

The rendering unit 5120 can specify a region corresponding to the cornea (cornea region) in the three-dimensional image of the anterior eye portion. For example, the rendering unit 5120 can specify a region (corneal surface region) corresponding to the surface (front surface) of the cornea. Further, the rendering unit 5120 can specify a region (corneal back surface region) corresponding to the back surface (rear surface) of the cornea. Such image region identification includes known image processing such as, for example, segmentation, edge detection, threshold processing, and the like.

When the rendering unit 5120 specifies the corneal surface region, the analysis unit 5130 can analyze this corneal surface region to obtain the radius of curvature of the cornea. For example, the analysis unit 5130 can calculate the radius of curvature at one or more representative points of the cornea (such as the apex of the cornea). The report creation control unit 5012 can input at least one of the corneal radius of curvature obtained by the analysis unit 5130 and the information based on the radius of curvature to the report template. Here, as an example of information based on the radius of curvature of the cornea, there is identification information (model number, etc.) of a contact lens.

The analysis unit 5130 may calculate the radius of curvature at multiple positions of the cornea based on the corneal surface region identified by the rendering unit 5120. That is, the analysis unit 5130 may obtain the corneal radius of curvature distribution. Further, the analysis unit 5130 can obtain a deviation distribution representing the deviation of the corneal radius of curvature distribution from the preset standard distribution. This process includes registration between the corneal radius of curvature distribution and the standard distribution, and comparison (difference, etc.) between the values at the corresponding positions. The report creation control unit 5012 can input at least one of the deviation distribution obtained by the analysis unit 5130 and the information based on the deviation distribution to the report template. Here, as an example of information based on the deviation distribution, there is contact lens identification information (model number, etc.).

The display control unit 5011 can display the deviation distribution obtained by the analysis unit 5130 on the display device 6000 m. At this time, the magnitude of the deviation from the standard value can be represented by a color. As a result, a color map showing the deviation distribution of the radius of curvature of the cornea is displayed. The report creation control unit 5012 can input such a color map into the report.

As described above, the registration unit 5105 can perform registration between the front image acquired by the front eye camera 70 and the three-dimensional image based on the scan. The display control unit 5011 can display this front image on the display device 6000 m. The user can specify a region of interest in the displayed front image using a user interface such as the operation unit 5300. The region of interest is, for example, a line segment representing a cross section or an area representing a three-dimensional region. The rendering unit 5120 identifies a partial region of the 3D image corresponding to the designated region of interest based on the result of registration between the front image and the 3D image. Further, the rendering unit 5120 forms a rendered image corresponding to the specified partial region. For example, when a line segment is specified for a front image, the rendering unit 5120 forms a cross-sectional image representing a plane (cross section) including the line segment. When a two-dimensional area is designated for the front image, the rendering unit 5120 forms a rendered image (for example, a volume rendered image) representing a three-dimensional area including the two-dimensional area.

When the rendering unit 5120 specifies a partial area of the three-dimensional image corresponding to the area of interest specified by the user, the display control unit 5011 sets the rendered image corresponding to this partial area and the front surface acquired by the front eye camera 70. The image can be displayed on the display device 6000 m. Further, the display control unit 5011 can display an image (rendered area image) representing the area corresponding to the rendered image on the front image. The rendered area image is, for example, an image representing a position specified by the user with respect to a front image, typically an image showing the position of a line segment, or an image showing the position of the above-mentioned two-dimensional area. ..

The rendering unit 5120 can form a stereoscopic image from a three-dimensional image based on scanning. The stereoscopic image may be, for example, a volume rendered image, a surface rendered image, an image representing a three-dimensional region specified by segmentation, or the like. The display control unit 5011 can display the stereoscopic image formed by the rendering unit 5120 on the display device 6000 m. The user can operate the stereoscopic image displayed on the display device 6000 m by using the user interface such as the operation unit 5300. Examples of this operation include rotation, enlargement / reduction, and the like. The rotation operation may be, for example, a drag operation. The enlargement / reduction operation may be, for example, an operation on a GUI (widget) or an operation on a scroll wheel. It is also possible to manipulate the opacity (alpha value) of the stereoscopic image. For example, by setting the opacity of a part of the stereoscopic image to be low, it is possible to transparently observe the portion located behind the opacity.

The rendering unit 5120 can identify the crystalline lens region in the three-dimensional image based on the scan. This process includes, for example, segmentation, edge detection, and the like. The analysis unit 5130 can analyze the crystalline lens region specified by the rendering unit 5120 to obtain the opacity distribution. This processing includes, for example, threshold processing and the like. Lens opacity is seen in cataracts and the like. The report creation control unit 5012 can input at least one of the obtained turbidity distribution and the information based on the obtained turbidity distribution into the report template. The turbidity distribution is represented, for example, as a map. The map showing the turbidity distribution may be a color map expressing the intensity of turbidity by color. The display control unit 5011 can display such a turbidity distribution (map) on the display device 6000 m. In addition, it is possible to observe the crystalline lens region by rotating it arbitrarily, or to observe arbitrary slices of the crystalline lens region. It is also possible to apply arbitrary analysis (eg, thickness measurement, volume measurement, etc.) to the crystalline lens region.

The rendering unit 5120 can identify the vitreous region in the three-dimensional image based on the scan. This process includes, for example, segmentation, edge detection, and the like. It is possible to observe the vitreous region by rotating it arbitrarily, or to observe any slice of the vitreous region. It is also possible to apply arbitrary analysis to the vitreous region (eg, measurement of the posterior vitreous cortex anterior pocket).

<Communication unit 5200>
The communication unit 5200 performs data communication with another device (for example, any of the ophthalmologic imaging device 2000-in, the terminal 3000- _n , and the management server 4000). The data communication method and encryption may be the same as those of the communication unit 170 of the _{ophthalmologic} imaging apparatus 2000-in.

<Operation unit 5300>
The operation unit 5300 is used for operating the remote terminal 5000m, inputting information to the remote terminal 5000m, and the like. In this embodiment, the operation unit 5300 is used to create a report. The operation unit 5300 includes an operation device and an input device. The operation unit 5300 includes, for example, a mouse, a keyboard, a trackball, an operation panel, switches, buttons, dials, and the like. The operation unit 5300 may include a touch screen.

The operation unit 5300 can be used to specify the operation mode of the slit lamp microscope 1. The slit lamp microscope 1 is provided with one or more operation modes in advance. In this embodiment, a three-dimensional photographing mode can be provided. The three-dimensional photographing mode is an operation mode for acquiring a three-dimensional image of the eye to be inspected. In the three-dimensional imaging mode, the control unit 101 of the slit lamp microscope 1 controls the illumination system 8, the observation imaging system 6, the moving mechanism 60, and the focusing mechanisms 40 and 50 in a coordinated manner in front of the eye E to be inspected. The image pickup device 13 is made to acquire a plurality of cross-sectional images of the eye portion. The operation mode of the slit lamp microscope 1 is not limited to the three-dimensional photographing mode.

The device used to specify the operation mode is not limited to the operation unit 5300. For example, the operation mode can be specified by using the operation unit 140 of the slit lamp microscope 1 or the terminal 3000-n. The mode of specifying the operation mode is not limited to such manual specification. For example, the operation mode applied to the subject in the past can be acquired from an electronic medical record or the like and specified. In addition, an operation mode associated with a specific disease can be automatically specified. In addition, an operation mode associated with the type of examination (for example, screening, examination, health examination, general medical care, etc.) can be automatically specified.

<Usage pattern>
An embodiment of the ophthalmic system 1000 according to the present embodiment will be described. 9A-9E show examples of usage of the ophthalmic system 1000. Here, FIGS. 9A and 9E are steps carried out in any of the first to Nth facilities, FIGS. 9B and 9C are steps carried out in the management server 4000, and FIG. 9C is any remote. This is a step carried out at the terminal 5000m. In this example, it is assumed that the ophthalmologic imaging apparatus 2000-in is a _slit lamp microscope 1.

It is assumed that the communication between the slit lamp microscope 1 (and / or the terminal 3000-n) and the management server 4000 has already been established. Alternatively, communication may be established between the slit lamp microscope 1 (and / or the terminal 3000-n) and the management server 4000 at any timing during the period from step S1 to step S6 in FIG. 9A. Further, the communication between the management server 4000 and the remote terminal 5000 m has already been established, or is established at an arbitrary timing in the period from step S1 in FIG. 9A to step S14 in FIG. 9B. Further, the processes shown in FIGS. 9A to 9E are executed, for example, in a time of several minutes to several tens of minutes. That is, the feedback (report) can be obtained within a few minutes to several tens of minutes after taking a picture with the slit lamp microscope 1.

(S1: Enter the subject information into the ophthalmologic imaging device)
See FIG. 9A. First, the subject information is input to the slit lamp microscope 1 (or the terminal 3000-n). The input subject information is stored in the storage unit 102. If communication between the slit lamp microscope 1 (and / or the terminal 3000-n) and the management server 4000 has already been established, the input subject information may be transmitted to the management server 4000 at this stage. .. The subject information includes, for example, a subject ID and background information. The management server 4000 can select the remote terminal 5000m (step S13 in FIG. 9B) at an arbitrary timing after receiving the subject information.

The subject ID includes, for example, an ID in a medical facility (patient ID), an ID in a medical examination, an ID in a medical examination, and the like. These are examples, and the subject ID is not limited to these.

The background information is arbitrary information about the subject, and as an example, it is recorded in the interview information of the subject, the information entered by the subject on a predetermined sheet, and any item of the electronic medical record of the subject. There is information that has been sent, images stored in the subject's account, and so on. Typically, the background information includes gender, age, height, weight, disease name, candidate disease name, test result (visual acuity value, optical power value, tonometry value, etc.), image (OCT image of anterior segment of the eye, etc.). ), Refraction correction tools (eyeglasses, contact lenses, etc.) wearing history, frequency, examination history, treatment history, etc. These are examples, and the background information is not limited to these.

For example, the user of the slit lamp microscope 1 (or the terminal 3000-n) can input the subject information by using the operation unit 140. Further, the control unit 101 and the communication unit 170 access the information processing system (for example, a customer management system, an electronic medical record system, a medical image archiving system, etc.) installed in the facility via a communication path to the subject. Information can be obtained. In addition, the subject information recorded on the recording medium can be read out using a data reader. These are examples, and the method of inputting the subject information is not limited to these.

(S2: Acquisition of front image of the anterior segment of the eye)
The slit lamp microscope 1 starts acquiring a front image of the anterior segment of the eye E to be inspected by the anterior segment camera 70. For example, the anterior eye camera 70 starts shooting a moving image of the anterior eye. The timing of acquiring the front image and the timing of starting the acquisition are not limited to those of this example.

(S3: Set to 3D shooting mode)
The operation mode of the slit lamp microscope 1 is set to the three-dimensional photographing mode. As described above, the operation mode is specified (or selected) manually or automatically.

(S4: Scan the anterior eye)
The slit lamp microscope 1 scans the anterior segment of the eye E to be inspected in the three-dimensional imaging mode set in step S3. As a result, a plurality of cross-sectional images of the anterior segment of the eye to be inspected E can be obtained.

(S5: Forming a three-dimensional image of the anterior segment of the eye)
The image synthesis unit 120 of the slit lamp microscope 1 forms a three-dimensional image based on the plurality of cross-sectional images acquired in step S4. As described above, the management server 4000, the remote terminal 5000 m, or another device may execute the three-dimensional image forming process.

(S6: Send data to the management server)
The control unit 101 of the slit lamp microscope 1 controls the communication unit 170 and transmits the acquired data to the management server 4000. The data to be transmitted includes the subject information input in step S1, at least one of the front images whose acquisition was started in step S2, the three-dimensional image formed in step S5, and the identification information of the facility (the facility). Facility ID) and included.

When a device other than the slit lamp microscope 1 executes the three-dimensional image forming process, a plurality of cross-sectional images acquired in step S4 are transmitted to the management server 4000 instead of the three-dimensional image.

(S11: The management server receives the data)
See FIG. 9B. The communication unit 4200 of the management server 4000 receives the data transmitted by the slit lamp microscope 1 in step S6.

(S12: Save data)
The control unit 4010 stores the data received in step S11 in a storage device such as a hard disk drive or a solid state drive, or an external database. The data is stored so as to be searchable based on, for example, the subject ID and the facility ID.

(S13: Select a remote terminal)
The selection unit 4120 selects one of the plurality of remote terminals 5000 m based on the data received in step S11 and the like. As mentioned above, various attributes such as the type of examination (for example, the type of imaging modality, the type of image, the type of disease, the type of candidate disease, etc.), the required specialty / skill level, and the type of language. It is also possible to select the remote terminal 5000 m by referring to.

The selection unit 4120 may have a function of monitoring the operating state (communication establishment information) of each remote terminal 5000 m. With this monitoring function, the selection unit 4120 contains a remote terminal 5000 m that is not currently in operation (a terminal that is not currently used for image interpretation, a terminal that is currently performing image interpretation, etc., but has a sufficient schedule, and a reservation for use. You can choose one of the following (such as no terminal). As a result, it is possible to select a remote terminal 5000 m that is not currently used for interpretation of images related to other subjects.

The monitoring function flags, for example, the operating status of each remote terminal 5000m based on the reaction to the information input from the remote terminal 5000m or the information transmitted to the remote terminal 5000m periodically or irregularly. It can be realized by managing with.

(S14: Send data to remote terminal)
The control unit 4010 of the management server 4000 controls the communication unit 4200 to transmit at least a part of the data received in step S11 to the remote terminal 5000m selected in step S13. The data to be transmitted includes the background information input in step S1, at least one of the front images whose acquisition was started in step S2, and the three-dimensional image formed in step S5. Further, information indicating the deadline date and time for creating the report (for example, within 30 minutes) may be transmitted to the remote terminal 5000 m.

When the remote terminal 5000m executes the three-dimensional image forming process, a plurality of cross-sectional images acquired in step S4 are transmitted to the remote terminal 5000m instead of the three-dimensional image.

(S21: Remote terminal receives data)
See FIG. 9C. The communication unit 5200 of the remote terminal 5000 m receives the data transmitted by the management server 4000 in step S14. The control unit 5010 stores the received data in the above-mentioned storage unit.

(S22: Start interpretation?)
A user of the remote terminal 5000 m (for example, a doctor, an optometrist, etc.) starts reading an image at a desired timing (S22: Yes).

(S23: Display front image)
The display control unit 5011 causes the display device 6000 m to display the front image included in the data received in step S21, for example. The display mode of the front image may be a moving image display or a still image display. It is possible to perform operations on the displayed front image. For example, it is possible to change the orientation and display magnification of the front image.

(S24: Specify a partial area)
The user can specify a partial area of the displayed front image by using the operation unit 5300. Here, the reference image or wide area image described above may be used.

Further, the partial area may be specified automatically. For example, it is possible to specify a corneal surface region, a corneal back surface region, a crystalline lens region, a vitreous region, and the like. In this case, the designated area can be analyzed by the analysis unit 5130.

(S25: Render 3D image)
The rendering unit 5120 renders a three-dimensional image based on the partial area specified in step S24. As a result, a rendered image representing a user-specified partial area (that is, an image of the region of interest that the user is paying attention to) is obtained.

(S26: Display rendered image)
The display control unit 5011 causes the display device 6000 m to display the rendered image acquired in step S25.

The display control unit 5011 can display the position information indicating the position of the rendered image on the display device 6000. This position information may be, for example, information indicating the position or range of the partial region specified in step S24, or information indicating the position or range of the rendered image formed in step S25. The position information may be displayed together with, for example, the front image started to be displayed in step S23, the above-mentioned reference image or wide area image, the schema diagram of the eye, and the like. Typically, such an image or an image showing a position or range in a schema diagram can be displayed as position information.

(S27: Finish reading?)
The user can perform image interpretation while arbitrarily changing the region of interest (S27: No). At that time, the background information input in step S1 and the front image whose display is started in step S23 can be referred to.

(S28: Create a report)
While performing the image interpretation or when the image interpretation is completed (S27: Yes), the user inputs the information obtained by the image interpretation, the diagnosis result, and the like by using the operation unit 5300. The report creation control unit 5012 creates a report based on the information input by the user or the information selected by the user.

(S29: Send a report to the management server)
The control unit 5010 of the remote terminal 5000m controls the communication unit 5200 and transmits the report created in step S28 to the management server 4000.

(S31: The management server receives the report)
See FIG. 9D. The communication unit 4200 of the management server 4000 receives the report transmitted by the remote terminal 5000m in step S29.

(S32: Save report)
The control unit 4010 stores the report received in step S31 in a storage device such as a hard disk drive or a solid state drive, or an external database. The report is stored so as to be searchable based on, for example, a subject ID or a facility ID.

(S33: Search for the facility where the photo was taken)
The control unit 4010 searches for the facility where the anterior eye portion of the subject was photographed, for example, by referring to the search ID. As a result, the destination (for example, network address) of the report received in step S31 is specified.

(S34: Send a report to the searched facility)
The control unit 4010 of the management server 4000 controls the communication unit 4200 to transmit the report received in step S31 to the facility searched in step S33. In this example, the report is transmitted to the terminal 3000-n installed in the searched facility.

(S41: The terminal of the searched facility receives the report)
See FIG. 9E. The terminal 3000-n receives the report transmitted by the management server 4000 in step S34.

(S42: Display report)
The terminal 3000-n displays the report received in step S41 on a display device (not shown).

(S43: Explain the contents of the report to the subject)
The user of the terminal 3000-n explains to the subject about the interpretation result, the diagnosis result, the treatment policy, the necessity / selection of the refraction correction tool, etc. while referring to the displayed report. This is the end of the process related to this example.

<Modification example>
A modified example of this embodiment will be described.

The configuration for changing the focus position of the slit lamp microscope 1 is not limited to the focusing mechanisms 40 and 50 described above.

For example, two or more images of the eye to be inspected are acquired by using two or more photographing units (two or more anterior eye camera) disclosed in Japanese Patent Application Laid-Open No. 2013-248376, and these images are analyzed to determine the focus position. It can be configured to determine (target position).

Other examples of configurations for changing the focus position include: The slit lamp microscope of this example includes an imaging unit, a driving unit, and a focusing control unit. The imaging unit captures the eye to be inspected and acquires a right image and a left image. The drive unit drives the optical system including the image pickup unit at least in the working distance direction. The focusing control unit controls the driving unit so as to automatically perform the focusing operation on the eye to be inspected based on the right image and the left image output from the imaging unit.

<Action / effect>
The actions and effects of the embodiments described above will be described.

The ophthalmology system (1000) according to the present embodiment includes a slit lamp microscope (1, ophthalmology imaging device 2000-in), a three-dimensional image forming unit (image composition unit 120), a rendering unit ( ₅₁₂₀ ), and display control. A unit (5011), a report creation unit (report creation control unit 5012, operation unit 5300), and a report output unit (terminal 3000-n) are included.

The slit lamp microscope includes a front image acquisition unit (anterior eye camera 70, observation imaging system 6) and an image acquisition unit (illumination system 8, observation imaging system 6, focusing mechanisms 40 and 50, moving mechanism 60). .. The front image acquisition unit acquires a front image by photographing the anterior eye portion of the eye to be inspected (E). The image collecting unit captures the anterior eye portion with slit light and collects a plurality of images (a plurality of cross-sectional images).

The three-dimensional image forming unit forms a three-dimensional image based on a plurality of images collected by the image collecting unit of the slit lamp microscope. In the present embodiment, the slit lamp microscope is provided with a three-dimensional image forming unit, but the three-dimensional image forming unit may be provided in another device.

The rendering unit renders the three-dimensional image formed by the three-dimensional image forming unit to form a rendered image. In the present embodiment, the rendering unit may include at least the rendering unit 5120, and may further include the partial area specifying unit 5110.

The display control unit causes the display means (display device 6000 m) to display the front image acquired by the front image acquisition unit and the rendered image formed by the rendering unit. The display means may be provided in the same device as the display control unit (remote terminal 5000 m), or may be a peripheral device connected to the device provided with the display control unit.

The report creation unit includes a user interface (operation unit 5300) for creating a report regarding information (typically including a front image and a rendered image) displayed on the display means by the display control unit.

The report output unit outputs the report created by the report creation unit. In the present embodiment, the terminal 3000-n displays the report, but the output mode of the report is not limited to the display, for example, printing on a paper medium or the like, transmitting to another device, recording on a recording medium, or the like. May be.

According to the ophthalmology system of the present embodiment configured in this way, a three-dimensional image and a frontal image of the anterior segment of the eye are acquired using a slit lamp microscope, and a report is created while arbitrarily rendering the three-dimensional image. Can be done. Therefore, doctors and optometrists can create reports while observing a desired region of interest in the anterior segment of the eye while freely rendering a three-dimensional image acquired using a slit lamp microscope.

This eliminates the need for doctors and optometrists to perform real-time operations from remote locations to obtain images of the anterior eye. Moreover, there is an advantage that the image acquired by the slit lamp microscope, which is most widely and frequently used in ophthalmologic image diagnosis, can be read at a remote place. Furthermore, it will be possible to promptly provide the report created in a remote location to the facility where the image was taken and the subject.

Therefore, according to the ophthalmology system of the present embodiment, it is possible to provide an ophthalmology telemedicine technique capable of effectively using a slit lamp microscope.

The ophthalmic system of the present embodiment includes a server (4000) connected to a slit lamp microscope via a communication path (1100) and an information processing device (remote terminal 5000 m) connected to the server via a communication path (1100). And include.

The server includes a storage unit (a storage device such as a hard disk drive and a solid state drive in the control unit 4010) and a communication unit (4200). The storage unit stores a three-dimensional image and a front image associated with the preset subject identification information (subject ID). In addition, as in this embodiment, it is possible to further associate the facility identification information (facility ID). The communication unit transmits at least a three-dimensional image and a front image to the information processing apparatus.

The information processing apparatus includes a communication unit (5200), a rendering unit (5120), a display control unit (5011), and a report creation unit (report creation control unit 5012, operation unit 5300).

The communication unit of the information processing apparatus receives at least a three-dimensional image and a front image transmitted from the server. Further, the communication unit of the information processing apparatus transmits the report created by the report creation unit to the server.

The communication unit of the server receives the report transmitted from the information processing device. In addition, the communication unit of the server sends at least a portion of this report to the facility where the slit lamp microscope that imaged the eye to be inspected is installed. The report output unit is located in the facility where the slit lamp microscope that took the image of the eye to be inspected is installed. In this example, the report is transmitted to the terminal 3000-n in the facility where the slit lamp microscope 1 is installed, but the report may be transmitted to the slit lamp microscope 1 or another device.

According to this configuration, it is possible to effectively provide ophthalmic telemedicine by using an information processing device located at a position away from the facility where the slit lamp microscope is installed.

In the present embodiment, the rendering unit may be configured to specify at least one of the corneal surface region and the corneal back surface region in the three-dimensional image of the anterior eye portion.

According to this configuration, it becomes possible to easily observe and analyze the state of the cornea, which is a typical site of interest in the anterior eye region.

In this embodiment, the rendering unit may be configured to specify at least the corneal surface area. Further, the ophthalmic system of the present embodiment may further include a first analysis unit (analysis unit 5130) for analyzing the specified corneal surface region to obtain the radius of curvature of the cornea. In addition, the report creator may be configured to create a report that includes at least one of the obtained corneal radius of curvature and information based on it (eg, contact lens model number, etc.).

According to this configuration, the radius of curvature of the cornea, which is a typical parameter of interest in the prescription of contact lenses, can be easily obtained. Furthermore, it becomes possible to easily and quickly provide a report in which the radius of curvature of the cornea is described.

In this embodiment, the rendering unit may be configured to specify at least the corneal surface area. Further, the ophthalmic system of the present embodiment may further include a second analysis unit (analysis unit 5130). The second analysis unit is configured to analyze the corneal surface region specified by the rendering unit to obtain the corneal radius of curvature distribution, and to obtain the deviation distribution representing the deviation of the corneal radius of curvature distribution from the preset standard distribution. To. In addition, the reporting unit may be configured to create a report containing at least one of the obtained deviation distribution and information based on it.

According to this configuration, it is possible to easily obtain information representing the distribution of the radius of curvature of the cornea, which is a typical parameter of interest in the formulation of contact lenses, for example. Furthermore, it becomes possible to easily and quickly provide a report containing information representing the distribution of the radius of curvature of the cornea.

In the present embodiment, the display control unit may be configured to display the deviation distribution obtained by the second analysis unit on the display means.

According to this configuration, the report creator (doctor, optometrist, etc.) creates a report by referring to the deviation distribution of the corneal radius of curvature distribution in addition to the frontal image and rendered image of the anterior segment of the eye to be inspected. Is possible.

The ophthalmic system of the present embodiment may further include a registration unit (5105) that performs registration between the front image of the anterior eye portion and the three-dimensional image. Further, in this embodiment, a user interface can be used to specify a region of interest (eg, a cross section, a three-dimensional region, etc.) in a frontal image. In addition, the rendering unit can identify a partial region of the three-dimensional image corresponding to the designated region of interest based on the registration result. Further, the rendering unit can form a rendered image (for example, a slice image, a Scheimpflug image, a volume rendered image, etc.) corresponding to the specified partial area.

According to this configuration, the report creator can easily specify the region of interest in the anterior segment of the eye. That is, the report author can easily specify where he wants to apply the rendering.

In the present embodiment, the display control unit can display the rendered image and the front image corresponding to the partial region in the three-dimensional image specified by the rendering unit on the display means. Further, the display control unit can display an image representing the area corresponding to the rendered image on the front image.

With this configuration, the report creator can easily grasp which part of the front image is displayed as the rendered image.

In the present embodiment, the rendering unit can form a stereoscopic image from the three-dimensional image of the anterior eye portion. Further, the display control unit can display the formed stereoscopic image on the display means. In addition, it is possible to use the user interface to manipulate the stereoscopic image displayed on the display means (eg, rotate, zoom in / out, etc.).

According to this configuration, the report creator can observe the anterior eye portion in three dimensions, and further, it is possible to perform detailed observation while arbitrarily manipulating the stereoscopic image.

In the present embodiment, the rendering unit can identify the crystalline lens region in the three-dimensional image of the anterior eye portion. Further, the ophthalmic system of the present embodiment may further include a third analysis unit (analysis unit 5130) that analyzes the specified lens region to obtain the opacity distribution. In addition, the report creation unit can create a report containing at least one of the obtained turbidity distribution and information based on the obtained turbidity distribution.

According to this configuration, for example, the distribution of lens opacity, which is a typical site of interest in the diagnosis of cataract eyes, can be easily obtained. Furthermore, it becomes possible to easily and quickly provide a report containing information representing the lens opacity distribution.

In the present embodiment, the display control unit may be configured to display the turbidity distribution obtained by the third analysis unit on the display means.

According to this configuration, report creators (doctors, optometrists, etc.) can create reports by referring to the lens opacity distribution in addition to the frontal image and rendered image of the anterior segment of the eye to be inspected. Become.

In the present embodiment, the image collecting unit of the slit lamp microscope may include an illumination system (8), an imaging system (observation imaging system 6), and a moving unit (moving mechanism 60). The lighting system illuminates the eye to be inspected with slit light. The photographing system guides the return light of the slit light from the eye to be inspected to the first image pickup apparatus (13). The moving unit moves the lighting system and the photographing system. Further, the three-dimensional image forming unit may be configured to form a three-dimensional image based on a plurality of cross-sectional images acquired by the first image pickup apparatus while moving the illumination system and the photographing system.

According to such a configuration, it is possible to acquire images of a plurality of cross sections of the eye to be inspected while changing the illumination angle and the photographing angle with respect to the anterior segment of the eye, and to form a three-dimensional image from these cross-sectional images.

In the present embodiment, the image collecting unit of the slit lamp microscope may include a focus position changing unit (focusing mechanism 40, focusing mechanism 50). The focus position changing unit changes at least one of the focus position of the lighting system and the focus position of the photographing system. Further, the three-dimensional image forming unit moves a plurality of images acquired by the first image pickup apparatus while moving at least one of the lighting system and the photographing system and changing at least one of the focus position of the lighting system and the focus position of the photographing system. A three-dimensional image can be formed based on the cross-sectional image.

According to such a configuration, it is possible to perform a plurality of times of photographing while changing the focus position with respect to the anterior eye portion, and it is possible to form a three-dimensional image from a plurality of cross-sectional images obtained thereby.

The ophthalmic system of the present embodiment may further include an operation mode designation unit for designating an operation mode of the slit lamp microscope. The operation mode designation unit may include, for example, an operation unit 5300 of the remote terminal 5000 m, an operation unit 140 of the slit lamp microscope 1, a terminal 3000-n, or another device. Further, the slit lamp microscope may include a control unit (101). When the three-dimensional shooting mode is designated by the operation mode designation unit, the control unit of the slit lamp microscope displays a plurality of cross-sectional images by controlling the illumination system, the shooting system, the moving unit, and the focus position changing unit in a coordinated manner. It may be configured to be acquired by the first image pickup apparatus.

With such a configuration, it becomes possible to automatically collect a plurality of cross-sectional images for forming a three-dimensional image of the anterior eye portion.

In the present embodiment, the front image acquisition unit may include a second image pickup device (anterior eye camera 70) different from the first image pickup device provided in the image collection unit.

According to such a configuration, even if the image collecting unit moves to acquire a three-dimensional image of the anterior eye portion (that is, to perform scanning), the anterior eye portion can be photographed from a fixed position. It will be possible.

The front image acquisition unit may be configured to acquire a front image of the anterior eye portion using a first image pickup device provided in the image collection unit. In this case, typically, the front image is acquired at a timing different from the scanning by the image collecting unit.

In the present embodiment, in parallel with the collection of a plurality of cross-sectional images by the first image pickup device provided in the image collection section, the second image pickup device of the front image acquisition section can take a moving image of the anterior eye portion.

This makes it possible to observe the state of the anterior eye portion while scanning by the image collecting unit.

The ophthalmic information processing device (remote terminal 5000 m) according to the present embodiment includes a communication unit (5200), a rendering unit (5120), a display control unit (5011), and a report creation unit (report creation control unit 5012, operation unit). 5300) and included.

The communication unit of the ophthalmologic information processing device uses a slit lamp microscope (1, _{ophthalmology} imaging device 2000-in) to photograph the anterior eye portion of the eye to be inspected, and obtains a three-dimensional image and a front image through a communication path (1100). Accept through. The rendering unit of the ophthalmic information processing device renders the three-dimensional image received by the communication unit to form the rendered image. The display control unit of the ophthalmic information processing device causes the display means (display device 6000 m) to display the front image received by the communication unit and the rendered image formed by the rendering unit. The report creation unit includes a user interface (operation unit 5300) for creating a report regarding the information displayed by the display control unit. The communication unit of the ophthalmic information processing device transmits the created report. The final destination for the report is the facility where the eye was photographed.

According to such an ophthalmology information processing apparatus, it is possible to provide an ophthalmology remote medical technique capable of effectively utilizing a slit lamp microscope, similar to the ophthalmology system of the present embodiment.

It is possible to configure a program that causes a computer to execute the process according to the present embodiment. The program is configured to cause the computer to perform the following steps: a step of capturing the anterior segment of the eye under test with a slit lamp microscope and accepting the acquired 3D and frontal images via a communication path; Steps to render the accepted 3D image to form a rendered image; Steps to display the accepted front image and the formed rendered image; Steps to accept input from the user; Report on the displayed information Steps to create based on user input; steps to submit a report.

According to such a program, it is possible to provide an ophthalmic telemedicine technique capable of effectively utilizing a slit lamp microscope, similar to the ophthalmic system of the present embodiment.

It is possible to create a computer-readable non-temporary recording medium on which such a program is recorded. This non-temporary recording medium may be in any form, and examples thereof include a magnetic disk, an optical disk, a magneto-optical disk, and a semiconductor memory.

It is possible to apply any of the various processes described in the exemplary embodiments to such programs or recording media.

The embodiments described above are merely typical examples of the present invention. Therefore, any modification (omission, substitution, addition, etc.) within the scope of the gist of the present invention can be appropriately applied.

1 Slit lamp microscope 6 Observation photography system 8 Lighting system 13 Imaging device 40 Focusing mechanism 50 Focusing mechanism 60 Moving mechanism 70 Front eye camera 101 Control unit 120 Image synthesis unit 140 Operation unit 150 Focusing position detection unit 160 Scan position detection Unit 170 Communication unit 1000 Ophthalmology system 2000-in Ophthalmology imaging device 4000 Management server ₄₀₁₀ Control unit 4020 Communication unit 5000m Remote terminal 5010 Control unit 5011 Display control unit 5012 Report creation control unit 5100 Data processing unit 5105 Registration unit 5110 Partial area designation Unit 5120 Rendering unit 5130 Analysis unit 5200 Communication unit 5300 Operation unit 6000m Display device

Claims (4)

A slit lamp microscope including a front image acquisition unit that photographs the anterior eye portion of the eye to be inspected to acquire a front image, and an image collection unit that captures the anterior eye portion with slit light and collects a plurality of images.
A three-dimensional image forming unit that forms a three-dimensional image based on the plurality of images,
A registration unit that performs registration between the front image and the three-dimensional image,
A user interface that accepts input from the user to specify the area of interest in the front image,
A rendering unit that identifies a partial region of the three-dimensional image corresponding to the region of interest based on the registration result and forms a rendered image corresponding to the partial region.
An ophthalmic system including a display control unit that displays the rendered image corresponding to the partial area and the front image on the display means, and displays an image representing the area corresponding to the rendered image on the front image. .. A communication unit that receives a three-dimensional image and a frontal image obtained by photographing the anterior eye portion of the eye to be inspected with a slit lamp microscope via a communication path, and a communication unit.
A registration unit that performs registration between the front image and the three-dimensional image,
A user interface that accepts input from the user to specify the area of interest in the front image,
A rendering unit that identifies a partial region of the three-dimensional image corresponding to the region of interest based on the registration result and forms a rendered image corresponding to the partial region.
Ophthalmology information including a display control unit that displays the rendered image corresponding to the partial area and the front image on the display means, and displays an image representing the area corresponding to the rendered image on the front image. Processing device. A step of receiving a three-dimensional image and a frontal image obtained by photographing the anterior segment of the eye to be inspected with a slit lamp microscope via a communication path, and
The step of performing registration between the front image and the three-dimensional image,
A step of accepting input from a user for designating a region of interest in the front image,
A step of specifying a partial region of the three-dimensional image corresponding to the region of interest based on the result of the registration and forming a rendered image corresponding to the partial region.
A program that causes a computer to perform a step of displaying the rendered image corresponding to the partial area and the front image on the display means, and displaying an image representing the area corresponding to the rendered image on the front image. .. A computer-readable non-temporary recording medium on which the program according to claim 3 is recorded.

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