JP5172248B2 - Ophthalmic imaging equipment - Google Patents

Description

  The present invention relates to an ophthalmologic photographing apparatus for photographing a predetermined part of an eye to be examined.

When diagnosing the eye to be examined using a device (for example, see Patent Document 1) that images a predetermined part (for example, fundus or cornea) of the eye to be examined, such as a fundus camera, a laser scanning ophthalmoscope, or a corneal endothelium photographing device. After aligning the imaging unit having the imaging optical system to either the left or right eye, the operator operates various adjustment conditions (focus position, aperture diameter, illumination light quantity, illumination light amount, etc.) according to the state of the eye to be examined. Etc.) and make a diagnosis on the eye to be examined.
JP 2007-89828 A

By the way, in the above-mentioned ophthalmologic photographing apparatus, an examination for the first purpose is performed on both eyes of the eye to be examined one by one in order, and then a precise examination is performed again on the right eye or the left eye based on the examination result. In this case, it is necessary for the examiner to readjust the photographing conditions by operating the adjusting member or the like in accordance with the state of the left and right eyes, which is troublesome for the examiner.
Even when observing changes over time of the eye to be examined (for example, fluorescence contrast imaging), the examiner re-adjusts the imaging conditions each time in order to move the imaging unit alternately left and right in accordance with the time change. Since it was necessary, it was troublesome for the examiner, and there was a possibility that an important part for diagnosis was overlooked in the change with time.

  In view of the above problems, the present invention provides an ophthalmologic photographing apparatus capable of efficiently inspecting left and right eye to be examined alternately and smoothly performing a precise inspection after the first appearance and time-lapse observation of the eye to be examined. Is a technical issue.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) an imaging unit having an imaging optical system for imaging the eye to be examined;
Left and right eye discriminating means for discriminating the left and right eyes of the subject imaged by the imaging unit;
Storage means for storing in association with imaging conditions set in accordance with the left and right Katamegoto of the subject to be photographed on the determination result by the right and left eyes discriminating means by said imaging unit,
When taken continuously alternately left and right eyes of the subject's eye by switching two or more times the image capturing unit to the right and left alternately, corresponding from the storage means based on the discrimination result by the discrimination and judgment results of the right and left eyes discriminating means and imaging condition setting means for setting the imaging conditions of the imaging by calling the shooting condition,
It is characterized by providing.
(2) In the ophthalmologic photographing apparatus according to (1), the photographing unit has a focus adjusting unit for adjusting a focus on the eye to be examined by driving a predetermined optical member of the photographing optical system, and the photographing condition is the focus The focus condition is set by the adjustment unit .

  According to the present invention, it is possible to smoothly perform a close examination after the first appearance and observation over time of an eye to be examined.

  Embodiments of the present invention will be described with reference to the drawings. FIG. 1 is an external configuration diagram of an ophthalmologic photographing apparatus according to the present embodiment. The ophthalmologic photographing apparatus is provided on a base 101, a moving base 102 that can move in the left and right direction (X direction) and the front and rear (working distance) direction (Z direction) with respect to the base 101. And a face support unit 105 fixed to the base 101 for supporting the face of the subject. The imaging unit 103 is moved in the vertical direction (Y direction) with respect to the subject's eye E by the Y drive unit 106 provided on the moving table 102. The moving table 102 is moved in the XZ direction on the base 101 by operating the joystick 104. Further, by rotating the rotary knob 104a, the Y drive unit 106 is driven Y and the photographing unit 103 is moved in the Y direction. A monitor 34 for displaying a fundus observation image and a fundus image is provided on the examiner side of the imaging unit 103.

  The photographing unit 103 incorporates a photographing optical system for photographing the eye to be examined, and FIG. 2 is a diagram illustrating the photographing optical system of the ophthalmologic photographing apparatus according to the present embodiment. Reference numeral 1 denotes a laser beam emitting unit capable of emitting a laser beam having a first wavelength and a laser beam having a second wavelength, and a first laser light source 1a that emits a laser beam having an infrared wavelength and a laser having a visible wavelength. A second laser light source 1b that emits light, a mirror 100, and a dichroic mirror 101 are included. In the present embodiment, the first laser light source 1a emits laser light having a wavelength of about 790 nm, and the second laser light source 1b emits laser light having a wavelength of about 490 nm. The infrared laser light emitted from the first laser light source 1a passes through the dichroic mirror 101, exits the laser light emitting unit 1, and travels on the optical axis L1. The visible laser beam emitted from the second laser light source 1b is bent by the mirror 100, then reflected by the dichroic mirror 101 and coaxial with the laser light emitted from the first laser light source, and is on the optical axis L1. Continue on.

  2 is a perforated mirror having an opening in the center, and 3 is a lens. Reference numerals 4 and 5 denote mirrors which can be moved in the direction of the arrow shown in FIG. 2 by driving a drive unit 31 (for example, a pulse motor), and focus adjustment (diopter correction) can be performed by changing the optical path length. it can. 6, 8 and 10 are concave mirrors. 7 is a polygon mirror serving as a scanning means for deflecting and scanning the laser beam in the horizontal direction on the fundus of the eye to be examined, and 9 is a scan for deflecting and scanning the laser beam in a direction perpendicular to the scanning direction by the polygon mirror 7. It is a galvanometer mirror as a means.

  The laser beams having the first and second wavelengths emitted from the laser beam emitting unit 1 pass through the opening of the perforated mirror 2, pass through the lens 3, and then are reflected by the mirror 4, the mirror 5, and the concave mirror 6. Head to the polygon mirror 7. The light beam reflected by the polygon mirror 7 is reflected by the concave mirror 8, the galvano mirror 9, and the concave mirror 10, and then condensed on the fundus of the eye to be examined, and the fundus is two-dimensionally (in the XY axis direction shown in the drawing). ) Scan. An irradiation optical system is formed by these optical members.

  Reference numeral 11 denotes a lens, and reference numeral 12 denotes a pinhole plate having a pinhole (opening) on the optical axis. The lens 11 places the observation point of the fundus of the eye to be examined and the pinhole plate at a conjugate position. Note that the opening provided in the pinhole plate 12 is a variable diaphragm capable of changing the size of the opening diameter by driving a drive unit 39 (for example, a pulse motor). Reference numeral 13 denotes a condensing lens, and reference numeral 14 denotes a light receiving element having sensitivity in the visible region and the infrared region. Note that an APD (avalanche photodiode) is used for the light receiving element 14 of the present embodiment.

  Reference numeral 24 denotes a first filter (for example, a barrier filter for photographing ICG (Indocyanine Green)) that transmits light in a predetermined wavelength region in order to obtain a first fluorescent image by irradiation with the first laser beam. Is a second filter (for example, a barrier filter for FAG imaging) that transmits light in a wavelength region different from the predetermined wavelength region in order to obtain a second fluorescent image by irradiation with the second laser light, and is driven The unit 21 is inserted into and removed from the imaging optical path by driving the unit 21.

  The reflected light of the laser beam scanned on the fundus of the eye to be examined follows the irradiation optical system in the reverse direction, is reflected by the perforated mirror 2, and is bent downward. The pupil position of the eye to be examined and the opening of the perforated mirror 2 are conjugated by the lens 3. The reflected light reflected by the perforated mirror 2 is focused on the pinhole of the pinhole plate 12 through the lens 11. The reflected light focused by the pinhole is received by the light receiving element 14 through the lens 13. A photographing optical system is formed by these optical members.

  FIG. 3 is a block diagram showing a control system of the ophthalmologic photographing apparatus according to this embodiment. Reference numeral 30 denotes a control unit that controls the entire apparatus. The controller 30 drives the laser light sources 1a and 1b, the polygon mirror 7 and the galvanometer mirror 9, the light receiving element 14, the drive unit 21 for driving the fluorescent filter, and the mirrors 4 and 5. Drive unit 31, control unit 32, image processing unit 33 for forming an image of the fundus oculi based on a signal received by the light receiving element 14, drive unit 39 for adjusting the opening diameter of the pinhole 12, The rotation knob 104a and the photographing switch 104b of the joystick 104, the Y drive unit 106, the left and right eye discrimination unit 110, and the like are connected. Reference numeral 34 denotes a monitor on which a fundus image formed by the image processing unit 33 is displayed. Reference numeral 35 denotes a storage unit for storing various information. The control unit 32 has predetermined adjustment knobs for adjusting the focus state of the fundus image using the drive unit 31, an aperture diameter adjustment knob for changing the size of the aperture diameter of the pinhole 12, and a fluorescent photographing mode. There are prepared a fluorescence photographing mode setting switch for setting the mode and various switches for operating the apparatus.

  Note that the control unit 30 can detect the movement position (movement amount) of the mirrors 4 and 5 from the number of rotation pulses of the drive unit 31 and store the movement position in the storage unit 35. Further, it is possible to detect the opening diameter of the pinhole 12 from the number of rotation pulses of the driving unit 39 and store the opening diameter in the storage unit 35. The positions of the mirrors 4 and 5 and the opening diameter of the pinhole 12 are initialized to a predetermined reference state when the power is turned on.

  The control unit 30 is connected to a left / right eye determination unit 110 for determining whether the eye to be inspected by the imaging unit 103 is one of the left and right eyes. The left and right eyes of the subject are discriminated based on the output signal output from the eye discriminating unit 110. For example, the left and right eye discriminating unit 110 discriminates the left and right eyes by detecting whether the imaging unit 103 is positioned on the left or right with respect to the left and right center by using a position detection sensor such as a micro switch or a potentiometer. Configuration is conceivable.

  In the above configuration, when obtaining a fundus image, the control unit 30 drives the drive unit 36 to operate the polygon mirror 7 and the galvanometer mirror 9, thereby scanning the laser beam two-dimensionally on the fundus of the eye to be examined. Let Thereby, the fundus reflection light corresponding to the scanning position of the laser beam on the eye fundus is sequentially received by the light receiving element 14. Here, the image processing unit 33 constructs one fundus image (an image for one frame) based on the light reception signal sequentially output from the light receiving element 14 and displays the fundus image on the monitor 34. Then, by repeating the above operation, the fundus of the eye to be examined can be observed in real time as a moving image on the screen of the monitor 34.

  The operation of the fundus imaging apparatus having the above configuration will be described. In the following description, a case will be described as an example in which the first eye fundus inspection is performed in the order of the right eye and the left eye, and then fluorescence contrast imaging is performed on the left and right eyes. First, the examiner observes the fundus of the subject's eye with infrared light in order to perform an examination for the first time on the subject's eye. As an initial setting, the control unit 30 drives the drive unit 21 to remove the first filter 24 and the second filter 25 from the imaging optical path, and emits infrared light from the first laser light source 1a. Use illumination light for observation. Further, the control unit 30 drives the drive unit 31 when the apparatus is turned on to place the mirrors 4 and 5 at the 0D focus position as a reference state, and drives the drive unit 39 to open the pinhole 12. Keep the aperture to a minimum.

  The examiner moves the imaging unit 103 using the joystick 104 while viewing the anterior segment image displayed on the monitor 34, and the imaging unit 103 is located at a predetermined position with respect to the subject's eye (right eye) to be imaged. Align so that the relationship is established. In this case, when the imaging unit 103 is moved in the right eye direction and the imaging unit 103 is moved to the left from the center of the apparatus as viewed from the examiner, the control unit 30 performs imaging based on a signal from the left and right eye discrimination unit 110. The eye to be examined (photographed eye) photographed by the unit 103 is determined to be the right eye, and the determination result is displayed on the monitor 34.

  When the examiner irradiates the fundus of the subject's eye with laser light and a fundus observation image appears on the screen of the monitor 34, the examiner operates the focus adjustment knob provided on the control unit 32 to focus the fundus image (in focus). ). In this case, the control unit 30 drives the drive unit 31 based on the operation signal and moves the mirrors 4 and 5 in the focus direction (optical axis direction). Moreover, the control part 30 will stop the drive of the drive part 31, if the input of an operation signal is stopped.

  Further, the examiner operates the opening diameter adjustment knob provided in the control unit 32 to adjust the resolution and brightness of the fundus observation image displayed on the monitor 34. In this case, the control unit 30 drives the drive unit 39 based on the operation signal, and changes the opening diameter of the variable aperture of the pinhole 12 stepwise. Moreover, the control part 30 will stop the drive of the drive part 39, if the input of an operation signal is stopped. When the aperture diameter of the pinhole 12 is adjusted, the smaller the aperture diameter, the higher the resolution of the obtained fundus image, but the obtained light amount is small and the whole becomes dark. On the other hand, the larger the aperture diameter, the brighter the fundus image obtained, but with a lower resolution and a rough image. The set focus information and opening diameter information of the pinhole 12 are displayed on the monitor 34. For example, the focus information is displayed as a diopter value, and the opening diameter information is displayed stepwise using a natural number corresponding to the opening diameter that is changed stepwise.

  As described above, when the adjustment of the imaging conditions is completed, the right eye of the subject is diagnosed while viewing the fundus moving image displayed in real time. Further, when the photographing switch 104b is pressed by the examiner, the control unit 30 stores the fundus image data for one frame in the storage unit 35 in association with the above-described left / right eye discrimination result based on the trigger signal.

  Further, the control unit 30 detects the moving position of the mirrors 4 and 5 from the number of rotation pulses of the driving unit 31 based on the trigger signal of the shooting switch 104b, and associates it with the left and right eye discrimination result to present the right eye when shooting. Are stored in the storage unit 35 as shooting conditions (for example, right eye: −3D, etc.). Further, the control unit 30 detects the aperture diameter from the number of rotation pulses of the drive unit 39, and stores the size information of the aperture diameter in the storage unit 35 in association with the left / right eye discrimination result as an imaging condition. As a result, the shooting conditions at the time of right-eye shooting are temporarily stored.

  When the first eye inspection for the right eye is completed as described above, the examiner operates the joystick 104 to move the photographing unit 103 in the left eye direction. In this case, since the imaging unit 103 is moved to the right side with respect to the center of the apparatus as viewed from the examiner, the control unit 30 determines that the imaging eye is the left eye based on the input signal input from the left and right eye discrimination unit 110. And the determination result is displayed on the monitor 34.

  Next, the examiner performs alignment so that the subject's left eye and the imaging unit 103 are in a predetermined positional relationship, and performs focus adjustment, aperture diameter adjustment, etc., as in the case of the right eye. When the adjustment is completed, the first visual inspection is performed on the left eye of the subject while viewing the fundus moving image displayed in real time. Here, when the imaging switch 104b is pressed by the examiner, the control unit 30 stores the fundus image data for one frame in the storage unit 35 in association with the left and right eye discrimination results, and the movement positions of the mirrors 4 and 5 The opening diameter of the pinhole 12 is stored in the storage unit 35 in association with the left / right eye discrimination result. As a result, the shooting conditions at the time of left-eye shooting are temporarily stored.

  In addition, when temporarily storing the imaging conditions for each eye of the left and right eyes in the storage unit 35 as described above, the control unit 30 is limited to a method using the imaging switch 104b as a trigger for instructing to store the imaging conditions. It is also possible to prepare a storage instruction switch for generating a trigger signal for instructing to store the photographing conditions.

  As described above, when the first inspection for both eyes of the eye to be examined is completed and a disease (for example, diabetic disease) is observed on the fundus of the eye to be examined, next, fluorescence contrast imaging for both eyes of the eye to be examined is performed. Transition. In the following description, a case where visible fluorescence imaging (FAG examination: fluorescent angiography) is performed on the eye to be examined will be described. In this case, the examiner intravenously injects a fluorescent agent for FAG imaging to the subject before the start of imaging. The examiner switches the mode to the FAG imaging mode by using a fluorescence imaging mode setting switch provided in the control unit 32. When the mode is switched, the control unit 30 turns off the first laser light source and emits visible laser light for fluorescence imaging from the second laser light source 1b. In addition, the control unit 30 drives the drive unit 21 to place the second filter 25 in the imaging optical path so as to obtain a desired fluorescent fundus image, and increases the sensitivity (gain) of the light receiving element 14 so that the fundus It is possible to acquire weak fluorescence that is excited in this way.

  In the case of fluorescence imaging, it is necessary to observe both eyes of the subject over time for each eye, so the examiner moves the imaging unit 103 alternately left and right as time elapses, and alternately observes the left and right eyes. I will do it.

  The control unit 30 detects switching between the left and right eyes based on the signal input from the left and right eye discriminating unit 110, calls up the imaging conditions corresponding to the left and right eyes discriminated as the eye to be examined from the storage unit 35, and takes an image at the time of shooting. Set as a condition. In this case, the control unit 30 causes the imaging optical system to operate so that the imaging conditions called from the storage unit 35 are set, thereby reproducing the imaging conditions of the eye to be examined at the first visual inspection.

  More specifically, when the first eye examination is completed in the order of the right eye and the left eye, and then the control unit 30 shifts to the fluorescence imaging of the right eye, the control unit 30 determines the eye to be examined based on the input signal from the left and right eye discrimination unit 110. When it is detected that the eye has switched to the right eye, the drive unit 31 and the drive unit 39 are set so that the movement position and the aperture diameter of the mirrors 4 and 5 at the time of right-eye photography stored in advance in the storage unit 35 are the same. Is controlled. For example, when the movement position of the mirrors 4 and 5 at the first eye examination of the right eye is −3D, the mirrors 4 and 5 are moved to the position −3D.

  In addition, when the right eye fluorescence imaging is shifted to the left eye fluorescence imaging, the control unit 30 detects that the eye to be examined is switched to the left eye based on the input signal from the left and right eye discrimination unit 110. The drive unit 31 and the drive unit 39 are driven and controlled so that the moving position and the aperture diameter of the mirrors 4 and 5 at the time of left-eye photography stored in the storage unit 35 are the same.

  When the right eye fluorescence imaging is performed again after the right eye and the left eye fluorescence imaging, the control unit 30 mirrors the right eye imaging stored in advance in the storage unit 35 in accordance with the left / right eye switching. The drive unit 31 and the drive unit 39 are driven and controlled so that the movement position and the opening diameter are 4 and 5.

  As described above, after the imaging conditions are stored in the storage unit 35, the control unit 30 determines the imaging conditions when imaging the eye to be examined again using the imaging unit 103 by the left and right eye discrimination unit 110. Based on the above, the corresponding shooting conditions are called from the storage unit 35 and set as shooting conditions at the time of shooting. As a result, after the first imaging of one eye of the subject, the imaging conditions of the first imaging are reproduced without trouble when the second imaging is performed on the one eye through the imaging of the other eye. As a result, it is possible to reduce the trouble of the examiner adjusting the photographing conditions again. This is particularly useful when the left and right eyes are switched a plurality of times as time elapses and the left and right eyes are observed over time, as in the case of fluorescence contrast imaging.

  Note that after the imaging conditions are automatically set according to the left and right eye switching as described above, the imaging knobs may be readjusted by the examiner operating the focus knob or the like. (For example, when the focus position, the brightness of the image, etc. are different between the first inspection and the fluorescence photographing). In this case, the control unit 30 temporarily stores the imaging conditions after readjustment by the examiner in association with the left and right eyes in the storage unit 35, and then performs imaging of the other eye to be examined. When the readjusted eye is imaged again, the control unit 30 may operate the imaging optical system so that the readjusted imaging conditions stored in the storage unit 35 are satisfied. In this way, when readjustment of the shooting conditions by the examiner of the focus position or aperture diameter is necessary, such as when the shooting mode is different between the first inspection and the close inspection, after readjustment is made Since the photographing conditions after readjustment are automatically set, the labor of the examiner when switching between the left and right eyes can be further reduced.

  In the above description, the switching of the left and right eyes is automatically detected, and the imaging conditions corresponding to the eye to be inspected at present are called from the storage unit 35 according to the switching of the left and right eyes, and the called imaging conditions are set. However, an imaging condition setting switch for generating a trigger signal for operating the imaging optical system may be provided so that the imaging conditions corresponding to the difference between the left and right eyes can be set. Good.

  In the above description, the current focus condition is stored by using the storage instruction signal from the predetermined storage instruction switch as a trigger. However, the imaging condition is detected at any time according to the changing operation of the imaging condition by the examiner. The shooting conditions before the change operation already stored in the storage unit 35 may be updated to the shooting conditions after the change operation. In this case, the control unit 30 operates the photographing optical system so that the updated photographing condition stored in the storage unit 35 is set in the setting of the photographing condition. The imaging conditions for each eye stored in the storage unit 35 can be deleted from the storage unit 35 by a predetermined operation (for example, a switch operation).

  In the above description, the laser scanning ophthalmoscope that captures the fundus of the eye to be examined by scanning the laser beam two-dimensionally on the eye fundus and receiving the reflected light has been described as an example. The fundus camera illuminates the entire fundus of the subject's eye with a flash lamp and receives the reflected light, and irradiates the cornea of the subject's eye with slit light and receives the reflected light. Corneal endothelium imaging device that images the cornea of the eye to be examined, ophthalmic optical interference that shoots a tomographic image of the eye by irradiating the eye with low coherent light and receiving interference light between the reflected light and the reference light The present invention can be applied to any ophthalmic imaging apparatus that adjusts imaging conditions for each eye of a subject and images a predetermined part of the subject's eye, such as a tomography apparatus.

  In the above description, the focus position and the aperture diameter have been described as examples of the imaging conditions. However, the illumination light amount to the imaging region, the gain of the light receiving element, the frame rate, the area to be enlarged and displayed on the screen of the monitor 34, and the like. As long as it is adjusted for each eye of the subject, the present invention is not limited to this.

It is an external appearance block diagram of the ophthalmologic imaging device which concerns on this embodiment. It is the figure which showed the optical system of the ophthalmologic imaging device which concerns on this embodiment. It is the block diagram which showed the control system of the ophthalmologic imaging device which concerns on this embodiment.

Explanation of symbols

30 Control Unit 31 Drive Unit 35 Storage Unit 39 Drive Unit 103 Imaging Unit 110 Left and Right Eye Discrimination Unit

Claims (2)

An imaging unit having an imaging optical system for imaging the eye to be examined;
Left and right eye discriminating means for discriminating the left and right eyes of the subject imaged by the imaging unit;
Storage means for storing in association with imaging conditions set in accordance with the left and right Katamegoto of the subject to be photographed on the determination result by the right and left eyes discriminating means by said imaging unit,
When taken continuously alternately left and right eyes of the subject's eye by switching two or more times the image capturing unit to the right and left alternately, corresponding from the storage means based on the discrimination result by the discrimination and judgment results of the right and left eyes discriminating means and imaging condition setting means for setting the imaging conditions of the imaging by calling the shooting condition,
An ophthalmologic photographing apparatus comprising: 2. The ophthalmologic photographing apparatus according to claim 1, wherein the photographing unit has a focus adjusting unit for adjusting a focus on the eye to be inspected by driving a predetermined optical member of the photographing optical system, and the photographing condition is determined by the focus adjusting unit. An ophthalmologic photographing apparatus characterized in that the focus condition is set .

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