JP5667730B1 - Myopia progression diagnostic device, myopia progression determination method, program, and storage medium - Google Patents

Abstract

A myopia progression diagnostic device that makes it possible to easily diagnose the progress of myopia in children and adults, so that the presence or absence of myopia in children can be predicted and a contact lens suitable for the eyes of the children can be prescribed. As shown in FIG. 1, a light irradiation unit 13 that irradiates measurement light to the retina in a direction that forms an angle θ with respect to an eye axis that connects the approximate center of the pupil of the eyeball 2 and the macula, and a reflection from the retina Detection unit 14 that receives the received light and obtains optical data D17 in the peripheral visual field of the fundus, and analyzes the optical data D17 to determine the focus position of the measurement light at the angle θ and the PSF characteristics of the positions before and after the focus And a data analysis device 20 for determining whether or not a hyperopic back focal point exists in the peripheral visual field of the fundus of the eyeball 2 to be examined based on the PSF characteristics. The correction power required for myopia suppression can be measured from the hyperopic power obtained by this measurement system.

Description

  The present invention diagnoses the progression of refractive myopia that continues to progress in adults that are expected to stop the progression of axial myopia in schoolchildhood where the change in the axial length of the eye is remarkable, and the progression of refractive myopia that continues to progress. The present invention relates to a myopia progress diagnosis apparatus, a myopia progress determination method, a program, and a storage medium that can be applied to a myopia progress diagnosis system that determines and treats the above.

  In Japan, about 50% of the population is short-sighted, and the use of glasses and contact lenses is required for daily life. Pathologic intensity myopia such as axial myopia, which is one of the causes of myopia progression, leads to blindness due to macular degeneration, retinal hemorrhage, etc., and myopia is the fifth leading cause of blindness. Since myopia is a risk factor for major blindness diseases such as glaucoma and retinal detachment, the rate of myopia as a potential cause of blindness is expected to be higher.

  Factors related to myopia and its progression are being elucidated, such as the environment, heredity, and lifestyle. However, little research has been done on its prevention, compared to other major causes of blindness such as diabetic retinopathy and glaucoma. There is little progress. This is because myopia is an extension of the axial length, the so-called inheritance is determined by individual differences in the usual `` eye growth '', and is only understood to the extent of `` individual height differences '' I can say that.

  However, in recent years, the relationship between blurring of the peripheral visual field and axial expansion has been clarified. In the background, it has been shown that the eyeball bulge (protrusion) occurs in the part where the visual stimulus was deprived in animal experiments and myopia proceeds (Wallman J, Science 1987). It has been confirmed that axial myopia progresses in premature babies who have been treated or in children with congenital cataracts whose intraocular lens is fixed in the eye.

  The closer the intraocular lens eye is to the fundus visual field, the more the retinal image degrades due to the effects of astigmatism and astigmatism (see FIG. 14). That is, it is suggested that the block of visual stimulation due to blurring of peripheral vision is greatly involved in not only amblyopia but also the growth of eyeball morphology (Connoly, Ophthalmolgy 2004). In other words, myopia progression, which has been considered to be individual differences due to heredity and environmental factors, is thought to be related to optical factors, and in recent years there has been a trend to suppress myopia progression with contact lenses and glasses, However, there is no research based on solid basic data.

  This is because detailed analysis of optical data in the peripheral visual field is difficult with conventional models. Although the latest Hartmann-Shack wavefront aberrometer can measure only the highest-order aberrations that are in focus, peripheral vision is always exposed to defocus by an adjustment function that adjusts to the central vision focus.

  Therefore, we conducted a prospective study during the period from 2009 to 2011 under the hypothesis that myopia progression in childhood is caused by optical degradation of the peripheral vision, mainly high-order aberrations. We found that low-order aberrations, especially relative hyperopia, are higher than higher-order aberration components, and are associated with myopia progression and axial extension, and there are individual differences in the relative hyperopia.

  There are reports that peripheral vision blur is related to axial myopia in primates and birds. In recent years, even in humans, there are reports that certain contact lenses suppress axial myopia in children, but details are unknown. In addition, in the analysis of the optical characteristics of the human peripheral visual field, many studies have examined only a simple refractive power, which has been a major problem in conventional peripheral vision research.

  FIG. 32A is a cross-sectional view showing the structure of a human eye (hereinafter referred to as eye 2 to be examined). In FIG. 32A, 41 is a cornea, 42 is a crystalline lens, 43 is a pupil, 44 is a vitreous body, and 46 is a retina. Note that description of the structure of the eyeball 2 to be examined is omitted. First, a general depth of focus when a near-sighted person looks far and a presbyopic person looks close will be described.

  As shown in FIG. 32A, whether a person with normal vision sees the distance or near, the light entering the eyeball forms an image at the correct position on the retina 46, that is, the macular 45. In the figure, O is the optical axis (ocular axis), and L1 is the axial length of a normal human eye. The axial length L1 refers to a length from the central apex of the cornea 41 to the macular 45 portion of the retina 46. The retina 46 is divided into a central retina which is a peripheral portion of the macular 45 and a peripheral retina which is a peripheral region of the central retina.

  On the other hand, when it extends rearward as compared with the axial length L1 shown in FIG. 32A like the axial length L2 (L2> L1) shown in FIG. This is a so-called myopic symptom that makes it difficult to see distant objects. When a near-sighted human sees from a distance, the light that has entered the eyeball forms an image on the near side rather than the correct position on the retina 46 rather than on the central retina. Further, since the focal depth is shallow, the focal position is in front of the retina 46.

  Since the axial length L2 extends backward and the shape of the eyeball is distorted when it starts to be myopic, the focus on the central retina shifts forward from the retina 46 (macular 45). The focus on the retina is moved onto the macular 45, and as a result, the axial length L2 further extends backward to match it, and as a result, it is thought that myopia progresses more and more because the focus is not focused on the central retina. . Although not shown, when a presbyopic person looks close, the lens 42 loses its elasticity and becomes hard, so that the image is formed not behind the correct position on the retina 46 but behind the retina 46.

  The optical analysis of the peripheral vision has a long history, dating back to Thomas Young, a British physicist and optician in the 1700s. In recent years, peripheral visual field optical characteristics have become measurable due to advances in computer-aided analysis technology and development of diagnostic equipment. There are facilities around the world that are doing research similar to this patent, but they are analyzing the optical properties of only the most focused part of the peripheral retina. Primates have an adjustment function that allows them to freely manipulate the focal point of the near and far by changing the thickness of the lens during the course of evolution.

  For such an optical analysis of the peripheral visual field, Patent Document 1 discloses an eye optical characteristic measuring method and an eye optical characteristic measuring apparatus regarding an apparatus and method for measuring eye optical characteristics at high speed.

JP 2006-263300 A

By the way, according to the eye optical characteristic measuring technique according to the conventional example, there are the following problems.
i. With regard to techniques for predicting the progression of myopia, many attempts have been made to suppress myopia progression. However, although large-scale clinical research such as atropine eye drops and progressive addition glasses has been carried out, it is said that there are some effects, but it does not reach a level that can be said to be sufficient for clinical use. That prediction has failed.

  ii. In recent years, there are clinical reports that myopia suppression with certain types of contact lenses and off-axis aberration suppression glasses stop myopia progression. This is due to the fact that there is no standard for determining whether a child with nearsightedness progresses or does not progress with myopia when volunteer children start intervention.

  iii. According to the eye optical characteristic measuring apparatus as shown in Patent Document 1, it is the actual situation that a detailed analysis of a sufficient defocus component is not performed in the optical analysis of the peripheral visual field. For this reason, even if the ophthalmic optical characteristic measurement device is applied to a myopia progression diagnostic device without any ingenuity, it is difficult to determine whether or not the child is progressing myopia.

In order to solve the above-described problem, the myopia progression diagnostic apparatus according to claim 1, the measurement light is transmitted to the retina in a direction that forms an angle θ with respect to an eye axis that connects the approximate center of the pupil of the eyeball to the macula. A light irradiating unit for irradiating; a light detecting unit for receiving light reflected from the retina to obtain optical data in the peripheral visual field of the fundus; and analyzing the optical data in the peripheral visual field of the fundus of the eye to be examined. a Lud over data analysis unit to determine whether the focus after hyperopic exists, the data analyzing unit, the position of the focal point of the measurement light the most-focus at the optical axis in said angle θ A calculation unit for obtaining a point image intensity distribution characteristic of a position of a front focal point located on the front side of the focal point on the optical axis, and a position of a rear focal point located on the rear side of the focal point on the optical axis line; Hyperopia in the peripheral visual field of the fundus of the subject eye based on the point image intensity distribution characteristics And a discriminator for discriminating whether or not there is a back focal point .

According to the myopia progression diagnostic apparatus according to claim 1, it is possible to determine (predict) whether or not myopia of the eyeball to be examined will proceed in the future. In addition, glasses and contact lenses suitable for the eyes of children and the like who are in the progressing stage of myopia can be easily prescribed.

Myopia progression diagnostic apparatus according to claim 2 according to claim 1, wherein the arithmetic unit, the refractive power of the position of the focal point of the measurement light, the refractive power of the position of the front focus and the refractive power of the position of the rear focal point Is calculated for each angle θ.

Myopia progression diagnostic apparatus according to claim 3 in claim 1, wherein the arithmetic unit, the refractive power of the position of the focal point of the measurement light, the refractive power of the position of the refractive power and the rear focal position of the front focal Each difference is calculated by subtracting the refractive power of the position of the focus of the measurement light at the eye axis (θ = 0 °) from each, and the discriminating unit determines whether the differences are both positive values or negative values. It is discriminate | determining whether it is.

The myopia progression diagnosis apparatus according to claim 4 , wherein the myopia progression diagnosis apparatus according to claim 2 displays a point image of the focus position of the measurement light, an astigmatism image of the front focus, and an astigmatism image of the rear focus for each angle θ It has a part.

Myopia progression diagnostic apparatus according to claim 5 according to claim 1, wherein the data analysis unit, contact lenses were introduced add power for the measurement light of the focal position point image blurred by analyzing the degree of myopia progression inhibition of It is discriminate | determined whether the treatment by this is possible.

The myopia progress determination method according to claim 6 , wherein the myopia progress diagnosis device for diagnosing the progress of myopia of the eyeball to be examined has an angle θ with respect to an eye axis line connecting the approximate center of the pupil of the eyeball to the macula a first step of irradiating the measuring light toward the retina, and a second step of obtaining optical data on the fundus of the peripheral vision by receiving light reflected from the retina, the by analyzing the optical data A third step of determining whether or not a hyperopic back focal point exists in the peripheral visual field of the fundus of the eye to be examined , wherein the third step is most focused on the optical axis at the angle θ. Further, the point image intensity distribution of the focus position of the measurement light, the position of the front focus located on the front side of the focus on the optical axis, and the position of the back focus located on the rear side of the focus on the optical axis. Determining the characteristics, and based on the point spread characteristic. And determining whether or not there is a hyperopic back focal point in the peripheral visual field of the fundus of the eyeball to be examined .

The program according to claim 7 is readable by a computer for executing the myopia progression determination method.

A storage medium according to an eighth aspect describes a computer-readable program for executing the myopia progression determination method.

  According to the myopia progress diagnosis apparatus according to claim 1 and the myopia progress determination method according to claim 7, since it is possible to determine (predict) whether or not myopia of the eyeball to be progressed in the future, the change in the axial length is remarkable. It is possible to easily diagnose the progression of refractive myopia that continues to progress in adults who are supposed to stop the progression of axial myopia during schoolchildhood and myopia. This makes it possible to easily prescribe glasses, contact lenses, and the like that match the eyes of children and the like who are in the progressing stage of myopia.

  According to the myopia progression diagnostic apparatus according to claim 4, when the three refractive powers are positive values, “the rear focal line located on the rear side from the front focal line located on the front side of the focal point on the optical axis line”. It is possible to diagnose that the hyperopic back focal point exists outside the retina.

  According to the myopia progression diagnostic apparatus according to claim 6, by analyzing the degree of blurring of the point image at the most focused position, the subject eyeball having a large blur of the point image becomes an excluded group that cannot be treated in this intervention test. It will be possible to classify whether this intervention study can be treated.

1 is a block diagram showing a configuration example of a myopia progression diagnostic apparatus 100 as a first embodiment according to the present invention. 3 is a block diagram illustrating a configuration example of a control system of the myopia progression diagnosis apparatus 100. FIG. It is an intraocular sectional view showing a determination example in which the evaluation formulas A, B, and C are positive values. It is an intraocular sectional view showing a determination example in which evaluation formulas A, B, and C are negative values. 4 is a flowchart showing an example of myopia progress determination (main routine) in the myopia progress diagnosis device 100. It is a flowchart which shows the myopia progress determination example (subroutine). A and B are image diagrams illustrating an example of conversion from a double pass PSF image to a single pass PSF image. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-4.45 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-4.20 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-3.95 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-3.70 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-3.45 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-3.20 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-2.95 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-2.70 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-2.45 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-2.20 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-1.95 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-1.70 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-1.45 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degrees] (-1.20 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-0.95 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-0.70 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-0.45 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (-0.20 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (0.05 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (0.30 [D]) of the optical data D17. It is an image figure which shows the acquisition example [(theta) = 20 degree] (0.55 [D]) of the optical data D17. It is a graph which shows the example of a characteristic of MTF vs. spatial frequency. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of a crystalline-lens eye. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of a crystalline lens [θ = -10 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of a crystalline lens [θ = 0 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of a crystalline lens [θ = 10 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of a crystalline lens [θ = 20 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of a crystalline lens [θ = 30 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of a crystalline lens [θ = 40 °]. It is a graph which shows the MTF characteristic example of a crystalline lens eye. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of an IOL eye [θ = -20 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of an IOL eye [θ = -10 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of an IOL eye [θ = 0 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of an IOL eye [θ = 10 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of an IOL eye [θ = 20 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of an IOL eye [θ = 30 °]. It is an image figure which shows the example of acquisition of the PSF image at the time of the best focus of an IOL eye [θ = 40 °]. It is a graph which shows the MTF characteristic example of an IOL eye. A and B are sectional views showing a configuration example of a contact lens 200 for suppressing myopia progression as a second embodiment according to the present invention. 5 is a cross-sectional view showing an example of wearing a contact lens 200. FIG. It is a graph which shows the example of a relationship between visual acuity and the frequency from a fovea. It is sectional drawing which shows the example (the 1) of correction | amendment of a myopic eye. It is sectional drawing which shows the example (the 2) of correction | amendment of a myopic eye. It is sectional drawing which shows the example (the 3) of correction | amendment of a myopic eye. It is sectional drawing which shows the prescription example of the contact lens 200 by type Ta. It is sectional drawing which shows the prescription example of the contact lens 200 by type Tb. It is sectional drawing which shows the prescription example of the contact lens 200 by type Tc. It is a flowchart which shows the prescription example (the 1) of a contact lens. It is explanatory drawing which shows the example of calculation of the fundus curvature radius rx. It is explanatory drawing which shows the prescription example of type Ta, Tb, Tc. FIG. 6 is an intraocular cross-sectional view of an eyeball 2 to be examined showing a determination example of types Ta, Tb, and Tc at an angle θ = 40 °. It is a flowchart which shows the prescription example (the 2) of the contact lens 200. It is explanatory drawing which shows the example of relationship between type Ta, Tb, and Tc of axial length Lx = 23.0mm and a fundus curvature shape. It is explanatory drawing which shows the example of a relationship with type Ta, Tb, Tc of axial length Lx = 24.0mm and a fundus curvature shape. It is explanatory drawing which shows the example of relationship between type Ta, Tb, and Tc of axial length Lx = 25.0mm and a fundus curvature shape. It is explanatory drawing which shows the example of a relationship with type Ta, Tb, Tc of the axial length Lx = 23.0, 24.0, 25.0 mm and the fundus curvature shape C23-C25. It is explanatory drawing which shows an intraocular dimension. It is explanatory drawing which shows the example of a relationship between axial length Lx = 23.0mm, a fundus curvature shape C23, and type Ta. It is explanatory drawing which shows the example of a relationship between axial length Lx = 24.0mm, a fundus curvature shape C24, and type Tb. It is explanatory drawing which shows the example of relationship between axial length Lx = 25.0mm, a fundus curvature shape C25, and type Tc. It is sectional drawing which shows the example of mounting | wearing of the spectacle lens 300 for myopia progress suppression as a comparative example. It is sectional drawing which shows the problem of the spectacle lens 300 for myopia progress suppression as a comparative example. It is sectional drawing which shows the symptom example of the to-be-tested eyeball (normal vision) which concerns on a prior art example. It is sectional drawing which shows the symptom example of the to-be-tested eyeball (myopia) at the time of myopia progress.

  In recent years, research on the progress of myopia in children has progressed, and it has been thought that the progress of myopia in children may be caused by blurring of the image in the peripheral retina. Therefore, the present inventor arrived at the idea that the progression of myopia can be suppressed by correcting the defocus of the peripheral retina, and the present invention has been achieved.

  The present invention makes it possible to easily diagnose the progress of myopia in children, adults, etc., and to predict the future progress of myopia in children, etc. An object is to provide a storage medium.

  Hereinafter, the contact lens and the selection method thereof according to the present invention will be described with reference to the drawings. A myopia progression diagnosis apparatus 100 shown in FIG. 1 is an apparatus that acquires and analyzes optical data of a peripheral visual field in an eyeball of a subject 1 such as a child or an adult (hereinafter referred to as an eyeball 2 to be examined). The myopia progression diagnostic apparatus 100 is capable of acquiring a wide range of optical data with a focus of ± 2.5 [D] (D: diopter) from the center of the crystalline lens of the human eye to the peripheral visual field shifted by an angle of 40 °. It is.

  The myopia progression diagnosis apparatus 100 is a device that devises an existing PSF analyzer (registered trademark). For example, whether myopia of a child or the like progresses in the future, and whether myopia that can progress can be suppressed by treatment. Determining whether or not it is possible to treat myopia suppression by adding a refractive lens to the periphery of a distance lens that can progress, and determining the effect after a certain period of treatment Etc. are applicable.

  The myopia progression diagnostic apparatus 100 includes an optical data acquisition unit 10 and a data analysis apparatus 20. The optical data acquisition unit 10 includes, for example, a main body unit 11, an XYZ stage 12, and an arcuate track 53. The main body 11 is placed on an XYZ stage 12, and the XYZ stage 12 can move on an arc-shaped track 53 in a clockwise direction or a counterclockwise direction. The XYZ stage 12 can move and adjust the main body 11 in the X direction (left-right direction), Y direction (front-rear direction), and Z direction (up-down direction: a direction perpendicular to the paper surface).

  For example, the XYZ stage 12 is provided with a setting unit 15, which is the same as the optical axis O described in FIG. 3: FIG. 32A and FIG. 32B that connects the approximate center of the pupil of the eye 2 to be examined and the macula. ) To set the angle θ. The setting unit 15 includes an angle indicator 51, an operation lever 52, and the like. For example, a digital display is used as the angle display 51, and the angle θ is displayed. When the subject 1 has his / her head and chin fixed in a fixed coordinate system different from the main body 11 and the angle θ is set by the setting unit 15, the XYZ stage 12 is set at the center of the pupil of the eyeball 2 to be examined. Thus, a method of rotating around the subject 1 by an angle θ is employed.

  In addition to a frame (not shown) for fixing the subject 1, a track 53 is attached to the fixed coordinate system. An XYZ stage 12 is movably engaged with the track 53. The angle indicator 51 is provided on the XYZ stage 12, and when the operator (ophthalmologist) sets the angle θ, if the XYZ stage 12 is moved along the track 53 with the operation lever 52, the angle indicator 51 Display as the value counts up sequentially. Of course, a method may be employed in which the angle indicator 51 is provided on the track 53, the base line is provided on the XYZ stage 12, and the base line is aligned with the scale displaying the analog angle.

  Alternatively, a driving mechanism (not shown) may be provided on the XYZ stage 12, the angle θ may be set with a numeric keypad, etc., and the driving mechanism may be operated to automatically rotate the XYZ stage clockwise or counterclockwise. . In the figure, 16 is an existing lever for XYZ stage operation. Reference numeral 54 denotes a fixation card (Landolt ring having a notch in a horizontal direction, a vertical direction, or the like: C symbol).

  For the optical data acquisition unit 10, a PSF analyzer (registered trademark), an autorefractometer, or the like is used. The auto-refractometer irradiates the subject's eyeball 2 with infrared light, and can automatically analyze the refraction state of the eye, mainly the presence or absence of myopia, hyperopia, and astigmatism, and the degree thereof, and the objective eyeball 2 can be objectively viewed. Can be measured numerically and digitized.

  The data analysis device 20 includes a keyboard 21, a mouse 22, a control unit 23, and a display unit 24. As the data analysis device 20, a personal computer (information processing device) such as a notebook computer or a desktop computer is used. The mouse 22 is a wired type or a wireless type. A liquid crystal display panel is used for the display unit 24.

  As shown in FIG. 2, the main body 11 includes a light irradiation unit 13, a light detection unit 14, and a data input / output unit 17, and these constitute a control system of the optical data acquisition unit 10. The light irradiation unit 13 is provided with components of a projection system such as a light source, a focusing lens, a polarization beam splitter, and a quarter wavelength plate (not shown). Based on the irradiation control signal S13, the light irradiation unit 13 irradiates the retina 46 (see FIG. 3, FIG. 4, etc.) in the direction of the angle θ with respect to the eye axis L with measurement light. The irradiation control signal S13 is a signal for controlling the light source, the focusing lens, and the like.

  The light detection unit 14 receives light reflected from the retina 46 in the angle θ direction and generates a light detection signal S14 in the peripheral visual field of the fundus. For example, the light detection unit 14 includes an imaging device (CCD). The light detection unit 14 generates a light detection signal S14 serving as optical data D17 in a wide refraction range including the defocus components of the front focal line and the rear focal line.

  Here, the defocus component (non-focus component) refers to a luminance component at a non-focus position shifted back and forth on the optical axis (direction) from the imaging position of the crystalline lens 42 (see FIG. 3). This defocus component around the visual field can be the first factor for predicting the presence or absence of myopia progression. In addition, since the existing PSF analyzer (registered trademark) can be used for the individual configurations and functions of the light irradiation unit 13, the light detection unit 14, and the data input / output unit 17, a detailed description thereof will be omitted.

  The data input / output unit 17 controls the light irradiation unit 13 and the light detection unit 14 by transferring the optical data D17 to the data analysis device 20 or receiving the control data D33 from the data analysis device 20. For example, the data input / output unit 17 performs D / A conversion on the control data D33 to create an irradiation control signal S13, and outputs the irradiation control signal S13 to the light irradiation unit 13.

  The data input / output unit 17 A / D converts the light detection signal S14 to create optical data D17, writes the angle θ in the header, attaches the optical data D17 to the header, and transfers the optical data D17 to the data analyzer 20. . The optical data D17 is a point spread function (PSF image) every 0.25 [D] steps in the range of the optical axis ± 2.0 [D] of the reflected light reflected from the retina 46 in the peripheral visual field at an angle θ. ) Is reproduced (imaged) and constitutes 21 double-pass PSF images. The control data D33 includes data for driving the focusing lens every 0.25 [D] steps in the range of ± 2.0 [D].

  The data input / output unit 17 is provided with an AD converter that converts the light detection signal S14 into digital optical data D17, and a DA converter that converts the control data D33 into the irradiation control signal S13. The AD converter and the DA converter A local central processing unit (CPU) is also provided for controlling input / output such as.

  When a PSF analyzer (registered trademark) is used for the optical data acquisition unit 10, the analyzer is fixed with the eye to be measured by the child, and the optical data D17 of the center of the fundus and its peripheral visual field is ± 2.0 [D ] In a wide range of 0.25 [D] steps. According to the optical data acquisition unit 10, the measurement light (light beam) incident on the subject's eyeball 2 is changed from convergent to parallel and divergent by driving the focusing lens of the light irradiating unit 13. A double-pass PSF image can be acquired by optically changing the distance to the light source in 0.25 [D] steps.

  Thereby, accurate optical data D17 including the front focal line and the rear focal line in the center of the fundus and the peripheral visual field in a child (child) and the like can be grasped in detail. It becomes possible to determine (predict) whether or not myopia of the eyeball 2 to be examined will proceed in the future.

  A data analysis device 20 is connected to the optical data acquisition unit 10, and the data analysis device 20 analyzes the optical data D17. For example, a point image intensity distribution characteristic (hereinafter referred to as a PSF characteristic) at a focus position of the measurement light at an angle θ and positions before and after the focus (step 0.25 [D]) is obtained, and based on the PSF characteristic. It is determined whether or not there is a hyperopic post-focal point in the peripheral visual field of the fundus of the optometry ball 2. Here, the back focal point refers to a non-focal point located on the rear focal line when the rear side of the focal point of the measurement light focused most on the optical axis L ′ at the angle θ is defined as the rear focal line.

  The data analysis apparatus 20 includes a control unit 23. The control unit 23 includes, for example, a calculation unit 31, a determination unit 32, a data input / output unit 33, and a memory unit 34. A central processing unit (CPU) is used for the calculation unit 31 and the determination unit 32.

  The calculation unit 31 obtains the position of the focus of the measurement light at the angle θ and the PSF characteristics of the positions before and after the focus from the optical data D17 related to the single-pass PSF image. For example, the calculation unit 31 has the position of the focus of the measurement light most focused on the optical axis L ′ at the angle θ, the position of the astigmatism on the front focal line located on the front side of the focus on the optical axis L ′, Then, the PSF characteristic of the position of the astigmatism on the rear focal line located behind the focal point on the optical axis L ′ is obtained.

  Further, the calculation unit 31 calculates the refractive power of the PSF image at the focal position at the angle θ, the refractive power of the front focal point, and the refractive power of the rear focal point for each angle θ. As a result, it is possible to predict the presence or absence of myopia from the refractive powers of the front focus and the back focus.

  In this example, the calculation unit 31 further determines the focal position of the measurement light at the eye axis L (θ = 0 °) from the refractive power of the point image at the focal position at the angle θ, the refractive power of the front focal point, and the refractive power of the rear focal point. Each difference obtained by subtracting the refractive power of the point image is calculated. This calculation is for discriminating whether or not the hyperopic back focal point exists outside the retina 46 in the peripheral visual field centered on the macula.

For example, as a pre-stage for determining whether or not there is a hyperopic back focal point, the calculation unit 31 sets the refractive power of the PSF image at the most focused position at the angle θ as BFRθ, and the same angle θ. The refractive power of the astigmatic image blurred on the front focal line is AFLRθ, the refractive power of the astigmatic image blurred on the rear focal line is PFLRθ, and the most focused on the eye axis L (θ = 0 °). Assuming that the refractive power of the PSF image at a certain position is BFR0 and the respective evaluation values are A, B, C, the following evaluation formulas (1) to (3), that is,
A = AFLRθ-BFR0 (1)
B = BFLRθ−BFR0 (2)
C = PFLRθ−BFR0 (3)
Is calculated.

  The discriminating unit 32 discriminates whether or not a hyperopic back focal point exists in the peripheral visual field of the fundus of the eye 2 to be examined based on the calculation results of the above-described equations (1) to (3). For example, the determination unit 32 determines whether the refractive power of the PSF image at the focus position of the measurement light, the refractive power of the astigmatism on the front focal line, and the refractive power of the astigmatism on the rear focal line are both positive values. Determine whether the value is negative.

  When all of the three evaluation values A, B, and C are positive values, the discriminating unit 32 “has a far-focused back focal point outside the retina from the front focal line to the rear focal line. It will be possible to diagnose. On the other hand, if any one of the three evaluation values A, B, and C is negative, it is determined that “no hyperfocal rear focus exists at a position from the front focal line to the rear focal line”. become able to.

  The optical data acquisition unit 10, the keyboard 21, the mouse 22, and the display unit 24 are connected to the data input / output unit 33 described above. The data input / output unit 33 receives the optical data D17 from the optical data acquisition unit 10, and transfers the control data D33 to the optical data acquisition unit 10. The data input / output unit 33 outputs display data D 24 to the display unit 24, inputs key data D 21 from the keyboard 21, and inputs operation data D 22 from the mouse 22.

  Note that a refractometer can be connected to the data input / output unit 33 instead of the optical data acquisition unit 10, and the fundus of the eyeball 2 to be examined is determined by the determination unit 32 based on the fundus shape data DIN obtained from the refractometer. It may be determined whether or not there is a hyperopic back focal point in the peripheral visual field.

  The memory unit 34 constitutes an example of a storage medium and describes a computer-readable program for executing the myopia progress determination method. In addition to ROM, RAM, etc., a hard disk device is used for the memory unit 34. For example, the ROM stores program data readable by a computer for executing the myopia progress determination method.

  The program data includes, for example, a step of irradiating measurement light to the retina 46 in the direction of an angle θ with respect to the eye axis L connecting the approximate center of the crystalline lens of the eyeball 2 to be examined and the macula, and light reflected from the retina 46. Receiving optical data D17 in the peripheral visual field of the fundus and analyzing the optical data D17 to obtain the position of the focus of the measurement light at the angle θ and the PSF characteristics at the positions 2 before and after the focus; A program for a main routine for executing a step (see FIG. 5) for determining whether or not a hyperopic back focus exists in the peripheral visual field of the fundus of the eyeball 2 to be examined based on the PSF characteristics. Is.

  Further, as a subroutine for determining whether or not a hyperopic back focus exists in the peripheral visual field of the fundus of the eye 2 to be examined, the refractive power AFLRθ of the astigmatism on the front focal line and the refraction of the focus on the axial length. The step of inputting the power BFR0, the step of obtaining the evaluation value A as the evaluation formula A = AFLRθ−BFR0, and the step of inputting the refractive power BFRθ at the most focused position and the refractive power BFR0 of the focal point on the axial length A step of obtaining an evaluation value B as an evaluation formula B = BFLRθ−BFR0, a step of inputting a refractive power PFLRθ of an astigmatism on the back focal line and a refractive power BFR0 of a focal point on the eye axis L, and an evaluation formula C = Program data for executing the step of obtaining the evaluation value C as PFLRθ−BFR0 and the step of determining whether or not the evaluation values A, B, and C are all positive values are also included.

  At the time of frequency transfer function (MTF) analysis, the converted optical data D17 is expanded in the RAM. In the MTF analysis, the degree of blurring of the PSF image with the best focus is analyzed. The hard disk device stores optical data D17 before and after conversion, display data D24, control data D33, and the like. The display data D24 is simulation image display data for displaying a thumbnail image for each angle θ. As a result, it becomes possible to analyze the influence of low-order and high-order aberrations at the most focused refraction position at the angle θ of the eye 2 to be examined. Ds in the figure is S curve data, which is image data for drawing the rear focal contour S of the radius rs, and is used when selecting a contact lens.

  The display unit 24 displays the PSF image at the most focused position calculated by the calculation unit 31, the astigmatic image on the front focal line, and the astigmatic image on the rear focal line for each angle θ. For example, the display data D24 is received from the data input / output unit 33, and the PSF image at the most focused position, the astigmatic image on the front focal line, and the thumbnail image of the astigmatic image on the rear focal line are displayed on one screen. (See FIGS. 8A to 8L and FIGS. 9A to 9I). Of course, the display unit 24 may display a schematic section of the eyeball 2 to be superposed with the optical axis L ′ at the angle θ (see FIGS. 3 and 4). A liquid crystal display panel is used for the display unit 24. These constitute the myopia progression diagnostic apparatus 100.

  Here, with reference to FIG.3 and FIG.4, the example of a determination in case the evaluation formulas A, B, and C become a positive value and a negative value is demonstrated. 3 and 4 are schematic cross sections of the eyeball 2 to be superposed with the optical axis L ′ at an angle θ, and the position (focus point) on the optical axis L ′ is a 0.25 [D] scale. And unfocused depth). According to the determination example in which the evaluation formulas A, B, and C shown in FIG. 3 are positive values, in the intraocular cross-sectional view, the child whose myopia has progressed is more likely to have the eyeball 2 to be examined compared to the child with normal vision shown in FIG. The axial length Lx extends. In the drawing, a plurality of (21) vertical short lines perpendicular to the optical axis L ′ indicated by the broken line at an angle θ = 20 ° indicate the eyeball to be examined by driving the focusing lens within a range of ± 2.0 [D]. When the measurement light (light beam) incident on 2 is changed, the positions of the non-focal point and the focal point are described for each 0.25 [D] step.

  On the optical axis L ′ indicated by the broken line, the most focused position (black circle mark) is BFp, the position of the astigmatism on the front focal line (black rhombus mark) is AFp, and the astigmatism on the rear focal line. The position BFp and the position RFp straddle the retina 46 and are located on the far vision side when the position (white diamond mark) is set to RFp. In the example described above, the position AFp corresponds to −3.45 [D] shown in FIG. 8E, the position BFp corresponds to −1.95 [D] shown in FIG. 8K, and the position RFp is This corresponds to −0.45 [D] illustrated in FIG. 9E.

  For the eyeball 2 of a child whose position BFp and position RFp are located on the farsighted side across the retina 46, the evaluation formulas A, B, and C are positive values, and myopia of the eyeball 2 progresses. It can be determined that

  According to the determination example in which the evaluation formulas A, B, and C shown in FIG. 4 are negative values, in the intraocular cross-sectional view, a normal-sighted child has an eye of the eyeball 2 to be examined as compared to a myopic child shown in FIG. The axial length Lx does not extend. In the figure, on the optical axis L ′ indicated by the broken line, the most focused position BFp and the astigmatic position AFp on the front focal line are located on the myopia side without straddling the retina 46. In the test eyeball 2 of the child whose position BFp and position RFp are located on the myopia side, the evaluation formulas A, B, and C are negative, and it is determined that the myopia of the test eyeball 2 is not progressing. can do.

  Next, with reference to FIG. 5 to FIG. 14, an example of the operation of the myopia progress diagnosis apparatus will be described for the myopia progress determination method according to the present invention. In this example, the myopia progression diagnosis apparatus 100 shown in FIG. 1 fixes the head of the subject 1 to its chin and causes the fixation card 54 to be fixed with a non-inspection eye. It is assumed that the optical data D17 in the peripheral visual field is measured by the myopia progression diagnostic apparatus 100. An example in which the myopia progress diagnosis device 100 executes the following steps ST1 to ST7, and in step ST5, the control unit 23 determines the progress of myopia of the eye 2 to be examined and diagnoses the progress of myopia of the eye 2 to be examined. To take.

  Based on these assumptions, first, in step ST1 of the flowchart shown in FIG. 5, the control unit 23 accepts the setting of the angle θ. The angle θ is an irradiation angle of the measurement light with respect to the eye axis L connecting the approximate center of the crystalline lens 42 of the eyeball 2 to be examined and the macula 45. For example, the ophthalmologist operates the setting unit 15 to set the angle θ. The setting unit 15 notifies the control unit 23 via the data input / output units 17 and 33 of the optical data D17 indicating the angle θ setting. Of course, the optical data D17 indicating the angle θ setting may be input to the control unit 23 by operating the keyboard 21 or the mouse 22.

  Next, in step ST2, the control unit 23 controls the light irradiation unit 13 to irradiate the measurement light to the retina 46 in the direction of the angle θ set previously. Based on the irradiation control signal S13 input from the data input / output unit 17, the light irradiation unit 13 irradiates the retina 46 (see FIG. 3, FIG. 4, etc.) in the direction of the angle θ with respect to the eye axis L.

  Further, in step ST3, the control unit 23 controls the data input / output unit 17 so as to acquire the optical data D17. The light detection unit 14 receives light reflected from the retina 46 in the direction of the angle θ and generates a light detection signal S14 having a wide refraction range including defocus components of front focal lines and rear focal lines in the peripheral visual field of the fundus. To do.

  The data input / output unit 17 receives the photodetection signal S14 from the photodetection unit 14, A / D converts the photodetection signal S14, and has a wide refraction range optical data including defocus components of the front focal line and the rear focal line. D17 is acquired. The optical data D17 is data constituting a double-pass PSF image shown in FIG.

  The double-pass PSF image is a point image formed on the retina 46 when a point light source is projected onto the eyeball optical system, and includes all optical information (optical data D17) of the eyeball optical system. By acquiring the optical data D17, it is possible to acquire the optical characteristics of the defocused component not only in the most focused portion in the peripheral portion of the visual field but also in a fine and wide range such as 0.25 [D].

  Next, in step ST4, the control unit 23 analyzes the optical data D17. For example, in step ST41, the control unit 23 obtains the PSF characteristics of the focus position of the measurement light at the angle θ and the positions before and after the focus. Since the measurement light passes through the eyeball optical system twice in the above-described double-pass PSF image, the double-pass PSF image shown in FIG. ) Convert to PSF image. At this time, the optical data D17 indicating the double pass PSF image is converted into the optical data D17 indicating the single pass PSF image by the same method as the conventional method.

  The converted optical data D17 is analyzed and used to determine whether or not a hyperopic back focus exists in the peripheral visual field of the fundus of the eye 2 to be examined. In the calculating part 31, the calculation which calculates | requires MTF as a function showing the transfer characteristic of a single pass PSF image, and a phase transfer function (Phase Transfer Function: PTF) is performed.

  An optical transfer function (OTF) that combines the characteristics of both the MTF and the PTF is obtained, and based on these characteristics, the image transfer characteristics of the lens of the eye 2 to be examined, in other words, the intraocular area of the subject 1 The imaging performance of the lens (the crystalline lens 42) is determined. The calculation unit 31 calculates contrast data (MTF data) reflecting low-order and high-order aberrations from the optical data D17.

  In this example, the unfocused blur of the peripheral visual field is analyzed (MTF analysis) by calculating MTF (fx, fy) in the PSF image at the most focused position. For example, the optical transfer function of the eyeball optical system of the eye 2 to be examined is OTF (fx, fy), the frequency transfer function is MTF (fx, fy), and the luminance signal component of the optical data D17 for non-focus and focus is S. (Fx, fy), S (0, 0), the horizontal spatial frequency is fx, and the vertical spatial frequency is fy.

からＭＴＦ（ｆx，ｆy）を計算する。

MTF (fx, fy) is calculated from the above.

  Based on this equation (4), for the range of ± 2.0 [D] at the angle θ, the point image intensity distribution characteristics (at 21 locations) of the non-focal point and the focal point (total of 21 locations) for every 0.25 [D] steps PSF characteristics) are calculated (see FIGS. 8A to 8L and FIGS. 9A to 9I). As a result, it is possible to perform MTF analysis on the degree of blurring of the PSF image with the best focus. The subject eyeball 2 in which the blur of the point image at the focal position of the measurement light is greatly blurred by this MTF analysis, for example, a child with a large blur of the PSF image, becomes an excluded group that cannot be treated in this intervention test, or is treated in this intervention test. It becomes possible to classify whether it is possible.

  In step ST42, the control unit 23 displays the focus and non-focus images for each 0.25 [D] step as thumbnail images on the display unit 24 in the range of ± 2.0 [D] at the angle θ. For example, the display unit 24 receives the display data D24 from the data input / output unit 33, and displays the PSF image at the most focused position, the astigmatic thumbnail image on the front focal line, and the thumbnail image of the astigmatic image on the rear focal line. They are displayed on the screen (see FIGS. 8A to 8L and FIGS. 9A to 9I).

  According to the image examples shown in FIGS. 8A to 8L and FIGS. 9A to 9I, the range of the optical axis ± 2.0 [D] of the reflected light reflected from the retina 46 at the periphery of the visual field at an angle θ = 20 °. , 21 single-pass PSF images reproduced (captured) every 0.25 [D] steps are constructed, and optical data D17 (contrast) of the single-pass PSF image converted from the double-pass PSF image shown in A of FIG. Data: MTF data)).

  The refractive powers shown in FIGS. 8A to 8L are −4.45 [D], −4.20 [D], −3.95 [D], −3.70 [D], −3.45 [D], -3.20 [D], -2.95 [D], -2.70 [D], -2.45 [D], -2.20 [D], -1.95 [D], -1 In 12 images of .70 [D], −3.45 [D] is a non-focus image on the front focal line at an angle θ = 20 °, and −1.95 [D] is at an angle θ = 20 °. It is a PSF image at the most focused position.

  9A to 9I have refractive powers of -1.45 [D], -1.20 [D], -0.95 [D], -0.70 [D], and -0.45 [D. ], −0.20 [D], 0.05 [D], 0.30 [D], and 0.55 [D] in nine images, −0.45 [D] is an angle θ = 20 °. It is a non-focus image on the back focal line in. The non-focus images shown in FIGS. 8A to 8J have a long and narrow elliptical shape with a width and a length that are large and small. The non-focus images shown in FIGS. 8L and 9A to 9I also have large and small widths and lengths, and have a long and narrow elliptical shape.

  The selection criterion for the non-focus image on the front focal line and the non-focus image on the rear focal line is, for example, a front focus at a position shifted by ± 0.25 [D] before and after the PSF image at the most focused position BFp. When the light intensity of the non-focal image on the line and the light intensity of the non-focus image on the back focal line are combined, the non-focus image on the front focal line and the rear at the symmetrical positions AFp and RFp that become the light intensity of the PSF image A non-focus image on the focal line is extracted. The other angles θ = 10 °, 30 °, and 40 ° are obtained in the same manner.

  According to the MTF-to-spatial frequency characteristic example shown in FIG. 10, the vertical axis is the MTF of the intraocular lens (the crystalline lens 42), and the contrast reduction corresponding to the spatial frequency indicating the fineness of the PSF image is reduced. Shows the percentage. The horizontal axis is the spatial frequency [c / deg].

  In the figure, the broken line is the horizontal MTF vs. spatial frequency characteristic of the PSF image, the alternate long and short dash line is the vertical MTF vs. spatial frequency characteristic of the PSF image, and the solid line is the average value of these MTF vs. spatial frequency characteristics. is there. Both characteristics are for a PSF image reproduced (simulated) at the most focused position of −1.95 [D] at an angle θ = 20 °. According to the MTF characteristics, the MTF (contrast) rapidly decreases as the spatial frequency increases (becomes a fine image). From this MTF characteristic, the optical characteristic of the crystalline lens 42 of the eye 2 to be examined can be grasped.

  Further, according to the PSF image acquisition examples shown in FIGS. 11A to 11G, there are seven PSF images at the time of the best focus of the crystalline lens eye at an angle θ = −20 to 40 °. In this example, the PSF image at the best focus of the crystalline eye shown in FIG. 11C is used as the refractive power BFR0 of the PSF image at the most focused position on the eye axis L (angle θ = 0 °).

  According to the MTF characteristic example of the crystalline eye shown in FIG. 12, the vertical axis is the MTF of the intraocular lens (the crystalline lens 42), the horizontal axis is the angle θ set at the time of measurement light irradiation, and θ = −20 to 40 °. The solid line in the figure is the MTF characteristic of the crystalline eye.

In step ST <b> 5, the control unit 23 determines whether or not a hyperopic back focus exists outside the peripheral visual field of the fundus of the eye 2 based on the MTF characteristic and the PSF characteristic. For example, the subroutine shown in FIG. 6 is called, and in step ST51, the calculation unit 31 inputs the refractive power AFLRθ of the astigmatism on the front focal line and the refractive power BFR0 of the focal point on the axial length. Next, in step ST52, the calculation unit 31
Evaluation formula A = AFLRθ-BFR0 (1)
An evaluation value A is obtained from Thereafter, the process proceeds to step ST57.

In step ST53, the calculation unit 31 inputs the refractive power BFRθ at the most focused position and the refractive power BFR0 of the focal point on the axial length. Next, in step ST54, the calculation unit 31
Evaluation formula B = BFLRθ-BFR0 (2)
An evaluation value B is obtained from Thereafter, the process proceeds to step ST57.

Further, in step ST55, the calculation unit 31 inputs the refractive power PFLRθ of the astigmatism on the rear focal line and the refractive power BFR0 of the focal point on the eye axis L. Next, in step ST56, the calculation unit 31
Evaluation formula C = PFLRθ-BFR0 (3)
An evaluation value C is obtained from Thereafter, the process proceeds to step ST57.

  In step ST57, the determination unit 32 determines whether or not the evaluation values A, B, and C are all positive values. When A, B, C> 0 is satisfied (YES), the process returns to step ST5 “the peripheral visual field has a hyperopic back focal point”. On the other hand, if A, B, C <0 (NO), the process returns to step ST5 “No hyperopic back focus in the peripheral visual field”.

Here, for the myopic eye 2 to be examined, the refractive power BFR0 of the focal point on the eye axis L is −0.3 [D], and the refractive power of the PSF image at the most focused position at an angle θ = 20 °. BFRθ is −1.5 [D], the refractive power AFLRθ of the astigmatic image on the front focal line is 0.0 [D] , and the refractive power PFLRθ of the astigmatic image on the rear focal line is −3.0 [D]. If the evaluation values are A, B, and C, it is determined whether or not there is a hyperopic back focal point.

  When these values are substituted into the expressions (1) to (3), the evaluation value A is +3, the evaluation value B is +1.5, the evaluation value C is 0.0, and the evaluation values A and B are positive values. Therefore, it can be determined that all hyperopic defocuses from the front focal line to the rear focal line exist.

  The child who has progressed myopia can expect that the focal point at the angle θ and the astigmatism on the rear focal line straddle the retina 46 and be positioned on the farsighted side. The angle θ is calculated not only for 20 °, but also for θ = 10 °, 30 °, and 40 °, and when it is determined that there is a hyperopic back focal point at one angle θ, it is calculated for another angle θ. Even if it does not perform, it can discriminate | determine that it is a myopia progress tendency. Specifically, it is possible to predict that the subject eyeball 2 is in the farsighted side of the retina 46 as shown in FIG.

  Further, for the normal eyeball 2 to be examined, the refractive power BFR0 of the focal point on the eye axis L is 0.0 [D], and the refractive power BFRθ of the PSF image at the most focused position at an angle θ = 20 °. Is -1.0 [D], the refractive power AFLRθ of the astigmatism on the front focal line is 0.0, and the refractive power PFLRθ of the astigmatism on the rear focal line is -2.0, the evaluation value Since A is 0.0, evaluation value B is −1.0, evaluation value C is −2.0, and evaluation values B and C are negative values, it can be determined that there is no hyperopic defocus. It becomes like this.

  A child whose myopia has not progressed can be predicted that the front focal line and the rear focal line at the angle θ do not straddle the retina 46 and are positioned on the myopic side of the retina 46. Specifically, astigmatism on the myopia side of the retina 46 as shown in FIG. 4 is present on the focal point and the front focal line, and it can be predicted that the eyeball 2 is not subject to myopia progression. .

  When the control unit 23 determines that “the myopia 2 does not progress myopia” in step ST5 described above, the control unit 23 informs the display unit 24 of “exclude from addition power introduction treatment” in step ST6. Is displayed.

  If the control unit 23 determines in step ST5 that “the eyeball 2 to be examined has a progress of myopia”, in step ST7, the control unit 23 displays “Apply prescription introduction of addition power” on the display unit 24. The For example, in the data analysis device 20, treatment with spectacles or a contact lens that introduces an addition power for suppressing myopia progression is prescribed from the analysis result of the degree of blurring of the point image of the focal position of the measurement light at the angle θ.

  In this step ST7, it may be determined whether or not the myopia that can be progressed can be suppressed by treatment, and how much refractive correction can be treated in the peripheral portion by adding the refractive correction to the peripheral portion. . For example, in eyeglasses or a contact lens, the addition power for returning the rear focal point outside the retina 46 at the angle θ to the myopia (intraocular) side is set around the far optical part (myopia correction lens).

  When prescribing a contact lens for suppressing myopia progression for a child with myopia of −0.3 [D] described above, around + 3 ° around the far optical part (concave lens) of −0.3 [D]. Set the near optical part (convex lens). This convex lens is for pulling back the rear focal point outside the retina 46 at an angle θ to the near vision side, and has a function different from that for both near and near vision.

  As described above, according to the myopia progression diagnosis apparatus 100 as the first embodiment, the optical data D17 in the peripheral visual field of the fundus obtained by receiving the light reflected from the retina 46 in the direction of the angle θ is analyzed. The data analysis device 20 is provided, and the data analysis device 20 has a hyperopic back focal point in the peripheral visual field of the fundus of the eye 2 based on the position of the focus of the measurement light at the angle θ and the PSF characteristics of the positions before and after the focus. It will be determined whether or not it exists.

  With this configuration, it is possible to determine (predict) the progress of myopia in the eyeball 2 to be examined, including the determination of whether or not the child's myopia will progress in the future, In adults who are supposed to stop the progression of myopia, the progression of refractive myopia that continues to progress can be easily diagnosed. This makes it possible to prescribe contact lenses and eyeglasses based on the individual child's basic data. It becomes possible to provide glasses and contact lenses suitable for the eyes of children and the like who are in the process of myopia.

  Further, according to the myopia progress diagnosis device 100, it is useful for preventing or suppressing myopia progression, such as periodically performing myopia progression determination and appropriately performing refractive correction while monitoring changes in the optical data D17 in the peripheral visual field. it can. Thereby, in the effect determination performed after a certain period of treatment, the treatment criteria can be clearly defined.

  Further, according to the myopia progression determination method, in the optical characteristics of the peripheral visual field of the fundus, the refraction of the front focal line and the rear focal line is taken into consideration, and in step ST4, the degree of blur of the point image at the focal position of the measurement light at the angle θ is determined. By the MTF analysis, the subject eyeball 2 in which the point image of the focus position of the measurement light is largely blurred can be identified (classified) as an exclusion group that cannot be treated in this intervention test or can be treated in this intervention test. Become.

  FIGS. 13A to 13G show seven PSF images when the subject 1 is an intraocular lens (IOL) eye and at the best focus at an angle θ = −20 to 40 °. Is shown. The IOL eye (intraocular lens eye) has been subjected to a method (lasik or the like) in which the crystalline lens 42 is removed by cataract surgery and an artificial crystalline lens is inserted (embedded) instead. According to the IOL eye, it becomes impossible to focus firmly on the periphery due to a large aberration component. Can be a second factor in myopia progression.

  FIG. 14 shows an example of MTF characteristics of the IOL eye. The vertical axis represents the MTF of the artificial lens (IOL eye), and the horizontal axis represents the angle θ set at the time of measurement light irradiation, where θ = −20 to 40 °. The solid line in the figure is the MTF characteristic of the IOL eye. The MTF characteristic of the IOL eye is flatter than that of the crystalline eye.

  In this example, the image diameter of the PSF image of the IOL eye is generally larger than the PSF image of the crystalline eye. It can be seen that the MTF is significantly degraded in the IOL eye. The above-described aberration component can also be identified by performing MTF analysis on the optical data D17. Since myopia progresses in IOL eyes in past reports, the introduction of the discrimination method of the present invention is effective as a method for distinguishing examples that should be excluded from intervention tests.

  In the above-described embodiment, the head of the subject 1 is fixed to the chin stand of the inspection device, and the optical data acquisition unit 10 is trajected while the fixation card 54 is fixed with a non-inspection eye. Although the case where the angle θ (optical axis) is displaced along the line 53 has been described, the present invention is not limited to this. For example, the optical data acquisition unit 10 is fixed with a child's eye to be measured, and an optical system including a point light source, a half mirror, a CCD, or the like inside the optical data acquisition unit 10 is mounted on a stage or the like.

  Then, the optical system is fixed independently to the rotating coordinate system with respect to the fixed coordinate system in which the subject 1 and the data acquisition unit main body are fixed, and the stage or the like in the rotating coordinate system is set at an angle θ (optical axis). You may take the method of displacing. Of course, a method may be adopted in which a reflecting mirror is disposed on the optical axis of the optical system, and the angle θ (optical axis) is displaced by rotationally driving the reflecting mirror. Also with these configurations, accurate optical data D17 including the front focal line and the rear focal line at the angle θ can be acquired.

  In addition, although this time demonstrated the case of the child regarding the subject 1, it cannot be overemphasized that the same effect is acquired even if it applies also to the myopia progress example in adulthood. Further, in the myopia progress diagnosis device 100 (myopia progress diagnosis system) according to the present invention, the correction power necessary for myopia suppression can be measured from the hyperopia power obtained from the data analysis device 20 (see step ST7). As described above, when the myopia begins, the axial length Lx extends rearward and the eyeball shape is distorted. However, the angle θ is set to the eye axis L that connects the approximate center vertex of the crystalline lens 42 of the eyeball 2 to the macular 45. By pulling back the hyperopic back focus from the outer position straddling the peripheral retina in the direction of formation to the inside (intraocular) of the peripheral retina, it becomes possible to suppress the progression of myopia (hereinafter referred to as myopia progression suppression theory) ).

<Contact lenses for suppressing myopia progression>
A contact lens 200 for suppressing myopia progression as a second embodiment shown in FIGS. 15A and 15B constitutes an example of a contact lens, and a rear focus control unit (hereinafter referred to as a refractive index for suppressing myopia progression) is set. The rear focal point control area 63 is provided in the peripheral region of the distance optical unit 62. The contact lens 200 according to the present invention is based on the following design basis.

  According to the myopia progression suppression theory described above, visual acuity progression due to the extension of the axial length Lx enters the eye from the peripheral part of the cornea, which becomes peripheral vision, and causes the front and rear focal points to appear in the peripheral part of the retina. It turns out that the reason is that it is tied behind. After that, since the focal distance from the retina varies depending on the difference in retinal curvature, a rear focal point control region corresponding to the retinal curvature is provided in the lens body 61, and the refractive power is set so that the rear focal point is connected to the front of the retina. A contact lens is designed in the control area 63.

  In this example, a soft contact lens is provided that focuses on the front focal line and the rear focal line based on the optical data D17 calculated by the myopia progression diagnostic apparatus 100 and aims to suppress the myopia progression of the eye 2 to be examined. is there. In FIG. 15A, the contact lens 200 has a bowl-shaped lens main body 61 having a concave central portion and a convex shape around the concave portion. As a material of the lens body 61, a member constituting a soft contact lens can be used conventionally.

  Dφ1 is the lens diameter of the lens body 61 shown in FIG. 15B, and is larger than Dφ1 = 14.0 mm to cover the cornea 41 (about 12 mm). The lens body 61 is provided with a frequency setting area I (additional area: ADD). The diameter Dφ2 of the frequency setting region I is set to about 7.0 mm because the pupil diameter Dφ3 shown in FIG. 16 is 4.6 mm on average. FIG. 16 shows an example in which the contact lens 200 is mounted on the cornea 41. The frequency setting area I includes a distance optical unit 62 and a rear focus control area 63.

The distance optical unit 62 is provided in the center region of the lens body 61, and a concave lens having a predetermined minus power for correcting myopia is disposed. The distance optical unit 62 has a width Dz , which is designed at the center of the lens when viewed from the front, and the distance optical unit 62 has a width Dz of about 2.5 mm. The reason for the width Dz = 2.5 mm is that the first purpose is to form an image around the macular 45 where cone cells are densely distributed.

Furthermore, the second object is to set the incident angle of light with little influence on the back of the retina 46 even in the vicinity of the macular 45. In this example, the remaining area obtained by subtracting the area area with the width Dz of the distance optical unit 62 from the frequency setting area I is referred to as a back focus control area 63. The power of the back focus control area 63 is determined based on the calculation formula created for the retinal curvature and the myopia progression suppression theory, regardless of the power of the myopic eye and how it is viewed.

  The reason for setting the diameter Dφ2 = 7.0 mm of the frequency setting region I described above is that a convex lens is added to form an image on the outer side of the retina 46 in the peripheral portion more in front of the retina 46 than the periphery of the macular 45. This is because the rear focus control area 63 is set within an angle of 30 ° (see FIG. 16) to control the light incident on the eye at this angle of 30 ° in order to provide power. The angle 30 ° is defined as an angle 0 ° with respect to the eye axis L connecting the substantially central vertex of the crystalline lens 42 of the eyeball 2 shown in FIG. , 24 °, 36 °, 48 ° and 60 °.

  The rear focus control area 63 is provided around the distance optical unit 62. In the rear focus control area 63, a convex lens having a predetermined plus power for suppressing myopia progression is arranged, and an eye axis L that connects the approximate center of the pupil 43 of the eyeball 2 to be examined (substantially the central vertex of the crystalline lens 42) and the macular 45. Thus, the far-focused back focus is pulled back from the outside position across the peripheral retina in the direction forming the angle θ to the inside (intraocular) of the peripheral retina.

  With respect to the refractive power of the back focus control area 63, the contact lens 200 represents the inner surface shape of the retina 46 including the macular 45 of the eye 2 to be examined by the fundus curvature radius, and the retina eye having the smallest fundus curvature radius and the fundus curvature radius are the smallest. If the retinal eye has a larger radius of curvature of the eyeball than the average retinal eye, based on the average retinal eye obtained by averaging the largest retinal eye, the average retinal eye If the retinal eye has a smaller radius of curvature of the fundus of the eye than the average retinal eye, a refractive power stronger than that of the average retinal eye is set. Is.

  In this example, the area outside the frequency setting area I is an area having no frequency, and the area between the area having no frequency and the area where the frequency is set is a loose junction (connection part; boundary part). ing. The sudden change in shape and frequency is to cause image jumps and distortions in the peripheral part of the field of view. In this example, the design has a zone (transition zone) in which the lens tip (outermost side) is gradually changed.

  The above-described contact lens 200 for suppressing myopia progression can be manufactured based on the basic data of the optical characteristics of the peripheral visual field of the eye 2 to be examined and the calculation formula. For example, in the contact lens 200, the myopia power of the distance optical unit 62 is arranged at the center, and the rear focus control area 63 obtained by the calculation formula is arranged at the periphery thereof.

If the distance Dz (area) of the distance optical unit 62 is set too wide, a large amount of light that enters the eye from the distance optical unit 62 reaches the periphery of the retina. In order to prevent this light from reaching the periphery of the retina, it is desirable to make the width Dz of the distance optical unit 62 as narrow (small) as possible.

The width Dz is also designed based on data calculated by a calculation formula. As described above, the feature of the present invention is that the area of the distance optical unit 62 in which the refractive power for the distance vision is contained is significantly smaller than the conventional contact lens for vision correction.

  The reason why the above-described contact lens 200 is a soft contact lens is that when the lens body 61 moves greatly on the cornea 41 due to blinking (blinking), the quality of appearance such as contrast is degraded by halo and glare. This is because the lens needs to have a small movement. Here, halo refers to the after-effects translated as annulus, accompanied by the symptoms that a ring-like light can be seen around the light. Depending on the type of light, the light itself may appear round and blurred. In any case, it feels dazzling because it is larger than the original light. Glare is a sequelae translated as radiance, and is accompanied by symptoms in which the light is more glaring and dazzling. Some people say that it looks blurred.

  Thus, according to the contact lens 200 as the second embodiment, the refractive index for suppressing myopia progression is set, and the rear focus control area 63 provided in the peripheral region of the distance optical unit 62 is provided. The far-focused back focus is pulled back from the outer position across the peripheral retina in the direction forming the angle θ of the optometry ball 2 to the inner side (intraocular) of the peripheral retina.

  With this configuration, the subsequent progress of myopia with respect to the subject's eyeball 2 in a myopic state without depending on the near view, which is the purpose of the bifocal lens, or without depending on the near view. Can be suppressed. Since the contact lens 200 according to the present invention is intended to suppress myopia progression, it is designed so that the light from the distance optical unit 62 is imaged on the macular 45 which is the center of the retina 46 in the distance vision. However, it is not intended to image the focal point of the back focus control area 63 on the macular 45.

  Therefore, since the refractive power of the rear focus control area 63 is determined by an objective examination by the myopia progression diagnostic apparatus 100, the visual appearance of the distance optical unit 62 is not improved. This is a major difference from the target existing bilateral contact lens. On the other hand, the existing bilateral contact lenses for vision correction aim to improve the perceptual distance and near vision and how clear images can be obtained, preventing ghosts and glare. At the same time, the distance optical unit 62 ′ and the near optical unit 63 ′ are designed for the purpose of preventing image jump (see FIG. 30).

  The contact lens 200 of the present invention is designed to move the image on the peripheral retina other than the macular 45, which is the central part of the retina 46, to the front of the retina 46. Thereafter, the refractive power of the focus control area 63 is set. There is a great difference in that it is determined by the angle (θ = 30 °) incident on the cornea 41.

  Further, in the peripheral power other than the distance optical unit 62, the existing vision correction and both near and far contact lenses must prescribe the power according to individual differences. However, since the human eyeball has an average size, it is possible to determine the specifications by performing several types of frequency designs based on the average eyeball size. Then, there is a merit that it leads to simplification of manufacturing. The soft contact lens is formed by, for example, injection molding by injecting a lens resin material into a mold that integrally represents the concave lens of the distance optical unit 62, the convex lens of the back focus control area 63, and the surrounding area. It is obtained by doing.

  The contact lens 200 described above is completely different from a general contact lens for correcting visual acuity, and the power provided in the rear focus control area 63 has nothing to do with the power of the distance optical unit 62 provided in the center. Neither is it related to the correction power required by the user. It is determined only by the difference in retinal curvature. Therefore, even if the eyes have the same myopia power and the same accommodation power, when the retinal curvature is different, the power of the rear focus control area 63 installed in the lens body 61 is different. For this reason, it is not intended to improve the near vision according to the frequency of the rear focus control area 63.

  In addition, like a general bilateral contact lens, by moving the lens body 61 on the cornea 41 by blinking or changing or moving the line of sight, the visual axis is moved to a place with a different addition power to What is not shown is another feature different from other contact lenses for correcting vision. For this reason, the point which is devised so that the lens main-body part 61 may not move on the cornea 41 by the blink or the change of eyes | visual_axis is also the characteristics.

  Further, since the contact lens according to the present invention is a contact lens for suppressing myopia, the distance optical unit 62 in front view also has a back focal point of the retina 46 around the macular 45 based on the myopia progression suppression theory. It is also characterized in that the distance optical unit 62 is remarkably narrow as compared with a general contact lens for correcting visual acuity in order to obtain a minimum angle with little influence on the back.

  Further, the frequency provided in the back focus control area 63 must be determined based on the myopia progression suppression theory. If the addition power is determined easily, the back focus cannot be moved to the front of the retina, and the purpose of suppressing the progression of myopia cannot be exhibited.

<Contact lens selection method>
Subsequently, an example of selecting a lens for suppressing myopia progression as an example will be described. Prior to this, first, with reference to FIGS. 17 to 23, a description will be given of the myopic eye correction and the contact lens 200 according to type.

  FIG. 17 is a graph showing the relationship between the angle from the macular 45, which is the center of the retina 46, and visual acuity. In FIG. 17, the vertical axis represents the relative value of visual acuity and indicates visual acuity 0.025 to 1.0. The horizontal axis is the frequency (angle) from the fovea (macular 45), and the position of the macular 45 on the eye axis L is 0 °. The nose side has a frequency of 0 ° to 70 ° and the ear side has a frequency of 0 ° to 60 °.

  According to the example of the relationship between visual acuity and power shown in FIG. 17, the visual acuity shows the highest value in the vicinity of the power of 0 °. Since the density of pyramidal cells decreases rapidly when the fovea is off, the visual acuity also decreases. In the figure, the hatched line near the frequency of 14 ° to 18 ° indicates a blind spot. The image cannot be recognized with this blind spot as a boundary. In other words, the image is not recognized as an image even when focused on the peripheral retina. This phenomenon is applied to the contact lens 200 of the present invention.

  That is, since the contact lens 200 of the present invention is intended to suppress myopia, in the distance vision, the light from the distance optical unit 62 is imaged around the macular 45 where cone cells are densely distributed. Designed to. However, the contact lens 200 does not have an optical area for designing a wide field of view. The reason for this is that, as shown in FIG. 17, the visual acuity is best at the central vision in the fovea of the macular 45, and the visual acuity drops rapidly when it is off the center.

In the visual field, the central visual acuity is the most sensitive and worse in the peripheral retina. When the central visual acuity is 1.0, the visual acuity is about 0.4 when the line of sight is shifted by 2 ° (angle), and is about 0.1 when the line of sight is shifted by 5 °. It is known to decline. From this, in the contact lens 200 according to the present invention, when the addition power (optical) area of the distance optical unit 62 provided at the center is set to a width Dz = 2.5 mm, A visual field of several degrees can be secured. In other words, the visual field for obtaining the required visual acuity is sufficiently secured at 2.5 mm.

  By the way, according to the myopia correction example (part 1) shown in FIG. 18, myopia is in a state where the focal point f is in front of the macular 45 which is the center of the retina 46. In this myopic state, the front focal point a and the rear focal point b that enter the eye from the peripheral part of the cornea 41 and appear in the peripheral part of the retina are both connected to the front of the retina 46. When the focal point f is moved to f ′ so as to form an image on the macular 45 of the part, the front focal point a moves to a ′, and the rear focal point b moves to b ′. As a result, the back focal point b ′ is connected behind the retina 46.

  In this example, a front focal contour T indicated by a one-dot chain line and a rear focal contour S indicated by a broken line are generated depending on an incident angle (angle θ; actually a solid angle) of light into the eye. Here, the front focal contour T refers to an arc drawn by sequentially connecting non-focal points having the same PSF characteristic on the front focal line obtained for each angle θ. The rear focal contour S is an arcuate shape in which non-focal points having the same PSF characteristic are connected in order on the rear focal line obtained for each angle θ. The lowest point of each arc of the rear focal contour S and the front focal contour T slides on the eye axis L and moves to the position of the macular 45. In the figure, rs is the radius of the rear focal contour S, and is the length from the origin Ox on the eye axis to the rear focal contour S.

  The degree of progression of myopia can be grasped by the difference in the shape of the fundus curvature of the eyeball 2 to be examined, for example, the size of the fundus curvature radius rx. In the figure, rx indicated by x = a, b, and c is the fundus curvature radius of the myopic eye, and is the length from the origin Ox on the eye axis to the retina 46. By finding the distance between the position of the rear focal contour S and the position of the retina 46, the degree of myopia progression can be determined. In order to suppress the progress of this myopia, the rear focus isoline S may be moved before the retina 46 of the myopic eye after myopia correction. For this purpose, a rear focus control area 63 having a frequency completely irrelevant to the hyperopia correction may be provided in the periphery of the distance optical unit 62.

  In addition, according to the correction example (part 2) of the myopic eye shown in FIG. 19, the case is the case of the retina 46 having a large (loose) fundus curvature radius ra as compared to the fundus curvature radius rx of the myopic eye shown in FIG. The fundus curvature radius ra is a length from the origin Oa on the eye axis to the retina 46. In this case, since both the moved front focal point a 'and rear focal point b' move to the front of the retina 46, it is a case where the prefocus control area 63 for suppressing myopia progression is hardly required. According to this case, even when a mildly convex lens is set in the rear focus control area 63, the rear focus contour S can be easily moved to the front of the retina 46.

  On the other hand, according to the correction example (part 3) of the myopic eye shown in FIG. 20, the retina 46 has a fundus curvature radius rc smaller than the fundus curvature radius rx of the myopia shown in FIG. The fundus curvature radius rc is a length from the origin Oc on the eye axis to the retina 46. In this case, since the moved focal point b 'is further moved to the rear and farther than the retina 46, it is a case where prescription of the rear focal point control area 63 for suppressing myopia progression is indispensable. According to this case, it is necessary to set a strong power convex lens in the back focus control area 63 in order to pull the back focus contour S back to the front of the retina 46 (inside the eye).

  Here, regarding the rear focus control area 63 for suppressing myopia progression, a prescription for setting (inserting) a light lens having a light power is set as type Ta, a prescription for setting a convex lens having a power higher than that of type Ta is set as type Tb, A prescription for setting a convex lens having a higher power is referred to as type Tc. For example, the refractive power of type Ta is set to +1, the refractive power of type Tb is +3, the refractive power of type Tb is set to +5, and the like.

  In this example, if the fundus curvature radius rx of the eyeball 2 to be examined obtained from the myopia progression diagnosis apparatus 100 is known, it is possible to determine which type Ta, type Tb, or type Tc back focus control area 63 is suitable. It becomes like this. According to the prescription example of the contact lens 200 of type Ta shown in FIG. 21, the rear focal contour S generated in the peripheral portion of the retina due to the correction of myopia is immediately in front of the retina 46. This is a case of a retinal eye having a large (loose) fundus curvature radius ra compared to the fundus curvature radius rx of the myopic eye shown in FIG.

  In this case, since the influence of the rear focal point b after correction is small even in the peripheral portion of the retina, the refractive index provided in the rear focal point control area 63 moves the rear focal contour S forward of the retina 46 even if the degree of refraction is extremely slight. be able to. Accordingly, a contact lens 200 of type Ta is prescribed. In this example, it is also a case that does not require prescription.

  Next, according to the prescription example of the type Tb contact lens 200 shown in FIG. 22, the rear focal contour S generated in the peripheral portion of the retina due to the correction of myopia is immediately behind the retina 46, and the rear focal contour S and This is the case of a retinal eye that is close to the retina 46 and that has the fundus curvature radius rx and the fundus curvature radius rb of the myopic eye shown in FIG. In this case, the refractive power provided in the back focal point control area 63 can be moved to the front of the retina 46 by setting a power higher than that of the retinal eye having a large fundus curvature radius ra. Therefore, a contact lens 200 of type Tb is prescribed.

  Finally, according to the prescription example of the contact lens 200 of type Tc shown in FIG. 23, the rear focal contour S generated in the peripheral portion of the retina due to the correction of myopia is located farther from the retina 46, and the rear focus In this case, the distance between the contour line S and the retina 46 is long, and the fundus curvature radius rc is smaller (tight) than the fundus curvature radius rx of the myopic eye shown in FIG. In this case, the refractive power provided in the back focus control area 63 is set to a higher power than that of the retinal eye having a large fundus curvature radius ra, so that the back focal contour S can be moved in front of the retina 46. Therefore, a contact lens 200 of type Tc is prescribed.

  Subsequently, some prescription examples of the contact lens 200 will be described with reference to FIGS. 21 to 29D. In these prescription examples, the refractive power for correcting myopia corresponding to the visual acuity of the eyeball 2 to be examined is set in the center region of the lens main body 61 to form the distance optical unit 62, and type in the peripheral region of the distance optical unit 62. A plurality of contact lenses 200 having a refractive index for suppressing myopia progression selected from Ta to Tc and set as the back focus control area 63 are prepared in advance, and from among them, the eyeball 2 to be examined is applied. It is assumed that one optimal contact lens 200 is prescribed.

  In the first example, the types Ta to Tc of the back focus control area 63 are determined based on whether the fundus curvature shape of the eyeball 2 to be examined is inside or outside with respect to the leveled back focal contour S. Was set. For this setting, when the inner surface shape of the retina 46 including the macular 45 of the eye 2 to be examined is represented by the fundus curvature radius rx, the retinal eye having the smallest fundus curvature radius rx and the retinal eye having the largest fundus curvature radius rx Are obtained to obtain a retinal eye having an average fundus curvature radius rx, and the average retinal eye obtained here is used as a reference (leveling) (FIG. 22). In this example, the posterior focal contour S of the average retinal eye is used as a comparison reference line when selecting types Ta to Tc. It is assumed that the rear focal contour S is reproduced from the leveled S curve data Ds. The S curve data Ds is image data for drawing the rear focal contour S of the radius rs.

  With these as selection conditions, for example, the control unit 23 is called from step ST7 shown in FIG. 5 and the control unit 23 in step ST71 shown in FIG. 24, the refractive power Rx of the far-field optical unit 62 of the eye 2 to be examined, fundus shape data Input DIN and S curve data Ds. The refractive power Rx, the fundus shape data DIN, and the S curve data Ds are read from, for example, the memory unit 34 and input to the calculation unit 31 and the determination unit 32.

  Next, in step ST72, the control unit 23 calculates the fundus curvature radius rx of the eyeball 2 to be examined. For example, the calculation unit 31 has at least two or more measurement points (symmetric positions) on the inner peripheral surface of the left and right retinas 46 of the eye axis L connecting the substantially central vertex (see FIG. 2) of the crystalline lens 42 of the eyeball 2 to be examined and the macular 45. ) Set p1 to p3, and calculate the fundus curvature radius rx from the axial length L1 obtained by measuring the depth to the measurement points p1 to p5 with the eye 2 to be examined and the depth information of each measurement point p1 to p5. To do. The fundus curvature radius rx is obtained by obtaining an arc (fundus curvature) having an arc length La and an arrow height h shown in FIG. 25A, superposing them using a known arc as a parameter, and matching the two arcs with each other. It is obtained by reading '.

  Next, in step ST73, the control unit 23 determines whether the refractive power type of the back focus control area 63 of the eye 2 to be examined is Ta or other than Ta. At this time, the discrimination unit 32 compares the rear focal contour S of the radius rs and the fundus curvature radius rx of the eyeball 2 to be examined. For this comparison, a pattern recognition method may be employed.

  In this example, when the retinal eye has a fundus curvature radius ra larger than the radius rs of the posterior focal contour S of the average retinal eye as shown in FIG. 21 (slow curvature shown in FIG. 25B). Since the determination unit 32 determines that the type of the fundus curvature radius ra is Ta, the process proceeds to step ST74. In step ST74, the control unit 23 performs display control for prescribing a contact lens of refractive power Rx + type Ta.

  The display unit 24 receives the display data D24 from the data input / output unit 33, and based on the display data D24, “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Ta”. Is displayed. As a result, it is possible to automatically select (prescribe) the contact lens 200 having a refractive power that is weaker than the average refractive power of the retinal eye.

  When the refractive power type of the back focal point control area 63 of the eyeball 2 to be examined is other than Ta in step ST73 described above, the control unit 23 proceeds to step ST75 and the control unit 23 performs the back focal point radius rx of the eyeball 2 to be examined. It is determined whether the type of the control area 63 is Tb or Tc. At this time, as a result of comparing the radius rs of the back focus isoline S and the fundus curvature radius rx of the eyeball 2 to be examined, the radius rs of the back focus isoline S and the fundus curvature radius rx are almost as shown in FIG. If they are equal (average curvature shown in FIG. 25B), the determination unit 32 determines that the type of the fundus curvature radius rb is Tb, and the process proceeds to step ST76. In step ST76, the control unit 23 performs display control for prescribing the contact lens 200 of refractive power Rx + type Tb.

  The display unit 24 displays based on the display data D24 that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tb”. As a result, it is possible to automatically select (prescribe) the contact lens 200 in which the refractive power substantially equal to the refractive power of the average retinal eye is set.

  Further, when the fundus curvature radius rx of the eyeball 2 to be examined is smaller than the radius rs of the back focal contour S in step ST75 described above (the tight curvature shown in FIG. 25B), the determination unit 32 determines the eyeball to be examined. Since it is determined that the type of the back focus control area 63 of the fundus curvature radius rc of 2 is Tc, the process proceeds to step ST77. In step ST77, the control unit 23 performs display control for prescribing the contact lens 200 of refractive power Rx + type Tc.

  The display unit 24 displays based on the display data D24 that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tc”. Thus, in the first embodiment, the contact lens 200 having a refractive power higher than the average refractive power of the retinal eye can be easily and automatically selected (prescription). Thereafter, the process returns to step ST7 shown in FIG.

  In the second embodiment, in the intraocular cross-sectional view of the eyeball 2 to be examined shown in FIG. 26, the non-focal point on the rear focal line existing on the optical axis at an angle θ, for example, θ = 40 ° (θmax) (hereinafter simply referred to as the rear). An example in which the types Ta to Tc of the rear focus control area 63 are determined based on the optical data D17 (refer to FIG. 2) indicating the position RFp of the focal point b ′) and the optical data D17 indicating the position Mp of the retina 46. I will give you. In this example, the angle θ = 40 ° is a portion where a difference between the position RFp of the back focal point b ′ and the position Mp of the retina 46 appears greatly.

  For example, when the rear focal point b ′ (see FIG. 19) is located inside the retina 46 on the optical axis at an angle θ = 40 °, the type Ta is used, and when the rear focal point b ′ is located outside the retina b ′, the retina is located. The remaining types Tb and Tc are determined based on the degree of separation of the rear focal point b ′ with respect to the 46 position Mp. Of course, the angle θ is not limited to θmax = 40 °, and the case of θ <40 ° or less may be extracted and the types Ta to Tc may be determined.

  With these as selection conditions, for example, it is called from step ST7 shown in FIG. 5, and in step ST71 ′ shown in FIG. 27, the refractive power Rx of the distance optical unit 62 and the back focal point b ′ of the angle θ = 40 °. The optical data D17 indicating the position RFp and the position Mp of the retina 46 are input. The data of the position RFp and the position Mp is obtained from the optical data D17, and is, for example, information indicating the optical axis length (depth) from the surface apex portion of the crystalline lens 42 to the position RFp, the position Mp, and the like. Here, the optical axis length from the surface apex part to the position RFp is set as the depth Lr, and the optical axis length from the surface apex part to the position Mp is set as the depth Lm (see FIG. 26).

  Next, in step ST <b> 72 ′, in the control unit 23, the calculation unit 31 calculates the depth difference Δd = Lr−Lm. Here, the depth difference Δd means a difference distance between the position Mp of the retina 46 and the position RFp of the back focal point b ′ at the angle θ.

  Next, in step ST73 ', the control unit 23 determines whether the refractive power type of the back focus control area 63 of the eye 2 to be examined is Ta or other than Ta. At this time, the determination unit 32 determines whether the depth difference Δd is plus (+) or minus (−), and the control unit 23 branches the control. Here, when the depth difference Δd is plus (+), the rear focal point b ′ exists outside the retina 46, and when the depth difference Δd is minus, the rear focal point b ′ does not exist outside the retina 46. Is the case.

  In this example, as shown in FIG. 21, when the retinal eye has a larger fundus curvature radius rx of the eyeball 2 to be examined than the posterior focal contour S of the average retinal eye, that is, the depth difference Δd is negative. In this case, since it is determined that the rear focal point b ′ does not exist outside the retina 46, the process proceeds to step ST74 ′. In step ST <b> 74 ′, the control unit 23 performs display control for prescribing a contact lens of refractive power Rx + type Ta.

  The display unit 24 receives the display data D24 from the data input / output unit 33, and based on the display data D24, “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Ta”. Is displayed. As a result, it is possible to automatically select (prescribe) the contact lens 200 having a refractive power that is weaker than the average refractive power of the retinal eye.

  If the depth difference Δd is positive (+) in step ST73 ′ described above, in step ST75 ′, the control unit 23 determines whether the refractive power Rθ type of the rear focus control area 63 is Tb or Tc. . In this example, when the depth difference Δd is positive, the back focal point b ′ is present outside the retina 46. Further, a value (1/2) of the average retinal eye depth difference Δd is used as a reference (threshold value Δdth). To determine.

For example, the depth difference Δd of the eye 2 to be examined is compared with the threshold value Δdth. If the depth difference Δdth is smaller than the threshold value Δdth, the type is Tb. If the depth difference Δd is larger than the threshold value Δdth, the type is Tc. The threshold value Δdth is set as ½ of the average depth difference Δd of the retinal eye. On the optical axis at the angle θ = 40 °, the retinal eye with the smallest depth difference Δd and the retinal eye with the largest depth difference Δd. Is obtained by averaging. (See FIG. 26).

  In this example, as shown in FIG. 22, when the average retinal eye and the fundus curvature radius rx of the subject eyeball 2 are substantially equal, that is, when the depth difference Δd of the subject eyeball 2 is compared with the threshold value Δdth. Although the rear focal point b ′ is located outside the retina 46, the position RFp of the rear focal point b ′ and the position Mp of the retina 46 are measured at substantially the same position. In this case, since the type of the refractive power Rθ of the rear focus control area 63 is determined to be Tb, the process proceeds to step ST76 '.

  In step ST76 ', the control unit 23 performs display control to prescribe a contact lens of refractive power Rx + type Tb. Based on the display data D24, the display unit 24 displays that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tb”. As a result, it is possible to automatically select (prescribe) the contact lens 200 in which the refractive power substantially equal to the refractive power of the average retinal eye is set.

If the depth difference Δd is larger than the threshold value Δdth in step ST75 ′ described above, it is determined that the type of the back focus control area 63 is Tc , and the process proceeds to step ST77 ′. In step ST77 ′, the control unit 23 performs display control for prescribing the contact lens 200 of refractive power Rx + type Tc.

  The display unit 24 displays based on the display data D24 that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tc”. As a result, in the second embodiment, the contact lens 200 having a refractive power higher than the refractive power of the average retinal eye can be easily and automatically selected (prescription). Thereafter, the process returns to step ST7 shown in FIG.

  Next, an example of determining types Ta, Tb, and Tc from the axial length Lx and the fundus curvature shape will be described with reference to FIGS. 28A to 28D. In this example, in the myopia progression diagnostic apparatus 100, the axial length is based on fundus shape data DIN obtained from a fundus image acquisition apparatus such as a refractometer instead of the optical data acquisition unit 10 or a posterior eye OCT (Optical Coherence Tomography). Lx was measured, and the types Ta, Tb, and Tc of the back focus control area 63 were determined from the axial length Lx and the average fundus curvature shape.

  For example, when the eyeball 2 to be examined shown in FIG. 28A has an axial length Lx = 23 mm and an average fundus curvature shape C23 as shown by a solid line in FIG. 28D, type Ta is prescribed. This makes it possible to prescribe the contact lens 200 having a refractive power that is weaker than the refractive power of the average retinal eye.

  In addition, when the eyeball 2 to be examined shown in FIG. 28B has an axial length Lx = 24 mm and an average fundus curvature shape C24 as shown by a broken line in FIG. 28D, type Tb is prescribed. This makes it possible to prescribe the contact lens 200 having a refractive power that is approximately equal to the refractive power of the average retinal eye.

  Furthermore, when the eyeball 2 to be examined shown in FIG. 28C has an axial length Lx = 25 mm and an average fundus curvature shape C25 as shown by a two-dot chain line in FIG. 28D, type Tc is prescribed. As a result, it is possible to easily prescribe the contact lens 200 in which a refractive power higher than that of the average retinal eye is set.

  Thus, when the discrimination method as described in the first and second embodiments cannot be adopted, the back focus control area 63 is based on the minimum fundus shape data DIN obtained from the optical data acquisition unit such as a refractometer. Types Ta, Tb, and Tc can be determined.

  Next, an example of determining types Ta, Tb, and Tc corresponding to the fundus curvature shape from the predicted axial length Lx will be described with reference to FIGS. 29A to 29D. In the average eyeball 2 shown in FIG. 29A, the axial length Lx is about 23.0 mm, and the diameter of the cornea 41 is about 12.0 mm. The thickness of the central part of the cornea 41 is about 0.5 mm, and the thickness of the peripheral part is about 0.7 mm.

  The diameter of the crystalline lens 42 is about 9.0 mm, the thickness of the crystalline lens 42 is about 3.6 mm, and the thickness of the anterior chamber 47 is about 3.3 mm. Here, when 1 mm of the axial length Lx is 3.00 [D], the corneal refractive power is 43.0 [D], and the crystalline lens refractive power is 20.0 [D]. When both are added, the combined value is 63.00 [D]. If, for example, lens refractive power = 20.00 [D] is subtracted from the refractive power data of the composite value, corneal refractive power = 43.0 [D] is obtained, and the axial length Lx is obtained based on 43.0 [D]. Therefore, types Ta, Tb, and Tc are determined based on the axial length Lx. Of course, if corneal refractive power = 43.0 [D] is known, it is used.

  In this example, the myopia progression diagnostic apparatus 100 uses optical data indicating corneal refractive power and refractive power such as myopia (myopia power) based on fundus shape data DIN obtained from a refractometer or the like instead of the optical data acquisition unit 10. The eye axis length Lx is predicted, and the types Ta, Tb, and Tc of the back focus control area 63 corresponding to the fundus curvature described with reference to FIGS. 28A to 28D are further determined from the eye axis length Lx.

  For example, when the corneal refractive power of the eyeball 2 to be examined shown in FIG. 29A is 43.0 [D], it can be predicted that the axial length Lx is an average Lx = 23 mm. Therefore, it can be predicted that the fundus has an average fundus curvature shape C23 as shown by a solid line in FIG. 28D. In this case, type Ta is prescribed.

  When the corneal refractive power of the eyeball 2 to be examined shown in FIG. 29B is 43.0 [D] and the myopia power is −3.00 [D], the axial length Lx is Lx = 24 mm. Can be predicted. Accordingly, it can be predicted that the fundus has a fundus curvature shape C24 as shown by a broken line in FIG. 28D. In this case, type Tb is prescribed.

  Furthermore, when the corneal refractive power of the eyeball 2 to be examined shown in FIG. 29C is 40.0 [D], it can be predicted that the axial length Lx is Lx = 25 mm. Accordingly, it can be predicted that the fundus has a fundus curvature shape C25 as shown by a two-dot chain line in FIG. 28D. In this case, type Tc is prescribed.

  Thus, when the discrimination method described in the first and second embodiments cannot be adopted, the types Ta, Tb, and Tc of the back focus control area 63 are changed based on the fundus shape data DIN obtained from the refractometer or the like. You can decide.

  Here, with reference to FIG. 30 and FIG. 31, the effect of the contact lens 200 for suppressing myopia progression according to the present invention and the spectacle lens 300 for suppressing myopia progression as a comparative example will be compared. A spectacle lens 300 shown in FIG. 30 is designed based on the myopia progression suppression theory according to the present invention, and has a lens body portion 61 ′ having a distance optical portion 62 ′ and a near optical portion 63 ′. Yes. According to the spectacle lens 300, when the focal point of light from the center is at the center of the macular 45 when viewed from the front, the front focal point a and the rear focal point b at the periphery of the retina are also in front of the retina 46, and there is no problem. Does not occur.

  However, in the case of the eyeglass lens 300, unlike the contact lens 200, the eyeball is a part having a movement independent of the head, so that only the eyeball is moved to change the line of sight as shown in FIG. When viewed, or when it happens to be near in the addition power area, the focal point of the light from the area of the distance optical unit 62 ′ provided in the center of the lens is in the vicinity of the retina 46, rather than the back of the retina, It moves quite far away.

  For this reason, when assuming the purpose of suppressing myopia progression due to the extension of the axial length Lx, the spectacle lens 300 not only provides the effect, but also gives an uncomfortable feeling to the appearance such as image distortion and jumping, There are concerns about problems such as eye strain that can cause visual impairment. In this regard, with the contact lens 200 of the present invention, even if only the eyeball is moved and the object is changed, such as the contact lens 200, the correction tool that continuously forms light on the macular 45 from the distance optical unit 62 provided at the center. Therefore, the above-mentioned problem does not occur.

  Thus, according to the selection method of the contact lens 200 as the first and second embodiments, one contact lens 200 is selected from the plurality of contact lenses 200 corresponding to the fundus curvature shape of the subject 1. To come.

  With this configuration, it is possible to select (prescribe) the contact lens 200 having an optimum refractive power suitable for the progress of myopia. Accordingly, the contact lens 200 having a refractive power weaker than the refractive power of the average retinal eye is easily prescribed for the subject 1 who is a retinal eye having a fundus curvature radius rx larger than that of the average retinal eye. The contact lens 200 having a refractive power stronger than the refractive power of the average retinal eye can be easily prescribed for the subject 1 who is a retinal eye having a fundus curvature radius rx smaller than that of the average retinal eye. It becomes like this.

  The present invention is a myopia progression diagnostic system for diagnosing the possibility of future progression of myopia in children and adults, determining the therapeutic effect and prospects, and treating them, and particularly for “children who are applied in clinical practice in the future” It is extremely suitable for application to a central system of “diagnosis, measurement, and treatment in myopia suppression therapy”.

DESCRIPTION OF SYMBOLS 10 Optical data acquisition part 13 Light irradiation part 14 Light detection part 20 Data analysis apparatus (data analysis part)
24 Display unit 31 Calculation unit
32 Discrimination part 61 Lens body part 62 Optical part for distance 63 Rear focus control area (rear focus control part)
100 Myopia Progress Diagnosis Device 200 Contact Lens

Claims (8)

A light irradiation unit that irradiates measurement light to the retina in a direction that forms an angle θ with respect to an eye axis that connects the approximate center of the pupil of the eyeball to the macula;
A light detection unit that receives light reflected from the retina and acquires optical data in the peripheral visual field of the fundus; and
Wherein a to the Determine whether the focus after hyperopic the fundus peripheral vision of the subject eyeball is present Lud over data analysis unit analyzes the optical data,
The data analysis unit
The position of the focal point of the measurement light most focused on the optical axis at the angle θ, the position of the front focal point located on the front side of the focal point on the optical axis, and the rear side of the focal point on the optical axis A calculation unit for obtaining a point image intensity distribution characteristic of the position of the back focal point located at
A myopia progression diagnostic apparatus comprising: a determination unit configured to determine whether or not a hyperopic back focal point exists in a peripheral visual field of the fundus of the eyeball based on the point image intensity distribution characteristics . The computing unit is
The refractive power of the position of the focal point of the measuring light, the front refracting power of the position of the focus and myopia progression diagnostic apparatus according to claim 1 for calculating the refractive power of the position of the rear focal point for each of the angle theta. The computing unit is
Refraction of the focus position of the measurement light at the eye axis (θ = 0 °) from the refractive power of the focus position of the measurement light, the refractive power of the front focus position, and the refractive power of the back focus position, respectively. Calculate each difference minus the frequency,
The discrimination unit
The myopia progression diagnostic apparatus according to claim 1 , wherein both of the differences are positive values or negative values. The myopia progression diagnosis apparatus according to claim 2 , further comprising a display unit that displays a point image of the focus position of the measurement light, an astigmatism image of the front focus, and an astigmatism image of the rear focus for each angle θ. The data analysis unit
The myopia progress diagnosis apparatus according to claim 1 , wherein the degree of blurring of the point image at the focal position of the measurement light is analyzed to determine whether or not treatment with a contact lens into which an addition power for suppressing myopia progression is possible is possible. A myopia progression diagnostic device for diagnosing the progression of myopia of the eye to be examined,
A first step of irradiating the retina in the direction of an angle θ with respect to the eye axis line connecting the approximate center of the pupil of the eyeball and the macula;
A second step of receiving light reflected from the retina and acquiring optical data in the peripheral visual field of the fundus;
And a third step of determining whether the focus after hyperopic the peripheral vision of the fundus of the subject eye by analyzing the optical data exists,
In the third step,
The position of the focal point of the measurement light most focused on the optical axis at the angle θ, the position of the front focal point located on the front side of the focal point on the optical axis, and the rear side of the focal point on the optical axis Obtaining a point image intensity distribution characteristic of the position of the back focal point located at
Determining whether there is a hyperopic back focal point in the peripheral visual field of the fundus of the eyeball based on the point image intensity distribution characteristics;
A method for determining myopia progress. A computer-readable program for executing the myopia progression determination method according to claim 6 . A storage medium in which the computer-readable program according to claim 7 is described.

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