JP6645003B2 - Ophthalmic examination information processing apparatus and ophthalmic examination information processing program - Google Patents

Description

  The present invention relates to an ophthalmic examination information processing apparatus for handling examination data of an eye to be inspected, and an ophthalmic examination information processing program.

  Various modalities such as an ophthalmic optical coherence tomography (OCT), a fundus camera, a laser scanning ophthalmoscope (SLO), a perimeter, and the like as an ophthalmic examination apparatus for examining an eye to be examined. It has been known. In addition, a combo machine having a plurality of modalities has been proposed, and an image obtained by one modality and an image obtained by another modality (that is, another modality image) are displayed on the same screen (Japanese Patent Application Laid-Open No. H10-163873). 1).

JP 2013-056274 A

  By the way, there are cases where images are respectively acquired in different shooting modes in the first modality. For example, in a combined apparatus of an OCT and a fundus camera, a first mode for continuously acquiring an OCT image and a color fundus image and a second mode for separately acquiring an OCT image or a color fundus image may be provided. is there. In OCT, an OCT image is often obtained at different scanning positions or scanning patterns, and the second mode is often used.

  However, in the conventional device, when the first mode is used, the OCT image and the color fundus image can be displayed as a set, but the OCT image obtained in the second mode is the same as the color fundus image. It is difficult to display as a set. Alternatively, in order to display each OCT image and the color fundus image as a set, there may be a method of performing the first mode a plurality of times, but it is necessary to perform the imaging a plurality of times, which is a burden on the eye to be examined.

  The present invention has been made in consideration of the above problems, and has as its technical object to provide an ophthalmic examination information processing apparatus and an ophthalmic examination information processing program that can easily confirm examination data obtained by different ophthalmic examination units.

  In order to solve the above problems, the present invention is characterized by having the following configuration.

(1) First examination data of the subject's eye obtained by the first ophthalmic examination unit, the first examination data being image data, and the first examination data of the subject's eye obtained by the second ophthalmic examination unit. An ophthalmologic examination information processing apparatus that stores second examination data in a storage unit and outputs the same to a display unit,
A plurality of first examination data having different imaging modes set at the time of examination by the first ophthalmic examination unit, and the second examination data obtained on the same day as the first examination data. Group setting means to associate as the same group;
Instruction reception for receiving a selection instruction for selecting any of the plurality of first inspection data stored in the storage unit and displayed on the display unit on the display unit Means,
The first inspection data selected and instructed by the instruction receiving means is displayed on the display unit, and the second inspection data associated as the same group with the first inspection data instructed by the selection is stored in the storage unit. Display control means for extracting and displaying the first inspection data on the display unit simultaneously with the first inspection data;
It is characterized by having.
(2) First examination data of the eye to be inspected obtained by the ophthalmic optical coherence tomography unit, the first examination data being image data, and an ophthalmic examination unit different from the ophthalmic optical coherence tomography unit An ophthalmologic examination information processing apparatus that stores the second examination data of the subject's eye obtained by the above and a storage unit and outputs the same to a display unit,
A plurality of first inspection data in which imaging modes set at the time of inspection in the ophthalmic optical coherence tomography unit are different from each other; and the second inspection data obtained on the same day as the first inspection data. Group setting means for associating
An instruction for receiving a selection instruction for selecting any of the plurality of first inspection data displayed on the display unit on the display unit, the plurality of first inspection data stored in the storage unit Reception means,
The first inspection data selected and instructed by the instruction receiving unit is displayed on the display unit, and the second inspection data associated with the selected first inspection data as the same group is stored in the storage unit. Display control means for taking out and displaying on the display unit simultaneously with the first inspection data;
It is characterized by having.
(3) First examination data of the subject's eye obtained by the first ophthalmic examination unit, the first examination data being image data, and the first examination data of the subject's eye obtained by the second ophthalmic examination unit. An ophthalmic examination information processing program executed in an ophthalmic examination information processing device that stores second examination data in a storage unit and outputs the second examination data to a display unit,
When executed by the processor of the ophthalmic examination information processing apparatus,
A plurality of first examination data having different imaging modes set at the time of examination in the first ophthalmic examination unit, and the second examination data obtained on the same day as the first examination data. A group setting step to associate as the same group,
An instruction for receiving a selection instruction for selecting any of the plurality of first inspection data displayed on the display unit on the display unit, the plurality of first inspection data stored in the storage unit Receiving step,
The first inspection data selected and instructed in the instruction receiving step is displayed on the display unit, and the second inspection data associated with the selected first inspection data as the same group is stored in the storage unit. A display control step of taking out and displaying on the display unit simultaneously with the first inspection data;
Is executed by the ophthalmic examination information processing apparatus.

FIG. 2 is a diagram illustrating an optical system and a control system of the ophthalmic examination apparatus. FIG. 9 is a diagram for describing an example of group information. 5 is a flowchart illustrating an example of a control operation according to the embodiment. FIG. 6 is a diagram for describing setting of a shooting mode. It is the schematic of the image acquired by the ophthalmic examination apparatus. FIG. 9 is a diagram for describing an example of grouping according to the present embodiment. FIG. 3 is a schematic diagram illustrating an example of a display screen according to the embodiment. FIG. 3 is a schematic diagram illustrating an example of a display screen according to the embodiment. It is a figure for explaining the example of a change of this example.

<Overview>
Hereinafter, an outline of the present embodiment will be described with reference to the drawings. In the description of the ophthalmologic examination information processing apparatus of the present embodiment, an example relating to an apparatus for acquiring a color fundus image and a tomographic image of an eye to be examined will be used (see FIG. 1). In this embodiment, the depth direction of the subject's eye is defined as the Z direction (the direction of the optical axis L1), and the horizontal component on a plane perpendicular to the depth direction (the same plane as the face of the subject) is defined as the X direction and the vertical direction. The component is described as the Y direction.

  The ophthalmic examination information processing apparatus according to the present embodiment (hereinafter, also referred to as the present apparatus) includes, for example, first examination data of an eye to be examined obtained by a first ophthalmic examination unit and obtained by a second ophthalmic examination unit. The stored second inspection data is stored in the storage unit 72 and output to the display unit. The ophthalmic examination information processing apparatus (for example, the control unit 70, the computer 90, and the like) includes, for example, a group setting unit (for example, the control unit 70, the computer 90, and the like) and an instruction receiving unit (for example, the control unit 70, the computer 90, and the like). And a display control unit (for example, the control unit 70 and the computer 90).

  The group setting unit may, for example, associate a plurality of pieces of first examination data having different examination modes set at the time of the examination with the first ophthalmic examination unit with the second examination data as the same group. Note that the first inspection data may be first image data. Note that the second inspection data may be second image data. The instruction receiving unit may receive, for example, a selection instruction for selecting any one of the plurality of first inspection data stored in the storage unit 72. The display control unit may, for example, display the first inspection data selected and instructed by the instruction receiving unit on a display unit (for example, the display unit 75, the display unit 95, or the like). At the same time, the display control unit may retrieve the second inspection data associated with the selected first inspection data as the same group from the storage unit 72 and display the second inspection data on the display unit simultaneously with the first inspection data. Good.

  In the present apparatus 1, for example, a plurality of first inspection data in different inspection modes and the second inspection data are associated as the same group, so that when the first inspection data is displayed, they are associated as the same group. The obtained second inspection data can be easily displayed on the display unit. This is expected to improve the efficiency and accuracy of diagnostic work using a plurality of ophthalmic examination data.

  Note that the group setting unit may associate a plurality of first test data and a plurality of second test data for the same subject obtained on the same day as the same group. This makes it easier for the examiner to collectively observe test data on the same subject acquired on the same day.

  Note that the group setting unit associates the plurality of first inspection data stored in different folders with the second inspection data stored in the same or different folder as any one of the first inspection data as the same group. You may. In this case, the first inspection data selected and instructed by the instruction receiving unit is displayed on the display unit, and the second inspection data associated with the selected first inspection data as the same group is stored in the storage unit 72. You may take it out. Further, the display control unit may simultaneously display the first inspection data and the second inspection data stored in different folders on the display unit.

  Note that group information that defines which group each test data belongs to may be used as the additional information, and the group information may be set for each test data. In this case, the group setting unit may associate the plurality of first inspection data and the second inspection data as the same group based on the group information. The group information may be set based on additional information such as an examination date and time, photographing information, and a flag relating to an apparatus main body or an operation program of the apparatus.

  As the additional information, an examination date and time, photographing information, a flag related to the apparatus main body or an operation program of the apparatus, or the like may be used, and such additional information may be set for the examination data. The group setting unit satisfies the set criteria (for example, whether the test date is the same, whether the test data is obtained from one start of the imaging software to the end thereof, etc.) based on the additional information described above. Such a plurality of first inspection data and second inspection data may be associated as the same group.

  In addition, the group setting unit is configured to use the operation information of the ophthalmic examination apparatus main body 1 including at least one of the first ophthalmic examination unit and the second ophthalmic examination unit as additional information, A plurality of first examinations according to at least one of operation information on software to be operated in accordance with the information, a series of examination instruction information set in advance on an electronic medical record, and examination position information on the fundus of each examination data. The data and the second inspection data may be associated as the same group. The operation information may be, for example, operation information on lighting of a light source or operation information on scanning of measurement light. Note that the operation information may be, for example, operation information regarding a setting operation of the subject, operation information regarding activation / termination of software, operation information regarding a set examination date and time, and operation information regarding data previously displayed by the user. Good. Note that the inspection instruction information may be, for example, inspection instruction information such as performing line imaging and map imaging of a macula portion with the OCT 200 and performing standard imaging with the fundus camera 30. For example, the inspection data acquired in response to the inspection instruction may be associated as the same group.

  In addition, the group setting unit includes the first examination data and the second examination data acquired through a series of examination operations on the same subject's eye by the ophthalmic examination apparatus 1 including both the first ophthalmic examination unit and the second ophthalmic examination unit. The two test data may be associated as the same group. Note that the series of inspection operations may be activation / termination of inspection software for one eye during binocular inspection, selection operation of a subject, setting operation of a new subject, and the like.

  Note that the group setting unit may perform association with the same group in accordance with an operation signal from an examiner who determines storage of the test data in the storage unit 72. For example, the group setting unit associates with the same group according to an operation signal from a save button for storing test data for a long term, an operation signal from a registration button for registering test data to data management software, and the like. May be performed.

  The instruction receiving unit may receive a selection instruction for selecting the second test data stored in the storage unit 72. In this case, the display control unit displays the second inspection data selected and instructed by the instruction reception unit on the display unit, and also displays the first inspection data associated with the selected second inspection data as the same group. May be selected and displayed on the display unit simultaneously with the second inspection data.

  The display control unit may automatically display the second inspection data at the same time as the display of the first inspection data. The display control unit displays, for example, in a state where the first inspection data is displayed, the second inspection data associated with the first inspection data as the same group based on a switch operation on the display unit. It may be. When there are a plurality of second inspection data, any of the inspection data of the same group may be selected.

  Note that the display control unit may preferentially display the second inspection data close to the first inspection data on the display unit. For example, the display control unit preferentially displays test data in which test positions (test sites on the fundus, fixation positions) overlap or approach, test data with close test dates and times, test data with high image similarity, and the like. It may be displayed in the section.

  In addition, the display control unit may display the first inspection data and the second inspection data displayed on the display unit in a position-related manner. When displaying the first inspection data and the second inspection data in a position-related manner, there are various display forms. For example, the display control unit electronically displays an inspection position corresponding to the other of the first inspection data and the second inspection data in one of the first inspection data and the second inspection data. You may. For example, the display control unit may match the first inspection data and the second inspection data by image processing, and combine and display them.

  Note that the display control unit may display the first inspection data and the second inspection data, for example, by adding a common reference in position. For example, a mark may be added to a position corresponding to the macula in each test data.

  For example, if the first inspection data is OCT data acquired by an ophthalmic optical coherence tomography unit (for example, the OCT optical system 200) and the second inspection data is a fundus front image, the display control unit May electronically display the scanning position of the OCT data on the fundus front image. The display control unit may electronically display the scanning position based on the scanning position information added to the OCT data.

  Note that the first ophthalmic examination unit is any one of an optical coherence tomography (for example, OCT optical system 200), a fundus camera (for example, fundus camera optical system 30), an optical scanning laser optometer (SLO), and a perimeter. It may be. In this case, the second ophthalmic examination unit may be any one of an optical coherence tomograph, a fundus camera, an optical scanning laser ophthalmoscope, and a perimeter, and may be different from the first ophthalmic examination unit. For example, the first ophthalmic examination unit may be an optical coherence tomography and the second ophthalmic examination unit may be different from the optical coherence tomography.

  Note that, as the ophthalmic optical coherence tomography unit, for example, an OCT unit 200 capable of acquiring a tomographic image of at least one of a fundus and an anterior segment is conceivable. Examples of the first examination data of the subject's eye obtained by the ophthalmic optical coherence tomography include, besides tomographic images, analysis data (eg, a layer thickness map) obtained by analyzing the tomographic images, angiographic images, Doppler images, polarization characteristic images and the like can be considered.

  Note that the ophthalmic examination information processing apparatus is a system 300 (see FIG. 1) connected to a combined ophthalmic examination apparatus (for example, the ophthalmic examination apparatus 1 or the like) including both the first ophthalmic examination unit and the second fundus examination unit. ). In this case, the combined ophthalmic examination apparatus may include, for example, a mode setting unit (for example, the control unit 70, the computer 90, and the like). The mode setting unit may set, for example, a continuous inspection mode and an individual inspection mode. The continuous examination mode may be, for example, an examination mode in which acquisition of examination data by the first ophthalmic examination unit and the second ophthalmic examination unit is continuously performed based on one trigger signal. The individual examination mode is, for example, an individual examination mode in which acquisition of examination data by the first ophthalmic examination unit and the second ophthalmic examination unit is performed based on individual trigger signals, and the examination by the first ophthalmic examination unit is performed. The examination mode may include at least a first examination mode for acquiring data and a second examination mode for acquiring examination data by the second ophthalmic examination unit. The group setting unit may associate the second inspection data obtained in the continuous inspection mode with the first inspection data obtained in the individual inspection mode as the same group.

  The ophthalmic examination information processing apparatus and the combined ophthalmic examination apparatus including both the first ophthalmic examination unit and the second fundus examination unit may be separate apparatuses or may be integrated. Good.

  Note that a control unit (for example, the control unit 70) for controlling the first ophthalmic examination unit and the second fundus examination unit and the like is provided separately from the ophthalmic examination information processing apparatus (for example, the control unit 70, the computer 90, and the like). May be used, or may be shared.

  Note that the processor (for example, the control unit 70, the computer 90, and the like) of the ophthalmic examination information processing apparatus 1 may execute an ophthalmic examination information processing program. The ophthalmic examination information program may include, for example, a setting step, an instruction receiving step, and a display control step.

  The setting step may be, for example, a step of associating a plurality of pieces of first test data having different test modes set at the time of the test with the first ophthalmic examination unit with the second test data as the same group. . The instruction receiving step may be, for example, a step of receiving a selection instruction for selecting any one of the plurality of first inspection data stored in the storage unit. In the display control step, for example, the first inspection data selected and instructed in the instruction receiving step is displayed on the display unit, and the second inspection data associated with the selected first inspection data as the same group is displayed. It may be a step of taking out from the storage unit and displaying it on the display unit simultaneously with the first inspection data.

<Example>
As shown in FIG. 1, the optical system of the ophthalmologic examination apparatus 1 according to the present embodiment includes an illumination optical system 10, a fundus camera optical system 30, an interference optical system 200 (hereinafter, also referred to as an OCT optical system), and a fixation optical system 80. , Mainly comprising. Further, the optical system may include a focus target projection optical system 40, an alignment target projection optical system 50, and an anterior ocular segment observation optical system 60. The fundus camera optical system 30 is used as a fundus camera optical system for obtaining a color fundus image by photographing the fundus with visible light (for example, a non-mydriatic state). The OCT optical system 200 obtains a tomographic image of the fundus of the eye to be examined non-invasively by using an optical interference technique.

<Illumination optical system>
The illumination optical system 10 includes, for example, an observation illumination optical system and a shooting illumination optical system. The photographing illumination optical system mainly includes a light source 14, a condenser lens 15, a ring slit 17, a relay lens 18, a mirror 19, a black spot plate 20, a relay lens 21, a perforated mirror 22, and an objective lens 25. The imaging light source 14 may be a flash lamp or the like. The sunspot plate 20 has a sunspot at the center.

  The observation illumination optical system mainly includes a light source 11, an infrared filter 12, a condenser lens 13, a dichroic mirror 16, and an optical system from the ring slit 17 to the objective lens 25. The light source 11 may be a halogen lamp or the like. The infrared filter 12 transmits near-infrared light having a wavelength of 750 nm or more. The dichroic mirror 16 is arranged between the condenser lens 13 and the ring slit 17. The dichroic mirror 16 has a characteristic of reflecting light from the light source 11 and transmitting light from the imaging light source 14.

<Fundus camera optical system>
The retinal camera optical system 30 mainly includes, for example, an objective lens 25, an imaging diaphragm 31, a focusing lens 32, an imaging lens 33, and a light receiving element 35. The photographing aperture 31 is located near the opening of the perforated mirror 22. The focusing lens 32 is movable in the optical axis direction. The light receiving element 35 can be used for imaging having sensitivity in the visible region. The photographing diaphragm 31 is disposed at a position substantially conjugate with the pupil of the eye E with respect to the objective lens 25. The focusing lens 32 is moved in the optical axis direction by a moving mechanism 49 having a motor.

  Further, a dichroic mirror 34 having a characteristic of reflecting a part of infrared light and visible light and transmitting most of visible light is disposed between the imaging lens 33 and the light receiving element 35. In the reflection direction of the dichroic mirror 37, a light receiving element 38 having sensitivity in the infrared region is arranged. The dichroic mirror 34 is used as an optical path coupling member for making the optical axis of the fundus camera optical system 30 and the optical axis of the fixation optical system 80 coaxial. For example, the dichroic mirror 34 is inserted into the optical path when observing the fundus, and is retracted from the optical path when photographing the fundus. The dichroic mirror 34 may be a half mirror.

  A dichroic mirror (wavelength selective mirror) 24 as an optical path branching member that can be inserted and removed is provided obliquely between the objective lens 25 and the perforated mirror 22. The dichroic mirror 24 reflects the wavelength light of the OCT measurement light and the wavelength light (center wavelength 940 nm) of the alignment index projection optical system 50 and the anterior segment illumination light source 58. Further, the dichroic mirror 24 has a characteristic of transmitting a wavelength of 900 nm or less including a light source wavelength (center wavelength 880 nm) of the wavelength light for fundus oculi observation illumination. At the time of photographing, the dichroic mirror 24 is flipped up in conjunction with the insertion / removal mechanism 66 and retracts outside the optical path. The insertion / removal mechanism 66 can be constituted by a solenoid and a cam.

  An optical path correction glass 28 is disposed on the light receiving element 35 side of the dichroic mirror 24 so as to be able to jump up by driving the insertion / removal mechanism 66. When the optical path is inserted, the optical path correction glass 28 has a role of correcting the position of the optical axis L1 shifted by the dichroic mirror 24.

  A light beam emitted from the observation light source 11 is converted into an infrared light beam by an infrared filter 12 and reflected by a condenser lens 13 and a dichroic mirror 16 to illuminate a ring slit 17. The light transmitted through the ring slit 17 reaches the perforated mirror 22 via the relay lens 18, the mirror 19, the black spot plate 20, and the relay lens 21. The light reflected by the perforated mirror 22 passes through the correction glass 28 and the dichroic mirror 24, and is once converged by the objective lens 25 near the pupil of the eye E, and then diffuses to illuminate the fundus of the eye.

  Light reflected from the fundus is received via the objective lens 25, the dichroic mirror 24, the correction glass 28, the opening of the perforated mirror 22, the photographing diaphragm 31, the focusing lens 32, the imaging lens 33, and the dichroic mirror 37. An image is formed on the element 38. Note that the output of the light receiving element 38 may be input to the control unit 70, and the control unit 70 may display the fundus observation image of the subject's eye captured by the light receiving element 38 on the display unit 75.

  Further, a light beam emitted from the imaging light source 14 passes through the dichroic mirror 16 via the condenser lens 15. Thereafter, the fundus is illuminated with visible light through the same optical path as the illumination light for fundus observation. Then, the reflected light from the fundus passes through the objective lens 25, the opening of the perforated mirror 22, the photographic stop 31, the focusing lens 32, and the imaging lens 33, and forms an image on the light receiving element 35.

<Focus index projection optical system>
The focus index projection optical system 40 mainly includes an infrared light source 41, a slit index plate 42, two deflection prisms 43, a projection lens 47, and a spot mirror 44 obliquely provided in the optical path of the illumination optical system 10. The two deflection prisms 43 are attached to the slit optotype plate 42. The spot mirror 44 is provided obliquely on the route of the illumination optical system 10. The spot mirror 44 is fixed to the tip of a lever 45. The spot mirror 44 is normally inclined with respect to the optical axis, but is retracted out of the optical path by rotation of the axis of the rotary solenoid 46 at a predetermined timing before photographing. The spot mirror 44 is disposed at a position conjugate with the fundus of the eye E. The light source 41, the slit index plate 42, the deflection prism 43, the projection lens 47, the spot mirror 44 and the lever 45 are moved in the optical axis direction by the moving mechanism 49 in conjunction with the focusing lens 32. Further, the light flux of the slit index plate 42 of the focus index projection optical system 40 is reflected by the spot mirror 44 via the deflection prism 43 and the projection lens 47, and thereafter, the relay lens 21, the perforated mirror 22, the dichroic mirror 24, The image is projected on the fundus of the eye E through the objective lens 25. When the fundus is out of focus, an index image (not shown) is projected on the fundus in a state where the index image is separated according to the shift direction and the shift amount. On the other hand, when the subject is in focus, the target image is projected onto the fundus in a matched state.

<Alignment index projection optical system>
The alignment target projection optical system 50 for projecting the alignment target light beam includes a plurality of infrared light sources at intervals of 45 degrees on a concentric circle with respect to the photographing optical axis L1, as shown in the figure in the upper left dotted line in FIG. Are located. The ophthalmic examination apparatus according to the present embodiment mainly includes a first optotype projection optical system (0 degrees and 180) and a second optotype projection optical system. The first optotype projection optical system has an infrared light source 51 and a collimating lens 52. The second optotype projection optical system is arranged at a position different from the first target projection optical system, and has six infrared light sources 53. The infrared light sources 51 are arranged symmetrically with respect to a vertical plane passing through the photographing optical axis L1. In this case, the first target projection optical system projects a target at infinity on the cornea of the eye E from the left and right directions. The second target projection optical system is configured to project a finite distance target on the cornea of the eye E from above and below or from an oblique direction. In FIG. 1, for convenience, only the first target projection optical system (0 degrees and 180 degrees) and only a part of the second target projection optical system (45 degrees and 135 degrees) are illustrated. .

<Anterior eye observation optical system>
An anterior segment observation (photographing) optical system 60 for imaging the anterior segment of the eye to be examined mainly includes a dichroic mirror 61, a diaphragm 63, a relay lens 64, and a light receiving element 65 on the reflection side of the dichroic mirror 24. The light receiving element 65 has an infrared sensitivity. Further, the light receiving element 65 also serves as an imaging device for detecting an alignment index, and images the anterior segment illuminated by the anterior segment illumination light source 58 that emits infrared light and the alignment index. The anterior segment illuminated by the anterior segment illumination light source 58 is received by the light receiving element 65 from the objective lens 25, the dichroic mirror 24 and the dichroic mirror 61 via the optical system of the relay lens 64. The alignment light beam emitted from the light source of the alignment target projection optical system 50 is projected on the cornea of the eye to be examined. The corneal reflection image is received (projected) on the light receiving element 65 via the objective lens 25 to the relay lens 64.

  The output of the light receiving element 65 is input to the control unit 70, and the anterior ocular segment image captured by the light receiving element 65 is displayed on the display unit 75. The anterior ocular segment observation optical system 60 also serves as a detection optical system for detecting the alignment state of the apparatus main body 1 with respect to the eye to be inspected.

<OCT optical system>
The OCT optical system 200 has a device configuration of a so-called optical coherence tomography (OCT) for ophthalmology, and captures a tomographic image of the eye E. The OCT optical system 200 divides the light emitted from the measurement light source 102 into measurement light (sample light) and reference light by a coupler (light splitter) 104. The OCT optical system 200 guides the measurement light to the fundus oculi Ef of the eye E by the measurement optical system 250 having an objective lens. Further, the reference light is guided to the reference optical system 110. The measurement optical system 250 may include, for example, the collimator lens 123, the focus lens 124, the scanning unit 108, the objective lens 25, and the like. The measurement light reaches the scanning unit 108 via the collimator lens 123 and the focus lens 124, and the reflection direction is changed by, for example, driving two galvanometer mirrors. Then, the measurement light reflected by the scanning unit 108 is reflected by the dichroic mirror 24 via the relay lens 22, and then condensed on the fundus of the eye to be examined via the objective lens 25. After that, the detector (light receiving element) 120 receives the interference light resulting from the combination of the measurement light reflected by the fundus oculi Ef and the reference light. The focus lens 124 can be moved in the optical axis direction by driving the driving unit 124a.

  The detector 120 detects an interference state between the measurement light and the reference light. In the case of Fourier domain OCT, the spectrum intensity of the interference light is detected by the detector 120, and a depth profile (A-scan signal) in a predetermined range is obtained by Fourier transform of the spectrum intensity data. For example, Spectral-domain OCT (SD-OCT) and Swept-source OCT (SS-OCT) are mentioned. In the case of Spectral-domain OCT (SD-OCT), for example, a broadband light source is used as the light source 102 and a spectrometer (spectrometer) is used as the detector 120. In the case of the Swept-source OCT, for example, a tunable light source is used as the light source 102 and a single photodiode is used as the detector 120 (balance detection may be performed). Further, it may be Time-domain OCT (TD-OCT).

  The scanning unit 108 scans light emitted from the measurement light source on the fundus of the subject's eye. For example, the scanning unit 108 scans the measurement light two-dimensionally (XY directions (transverse directions)) on the fundus. Scanning section 108 is arranged at a position substantially conjugate with the pupil. The scanning unit 108 is, for example, two galvanometer mirrors, and the reflection angle thereof is arbitrarily adjusted by the driving unit 151.

  Thus, the light beam emitted from the light source 102 changes its reflection (progression) direction, and is scanned on the fundus in an arbitrary direction. Thereby, the imaging position on the fundus oculi Ef is changed. The scanning unit 108 may have any configuration as long as it deflects light. For example, in addition to a reflection mirror (galvano mirror, polygon mirror, resonant scanner), an acousto-optic device (AOM) for changing the traveling (deflection) direction of light is used.

  The reference optical system 110 generates reference light that is combined with reflected light obtained by reflection of the measurement light at the fundus oculi Ef. The reference optical system 110 may be a Michelson type or a Mach-Zehnder type.

  The reference optical system 110 may change the optical path length difference between the measurement light and the reference light by moving the optical member in the reference light path. For example, the reference mirror is moved in the optical axis direction. The configuration for changing the optical path length difference may be arranged in the measurement optical path of the measurement optical system 250.

  More specifically, the reference optical system 110 mainly includes, for example, a collimator lens 129, a reference mirror 131, and a reference mirror driving unit 150. The reference mirror driving unit 150 is arranged in the reference light path, and is configured to be movable in the optical axis direction so as to change the optical path length of the reference light. The light is reflected back by the reference mirror 131, returned to the coupler 104 again, and guided to the detector 120. As another example, the reference optical system 110 is formed by a transmission optical system (for example, an optical fiber), and guides the light from the coupler 104 to the detector 120 by transmitting the light without returning.

<Fixation optical system>
The fixation optical system is provided for projecting a fixation target toward the eye to be inspected. When the subject sees the fixation target, the movement of the line of sight is suppressed. The fixation optical system 80 may include, for example, a fixation target display 81 and a relay lens 83, and may share the optical path of the fundus camera optical system 30 from the dichroic mirror 34 to the objective lens 25. The fixation target display 81 emits visible light.

  The fixation optical system 80 is arranged by the dichroic mirror 34 such that its optical axis L2 is coaxial with the optical axis L1 of the OCT optical system 200 and the fundus camera optical system 30. The dichroic mirror 34 transmits light reflected from the fundus.

  The visible light emitted from the fixation target display body 81 passes through a relay lens 83, a dichroic mirror 34, an imaging lens 33, a focusing lens 32, a perforated mirror 22, a dichroic mirror 24, and an objective lens 25, and the fundus of the eye to be examined. Focus on The subject visually recognizes the visible light flux as a fixation target.

<Operation section>
The operation unit 74 receives an operation from the examiner and transmits an operation signal to a control unit 70 described later. As the operation unit 74, various user interfaces (for example, a mouse, a keyboard, a touch panel, various operation buttons, and the like) are used. The touch panel type display may also be used as the display unit 75.

<Control unit>
The control unit 70 controls the entire apparatus. For example, the control unit 70 controls various controls of the ophthalmologic examination apparatus 1 (for example, control of grouping described later). The control unit 70 is connected to, for example, the storage unit 72 and the like. The storage unit 72 stores programs, images, and the like. The storage unit 72 may include, for example, a ROM 72a, a RAM 72b, a nonvolatile memory 72c, and the like. Various programs for controlling the operation of the ophthalmic examination apparatus 1, initial values, and the like are stored in the ROM 72a. Various information is temporarily stored in the RAM 72b. The non-volatile memory 72c is a non-transitory storage medium capable of retaining stored contents even when power supply is cut off. Of course, the storage unit 72 may be a storage medium such as a USB or a flash memory.

  The storage unit 72 may include, for example, a first storage area, a second storage area, and a third storage area. The first storage area is, for example, a storage area for temporarily storing an image obtained by the image obtaining unit. The second storage area is, for example, a storage area for long-term storage of an image obtained by the image obtaining unit. The third storage area may store, for example, group information for grouping the images acquired by the image acquiring unit into a plurality of image groups. The group information is, for example, information in which identification numbers and the like of images grouped into the same image group are collectively collected in a group unit. For example, the control unit 70 may store the image IDs in the storage unit 72 collectively for each image group. For example, as shown in FIG. 2, the control unit 70 may cause the storage unit 72 to store the identification numbers of the sorted images for each image group.

  The control unit 70 according to the present embodiment includes a display unit 75, a shooting start switch 73, an operation unit 74, a storage unit 72, a computer 90, light receiving elements, light sources (not shown), and various actuators (not shown). , The fixation target display 81 and the like are connected. When the examiner operates the imaging start switch 73, the imaging start switch 73 transmits an imaging start signal to the control unit 70.

<Control operation during shooting>
A control operation at the time of photographing in the apparatus having the above configuration will be described. First, the examiner transmits an operation signal for turning on a fixation target for macular imaging to the control unit 70 by input to the operation unit 74, for example. The control unit 70 turns on the instructed fixation lamp 81.

  Next, the examiner instructs the subject to gaze at the fixation target formed by the emitted light of the illuminated fixation lamp 81. In the initial stage, the dichroic mirror 24 is inserted into the optical path of the fundus camera optical system 30, and the anterior eye image captured by the light receiving element 65 is displayed on the display unit 75.

  The examiner operates a joystick (not shown) as an alignment adjustment in the up / down / left / right direction, and moves the measurement unit of the apparatus 1 up / down / left / right so that an anterior eye image (not shown) appears on the display unit 75. When the anterior ocular segment image appears on the display unit 75, eight index images appear on the anterior ocular segment image.

<Alignment detection and automatic alignment in XYZ directions>
When the eight alignment index images are detected by the light receiving element 65, the control unit 70 starts automatic alignment control. The control unit 70 detects an alignment deviation amount of the measurement unit with respect to the subject's eye based on the imaging signal output from the light receiving element 65.

  Then, the control unit 70 controls the driving of the measuring unit so that the deviation amount falls within the allowable range of the completion of the alignment, and performs the automatic alignment.

  Further, the control unit 70 performs alignment in the Z direction from the eight indices detected as described above. As an alignment method, for example, an alignment method described in JP-A-6-46999 may be used.

  The control unit 70 also calculates the amount of deviation from the alignment reference position in the Z direction with respect to the Z direction, and drives the measuring unit so that the amount of deviation falls within the alignment allowable range where the alignment is completed. Control and perform automatic alignment.

  When the alignment state in the XYZ directions satisfies the condition of completion of the alignment by the above-described alignment operation, the control unit 70 determines that the alignment in the XYZ directions has been matched, and proceeds to the next step. Here, when the alignment in the XYZ directions is completed, the control unit 70 outputs an alignment completion signal.

<Determination of pupil diameter>
After the alignment is completed, the control unit 70 starts determining whether or not the pupil state of the subject's eye is appropriate. In this case, the appropriateness of the pupil diameter is determined based on whether or not the pupil edge detected from the anterior eye image by the light receiving element 65 is out of a predetermined pupil determination area. The size of the pupil determination area is set as a diameter (for example, a diameter of 4 mm) through which a fundus illumination light beam can pass with reference to the center of the image (the center of the imaging optical axis). For simplicity, four pupil edges detected in the horizontal direction and the vertical direction based on the center of the image are used. If the point of the pupil edge is outside the pupil determination area, a sufficient amount of illumination light at the time of photographing is ensured (for details, refer to JP-A-2005-160549 by the present applicant). The determination as to whether the pupil diameter is appropriate is continued until the photographing is performed, and the determination result is displayed on the display unit 75.

<Detection of focus state / auto focus>
When the alignment using the light receiving element 65 is completed, the control unit 70 performs autofocus on the fundus of the subject's eye. On the display unit 75 or the display unit 95, a fundus image captured by the light receiving element 38 is displayed, and a focus index image by the focus target projecting optical system 40 is projected on the center of the fundus image. Here, the focus index image is separated when out of focus, and is consistently projected when in focus. The control unit 70 detects the index image by image processing, and obtains the separation information. Then, the control unit 70 controls the driving of the moving mechanism 49 based on the separation information of the index image, and moves the lens 32 so that the lens 32 is focused.

<Optimization control>
When the alignment completion signal is output, control unit 70 issues a trigger signal for starting optimization control, and starts the control operation for optimization. The control unit 70 performs the optimization so that the examiner can observe a desired fundus site with high sensitivity and high resolution. In this embodiment, the optimization control is control of optical path length adjustment, focus adjustment, and polarization state adjustment (polarizer adjustment). In the optimization control, it is only necessary to satisfy a certain allowable condition for the fundus, and it is not always necessary to adjust to the most appropriate state.

  In the optimization control, the control unit 70 sets the positions of the reference mirror 131 and the focusing lens 124 to the initial positions as initialization control. After the initialization is completed, the control unit 70 moves the reference mirror 131 in one direction at a predetermined step from the set initial position, and performs the first optical path length adjustment (first automatic optical path length adjustment). In parallel with the first optical path length adjustment, the control unit 70 acquires focusing position information for the fundus of the eye to be examined based on a fundus image acquired by a light receiving signal output from the light receiving element 38. When the in-focus position information is obtained, the control unit 70 moves the focusing single lens 124 to the in-focus position and performs auto-focus adjustment (focus adjustment). Note that the in-focus position may be any position at which the contrast of a tomographic image that can be tolerated as an observation image can be acquired, and does not necessarily need to be the optimal position of the focus state.

  After the focus adjustment is completed, the control unit 70 moves the reference mirror 131 in the optical axis direction again, and performs a second optical path length adjustment for re-adjusting the optical path length (fine adjustment of the optical path length). After the completion of the second optical path length adjustment, the control unit 70 drives the polarizer 133 for adjusting the polarization state of the reference light, and adjusts the polarization state of the measurement light (for details, refer to Japanese Patent Application No. 2012-56292).

  By completing the optimization control as described above, the examiner can observe the desired fundus region with high sensitivity and high resolution. Then, the control unit 70 controls the driving of the scanning unit 108 based on the scanning method set in each shooting mode, and scans the measurement light on the fundus.

  The imaging signal (spectral data) detected by the detector 120 is transmitted to the computer 90. The computer 90 receives the imaging signal detected by the detector 120 and generates a tomographic image of the subject's eye by performing arithmetic processing on the imaging signal.

  When the alignment and the image quality adjustment are completed, the control unit 70 controls the driving of the scanning unit 108, causes the measurement light to scan on the fundus in a predetermined direction, and performs a predetermined operation based on an output signal output from the detector 120 during the scanning. The light receiving signal corresponding to the scanning area is obtained to form a tomographic image.

  Next, shooting of a color fundus image by the fundus camera optical system 30 will be described. The examiner transmits an operation signal for turning on a fixation lamp for standard imaging to the control unit 70 by inputting to the operation unit 74, for example, to perform standard imaging of the fundus camera. When receiving the operation signal from the operation unit 74, the control unit 70 turns on a fixation lamp for standard photographing of the fundus camera.

  Next, the examiner instructs the subject to gaze at the fixation target formed by the light emitted from the fixation lamp 81. In the case of standard imaging, for example, the fundus camera optical system 30 can capture an image in which the middle portion between the macula of the subject's eye and the optic disc is centered.

  While observing the fundus image displayed on the display unit 75, the examiner finely adjusts the alignment and focus so that the photographer can take a picture in a desired state. When the examiner inputs the photographing start switch 73, photographing is performed. The control unit 70 drives the insertion / removal mechanism 66 based on a trigger signal for starting the photographing by the photographing start switch 73, thereby detaching the dichroic mirror 24 from the optical path and causing the photographing light source 14 to emit light.

  When the imaging light source 14 emits light, the fundus of the subject's eye is irradiated with visible light. The light reflected from the fundus passes through the objective lens 25, the opening of the perforated mirror 22, the photographic stop 31, the focusing lens 32, the imaging lens 33, and the dichroic mirror 37, and forms an image on the two-dimensional light receiving element 35. The fundus image 82 photographed by the two-dimensional light receiving element 35 is received by the control unit, and then stored in the storage unit 72.

<Grouping and display control>
Hereinafter, the flow of grouping images having different modalities photographed in the individual photographing mode (individual inspection mode) and displaying the images on the display unit 75 will be described. For example, the examiner separately photographs macular line photography, macular map photography, and color fundus image photography in the individual photography mode. The examiner switches to a photographing mode of an image to be photographed and performs photographing. The examiner switches the photographing mode each time photographing is completed, thereby sequentially performing photographing such as macular line photographing, macular map photographing, and color fundus image photographing.

  Note that the macular line imaging mode is an imaging mode in which the OCT optical system 200 is used to scan the measurement light linearly in the macula of the fundus. The macular map photographing is a photographing mode (preferably, raster scan) in which the OCT optical system 200 is used to scan the measurement light two-dimensionally in the fundus macula. The color fundus image photographing is a photographing mode for photographing a color fundus front image using the fundus camera optical system 30.

[Macular line photography]
In step 1 of FIG. 3, the control unit 70 starts macular line imaging. First, the examiner selects the macula line imaging mode by operating the operation unit 74 (see FIG. 4). The operation unit 74 transmits an operation signal to the control unit 70 based on an operation from the examiner. The control unit 70 receives an operation signal from the operation unit 74, and sets the imaging mode to the macular line imaging mode.

  The control unit 70 receives, for example, an imaging start signal (release signal) output from the imaging start switch 73 by the examiner, and starts macular line imaging. For example, the control unit 70 controls the driving of the scanning unit 30 and performs a line scan on the macula. The control unit 70 acquires a macular line image (tomographic image of the macula) as shown in FIG. When the acquisition operation is completed, the control unit 70 shifts the display screen from the shooting operation screen to the image confirmation screen, and causes the display unit 75 to display the macular line image. Thereby, the examiner can confirm whether or not the macular line image has been successfully taken.

  Here, when it is received that the macular line image is OK based on the operation signal from the operation unit 74 by the examiner, the control unit 70, for example, adds tag information (addition) to the acquired macular line image. ) Is set and temporarily stored in the storage unit 72. The tag information is, for example, information related to a captured image, such as an image identification number, a subject name, a capturing date and time, a left eye and a right eye, a capturing site, a scanning pattern, and a fixation position. When the control unit 70 temporarily stores the macular line image, the control unit 70 shifts to a shooting operation screen and proceeds to step 2.

[Macula map shooting]
In step 2, the control unit 70 performs macular map imaging. First, the examiner selects the macula map photographing mode by operating the operation unit 74. The operation unit 74 transmits an operation signal to the control unit 70 based on an operation from the examiner. The control unit 70 receives an operation signal from the operation unit 74 and switches the shooting mode to the macular map shooting mode.

  When the photographing mode is switched to the macular map photographing mode and the adjustment work is completed, the examiner presses the photographing start switch 73 again. When receiving the shooting start signal output from the shooting start switch 73, the control unit 70 starts macular map shooting. For example, the control unit 70 controls the driving of the scanning unit and performs a raster scan on the macula. The control unit 70 acquires a macular map image (three-dimensional OCT data relating to the macula) as shown in FIG. The three-dimensional OCT data includes, for example, a tomographic image for each scan line forming a raster scan.

  The control unit 70 shifts the display screen from the shooting operation screen to the image confirmation screen and causes the display unit 75 to display the macula map image (for example, an OCT front image formed based on three-dimensional OCT data is displayed). . Thereby, the examiner can confirm whether or not the macular map image has been successfully taken.

  Subsequently, when it is received that the macular map image is OK based on the operation signal from the operation unit 74 by the examiner, the control unit 70 sets tag information in the acquired macular map image, and sets the tag information in the storage unit. 72 is temporarily stored. Here, the tag information to be added is different from the tag information set for the above-described macula line image. When the control unit 70 temporarily stores the macula map image, the control unit 70 shifts to a shooting operation screen and proceeds to step 3.

[Color fundus photography]
In step 3, the control unit 70 performs color fundus imaging of the center of the macula. First, the examiner selects the color fundus imaging mode by operating the operation unit 74. The operation unit 74 transmits an operation signal to the control unit 70 based on an operation from the examiner. The control unit 70 receives an operation signal from the operation unit 74 and switches the imaging mode to the color fundus imaging mode.

  When the imaging mode is switched to the color fundus imaging mode, the examiner presses the imaging start switch 73 again. When receiving the imaging start signal output from the imaging start switch 73, the control unit 70 starts color fundus imaging. For example, the control unit 70 causes the imaging light source 14 to emit light, and acquires a color fundus front image of the eye to be inspected by the two-dimensional light receiving element 35. The control unit 70 acquires a color fundus front image of the center of the macula as shown in FIG.

  The control unit 70 shifts the display screen from the shooting operation screen to the image confirmation screen, and causes the display unit 75 to display the color fundus front image. Thereby, the examiner can confirm whether or not the color fundus front image has been successfully photographed.

  Subsequently, when it is received that the color fundus front image is OK based on the operation signal from the operation unit 74 by the examiner, the control unit 70 adds the tag information to the acquired color fundus front image at the center of the macula. It is set and stored in the storage unit 72. Here, the tag information to be added is different from the tag information set for the above-described macular line image and macular map image. The control unit 70 temporarily stores the color fundus front image. When the photographing operation is completed as described above, and based on the operation signal from the operation unit 74, the control unit 70 receives an instruction to shift to the image analysis screen or an instruction to end the imaging software, the control unit 70 proceeds to step 4. move on.

[Image storage]
In step 4, the control unit 70 causes the storage unit 72 to store the images photographed in each photographing mode for a long term.

  As an example, the macular line image, the macular map image, and the color fundus front image temporarily stored in the storage unit 72 are collectively stored in the storage unit 72 for a long time. The control unit 70 proceeds to step 5 after storing the image in the storage unit 72 for a long time.

[Grouping Images]
In step 5, for example, the control unit 70 groups the acquired macular line image, macular map image, and color fundus front image and associates them as the same image group. The control unit 70 causes the storage unit 72 to store group information for identifying the group as an associated group. Here, the group information defines which group each test data belongs to.

  More specifically, for example, as shown in FIG. 6, a group number is stored together with information such as a patient name, a photographing date, and a photographing pattern of a photographed image. In the example of FIG. 6, macular line imaging, macular map imaging, and color fundus imaging are performed on patient A on day XX. On day △△ different from day △△, patient A performs macular map photography and color fundus photography, and patient B performs nipple map photography and color fundus photography. In this case, on the database of the storage unit 72, the first group number is set for the macular line image, the macular map image, and the color fundus image related to the patient A taken on the day XX, and the first image group is assigned to the first image group. Be grouped. Then, a second group number is set for the macular map image and the color fundus image relating to patient A taken on the △△ day, and the images are grouped into a second image group. Further, a third group number is set for the nipple map image of patient B and the color fundus image taken on the △△ day, and the images are grouped into a third image group. As shown in FIG. 6, the groups may be preferentially grouped in the order of imaging date and patient. Further, as shown in FIG. 6, one image data may be grouped into a plurality of image groups (for example, first to fifth image groups).

  Note that, as a grouping method, for example, a method of registering images having the same timing stored in the storage unit 72 in the long term as the same image group as described above may be used. For example, the identification numbers of the macular line image, the macular map image, and the color fundus front image stored together at the same timing in step 4 may be extracted and stored in the storage unit 72 as group information. Therefore, for example, the images stored at “13:20:15 on April 30, 2014” are grouped as a first image group, and are stored at “13:22:50 on April 30, 2014”. The stored images are grouped as a second image group different from the first image group.

  In the above-described manner, the control unit 70 groups images acquired by different modalities. The control unit 70 may use the above methods individually or may use a combination of the above methods. As described above, the control unit 70 functions as a group setting unit that groups images. When the control unit 70 stores the group information in the storage unit 72, the process proceeds to step 6. Since there are various methods for grouping, a description will be given of a modified example.

[display]
In step 6, the control unit 70 causes the display unit 75 to display, for example, an image selection screen. For example, as shown in FIG. 7, the control unit 70 causes the display unit 75 to display a list screen of images related to a certain subject. On the list screen, for example, images obtained by various modalities are displayed in a list for each folder. After displaying the image selection screen on the display unit 75, the control unit 70 proceeds to step S7. At least one photographed image obtained in one photographing mode is stored in each folder, and at least a part of the images stored in each folder is displayed on the display unit 75 as a thumbnail image. Displayed above. It should be noted that the layout may not be a layout in which thumbnail images are displayed for each folder, but may be a layout in which each captured image is displayed in a list without being classified into folders.

  In step 7, the control unit 70 receives a selection instruction for selecting an image of a certain modality from images (folders) obtained by various modalities. As an example, the examiner selects and touches either the fundus tomographic image or the fundus frontal image displayed on the list screen. At this time, the control unit 70 receives a selection instruction from the examiner based on a detection signal of the touch panel used as the operation unit 74. Thus, the control unit 70 functions as an instruction receiving unit that receives an instruction to select the first image. Control unit 70 proceeds to step 8 when receiving the selection instruction. The control unit 70 may receive a selection instruction from the examiner by a mouse click operation.

  In step 8, the control unit 70 searches for an image associated with the selected image (first image) as the same group as described above. For example, the control unit 70 searches for image data belonging to the first image group selected by the selection instruction in step 7. In this case, for example, the control unit 70 searches the group information stored in the storage unit 72 for an image set as the first image group. The control unit 70 proceeds to step 9 when searching for the first image group.

  In step 9, the control unit 70 determines whether there is an image acquired by a modality other than the selected image in the first image group. If the control unit 70 determines that there is no image acquired by a modality other than the first image, the process proceeds to step 10, and if it determines that there is an image, the process proceeds to step 11.

  In step 10, the control unit 70 causes the display unit 75 to enlarge and display the selected and instructed image. More specifically, the captured images stored in the selected folder are enlarged and displayed on the display unit 75. After displaying the first image on the display unit 75, the control unit 70 ends the display control of the image.

  In step 11, the control unit 70 selects one of a plurality of images acquired by a modality other than the selected image from the first image group. One of the plurality of images acquired by another modality (hereinafter, a second image) is displayed on the display unit 75 together with the image instructed to be selected. More specifically, one of a plurality of images stored in a different folder from the first image and acquired by another modality is selected. Note that the control unit 70 may select an image suitable for being displayed on the display unit 75 together with the first image as the second image.

  As a method of selecting a second image from a plurality of images associated as the same image group, for example, a method of selecting an image based on an imaging region on the fundus can be considered. For example, the control unit 70 may acquire the imaging part information from the tag information of the first image, and may select an image in the same image group whose imaging part is closer as the second image.

  As an example, a case where the first image is a tomographic image obtained by macular line imaging will be described. In the same image group as the first image, when there is a color fundus front image in which the macula center is set as the imaging region and a color fundus front image in which the nipple center is set as the imaging region, the control unit 70 May select a color fundus image at the center of the macula where the imaging region overlaps as the second image.

  When there is only one image acquired by another modality, the control unit 70 may select this one image as the second image.

  As described above, the control unit 70 functions as a data selection unit that selects one second image from a plurality of images in the image group. After selecting the second image, the control unit 70 proceeds to step 12.

  In step 12, the control unit 70 retrieves the second image selected in step 11 from the storage unit 72, and causes the display unit 75 to display the second image simultaneously with the first image (see FIG. 8). When displaying the first image and the second image on the display unit 75, the control unit 70 ends the display control.

  As described above, the acquired images are automatically grouped, so that the examiner does not have to set the association with another image for each image. Further, since the image group is determined, the display of the related data is easy. For example, since images obtained by different modalities are associated with each other, the examiner can easily confirm a plurality of pieces of examination data and can easily make a diagnosis.

  More specifically, since the plurality of first image data having different shooting modes and the second image data are associated as the same group, when the first image data is displayed on the display unit 75, Is easily displayed on the display unit 75.

  In addition, by automatically selecting an image suitable as the second image from the image group, the examiner can save the trouble of selecting an appropriate image from the images in the group.

<Transformation example>
Note that the grouping method may have various modifications as described below. The above methods may be used individually or in combination.

  For example, a method is conceivable in which the captured images are registered as the same image group between the time when the preset combo shooting mode is set and the time when the shooting in the plurality of shooting modes is canceled until the shooting is canceled. As the combo shooting mode, for example, a mode in which a macular line shooting mode, a macula line shooting mode, and a color fundus shooting mode are sequentially set may be considered.

  In this case, when shooting in each shooting mode preset as the combo shooting mode is completed, the control unit 70 may group the images shot in the combo shooting mode as the same image group. More specifically, when the first combo shooting mode is set, each obtained image is registered in the first image group, and when the next second combo shooting mode is set, each obtained image is obtained. Each image is registered in a second image group.

  As another example, images captured from when the imaging software for performing imaging using the ophthalmic examination apparatus 1 is started until the imaging software is ended may be grouped as the same image group. Therefore, the grouping is performed as a separate image group each time the photographing software is started / terminated.

  As a grouping method, for example, a method of registering images having similar shooting conditions as the same image group can be considered. For example, the control unit 70 may group the images by referring to the shooting date and time, the right and left eyes, the shooting pattern, the fixation position information, and the like, from which the images were acquired, from the tag information of the images. More specifically, the control unit 70 may group images having the same or close image capturing date and time as the same image group. Further, the control unit 70 may, for example, divide the image group into a right-eye image group and a left-eye image group. Further, the control unit 70 may group the tomographic images such as macular line photographing, macular map photographing, nipple circle photographing, and nipple radial photographing mode. Further, the control unit 70 may perform grouping according to a lighting position of a fixation lamp of a fundus front image such as a macular center photograph, a nipple center photograph, a midpoint photograph between the macula and the nipple, and a panoramic photograph.

  In this case, for example, images having different shooting dates are grouped as different image groups. Further, different images such as right eye left eye, photographing pattern, fixation position information, and the like may be grouped as another image group.

  As a method of grouping, for example, a method of registering images acquired by a modality specified in advance as the same group can be considered. For example, when the examination items of the subject are predetermined, the control unit 70 may set the images of the modalities related to the scheduled examination in the same group. As an example, the control unit 70 may acquire inspection items received by the subject from an electronic medical record or the like, and group images of modalities used for those inspections into the same image group. In this case, for example, images acquired by a modality not related to the inspection item are grouped as another image group. The control unit 70 functions as an inspection item acquisition unit that acquires an inspection item.

  Further, as a grouping method, for example, a method of registering images consecutively photographed in the continuous photographing mode (continuous inspection mode) as the same image group can be considered. For example, the continuous photographing mode is a photographing mode in which photographing such as macular line photographing, macular map photographing, and color fundus photographing is continuously performed. For example, on the screen illustrated in FIG. 4, the examiner selects items to be continuously photographed. When a shooting item is selected, the control unit 70 continuously shoots the selected item. The control unit 70 may group the macular line image, the macular map image, and the color fundus front image at the center of the macular acquired in the continuous shooting mode. In this case, the images may be grouped when the continuous shooting mode ends, and the images shot next may be grouped as another image group.

  Note that, in the above description, the case of imaging in the order of macular line imaging, macular map imaging, and color fundus imaging has been described, but the order of imaging may be switched. In general, in the color fundus imaging, the emission of the flash is a burden on the subject, and therefore the imaging is often performed last. Further, the photographing pattern is not limited to the one described above. In the case of fundus tomographic imaging, imaging may be performed in an imaging mode such as macular cross imaging, macular radial imaging, nipple map imaging, nipple radial imaging, or nipple circle imaging.

  In the above description, the control unit 70 has described that images can be grouped according to the timing at which images are stored for a long period of time. However, the present invention is not limited to this. For example, the control unit 70 may group the images based on the timing at which the images stored in the storage unit 72 are registered in the image management software.

  Note that the group information may be automatically grouped by the control unit 70 and may be corrected later. For example, the group information may be modified by the examiner on a group modification screen or the like. For example, when an image is to be added to a group later, the image can be added by editing the group information. Alternatively, a new image group may be created by editing the group information.

  In this embodiment, the group information is managed by being added to each image. Thus, it is not necessary to store each image in the same location (for example, the same folder) for each group, and images can be stored separately in different locations (for example, different folders). Therefore, the capacity of a storage unit (for example, a hard disk drive) for storing images is reduced.

<Selection of second image>
In addition, a modified example of a method of selecting a second image from a plurality of images will be described below. For example, a method of selecting an image based on a lighting position of a fixation lamp at the time of photographing can be considered. For example, the control unit 70 may acquire the fixation light position information from the tag information of the first image, and select an image in the same image group having a close fixation light position as the second image.

  Further, as a method of selecting a second image from a plurality of images, for example, a method of selecting an image based on a positional shift amount with respect to the first image is considered. For example, the control unit 70 may calculate a shift amount between the first image and the images in the image group, and select an image having a small shift amount as the second image. Note that the shift amount may be calculated by, for example, a matching process with the first image.

  Further, the control unit 70 may select the second image based on the similarity of the image to the first image. For example, the similarity between the first image and images obtained by different modalities in the same image group may be analyzed, and an image having a large similarity may be selected as the second image. As a result, for example, an image that was not successfully photographed due to the subject's blinking or the like is not selected. Note that the similarity may be obtained based on, for example, the number of pixels in the overlapping area, the correlation of the luminance distribution, the cross-correlation coefficient, and the like when a part of the image is matched. Such control is advantageous in a case where the tomographic image and the color front image are associated using the infrared front image acquired simultaneously with the tomographic image and the infrared front image acquired simultaneously with the color front image. It is.

  In the above description, the control unit 70 displays an image suitable for the second image together with the first image from the same image group, but is not limited thereto. For example, as shown in FIG. 9A, when displaying the first image, the control unit 70 may be able to display a list of images belonging to the same image group as the first image. For example, the examiner may be able to select an image to be displayed together with the first image from the list. The control unit 70 may display the second image selected from the image group together with the first image. As described above, the control unit 70 may be able to selectively display the second image.

  In the above description, the control unit 70 selects a suitable second image from images belonging to the same image group as the selected first image, and causes the display unit 75 to display the selected second image together with the first image. However, it is not always necessary to select a suitable image. Any image may be selected as long as it belongs to the same image group.

  Note that the control unit 70 may acquire examination information different from the fundus tomographic image and the fundus front image, and may group them. For example, the control unit 70 may group an anterior segment front image, an anterior segment tomographic image, or the like of the subject. In addition, the control unit 70 may group the retinal thickness information of the subject's eye obtained by analyzing the fundus tomographic image. In addition, the control unit 70 may group the visual field sensitivity information and the like of the subject's eye measured by a perimeter (not shown). In other words, the data to be handled may be test data relating to the eye test.

  Then, the control unit 70 outputs the anterior ocular segment front image, the anterior ocular segment tomographic image, the thickness from the first group associated as the same group with the selected examination data (for example, fundus tomographic image, fundus frontal image). At least one of the information and the visual field sensitivity information may be selected as the second image and displayed on the display unit 75. For example, as shown in FIG. 9B, the control unit 70 may superimpose and display retinal thickness information and visual field sensitivity information of the subject's eye on a fundus front image or the like.

  The ophthalmic examination apparatus 1 is provided integrally with various modalities such as a scanning laser ophthalmoscope (SLO) in addition to an ophthalmic optical coherence tomography (OCT) and a fundus camera. You may be. Further, the control unit 70 may acquire data of the subject's eye acquired by the modality of the external device.

Reference Signs List 1 ophthalmic examination apparatus 34 dichroic mirror 70 control unit 72 storage unit 75 display unit 80 fixation optical system 90 computer 95 display unit 104 coupler 110 reference optical system 200 OCT optical system

Claims (8)

First examination data of an eye to be examined obtained by a first ophthalmic examination unit, the first examination data being image data, and a second examination data of the eye to be examined acquired by a second ophthalmic examination unit. An ophthalmic examination information processing apparatus that stores test data and a storage unit and outputs the same to a display unit,
A plurality of first examination data having different imaging modes set at the time of examination by the first ophthalmic examination unit, and the second examination data obtained on the same day as the first examination data. Group setting means to associate as the same group,
Instruction reception for receiving a selection instruction for selecting any of the plurality of first inspection data stored in the storage unit and displayed on the display unit on the display unit Means,
The first inspection data selected and instructed by the instruction receiving unit is displayed on the display unit, and the second inspection data associated with the selected first inspection data as the same group is stored in the storage unit. Display control means for extracting and displaying the first inspection data on the display unit simultaneously with the first inspection data;
An ophthalmologic examination information processing apparatus, comprising: The group setting means sets the plurality of first inspection data stored in different folders and the second inspection data stored in the same or different folder as any one of the first inspection data as the same group Association,
The first inspection data selected and instructed by the instruction receiving unit is displayed on the display unit, and the second inspection data associated with the selected first inspection data as a same group is stored in the storage unit. 2. The ophthalmologic examination information processing apparatus according to claim 1, wherein the first examination data and the second examination data stored in different folders can be simultaneously displayed on the display unit by taking out the first examination data and the second examination data. . The instruction receiving means receives a selection instruction for selecting the second inspection data stored in the storage unit,
The display control means displays the second inspection data selected and instructed by the instruction receiving means on a display unit, and the first inspection data associated with the second inspection data selected and instructed as the same group. 3. The ophthalmic examination information processing apparatus according to claim 1, wherein the information is selected and displayed on the display unit simultaneously with the second examination data.   The group setting means may include, as additional information, operation information of an ophthalmologic examination apparatus main body including at least one of the first ophthalmic examination unit and the second ophthalmic examination unit, and the ophthalmologic examination apparatus main body may be operated in accordance with an examiner's operation. A plurality of pieces of first examination data according to at least one of operation information on software for operating the apparatus, a series of examination instruction information set in advance on an electronic medical record, and examination position information on the fundus regarding each examination data. The ophthalmic examination information processing apparatus according to any one of claims 1 to 3, wherein the second examination data and the second examination data are associated as the same group.   The group setting unit may include a first examination data acquired through a series of examination operations on the same subject's eye by an ophthalmic examination apparatus including both the first ophthalmic examination unit and the second ophthalmic examination unit, and the first examination data. The ophthalmologic examination information processing apparatus according to any one of claims 1 to 4, wherein the two examination data are associated as the same group. First examination data of the subject's eye obtained by the ophthalmic optical coherence tomography unit, the first examination data being image data, and an ophthalmic examination unit different from the ophthalmic optical coherence tomography unit. An ophthalmologic examination information processing apparatus that stores the second examination data of the subject's eye in a storage unit and outputs it to a display unit,
A plurality of first inspection data having different imaging modes set at the time of inspection in the ophthalmic optical coherence tomography unit; and the second inspection data obtained on the same day as the first inspection data. Group setting means for associating as a same group,
An instruction for receiving a selection instruction for selecting any of the plurality of first inspection data displayed on the display unit on the display unit, the plurality of first inspection data stored in the storage unit Reception means,
The first inspection data selected and instructed by the instruction receiving unit is displayed on the display unit, and the second inspection data associated with the selected first inspection data as the same group is stored in the storage unit. Display control means for extracting and displaying the first inspection data on the display unit simultaneously with the first inspection data;
An ophthalmologic examination information processing apparatus, comprising: The ophthalmologic examination information processing apparatus according to any one of claims 1 to 6,
A system connected to a combined ophthalmic examination apparatus including both a first ophthalmic examination unit and the second ophthalmic examination unit,
The combined ophthalmic examination apparatus,
A continuous examination mode in which acquisition of examination data by the first ophthalmic examination unit and the second ophthalmic examination unit is continuously performed based on one trigger signal;
An individual examination mode in which acquisition of examination data by the first ophthalmic examination unit and the second ophthalmic examination unit is performed based on an individual trigger signal, wherein acquisition of examination data by the first ophthalmic examination unit is performed. A first examination mode to be performed, and an individual examination mode having at least a second examination mode for acquiring examination data by the second ophthalmic examination unit;
Mode setting means that can set
The group setting means,
An ophthalmologic examination information processing apparatus, wherein the second examination data obtained in the continuous examination mode and the first examination data obtained in the individual examination mode are associated as the same group. First examination data of an eye to be examined obtained by a first ophthalmic examination unit, the first examination data being image data, and a second examination data of the eye to be examined acquired by a second ophthalmic examination unit. Examination data, an ophthalmic examination information processing program executed in the ophthalmic examination information processing device that stores in the storage unit and outputs to the display unit,
When executed by the processor of the ophthalmic examination information processing apparatus,
A plurality of first examination data having different imaging modes set at the time of examination by the first ophthalmic examination unit, and the second examination data obtained on the same day as the first examination data. A group setting step to associate as the same group,
An instruction for receiving a selection instruction for selecting any of the plurality of first inspection data displayed on the display unit on the display unit, the plurality of first inspection data stored in the storage unit Receiving step,
The first inspection data selected and instructed in the instruction receiving step is displayed on the display unit, and the second inspection data associated with the selected first inspection data as a same group is stored in the storage unit. A display control step of taking out and displaying on the display unit simultaneously with the first inspection data;
An ophthalmic examination information processing program causing the ophthalmic examination information processing apparatus to execute the above.

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