JP7106320B2 - Ophthalmic device and control method for ophthalmic device - Google Patents

Description

The present invention relates to an ophthalmic apparatus and a control method for an ophthalmic apparatus.

Axial length is one of intraocular parameters useful for selection of power of intraocular lens before cataract surgery, confirmation of axial refractive error, and the like. Such intraocular parameters can be obtained using optical coherence tomography (eg, Patent Document 1).

The axial length is obtained, for example, from a scan result obtained by performing an anterior segment OCT scan on the anterior segment of the subject's eye. In the anterior segment OCT scan, the anterior segment is scanned with measurement light focused on a predetermined position on the fundus. From the results of the anterior segment OCT scan, corneal shape information and lens information useful for selecting the power of the intraocular lens are obtained. In this case, the axial length of the eye is specified as the distance between the position corresponding to the corneal vertex obtained by the anterior segment OCT scan and a predetermined position on the fundus.

JP 2017-77250 A

The axial length is defined as the distance between the corneal vertex and the macula (fovea). However, with conventional methods, it is difficult to determine whether the position on the fundus obtained by the anterior segment OCT scan is the macula. Similarly, it is difficult to determine whether the position of the corneal apex obtained by the anterior segment OCT scan is the true position of the corneal apex. Therefore, in the conventional method, it is difficult to determine whether the obtained axial length is the true distance between the corneal vertex and the macula, and the reliability of the measurement result of the axial length decreases. There is a problem.

In addition, not only the axial length of the eye but also the measurement results of intraocular distances such as corneal thickness, anterior chamber depth, and crystalline lens thickness may be similarly unreliable.

SUMMARY OF THE INVENTION The present invention has been made in view of such circumstances, and an object thereof is to provide an ophthalmologic apparatus and a control method for the ophthalmic apparatus that can obtain highly reliable intraocular distance measurement results. It is in.

According to a first aspect of some embodiments, light from a light source is split into measurement light and reference light, the measurement light is projected onto an eye to be inspected, return light of the measurement light from the eye to be inspected and the reference light are emitted. an interference optical system that detects interference light with light; an artifact identification unit that identifies an artifact at a position corresponding to the corneal vertex of the eye to be examined based on the detection result of the interference light; A moving mechanism that relatively moves an optical system, a control unit that controls the moving mechanism, and detection of the interference light obtained in a state in which alignment between the artifact and the interference optical system is completed by the moving mechanism. Based on the result, an eye based on a macular portion identifying portion that identifies a position corresponding to the macular portion in the eye to be examined, and a position corresponding to the macular portion identified by the position of the artifact and the macular portion identifying portion. and an intraocular distance calculator that calculates the intraocular distance.

In a second aspect of some embodiments, in the first aspect, the intraocular distance calculator calculates the axial length of the eye to be examined.

In a third aspect of some embodiments, in the first aspect or the second aspect, the controller controls the movement mechanism so as to cancel the displacement of the interference optical system with respect to the artifact.

A fourth aspect of some embodiments is any one of the first to third aspects, comprising a tomographic image forming unit that forms a tomographic image of the subject's eye based on the detection result of the interference light, The macular portion identifying unit identifies the macular portion by analyzing the tomographic image in which the artifact has been identified.

A fifth aspect of some embodiments is any one of the first to fourth aspects, including a fixation projection system that projects a fixation target onto the eye to be examined, wherein the control unit comprises the macular identification unit When the macula cannot be identified by the above, the fixation projection system is controlled so as to change the projection position of the fixation target in the eye to be examined, and the intraocular distance calculator determines that the projection position of the fixation target is In the changed state, the intraocular distance is calculated based on the position of the artifact specified by the artifact specifying unit and the position corresponding to the macula specified by the macular part specifying unit.

A sixth aspect of some embodiments is, in the fifth aspect, forming a three-dimensional image of the subject's eye based on the detection result of the interference light when the macular portion cannot be specified by the macular portion specifying unit. a dimensional image forming unit, wherein the macular portion specifying unit specifies the macular portion based on the three-dimensional image; and the control unit specifies the macular portion specified by the macular portion specifying unit based on the three-dimensional image The fixation projection system is controlled based on the position corresponding to the macula.

According to a seventh aspect of some embodiments, light from a light source is split into measurement light and reference light, the measurement light is projected onto an eye to be inspected, return light of the measurement light from the eye to be inspected and the reference light are emitted. A control method for an ophthalmologic apparatus including an interference optical system for detecting interference light with light and a movement mechanism for moving the interference optical system relative to the eye to be examined. A control method for an ophthalmologic apparatus includes an artifact identifying step of identifying an artifact at a position corresponding to the corneal vertex of the eye to be inspected based on the detection result of the interference light, and the artifact identified in the artifact identifying step by the moving mechanism. and the interference optical system, and a macular portion for specifying a position corresponding to the macular portion in the eye to be examined based on the detection result of the interference light acquired after the alignment step. and an intraocular distance calculating step of calculating an intraocular distance based on the position of the artifact and the position corresponding to the macular portion identified in the macular portion identifying step.

According to an eighth aspect of some embodiments, in the seventh aspect, the intraocular distance calculating step calculates an axial length of the eye to be examined.

A ninth aspect of some embodiments is the seventh aspect or the eighth aspect, comprising a tomographic image forming step of forming a tomographic image of the eye to be examined based on the detection result of the interference light, The step identifies the macular region by analyzing the tomogram in which the artifact has been identified.

According to a tenth aspect of some embodiments, in any one of the seventh to ninth aspects, the ophthalmologic apparatus includes a fixation projection system that projects a fixation target onto the subject's eye. The method for controlling an ophthalmologic apparatus includes a fixation control step of controlling the fixation projection system to change the projection position of the fixation target on the eye to be examined when the macular portion cannot be identified in the macular portion identification step. wherein the intraocular distance calculating step corresponds to the position of the artifact identified in the artifact identifying step and the macular portion identified in the macular portion identifying step with the projection position of the fixation target changed. The intraocular distance is calculated based on the position where the

An eleventh aspect of some embodiments is, in the tenth aspect, forming a three-dimensional image of the subject's eye based on the detection result of the interference light when the macular portion cannot be identified in the macular portion identification step. a dimensional image forming step, wherein the macular portion identifying step identifies the macular portion based on the three-dimensional image; and the fixation control step identifies the macular portion based on the three-dimensional image in the macular portion identifying step; The fixation projection system is controlled based on the position corresponding to the macula.

Advantageous Effects of Invention According to the present invention, it is possible to provide an ophthalmologic apparatus capable of obtaining a highly reliable intraocular distance measurement result, and a control method for the ophthalmic apparatus.

1 is a schematic diagram showing a configuration example of an optical system of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram showing a configuration example of an optical system of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment; FIG. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment; FIG. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment; FIG.

Embodiments of an ophthalmologic apparatus and an ophthalmologic apparatus control method according to the present invention will be described in detail with reference to the drawings. It should be noted that the descriptions of the documents cited in this specification and any known techniques can be incorporated into the following embodiments.

An ophthalmologic apparatus according to an embodiment can perform Optical Coherence Tomography (OCT) on the anterior segment and the posterior segment of an eye to be examined. The anterior segment includes at least the corneal vertex. The posterior segment includes at least the macula (fovea fovea).

Hereinafter, in the embodiments, a case where a swept source type OCT method is used will be described in detail. It is also possible to

An ophthalmologic apparatus according to some embodiments includes an OCT optical system for performing OCT and other examination optical systems. Such an inspection optical system includes a subjective inspection optical system for subjective inspection or an objective measurement optical system for objective measurement other than optical interference measurement.

Subjective testing is a measurement technique that uses responses from subjects to obtain information. The subjective examination includes subjective refraction measurement such as distance examination, near examination, contrast examination, glare examination, and visual field examination.

Objective measurement is a measurement technique that obtains information about the subject's eye using mainly physical techniques without referring to responses from the subject. Objective measurement includes measurement for acquiring characteristics of the eye to be inspected and photographing for acquiring an image of the eye to be inspected. Objective measurements include refractive power measurement, corneal shape measurement, intraocular pressure measurement, fundus photography, and the like.

Hereinafter, an ophthalmologic apparatus according to an embodiment will be described in which it includes an OCT optical system and a refractive power measurement optical system (reflector measurement optical system) for performing refractive power measurement. Further, hereinafter, the fundus conjugate position is a position that is substantially optically conjugate with the fundus of the subject's eye after alignment is completed, and means a position that is optically conjugate with the fundus of the subject's eye or its vicinity. do. Similarly, the pupil conjugate position is a position that is approximately optically conjugate with the pupil of the eye to be inspected in a state in which alignment is completed, and means a position that is optically conjugate with the pupil of the eye to be inspected or in the vicinity thereof. .

<Configuration of optical system>
FIG. 1 shows a configuration example of an optical system of an ophthalmologic apparatus according to an embodiment. An ophthalmologic apparatus 1000 according to an embodiment includes an optical system for observing an eye to be examined E, an optical system for examining the eye to be examined E, and a dichroic mirror for wavelength-separating the optical paths of these optical systems. An anterior segment observation system 5 is provided as an optical system for observing the eye E to be examined. An OCT optical system and a reflector measurement optical system (refractive power measurement optical system) are provided as an optical system for examining the eye E to be examined.

The ophthalmologic apparatus 1000 includes a Z alignment system 1, an XY alignment system 2, a keratometric measurement system 3, a fixation projection system 4, an anterior segment observation system 5, a reflector measurement projection system 6, a reflector measurement light receiving system 7, and an OCT optical system 8. including. In the following, for example, the anterior segment observation system 5 uses light of 940 nm to 1000 nm, the reflector measurement optical system (reflection measurement projection system 6, reflection measurement light receiving system 7) uses light of 830 nm to 880 nm, and the fixation projection system 4 uses light of 400 nm to 700 nm, and the OCT optical system 8 uses light of 1000 nm to 1100 nm.

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

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

(XY alignment system 2)
The XY alignment system 2 applies light (infrared light) to the eye to be examined E for alignment in directions perpendicular to the optical axis of the anterior eye observation system 5 (horizontal direction (X direction) and vertical direction (Y direction)). to irradiate. The XY alignment system 2 includes an XY alignment light source 21 and a collimator lens 22 provided in an optical path branched from the optical path of the anterior eye observation system 5 by a half mirror 23 . Light output from the XY alignment light source 21 passes through the collimator lens 22 , is reflected by the half mirror 23 , and is projected onto the subject's eye E through the anterior eye observation system 5 . Reflected light from the cornea Cr of the eye E to be inspected is guided to the imaging device 59 through the anterior segment observation system 5 .

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

In addition, the processing unit 9 can display the B-scan image of the subject's eye E acquired using the OCT optical system 8 on the display screen of the display unit in real time. The user can manually perform the XY alignment by moving the optical system so that the displacement between the predetermined position in the B-scan image and the optical system is cancelled. Further, the processing unit 9 can automatically perform XY alignment by performing control to move the optical system so as to cancel the displacement between the predetermined position in the B-scan image and the optical system. In this embodiment, the predetermined position in the B-scan image is the position of an artifact rendered at a position corresponding to the corneal vertex of the eye E to be examined, as will be described later. In some embodiments, the Z-direction alignment of the optical system to a predetermined position in the B-scan image is also manually or automatically performed.

(Kerato measurement system 3)
The keratometry system 3 projects a ring-shaped light beam (infrared light) for measuring the shape of the cornea Cr of the eye E to be examined onto the cornea Cr. The keratoplate 31 is arranged between the objective lens 51 and the eye E to be examined. A kerato ring light source 32 is provided on the back side of the kerato plate 31 (on the objective lens 51 side). A ring-shaped light flux is projected onto the cornea Cr of the eye E to be inspected by illuminating the kerat plate 31 with light from the keratizing light source 32 . Reflected light (keratling image) from the cornea Cr of the subject's eye E is detected by the imaging element 59 together with the anterior segment image E'. The processing unit 9 calculates corneal shape parameters representing the shape of the cornea Cr by performing known calculations based on this keratling image.

(ref measurement projection system 6, ref measurement light receiving system 7)
The ref measurement optical system includes a ref measurement projection system 6 and a ref measurement light receiving system 7 used for refractive power measurement. The ref measurement projection system 6 projects a refractive power measurement light beam (for example, a ring-shaped light beam) (infrared light) onto the fundus oculi Ef. The ref measurement light-receiving system 7 receives the return light from the subject's eye E of this luminous flux. The reflector measurement projection system 6 is provided on an optical path branched by a perforated prism 65 provided in the optical path of the reflector measurement light receiving system 7 . The aperture formed in the apertured prism 65 is arranged at the pupil conjugate position. In the optical system passing through the ref measurement light-receiving system 7, the imaging surface of the imaging device 59 is arranged at the fundus conjugate position.

In some embodiments, the ref measurement light source 61 is an SLD (Superluminescent Diode) light source, which is a high luminance light source. The ref measurement light source 61 is movable in the optical axis direction. A reflex measurement light source 61 is arranged at a fundus conjugate position. The light output from the ref measurement light source 61 passes through the relay lens 62 and enters the conical surface of the conical prism 63 . Light incident on the conical surface is deflected and emitted from the bottom surface of the conical prism 63 . Light emitted from the bottom surface of the conical prism 63 passes through a ring-shaped transparent portion of the ring aperture 64 . The light (ring-shaped luminous flux) that has passed through the transparent portion of the ring diaphragm 64 is reflected by the reflecting surface formed around the hole of the apertured prism 65, passes through the rotary prism 66, and is reflected by the dichroic mirror 67. be. The light reflected by the dichroic mirror 67 is reflected by the dichroic mirror 52, passes through the objective lens 51, and is projected onto the eye E to be examined. The rotary prism 66 is used for averaging the light quantity distribution of the ring-shaped light flux for blood vessels and diseased areas of the fundus oculi Ef and for reducing speckle noise caused by the light source.

The return light of the ring-shaped luminous flux projected onto the fundus oculi Ef passes through the objective lens 51 and is reflected by the dichroic mirrors 52 and 67 . The return light reflected by the dichroic mirror 67 passes through the rotary prism 66, passes through the aperture of the perforated prism 65, passes through the relay lens 71, is reflected by the reflecting mirror 72, and passes through the relay lens 73 and the focusing lens. Pass 74. The focusing lens 74 is movable along the optical axis of the ref measurement light receiving system 7 . The light that has passed through the focusing lens 74 is reflected by the reflecting mirror 75 , reflected by the dichroic mirror 76 , and imaged on the imaging surface of the imaging element 59 by the imaging lens 58 . The processing unit 9 calculates the refractive power value of the subject's eye E by performing a known calculation based on the output from the imaging device 59 . For example, power values include spherical power, cylinder power and cylinder axis angle, or equivalent spherical power.

(Fixation projection system 4)
An OCT optical system 8, which will be described later, is provided in an optical path separated by a dichroic mirror 67 from the optical path of the reflective measurement optical system. A fixation projection system 4 is provided on an optical path branched from the optical path of the OCT optical system 8 by a dichroic mirror 83 .

A fixation projection system 4 presents a fixation target to the eye E to be examined. The liquid crystal panel 41 controlled by the processing unit 9 displays a pattern representing the fixation target. By changing the display position of the pattern on the screen of the liquid crystal panel 41, the fixation position of the subject's eye E can be changed. The fixation position of the subject's eye E includes a position for acquiring an image centered on the macula of the fundus oculi Ef, a position for acquiring an image centered on the optic papilla, and a position between the macula and the optic papilla. There is a position for acquiring an image centered on the center of the fundus in between. It is possible to arbitrarily change the display position of the pattern representing the fixation target.

Light from the liquid crystal panel 41 passes through the relay lens 42 , dichroic mirror 83 , relay lens 82 , reflection mirror 81 , dichroic mirror 67 , and dichroic mirror 52 . . The light reflected by the dichroic mirror 52 passes through the objective lens 51 and is projected onto the fundus oculi Ef. The liquid crystal panel 41 (or the liquid crystal panel 41 and relay lens 42) is movable in the optical axis direction.

(OCT optical system 8)
The OCT optical system 8 is an optical system for performing OCT measurement. The position of the focusing lens 87 is adjusted so that the end face of the optical fiber f1 is conjugated to the fundus oculi Ef and the optical system based on the reflex measurement results performed prior to the OCT measurement.

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

OCT optical system 8 includes an OCT unit 100 . As shown in FIG. 2, in the OCT unit 100, the OCT light source 101 is a wavelength-swept (wavelength scanning) light source capable of sweeping (scanning) the wavelength of emitted light, similar to a general swept-source type OCT apparatus. Consists of A swept-wavelength light source includes a laser light source including a resonator. The OCT light source 101 temporally changes the output wavelength in the near-infrared wavelength band invisible to the human eye.

As illustrated in FIG. 2, the OCT unit 100 is provided with an optical system for performing swept-source OCT. This optical system includes an interference optical system. This interference optical system has a function of dividing light from a wavelength tunable light source (wavelength swept light source) into measurement light and reference light, return light of the measurement light from the subject's eye E, and reference light passing through the reference light path. and a function of generating interference light and a function of detecting this interference light. A detection result (detection signal) of the interference light obtained by the interference optical system is a signal indicating the spectrum of the interference light, and is sent to the processing unit 9 .

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

The reference light LR is guided by the optical fiber 110 to the collimator 111 and converted into a parallel beam, and guided to the corner cube 114 via the optical path length correction member 112 and the dispersion compensation member 113 . The optical path length correction member 112 acts to match the optical path length of the reference light LR and the optical path length of the measurement light LS. The dispersion compensation member 113 acts to match the dispersion characteristics between the reference light LR and the measurement light LS. The corner cube 114 is movable in the incident direction of the reference light LR, thereby changing the optical path length of the reference light LR.

The reference light LR that has passed through the corner cube 114 passes through the dispersion compensating member 113 and the optical path length correcting member 112 , is converted by the collimator 116 from a parallel beam to a converged beam, and enters the optical fiber 117 . The reference light LR incident on the optical fiber 117 is guided to the polarization controller 118 to adjust its polarization state, guided to the attenuator 120 by the optical fiber 119 to adjust the light amount, and guided to the fiber coupler 122 by the optical fiber 121.

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

The light scanner 88 deflects the measurement light LS one-dimensionally or two-dimensionally. Optical scanner 88 includes, for example, a first galvanometer mirror and a second galvanometer mirror. The first galvanomirror deflects the measurement light LS so as to scan the fundus oculi Ef in the horizontal direction perpendicular to the optical axis of the OCT optical system 8 . The second galvanomirror deflects the measurement light LS deflected by the first galvanomirror so as to scan the fundus oculi Ef in the vertical direction perpendicular to the optical axis of the OCT optical system 8 . Scanning modes of the measurement light LS by the light scanner 88 include, for example, horizontal scanning, vertical scanning, cross scanning, radial scanning, circular scanning, concentric scanning, and spiral scanning.

The measuring light LS reflected by the dichroic mirror 83 passes through the relay lens 82, is reflected by the reflecting mirror 81, passes through the dichroic mirror 67, is reflected by the dichroic mirror 52, is refracted by the objective lens 51, and reaches the subject's eye E incident on The measurement light LS is scattered and reflected at various depth positions of the eye E to be examined. The return light of the measurement light LS from the subject's eye E travels in the opposite direction along the same path as the forward path, is guided to the fiber coupler 105 , and reaches the fiber coupler 122 via the optical fiber 128 .

The fiber coupler 122 combines (interferences) the measurement light LS that has entered via the optical fiber 128 and the reference light LR that has entered via the optical fiber 121 to generate interference light. The fiber coupler 122 generates a pair of interference lights LC by splitting the interference lights at a predetermined splitting ratio (for example, 1:1). A pair of interference beams LC are guided to detector 125 through optical fibers 123 and 124, respectively.

Detector 125 is, for example, a balanced photodiode. A balanced photodiode includes a pair of photodetectors that respectively detect a pair of interference lights LC, and outputs a difference between a pair of detection results obtained by these photodetectors. The detector 125 sends this output (detection signal) to a DAQ (Data Acquisition System) 130 .

A clock KC is supplied from the OCT light source 101 to the DAQ 130 . The clock KC is generated in the OCT light source 101 in synchronization with the output timing of each wavelength swept within a predetermined wavelength range by the wavelength tunable light source. The OCT light source 101, for example, optically delays one of the two branched lights obtained by branching the light L0 of each output wavelength, and then outputs the clock KC based on the result of detecting these combined lights. Generate. The DAQ 130 samples the detection signal input from the detector 125 based on the clock KC. The DAQ 130 sends the sampling result of the detection signal from the detector 125 to the arithmetic processing section 220 of the processing section 9 . For example, for each series of wavelength scans (for each A line), the arithmetic processing unit 220 forms a reflection intensity profile for each A line by applying Fourier transform or the like to the spectral distribution based on the sampling data. Furthermore, the arithmetic processing unit 220 forms image data by imaging the reflection intensity profile of each A line.

In this example, a corner cube 114 is provided for changing the length of the optical path (reference optical path, reference arm) of the reference light LR. It is also possible to change the difference between

The processing unit 9 calculates a refractive power value from the measurement result obtained using the reflector measurement optical system, and based on the calculated refractive power value, the fundus oculi Ef, the reflector measurement light source 61, and the image sensor 59 are conjugated. The ref measurement light source 61 and the focusing lens 74 are moved in the optical axis direction to the respective positions. In some embodiments, the processing unit 9 moves the focusing lens 87 of the OCT optical system 8 along its optical axis in conjunction with the movement of the focusing lens 74 . In some embodiments, the processing unit 9 moves the liquid crystal panel 41 along its optical axis in conjunction with the movement of the ref measurement light source 61 and the focusing lens 74 .

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

The processing unit 9 controls each unit of the ophthalmologic apparatus 1000 . In addition, the processing unit 9 can execute various arithmetic processing. The processing unit 9 includes a processor.プロセッサの機能は、例えば、ＣＰＵ（Ｃｅｎｔｒａｌ Ｐｒｏｃｅｓｓｉｎｇ Ｕｎｉｔ）、ＧＰＵ（Ｇｒａｐｈｉｃｓ Ｐｒｏｃｅｓｓｉｎｇ Ｕｎｉｔ）、ＡＳＩＣ（Ａｐｐｌｉｃａｔｉｏｎ Ｓｐｅｃｉｆｉｃ Ｉｎｔｅｇｒａｔｅｄ Ｃｉｒｃｕｉｔ）、プログラマブル論理デバイス（例えば、ＳＰＬＤ（Ｓｉｍｐｌｅ Ｐｒｏｇｒａｍｍａｂｌｅ Ｌｏｇｉｃ Ｄｅｖｉｃｅ）、ＣＰＬＤ（Ｃｏｍｐｌｅｘ Ｐｒｏｇｒａｍｍａｂｌｅ Ｌｏｇｉｃ Ｄｅｖｉｃｅ） , FPGA (Field Programmable Gate Array)). The processing unit 9 implements the functions according to the embodiment by, for example, reading and executing a program stored in a storage circuit or storage device.

Processing unit 9 includes control unit 210 and arithmetic processing unit 220 . The ophthalmologic apparatus 1000 also includes a moving mechanism 200 , a display section 270 , an operation section 280 and a communication section 290 .

The moving mechanism 200 includes a Z alignment system 1, an XY alignment system 2, a keratometric measurement system 3, a fixation projection system 4, an anterior segment observation system 5, a reflector measurement projection system 6, a reflector measurement light receiving system 7, an OCT optical system 8, and the like. This is a mechanism for moving the head section in which the optical system is housed in the front, rear, left, and right directions. For example, the moving mechanism 200 is provided with an actuator that generates driving force for moving the head section and a transmission mechanism that transmits this driving force. The actuator is composed of, for example, a pulse motor. The transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like. The control unit 210 (main control unit 211) controls the movement mechanism 200 by sending control signals to the actuators.

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

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

Control of the XY alignment system 2 includes control of the XY alignment light source 21 and the like. The control of the XY alignment light source 21 includes turning on/off the light source, adjusting the amount of light, and adjusting the aperture. Thereby, lighting and non-lighting of the XY alignment light source 21 are switched, or the amount of light is changed. The main control unit 211 captures the signal detected by the imaging element 59 and identifies the position of the bright spot image based on the return light from the XY alignment light source 21 based on the captured signal. The main control unit 211 controls the moving mechanism 200 so as to cancel the displacement of the position of the bright point image Br with respect to a predetermined target position (for example, the center position of the alignment mark AL), and moves the head unit in left, right, up and down directions. Move (XY alignment).

In this embodiment, the main control unit 211 can display a B-scan image of the subject's eye E on the display unit 270 during intraocular distance measurement such as the axial length of the eye using the OCT optical system 8 . When the user operates the operation unit 280 while confirming the position of the artifact at the position corresponding to the corneal vertex displayed on the display unit 270, the main control unit 211 outputs a control signal corresponding to the operation content. Based on this, it is possible to manually align the optical system with respect to the artifact by controlling the movement mechanism 200 . Further, the main control unit 211 can automatically align the optical system with respect to the artifact by controlling the moving mechanism 200 so that the displacement of the artifact position with respect to the desired target position in the B-scan image is cancelled. It is possible. A desired target position can be specified by the user using the operation unit 280 .

Control of the keratometry system 3 includes control of the keratometry light source 32 and the like. The control of the keratling light source 32 includes turning on/off the light source, adjusting the amount of light, and adjusting the aperture. Thereby, lighting and non-lighting of the keratling light source 32 are switched, or the amount of light is changed. The main control unit 211 causes the arithmetic processing unit 220 to perform a known arithmetic operation on the keratling image detected by the imaging device 59 . Thereby, the corneal shape parameter of the eye E to be examined is obtained.

Control of the fixation projection system 4 includes control of the liquid crystal panel 41 and the like. The control of the liquid crystal panel 41 includes turning on/off the display of the fixation target, switching the display position of the fixation target, and the like. Thereby, the fixation target is projected onto the fundus Ef of the eye E to be examined. For example, the fixation projection system 4 includes a moving mechanism that moves the liquid crystal panel 41 (or the liquid crystal panel 41 and the relay lens 42) in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the movement mechanism by sending control signals to the actuators, and moves at least the liquid crystal panel 41 in the optical axis direction. Thereby, the position of the liquid crystal panel 41 is adjusted so that the liquid crystal panel 41 and the fundus oculi Ef are optically conjugated.

The control of the anterior segment observation system 5 includes control of the anterior segment illumination light source 50, control of the imaging element 59, and the like. The control of the anterior ocular segment illumination light source 50 includes turning on/off the light source, light amount adjustment, aperture adjustment, and the like. As a result, the lighting and non-lighting of the anterior segment illumination light source 50 is switched, or the amount of light is changed. Control of the imaging element 59 includes exposure adjustment, gain adjustment, detection rate adjustment, and the like of the imaging element 59 . The main control unit 211 captures the signals detected by the imaging device 59 and causes the arithmetic processing unit 220 to execute processing such as formation of an image based on the captured signals.

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

Control of the ref measurement light-receiving system 7 includes control of the focusing lens 74 and the like. Control of the focusing lens 74 includes movement control of the focusing lens 74 in the optical axis direction. For example, the ref measurement light-receiving system 7 includes a moving mechanism that moves the focusing lens 74 in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the moving mechanism by sending a control signal to the actuator to move the focusing lens 74 in the optical axis direction. The main control unit 211 controls the refractometer measurement light source 61 and the focusing lens 74 according to the refractive power of the subject's eye E, for example, so that the refractometer light source 61, the fundus oculi Ef, and the imaging device 59 are optically conjugate. Axial movement is possible.

Control of the OCT optical system 8 includes control of the OCT light source 101, control of the optical scanner 88, control of the focusing lens 87, control of the corner cube 114, control of the detector 125, control of the DAQ 130, and the like. The control of the OCT light source 101 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. Control of the optical scanner 88 includes control of the scanning position, scanning range, and scanning speed by the first galvanomirror, and control of the scanning position, scanning range, and scanning speed by the second galvanomirror. Control of the focusing lens 87 includes movement control of the focusing lens 87 in the optical axis direction. For example, the OCT optical system 8 includes a moving mechanism that moves the focusing lens 87 in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the moving mechanism by sending a control signal to the actuator to move the focusing lens 87 in the optical axis direction. In some embodiments, the ophthalmic device is provided with a retaining member that retains the focusing lenses 74 and 87 and a drive that drives the retaining member. The main control section 211 performs movement control of the focusing lenses 74 and 87 by controlling the driving section. For example, the main control unit 211 may move only the focusing lens 87 based on the intensity of the interference signal after moving the focusing lens 87 in conjunction with the movement of the focusing lens 74 . The control of the corner cube 114 includes movement control of the corner cube 114 along the optical path. For example, the OCT optical system 8 includes a moving mechanism that moves the corner cube 114 along the optical path. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the moving mechanism by sending control signals to the actuators to move the corner cube 114 along the optical path. Control of the detector 125 includes exposure adjustment, gain adjustment, and detection rate adjustment of the detection element. The main control unit 211 samples the signal detected by the detector 125 by the DAQ 130, and causes the arithmetic processing unit 220 (image forming unit 222) to perform processing such as formation of an image based on the sampled signal.

The main control unit 211 also performs processing of writing data to the storage unit 212 and processing of reading data from the storage unit 212 .

(storage unit 212)
The storage unit 212 stores various data. The data stored in the storage unit 212 includes, for example, objective measurement results, tomographic image data, fundus image image data, and subject eye information. The eye information to be examined includes information about the subject such as patient ID and name, and information about the eye to be examined such as left/right eye identification information. The storage unit 212 also stores various programs and data for operating the ophthalmologic apparatus.

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

The eye refractive power calculation unit 221 calculates a ring image (pattern image ). For example, the eye refractive power calculator 221 obtains the barycentric position of the ring image from the luminance distribution in the obtained image in which the ring image is rendered, and obtains the luminance distribution along a plurality of scanning directions radially extending from this barycentric position. , the ring image is specified from this luminance distribution. Subsequently, the eye refractive power calculation unit 221 obtains an approximated ellipse of the specified ring image, and obtains the spherical power, the cylindrical power, and the cylindrical axis angle by substituting the major axis and minor axis of the approximated ellipse into a known formula. . Alternatively, the eye refractive power calculator 221 can obtain parameters of the eye refractive power based on deformation and displacement of the ring image with respect to the reference pattern.

The eye refractive power calculator 221 also calculates the corneal refractive power, the corneal astigmatism degree, and the corneal astigmatism axis angle based on the keratling image acquired by the anterior eye observation system 5 . For example, the eye refractive power calculator 221 calculates the corneal curvature radii of the strong and weak principal meridians of the corneal front surface by analyzing the keratling image, and calculates the above parameters based on the corneal curvature radii.

The image forming unit 222 forms image data of a tomographic image of the anterior ocular segment or the fundus oculi Ef based on the signal detected by the detector 115 . That is, the image forming unit 222 forms image data of the subject's eye E based on the detection result of the interference light LC by the interference optical system. This processing includes processing such as filter processing and FFT (Fast Fourier Transform), as in conventional spectral domain type OCT. The image data acquired in this manner is a data set containing a group of image data formed by imaging reflection intensity profiles in a plurality of A-lines (paths of each measuring light LS in the eye E to be examined). be.

To improve image quality, multiple data sets collected by scanning the same pattern multiple times can be superimposed (averaged).

The data processing unit 223 performs various data processing (image processing) and analysis processing on the tomogram formed by the image forming unit 222 . For example, the data processing unit 223 executes correction processing such as image luminance correction and dispersion correction. In addition, the data processing unit 223 performs various image processing and analysis processing on the image (anterior segment image, etc.) obtained using the anterior segment observation system 5 .

The data processing unit 223 forms image data of a three-dimensional image of the anterior segment or the fundus Ef by executing known image processing such as interpolation processing for interpolating pixels between tomographic images. Note that image data of a three-dimensional image means image data in which pixel positions are defined by a three-dimensional coordinate system. Image data of a three-dimensional image includes image data composed of voxels arranged three-dimensionally. This image data is called volume data or voxel data. When displaying an image based on volume data, the image forming unit 222 performs rendering processing (volume rendering, MIP (Maximum Intensity Projection: maximum intensity projection), etc.) on this volume data so that it can be viewed from a specific line-of-sight direction. Image data of a pseudo three-dimensional image is formed.

Stack data of a plurality of tomographic images can also be formed as image data of a three-dimensional image. Stack data is image data obtained by three-dimensionally arranging a plurality of tomographic images obtained along a plurality of scanning lines based on the positional relationship of the scanning lines. That is, stack data is image data obtained by expressing a plurality of tomographic images, which were originally defined by individual two-dimensional coordinate systems, by one three-dimensional coordinate system (that is, embedding them in one three-dimensional space). be.

The data processing unit 223 includes an artifact identification unit 223A, a macular area identification unit 223B, and an intraocular distance calculation unit 223C.

The artifact specifying unit 223A specifies an artifact at a position corresponding to the corneal vertex of the eye E to be examined based on the detection result of the interference light LC obtained by the OCT optical system 8 . The control unit 210 specifies the position (three-dimensional position) of the corneal vertex of the subject's eye E in the control coordinate system of the optical system corresponding to the position of the artifact specified by the artifact specifying unit 223A. For example, the control unit 210 adjusts the position of the subject's eye in the control coordinate system based on information representing the position of the artifact in the scan range, information representing the scan range with respect to the optical system, and information representing the position of the optical system in the control coordinate system. Locate the corneal vertex of E. The control unit 210 can align the optical system with the position of the corneal vertex of the subject's eye E in the specified control coordinate system.

In some embodiments, the artifact identification unit 223A identifies pixels (the center of a group of pixels, the center of gravity, etc.) having luminance equal to or higher than a predetermined threshold as artifacts. In some embodiments, the artifact identification unit 223A identifies the peak position of the detection signal corresponding to the detection result of the interference light LC as the artifact position.

The artifact specifying unit 223A can specify an artifact at a position corresponding to the corneal vertex of the eye to be inspected E in the tomogram based on the tomographic image of the eye to be inspected E formed by the image forming unit 222 . In this case, the control unit 210 causes the display unit 270 to display a tomographic image in which the position of the specified artifact is displayed so as to be identifiable.

The artifact specifying unit 223A can specify an artifact at a position corresponding to the corneal vertex of the eye to be examined E in the three-dimensional image based on the three-dimensional image of the eye to be examined E formed by the image forming unit 222. .

In some embodiments, the artifact specifying unit 223A specifies a position corresponding to the corneal vertex where no artifact is rendered by performing segmentation processing on the tomographic image or the three-dimensional image formed by the image forming unit 222. .

The macula identification unit 223B identifies the position corresponding to the macula of the subject's eye E based on the detection result of the interference light LC obtained by the OCT optical system 8 . In some embodiments, the macula identification unit 223B identifies the position corresponding to the macula of the subject's eye E by identifying the morphology of the fundus oculi Ef based on the detection result of the interference light LC.

Based on the tomographic image (B scan image) of the eye to be examined E formed by the image forming unit 222, the macular part identifying part 223B can identify the position corresponding to the macular part of the eye to be examined E in the tomographic image. is. The macula identification unit 223B identifies the position corresponding to the macula by analyzing the cross-sectional shape of the retina and the thickness of the retina. The tomographic image of the subject's eye E may be a tomographic image in which artifacts are specified by the artifact specifying unit 223A.

Based on the three-dimensional image of the subject's eye E formed by the image forming section 222, the macular portion identifying section 223B can identify a position corresponding to the macular portion of the subject's eye E in the three-dimensional image. The three-dimensional image of the subject's eye E may be a three-dimensional image in which artifacts are specified by the artifact specifying unit 223A.

In some embodiments, the macular portion identifying unit 223B identifies the macular portion based on the front image of the fundus oculi Ef of the eye to be examined E, and detects interference light LC in the depth direction corresponding to the position of the identified macular portion. A position corresponding to the macula is specified based on the result. The macular portion identification unit 223B can identify a pixel group having luminance equal to or less than a predetermined threshold in the front image as the macular portion. In addition, the macular portion specifying unit 223B can specify the optic papilla in the front image, and specify the position of the macula in the front image based on the specified position of the optic papilla. The front image includes a C-scan image, a projection image, a shadowgram, and a fundus image obtained separately by a fundus observation optical system. A C-scan image is obtained by selecting pixels (pixels, voxels) on a cross section corresponding to the fundus oculi Ef from a three-dimensional data set in the image forming unit 222 or the data processing unit 223 . A projection image is obtained by projecting a three-dimensional data set in a predetermined direction (Z direction, depth direction, A scan direction) in the image forming unit 222 or data processing unit 223 . A shadowgram is obtained by projecting a part of the three-dimensional data set (for example, partial data corresponding to a specific layer) in a predetermined direction in the image forming unit 222 or the data processing unit 223 .

The intraocular distance calculator 223C calculates the intraocular distance of the subject's eye E based on the position of the artifact identified by the artifact identifier 223A and the position corresponding to the macula identified by the macular part identifier 223B. The intraocular distance includes axial length, corneal thickness, anterior chamber depth, lens thickness, and the like. The intraocular distance calculator 223C can calculate the intraocular distance of the subject's eye E based on the position of the artifact specified in the A-scan image and the position corresponding to the macula.

In some embodiments, the intraocular distance calculator 223C calculates an intraocular distance for each of a plurality of A-scan images, and outputs an average value of the plurality of calculated intraocular distances.

The control unit 210 (main control unit 211) can control the fixation projection system 4 so as to change the projection position of the fixation target on the subject's eye E when the macular portion cannot be specified by the macular portion specifying unit 223B. is. The intraocular distance calculation unit 223C corresponds to the position of the artifact identified by the artifact identification unit 223A and the macula identified by the macular identification unit 223B in a state where the projection position of the fixation target is changed by the main control unit 211. The intraocular distance is calculated based on the position where the For example, the intraocular distance calculation unit 223C identifies each part on the measurement optical axis that connects the position of the artifact identified by the artifact identification unit 223A and the position corresponding to the macula identified by the macular identification unit 223B. Thus, intraocular distances such as axial length, corneal thickness, anterior chamber depth, and lens thickness are calculated.

In some embodiments, the data processing unit 223 (image forming unit 222) forms a three-dimensional image of the subject's eye E based on the detection result of the interference light LC when the macular portion cannot be specified by the macular portion specifying unit 223B. do. The macular portion identification unit 223B identifies the macular portion based on the three-dimensional image formed by the data processing unit 223. FIG. The control unit 210 (main control unit 211) controls the fixation projection system 4 based on the position corresponding to the macular identified by the macular identification unit 223B based on the three-dimensional image. That is, the control unit 210 changes the projection position of the fixation target based on the position corresponding to the macula specified based on the three-dimensional image of the eye E to be examined. For example, if the macula is shifted to the left with respect to the optical axis (measurement optical axis) of the OCT optical system 8, the eye rotates leftward by shifting the fixation target to the left. Since the center of rotation is within the eye, the macula moves to the right, and by adjusting the movement amount, it is possible to move the macula to an appropriate position (for example, on the measurement optical axis). As for the amount of movement, if the amount of deviation of the characteristic part (fundus) such as the macula from the measurement optical axis can be specified, it is possible to move the fixation target to the optimal position by moving the position of the fixation target by the angle of view. is. If the artifact disappears at this time, alignment is performed again at the position where the artifact appears, and if the macula is shifted to the optimal position, the fixation target is moved repeatedly, and the artifact is obtained and the macula is realigned. Alignment can be performed so that the . However, if the fixation condition of the subject's eye is poor and the eye does not rotate as intended when the fixation target is moved, the position of the fixation target should be dynamically moved to fix it closer to the desired position. It is also possible to stop moving the target and take measurements at that position. As a result, the intraocular distance between the position of the artifact and the position corresponding to the macula can be calculated with the macula positioned at the desired position.

FIG. 5 shows an operation explanatory diagram of the intraocular distance calculator 223C according to the embodiment. FIG. 5 shows an example of a B-scan image of the subject's eye E when alignment of the optical system with respect to the position of the artifact specified by the artifact specifying unit 223A is completed. FIG. 5 shows an operation explanatory diagram when the intraocular distance calculator 223C calculates the axial length of the eye.

The artifact specifying unit 223A specifies the position P1 of the artifact. The control unit 210 aligns the optical system with the identified artifact position P1.

After that, the macular portion identification unit 223B identifies a position P2 corresponding to the macular portion in the tomogram in which the artifact has been identified. The macula identification unit 223B can identify the position P2 corresponding to the macula based on the morphology of the fundus oculi Ef.

The intraocular distance calculator 223C obtains the axial length based on the distance between the position P1 of the artifact and the position P2 corresponding to the macula.

According to the embodiment, the artifact is identified based on the detection result of the interference light, and the optical system is aligned with the identified artifact position. Since the macula is identified based on the detection result of the interference light obtained after this alignment is completed, the measurement light passing through the corneal vertex where the artifact is drawn and the macula can be used to estimate the axial length of the eye. It becomes possible to confirm that the inner distance has been measured.

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

The operation unit 280 is used as a user interface unit to operate the ophthalmologic apparatus. The operation unit 280 includes various hardware keys (joystick, button, switch, etc.) provided in the ophthalmologic apparatus. The operation unit 280 may also include various software keys (buttons, icons, menus, etc.) displayed on the touch panel display screen 10a.

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

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

The OCT light source 101 is an example of a "light source" according to the embodiment. The OCT optical system 8 is an example of the "interference optical system" according to the embodiment. The image forming unit 222 is an example of a "tomographic image forming unit" according to the embodiment. The data processing unit 223 is an example of a "three-dimensional image forming unit" according to the embodiment.

<Operation example>
The operation of the ophthalmologic apparatus 1000 according to the embodiment will be described. An operation example for measuring the axial length of the eye will be described below.

6 and 7 show an example of the operation of the ophthalmologic apparatus 1000. FIG. FIG. 6 depicts a flow diagram of an example operation of the ophthalmic device 1000 . FIG. 7 shows a flow diagram of an example of the operation of step S8 in FIG. The storage unit 212 stores computer programs for realizing the processes shown in FIGS. 6 and 7 . The main control unit 211 executes the processes shown in FIGS. 6 and 7 by operating according to this computer program.

Prior to the process shown in FIG. 6, the examiner performs a predetermined operation on the operation unit 280 in a state in which the subject's face is fixed to a face receiving unit (not shown). It is assumed that the XY alignment using the alignment system 2 and the Z alignment using the Z alignment system 1 have been completed. At this time, even if XY alignment and Z alignment are performed from two or more anterior segment images provided with parallax by photographing the anterior segment substantially simultaneously from mutually different directions using two or more imaging units. good.

(S1: Acquire B-scan image)
First, the main control unit 211 performs control for performing OCT measurement and acquiring a B-scan image of the eye E to be inspected.

Prior to the OCT measurement, the main control unit 211 can move the focusing lens 87 to a position corresponding to the refractive power of the eye E to be examined using the reflector measurement optical system.

The main control unit 211 causes the OCT measurement to be performed by controlling the OCT optical system 8 while the focusing lens 87 is moved. The main controller 211 turns on the OCT light source 101 and controls the optical scanner 88 to scan the fundus oculi Ef with the measurement light LS. A detection signal obtained by scanning with the measurement light LS is sent to the image forming section 222 . The image forming unit 222 forms a B-scan image of the subject's eye in which the anterior segment and the fundus Ef are depicted from the obtained detection signals (see FIG. 5).

In some embodiments, the main control unit 211 moves the focusing lens 87 in the optical axis direction so that the focal position of the measurement light is positioned at the corneal vertex or the crystalline lens, and the measurement light is focused on the corneal vertex or the like. OCT measurements are performed in the state.

(S2: Artifact identification processing)
Subsequently, the main control unit 211 causes the artifact identification unit 223A to perform artifact identification processing based on the B-scan image acquired in step S1. The artifact identification unit 223A executes artifact identification processing by analyzing the B-scan image as described above.

Note that the artifact identifying unit 223A may identify the position corresponding to the corneal vertex that is not rendered as an artifact by performing segmentation processing on the B-scan image as described above.

(S3: Artifact identified?)
Next, the main control unit 211 determines whether or not an artifact has been identified in step S2. The main control unit 211 can determine whether or not an artifact has been identified based on the processing result of the artifact identification unit 223A.

When it is determined that the artifact has been identified (S3: Y), the operation of the ophthalmologic apparatus 1000 proceeds to step S5. When it is determined that no artifact has been identified (S3: N), the operation of the ophthalmologic apparatus 1000 proceeds to step S4.

(S4: Alignment)
When it is not determined that the artifact has been specified (S3: N), the main control unit 211 controls the moving mechanism 200 to move the optical system relative to the eye E by a predetermined moving amount in a predetermined moving direction. to move. The operation of the ophthalmologic apparatus 1000 proceeds to step S1.

That is, alignment of the optical system with respect to the subject's eye E is performed until an artifact is identified in the B-scan image.

(S5: Macular Part Specific Processing)
When it is determined in step S3 that an artifact has been identified (S3: Y), the main control unit 211 causes the macular portion identification unit 223B to execute macular portion identification processing based on the B-scan image acquired in step S2. . The macular portion identification unit 223B executes macular portion identification processing by analyzing the B-scan image as described above.

(S6: Identify macula?)
Next, the main control unit 211 determines whether or not the macula has been identified in step S5. The main control unit 211 can determine whether or not the macular portion has been specified based on the processing result of the macular portion specifying unit 223B.

When it is determined that the macula has been identified (S6: Y), the operation of the ophthalmologic apparatus 1000 proceeds to step S7. When it is not determined that the macula has been specified (S6:N), the operation of the ophthalmologic apparatus 1000 proceeds to step S8.

(S7: Calculate axial length)
When it is determined in step S6 that the macula has been identified (S6: Y), the main control section 211 causes the intraocular distance calculation section 223C to calculate the axial length of the eye E to be examined. The intraocular distance calculator 223C calculates the axial length based on the distance between the position of the artifact specified in step S3 (the position corresponding to the corneal vertex) and the position corresponding to the macula specified in step S5. . In step S7, intraocular distances such as corneal thickness, anterior chamber depth, and crystalline lens thickness other than the axial length can be calculated. After step S7, a tomographic image of the posterior segment of the eye may be obtained. With this, the operation of the ophthalmologic apparatus 1000 is completed (end).

(S8: macular portion re-specification processing)
When it is not determined in step S6 that the macula has been identified (S6: N), the main control unit 211 executes macula re-identification processing. Specifically, the main controller 211 controls the fixation projection system 4 to change the projection position of the fixation target on the eye E to be examined. In step S8, as will be described later, the position of the artifact and the position corresponding to the macula are newly identified with the projection position of the fixation target changed. After that, the operation of the ophthalmologic apparatus 1000 proceeds to step S7.

At step S8 in FIG. 6, a process as shown in FIG. 7 is executed.

(S11: 3D scanning)
First, the main controller 211 controls the optical scanner 88 to scan the fundus oculi Ef with the measurement light LS. A detection signal obtained by scanning with the measurement light LS is sent to the image forming section 222 . The image forming unit 222 forms a tomographic image showing the fundus oculi Ef from the obtained detection signals. The data processing unit 223 forms a three-dimensional image of the subject's eye E from the tomogram formed by the image forming unit 222 . Note that the scan interval of the scans in step S11 may be coarser than the scan interval of the scans in steps S1 and S14.

(S12: Macular Part Specific Processing)
The main control unit 211 causes the macular portion specifying unit 223B to execute the macular portion specifying process based on the three-dimensional image acquired in step S11. The macular portion identification unit 223B executes macular portion identification processing by analyzing the three-dimensional image as described above.

(S13: Move fixation target)
The main control unit 211 obtains the displacement between the desired fixation position and the position of the macula specified in step S12. The main control unit 211 controls the fixation projection system 4 so that the obtained displacement is canceled, and changes the display position of the fixation target on the liquid crystal panel 41 to change the projection position of the fixation target on the fundus oculi Ef. change.

(S14: Acquire B-scan image)
Subsequently, the main control unit 211 performs control for performing OCT measurement and acquiring a B-scan image of the subject's eye E, as in step S1. As a result, a B-scan image is obtained with the projection position of the fixation target changed.

(S15: Artifact identification process)
Next, the main control unit 211 causes the artifact identifying unit 223A to identify artifacts based on the B-scan image acquired in step S14, as in step S2.

(S16: Artifact identified?)
The main control unit 211 determines whether or not an artifact is identified in step S15, as in step S3.

When it is determined that the artifact has been identified (S16: Y), the operation of the ophthalmologic apparatus 1000 proceeds to step S17. When it is determined that no artifact has been identified (S16:N), the operation of the ophthalmologic apparatus 1000 proceeds to step S19.

(S17: Macular Part Specific Processing)
When it is determined in step S16 that the corneal vertex has been identified (S16: Y), the main control unit 211 performs the macular portion identification process based on the B-scan image acquired in step S14, as in step S5. This is executed by the part specifying part 223B.

(S18: Identify macula?)
The main control unit 211 determines whether or not the macula has been identified in step S17, as in step S6.

When it is determined that the macula has been specified (S18: Y), the operation of step S8 in FIG. 6 is finished (end). When it is not determined that the macula has been specified (S18:N), the operation of the ophthalmologic apparatus 1000 proceeds to step S13.

(S19: Change scan range)
When it is not determined in step S16 that an artifact has been specified (S16: N), the main control unit 211 moves the optical system relative to the subject's eye E by controlling the moving mechanism 200 .

In some embodiments, the main controller 211 relatively moves the optical system with respect to the subject's eye E by a predetermined movement amount in a predetermined movement direction. If the transition from step S16 to step S19 continues for a predetermined number of times or more, the main control unit 211 can change at least one of the moving direction and the moving amount.

In some embodiments, the main controller 211 changes the relative position of the optical system with respect to the subject's eye E by controlling the moving mechanism 200 based on the user's operation on the operation unit 280 . In this case, the user can use the operation unit 280 to specify the direction and amount of movement of the optical system while viewing the B-scan image displayed on the display unit 270 in real time.

In some embodiments, the main controller 211 changes the scanning range (scanning position) on the fundus oculi Ef by controlling the optical scanner 88 .

After that, the operation of the ophthalmologic apparatus 1000 proceeds to step S14.

In the above embodiment, two or more imaging units are used to image the anterior segment substantially simultaneously from different directions, and artifacts in the subject's eye E are detected from the two or more anterior segment images provided with parallax. The optical system may be aligned with the subject's eye E by specifying the position and controlling the moving mechanism 200 based on the specified position.

In the above embodiments, at least one function of focusing lenses 74 and 87 may be realized by liquid crystal or liquid lenses.

[Action/effect]
The actions and effects of the ophthalmologic apparatus and the control method for the ophthalmic apparatus according to the embodiment will be described.

An ophthalmologic apparatus (1000) according to some embodiments includes an interference optical system (OCT optical system 8), an artifact identification unit (223A), a movement mechanism (200), a control unit (210), a macular identification unit a section (223B) and an intraocular distance calculation section (223C). The interference optical system splits the light (L0) from the light source (OCT light source 101) into measurement light (LS) and reference light (LR), projects the measurement light onto the subject's eye (E), Interference light (LC) between the return light of the measurement light and the reference light is detected. The artifact specifying unit specifies an artifact at a position corresponding to the corneal vertex of the subject's eye based on the detection result of the interference light. The moving mechanism relatively moves the interference optical system with respect to the subject's eye. The controller controls the moving mechanism. The macula specifying unit specifies a position corresponding to the macula in the subject's eye based on the detection result of the interference light obtained after the alignment of the artifact and the interference optical system is completed by the movement mechanism. The intraocular distance calculation unit calculates the intraocular distance based on the position of the artifact and the position corresponding to the macula identified by the macular identification unit.

In such a configuration, the artifact is specified based on the detection result of the interference light, and the interference optical system is aligned with the position of the specified artifact. Since the macula is identified based on the detection result of the interference light obtained with this alignment completed, the intraocular distance can be measured with the measurement light passing through the corneal vertex where the artifact is drawn and the macula. It is possible to confirm that Thereby, it becomes possible to obtain a highly reliable intraocular distance measurement result.

In the ophthalmologic apparatus according to some embodiments, the intraocular distance calculator calculates the axial length of the subject's eye.

According to such a configuration, it is possible to confirm that the axial length is measured by the measurement light passing through the corneal vertex where the artifact is drawn and the macular portion, so that the axial length is highly reliable. measurement results can be obtained.

In the ophthalmologic apparatus according to some embodiments, the controller controls the moving mechanism to cancel the displacement of the interference optical system with respect to the artifact.

According to such a configuration, it is possible to automatically perform the alignment of the interference optical system with respect to the artifact, so that it is possible to provide an ophthalmologic apparatus capable of easily obtaining a highly reliable intraocular distance. can be done.

The ophthalmologic apparatus according to some embodiments includes a tomographic image forming unit (image forming unit 222) that forms a tomographic image of the subject's eye based on the detection result of interference light, and the macular portion identifying unit identifies artifacts. The macula is identified by analyzing the resulting tomogram.

According to such a configuration, it is possible to provide an ophthalmologic apparatus capable of confirming that the intraocular distance has been measured with the measurement light passing through the corneal vertex and the macula based on the tomographic image. .

An ophthalmologic apparatus according to some embodiments includes a fixation projection system (4) that projects a fixation target onto the subject's eye, and the controller determines the fixation target in the subject's eye when the macula cannot be identified by the macular area identification unit. The intraocular distance calculator controls the fixation projection system so as to change the projection position of the fixation target, and calculates the position of the artifact identified by the artifact identification unit and the macular region while the projection position of the fixation target is changed. The intraocular distance is calculated based on the position corresponding to the macula specified by the specifying part.

According to such a configuration, even if the macular portion cannot be specified, by changing the projection position of the fixation target with respect to the eye to be examined, it is possible to obtain a highly reliable intraocular distance measurement result. become.

The ophthalmologic apparatus according to some embodiments includes a three-dimensional image forming section (data processing section 223 ), the macular portion specifying unit specifies the macular portion based on the three-dimensional image, and the control unit fixes the macular portion based on the position corresponding to the macular portion specified based on the three-dimensional image by the macular portion specifying unit. Controls the visual projection system.

According to such a configuration, since the projection position of the fixation target is changed based on the macula identified by 3D scanning, the macula can be reliably identified, and the intraocular distance can be measured with high reliability. It becomes possible to provide an ophthalmic device capable of obtaining results.

A control method for an ophthalmologic apparatus according to some embodiments divides light (L0) from a light source (OCT light source 101) into measurement light (LS) and reference light (LR), and the measurement light is applied to an eye to be examined (E ), and an interference optical system (OCT optical system 8) that detects interference light (LC) between the return light of the measurement light from the eye to be inspected and the reference light, and the interference optical system relative to the eye to be inspected. and a moving mechanism (200) that moves. A control method for an ophthalmologic apparatus includes an artifact identification step, an alignment step, a macular portion identification step, and an intraocular distance calculation step. The artifact identification step identifies an artifact at a position corresponding to the corneal vertex of the subject's eye based on the detection result of the interference light. The alignment step aligns the artifact identified in the artifact identification step with the interference optical system by the moving mechanism. The macula specifying step specifies a position corresponding to the macula in the subject's eye based on the detection result of the interference light acquired after the alignment step. The intraocular distance calculating step calculates an intraocular distance based on the position of the artifact and the position corresponding to the macula specified in the macula specifying step.

In such a configuration, the artifact is specified based on the detection result of the interference light, and the interference optical system is aligned with the position of the specified artifact. Since the macula is identified based on the detection result of the interference light obtained with this alignment completed, the intraocular distance can be measured with the measurement light passing through the corneal vertex where the artifact is drawn and the macula. It is possible to confirm that This makes it possible to obtain a highly reliable measurement result of the intraocular distance.

In the ophthalmologic apparatus control method according to some embodiments, the intraocular distance calculating step calculates the axial length of the subject's eye.

According to such a configuration, it is possible to confirm that the axial length has been measured with the measurement light passing through the corneal vertex where the artifact is drawn and the macular portion, so that the axial length is highly reliable. measurement results can be obtained.

A control method for an ophthalmologic apparatus according to some embodiments includes a tomographic image forming step of forming a tomographic image of an eye to be examined based on a detection result of interference light, and a macular portion identifying step includes a tomographic image in which an artifact is identified. The macula is identified by analyzing the images.

According to such a configuration, it is possible to confirm that the intraocular distance has been measured with the measurement light passing through the corneal vertex and the macula based on the tomographic image.

In the ophthalmic apparatus control method according to some embodiments, the ophthalmic apparatus includes a fixation projection system that projects a fixation target onto the subject's eye. A control method for an ophthalmologic apparatus includes a fixation control step of controlling a fixation projection system to change a projection position of a fixation target in an eye to be inspected when the macula cannot be identified in the macula identification step. The calculating step calculates the intraocular distance based on the position of the artifact identified in the artifact identifying step and the position corresponding to the macula identified in the macular portion identifying step with the projection position of the fixation target changed. do.

According to such a configuration, even if the macula cannot be specified, it is possible to obtain a highly reliable intraocular distance measurement result by changing the projection position of the fixation target with respect to the eye to be examined. become.

A control method for an ophthalmologic apparatus according to some embodiments includes a three-dimensional image forming step of forming a three-dimensional image of an eye to be inspected based on a detection result of interference light when the macular portion cannot be identified in the macular portion identifying step. The step of identifying the macular portion identifies the macular portion based on the three-dimensional image, and the step of controlling visual fixation is performed based on the position corresponding to the macular portion identified based on the three-dimensional image in the step of identifying the macular portion. Control the projection system.

According to such a configuration, since the projection position of the fixation target is changed based on the macula identified by 3D scanning, the macula can be reliably identified, and the intraocular distance can be measured with high reliability. It becomes possible to provide an ophthalmic device capable of obtaining results.

<Others>
The embodiment shown above is merely an example for carrying out the present invention. A person who intends to implement this invention can make arbitrary modifications, omissions, additions, etc. within the scope of the gist of this invention.

1 Z alignment system 2 XY alignment system 3 Keratometry system 4 Fixation projection system 5 Anterior eye observation system 6 Reflex measurement projection system 7 Reflex measurement light receiving system 8 OCT optical system 9 Processing unit 210 Control unit 211 Main control unit 220 Arithmetic processing Section 222 Image Forming Section 223 Data Processing Section 223A Artifact Identification Section 223B Macula Identification Section 223C Intraocular Distance Calculation Section 1000 Ophthalmic Apparatus

Claims (9)

An interference optical system that splits light from a light source into measurement light and reference light, projects the measurement light onto an eye to be inspected, and detects interference light between the return light of the measurement light from the eye to be inspected and the reference light. When,
an artifact identifying unit that identifies an artifact at a position corresponding to the corneal vertex of the eye to be inspected based on the detection result of the interference light;
a movement mechanism for moving the interference optical system relative to the eye to be examined;
a control unit that controls the movement mechanism;
A macular portion identifying unit that identifies a position corresponding to the macular portion in the subject's eye based on the detection result of the interference light obtained after the alignment of the artifact and the interference optical system is completed by the moving mechanism. When,
an intraocular distance calculation unit that calculates an intraocular distance based on the position of the artifact and the position corresponding to the macula identified by the macular identification unit;
a fixation projection system that projects a fixation target onto the eye to be examined;
including
The control unit controls the fixation projection system to change a projection position of the fixation target on the eye to be examined when the macular portion cannot be specified by the macular portion specifying unit,
The intraocular distance calculator calculates the position of the artifact specified by the artifact specifying unit and the position corresponding to the macular specified by the macular part specifying unit while the projection position of the fixation target is changed. and calculating the intraocular distance based on . The ophthalmologic apparatus according to claim 1, wherein the intraocular distance calculator calculates an axial length of the eye to be examined. 3. The ophthalmologic apparatus according to claim 1, wherein the controller controls the movement mechanism so as to cancel displacement of the interference optical system with respect to the artifact. a tomographic image forming unit that forms a tomographic image of the subject's eye based on the detection result of the interference light;
The ophthalmologic apparatus according to any one of claims 1 to 3, wherein the macular portion identification unit identifies the macular portion by analyzing the tomographic image in which the artifact has been identified. a three-dimensional image forming unit that forms a three-dimensional image of the subject eye based on a detection result of the interference light when the macular portion cannot be specified by the macular portion specifying unit;
The macular portion identifying unit identifies the macular portion based on the three-dimensional image,
1. The control unit controls the fixation projection system based on the position corresponding to the macular identified by the macular identification unit based on the three - dimensional image. 5. The ophthalmic device according to any one of 4 . An interference optical system that splits light from a light source into measurement light and reference light, projects the measurement light onto an eye to be inspected, and detects interference light between the return light of the measurement light from the eye to be inspected and the reference light. and a movement mechanism for moving the interference optical system relative to the eye to be inspected, and a fixation projection system for projecting a fixation target onto the eye to be inspected, comprising :
an artifact identification step of identifying an artifact at a position corresponding to the corneal vertex of the eye to be inspected based on the detection result of the interference light;
an alignment step of aligning the artifact identified in the artifact identifying step by the moving mechanism with the interference optical system;
a macular portion specifying step of specifying a position corresponding to the macular portion in the eye to be inspected based on the detection result of the interference light acquired after the alignment step;
an intraocular distance calculating step of calculating an intraocular distance based on the position of the artifact and the position corresponding to the macular portion identified in the macular portion identifying step;
a fixation control step of controlling the fixation projection system to change a projection position of the fixation target on the eye to be examined when the macular portion cannot be identified in the macular portion identifying step;
including
In the intraocular distance calculating step, the position of the artifact identified in the artifact identifying step and the position corresponding to the macula identified in the macular portion identifying step with the projection position of the fixation target changed. and calculating the intraocular distance based on . 7. The method of controlling an ophthalmologic apparatus according to claim 6, wherein the intraocular distance calculating step calculates an axial length of the eye to be examined. a tomographic image forming step of forming a tomographic image of the eye to be inspected based on the detection result of the interference light;
8. The method of controlling an ophthalmologic apparatus according to claim 6 , wherein the macular portion identifying step identifies the macular portion by analyzing the tomographic image in which the artifact has been identified. a three-dimensional image forming step of forming a three-dimensional image of the subject's eye based on the detection result of the interference light when the macular portion cannot be identified in the macular portion identifying step;
The macular portion identifying step identifies the macular portion based on the three-dimensional image,
6. The fixation control step controls the fixation projection system based on the position corresponding to the macula identified based on the three-dimensional image in the macular identification step. The method for controlling an ophthalmologic apparatus according to claim 8 .

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