JP7512577B2 - Photographing method, ophthalmic device, and program - Google Patents

Description

The present invention relates to a photographing method, an ophthalmic device, and a program.

Patent Document 1 discloses performing fluorescence imaging using multiple fluorescent substances. There is a demand for performing fluorescence imaging using fluorescent substances that have fewer side effects.

International Publication No. 2009/140757

The imaging method of the first aspect of the disclosed technology includes receiving a first fluorescence from a first fluorescent substance and a second fluorescence from a second fluorescent substance different from the first fluorescent substance from a test eye, generating first fluorescence image data based on the first fluorescence and second fluorescence image data based on the second fluorescence, and generating fluorescence image data of the test eye using the first fluorescence image data and the second fluorescence image data.

The ophthalmic device according to the second aspect of the disclosed technology includes an irradiation unit that irradiates a test eye with a first excitation light that excites a first fluorescent substance and a second excitation light that excites a second fluorescent substance different from the first fluorescent substance, a detector unit that receives from the test eye a first fluorescence from the first fluorescent substance excited by the first excitation light and a second fluorescence from the second fluorescent substance excited by the second excitation light, and a control unit that controls the irradiation unit so that the test eye is irradiated with the first excitation light and the second excitation light, and controls the detector unit so that the first fluorescence and the second fluorescence from the test eye are received.

A third aspect of the technology disclosed herein is a program that causes a control unit to execute an image capturing process of a test eye, the image capturing process including controlling an irradiation unit so that a first excitation light that excites a first fluorescent substance and a second excitation light that excites a second fluorescent substance different from the first fluorescent substance are irradiated onto the test eye, and controlling a detector unit so that a first fluorescence from the first fluorescent substance excited by the first excitation light and a second fluorescence from the second fluorescent substance excited by the second excitation light are received from the test eye.

The ophthalmic device according to the fourth aspect of the disclosed technique includes an irradiation unit capable of irradiating a subject's eye with each of a plurality of excitation lights that excite each of a plurality of fluorescent substances, a detector unit capable of receiving from the subject's eye of a patient a plurality of fluorescences from each of the plurality of fluorescent substances excited by each of the plurality of excitation lights, a display unit that displays a combination of a plurality of fluorescent substance patterns, each of which includes two of the fluorescent substances, a selection unit for selecting one combination from the displayed plurality of fluorescent substance patterns, and a control unit that controls the irradiation unit so that the subject's eye is irradiated with two excitation lights corresponding to the selected combination and controls the detector unit so that two fluorescences from the subject's eye corresponding to the selected combination are received, generates two fluorescence image data based on the two received fluorescences, and generates fluorescence image data of the subject's eye using the two fluorescence image data.

FIG. 1 is a block diagram of an ophthalmology system 100. 1 is a schematic diagram showing the overall configuration of an ophthalmic apparatus 110. FIG. FIG. 2 is a functional block diagram of a CPU 16A of the ophthalmic apparatus 110. FIG. 4 is a flowchart showing a photographing processing program. FIG. 5 is a diagram showing a list 500 of combination patterns of fluorescent materials. 2 is a diagram showing wavelength bands of light emitted by each of a first light source 40 to a fourth light source 46. FIG. 2 is a diagram showing wavelength bands of light received by each of a first sensor 70 to a third sensor 74. FIG. FIG. 5 is a diagram showing a shooting pattern table 550. FIG. 13 is a diagram showing a shooting timing selection screen. FIG. 13 is a diagram showing the administration order displayed when the corresponding buttons are operated simultaneously to capture images. FIG. 7 is a diagram showing a first fundus image display screen 700A. FIG. 7 is a diagram showing a second fundus image display screen 700B. FIG. 7 is a diagram showing a third fundus image display screen 700C.

The following describes in detail an embodiment of the present invention with reference to the drawings.

The configuration of the ophthalmic system 100 will be described with reference to FIG. 1. As shown in FIG. 1, the ophthalmic system 100 includes an ophthalmic device 110, an axial length measuring device 120, a management server device (hereinafter referred to as "server") 140, and an image display device (hereinafter referred to as "viewer") 150. The ophthalmic device 110 irradiates the patient's test eye with excitation light while a fluorescent substance is flowing through the blood vessels of the test eye, receives fluorescence from the fluorescent substance, and generates a fluorescent image of the test eye. The axial length measuring device 120 measures the axial length of the patient. The server 140 stores multiple fluorescent images, axial lengths, and tomographic images obtained by photographing the fundus of multiple patients by the ophthalmic device 110, corresponding to the patient's ID. The viewer 150 displays the fluorescent images obtained from the server 140.

The ophthalmic device 110, axial length measuring device 120, server 140, and viewer 150 are connected to each other via network 130.

Next, the configuration of the ophthalmic device 110 will be described with reference to FIG. 2. FIG. 2 shows a schematic configuration of the ophthalmic device 110.

For ease of explanation, Scanning Laser Ophthalmoscope will be referred to as "SLO." Optical Coherence Tomography will be referred to as "OCT."

When the ophthalmic device 110 is placed on a horizontal plane, the horizontal direction is the "X direction", the vertical direction to the horizontal plane is the "Y direction", and the optical axis direction of the imaging optical system 19, which will be described later, is the "Z direction". The device is positioned with respect to the subject's eye so that the center of the pupil of the subject's eye is located on the optical axis in the Z direction. The X direction, Y direction, and Z direction are perpendicular to each other.

The ophthalmic device 110 includes an imaging device 14 and a control device 16. The imaging device 14 includes an SLO unit 18 that acquires an image of the fundus 12A of the subject's eye 12, an OCT unit 20 that acquires a tomographic image of the subject's eye 12, and an imaging optical system 19.

The control device 16 is equipped with a computer having a CPU (Central Processing Unit) 16A, a RAM (Random Access Memory) 16B, a ROM (Read-Only Memory) 16C, and an input/output (I/O) port 16D. The ROM 16C (or a storage device not shown) stores an imaging processing program (described below) and identification data for fluorescent materials.

The control device 16 is equipped with an input/display device 16E connected to the CPU 16A via an I/O port 16D. The input/display device 16E has a graphic user interface that displays an image of the subject's eye 12 and receives various instructions from the user. The input/display device 16E can be a touch panel display.

The control device 16 is equipped with an IC chip reader 16F connected to the I/O port 16D.

The control device 16 includes an image processing device 16G connected to an I/O port 16D. The image processing device 16G generates an image of the subject's eye 12 based on data obtained by the photographing device 14. The control device 16 includes a communication interface (I/F) 16H connected to the I/O port 16D. The ophthalmic device 110 is connected to an axial length measuring device 120, a server 140, and a viewer 150 via the communication interface (I/F) 16H and a network 130.

As described above, in FIG. 2, the control device 16 of the ophthalmic device 110 is equipped with an input/display device 16E, but the technology of the present disclosure is not limited to this. For example, the control device 16 of the ophthalmic device 110 may not be equipped with the input/display device 16E, but may be equipped with a separate input/display device that is physically independent from the ophthalmic device 110. In this case, the display device may be equipped with an image processing processor unit that operates under the control of the CPU 16A of the control device 16. The image processing processor unit may be configured to display an SLO image, etc., based on an image signal that is instructed to be output by the CPU 16A.

The imaging device 14 operates under the control of the control device 16. The imaging device 14 includes an SLO unit 18, an imaging optical system 19, and an OCT unit 20.

The SLO system is realized by the control device 16, the SLO unit 18, and the imaging optical system 19 shown in FIG. 2.

The SLO unit 18 has multiple light sources. For example, as shown in FIG. 2, it has four light sources, a first light source 40 to a fourth light source 46.

Now, referring to FIG. 5B, the wavelength bands of the light emitted by each of the first light source 40 to the fourth light source 46 will be described. The light emitted by each of the first light source 40 to the fourth light source 46 is excitation light for a fluorescent material, which will be described later. P1 to P5 in FIG. 5B indicate that they correspond to patterns P1 to 5, which will be described later.

The first light source 40 emits a first light in a first predetermined range of wavelength bands including 425 nm and 448 nm. Since the first light includes light at 425 nm, it is excitation light for fucoxanthin (see pattern 5 in FIG. 5A), and since the first light includes light at 448 nm, it is excitation light for riboflavin and chlorophyll (see patterns 1 and 2 in FIG. 5A).

The second light source 42 emits a second light in a second predetermined range of wavelength bands including 488 nm and 494 nm. The second light includes 488 nm light, and is therefore excitation light for phycoerythrin (see pattern 1 in FIG. 5A), and includes 494 nm light, and is therefore excitation light for fluorescein (see pattern 3 in FIG. 5A).

The third light source 44 emits third light in a third predetermined range of wavelengths including 610 nm. The third light includes light at 610 nm, and is therefore an excitation light for phycocyanin (see pattern 2 in FIG. 5A).

The fourth light source 46 emits a fourth light in a fourth predetermined range of wavelength bands including 774 nm. Since the fourth light includes light of 774 nm, it is an excitation light of indocinian green (see pattern 5 in FIG. 5A).

The light emitted from each light source 40, 42, 44, 46 is directed to the same optical path via each optical member 48, 50, 52, 54, 56. The optical members 48, 56 are mirrors, and the optical members 50, 52, 54 are beam splitters. The first light is guided to the optical path of the photographing optical system 19 via the optical members 48, 50, 54. The second light is guided to the optical path of the photographing optical system 19 via the optical members 50, 54. The third light is guided to the optical path of the photographing optical system 19 via the optical members 52, 54. The fourth light is guided to the optical path of the photographing optical system 19 via the optical members 56, 52. The light sources 40, 42, 44, 46 can be LED light sources or laser light sources. An example using a laser light source will be described below. The optical members 48, 56 can be total reflection mirrors. In addition, a dichroic mirror, a half mirror, etc. can be used as the optical elements 50, 52, and 54.

The laser light incident on the imaging optical system 19 from the SLO unit 18 via the beam splitters 58, 60, and 64 is scanned in the X and Y directions by the first optical scanner 22, which will be described later. The scanning light passes through the pupil 27 and is irradiated onto the posterior segment (e.g., the fundus 12A) of the subject's eye 12. As will be described in detail later, the fluorescent material flowing through the blood vessels of the fundus 12A is excited, generating fluorescence, which is incident on the SLO unit 18 via the imaging optical system 19.

Fluorescence generated by excitation of the fluorescent substance flowing through the blood vessels of the fundus 12A is detected by sensors 70, 72, 74 via beam splitters 64, 58, 60. The sensors 70, 72, 74 receive from the subject's eye a first fluorescence from a first fluorescent substance described below, and a second fluorescence from a second fluorescent substance having excitation characteristics different from those of the first fluorescent substance. In detail, the sensors 70, 72, 74 receive fluorescence generated by excitation of the fluorescent substance flowing through the blood vessels of the fundus 12A.

Now, referring to FIG. 5C, the first sensor 70 to the third sensor 74 will be described. The first sensor 70 to the third sensor 74 receive the fluorescence generated by exciting the fluorescent substance. P1 to P5 in FIG. 5C indicate that they correspond to patterns P1 to P5, which will be described later.

The first sensor 70 is configured by arranging a set of a first light receiving element, a second light receiving element, and a third light receiving element (not shown) in a matrix. The first light receiving element receives light in a first predetermined range of wavelength bands including 521 nm. 521 nm is the fluorescent wavelength of fluorescein (see pattern 3 in FIG. 5A). The second light receiving element receives light in a second predetermined range of wavelength bands including 550 nm. 550 nm is the fluorescent wavelength of riboflavin (see pattern 1 in FIG. 5A). The third light receiving element receives light in a third predetermined range of wavelength bands including 577 nm. 577 nm is the fluorescent wavelength of phycoerythrin (see pattern 1 in FIG. 5A).

The first, second, and third predetermined ranges do not overlap. The first sensor 70 detects light of a wavelength band including the first to third predetermined ranges that is reflected by the beam splitter 64. A signal whose size corresponds to the intensity of the received light is output to the image processing device 16G from each of the first, second, and third light receiving elements of each set.

The image processing device 16G generates first image data of a fluorescent image based on the fluorescence of fluorescein based on the signals output from each of the first light receiving elements. The image processing device 16G generates second image data of a fluorescent image based on the fluorescence of riboflavin based on the signals output from each of the second light receiving elements. The image processing device 16G generates third image data of a fluorescent image based on the fluorescence of phycoerythrin based on the signals output from each of the third light receiving elements.

The second sensor 72 is configured by arranging in a matrix a set of a fourth light receiving element that receives light of a wavelength in a fourth predetermined range including 640 nm and a fifth light receiving element that receives light of a wavelength band in a fifth predetermined range including 680 nm. 640 nm is the fluorescent wavelength of phycocyanin (see pattern 2 in FIG. 5A). 680 nm is the fluorescent wavelength of chlorophyll and fucoxanthin (see patterns 2 and 5 in FIG. 5A). The fourth and fifth predetermined ranges do not overlap. The second sensor 72 detects light of a wavelength band including the fourth and fifth predetermined ranges that is transmitted through the beam splitter 64 and reflected by the beam splitter 58. A signal whose size corresponds to the intensity of the received light is output to the image processing device 16G from each of the fourth and fifth light receiving elements of each set.

The image processing device 16G generates fourth image data of a fluorescent image based on the fluorescence of phycocyanin based on the signals output from each of the fourth light receiving elements. The image processing device 16G generates fifth image data of a fluorescent image based on the fluorescence of chlorophyll or fucoxanthin based on the signals output from each of the fifth light receiving elements.

The third sensor 74 is configured by arranging sixth light receiving elements in a matrix, which receive light in a sixth predetermined range of wavelength bands including 805 nm. 805 nm is the fluorescent wavelength of indocinian green (see pattern 5 in FIG. 5A). The third sensor 74 detects light in a wavelength band including the sixth predetermined range that is transmitted through the beam splitters 64, 58 and reflected by the beam splitter 60. A signal whose size corresponds to the intensity of the received light is output from each sixth light receiving element to the image processing device 16G. The image processing device 16G generates sixth image data based on the fluorescence of indocinian green based on the signal from each sixth light receiving element.

The image processing device 16G generates image data of the fluorescence image using at least two of the first image data to the sixth image data.

For example, the image processing device 16G generates image data of a fluorescence image using at least two of the first image data, the second image data, and the third image data.

The image processing device 16G generates image data of the fluorescence image using the fourth image data and the fifth image data.

The image processing device 16G generates image data of the fluorescence image using at least one of the first image data to the fifth image data and the sixth image data. For example, the image processing device 16G generates image data of the fluorescence image using the fifth image data and the sixth image data.

The fluorescent image of the test eye obtained from at least two types of image data is an angiographic image (fundus fluorescent image) based on the fluorescence of the fundus. Blood vessels at different depths in the fundus can be visualized depending on the wavelength of the excitation light and fluorescence of the fluorescent substance. For example, retinal blood vessels and choroidal blood vessels can be visualized.
In addition, by performing fluorescence photography of the anterior segment of the subject's eye as well as the posterior segment such as the fundus, an angiographic image (anterior segment fluorescence image) can be obtained by fluorescence photography of the anterior segment. In the structure of the anterior segment, the vascular structure of tissues containing blood vessels, such as the reticular formation, can be visualized.
The anterior segment of the subject's eye includes, for example, the cornea, iris, angle, crystalline lens, ciliary body, and part of the vitreous body as an anterior segment. The posterior segment of the subject's eye includes, for example, the remaining part of the vitreous body, the retina, the choroid, and the sclera as a posterior segment. The vitreous body belonging to the anterior segment is the part of the vitreous body on the cornea side with respect to the X-Y plane passing through the point of the crystalline lens closest to the center of the eyeball as a boundary, and the vitreous body belonging to the posterior segment is the part of the vitreous body other than the vitreous body belonging to the anterior segment.
An angiographic image based on fluorescence of the fundus and an angiographic image based on fluorescence of the anterior segment are examples of the "fluorescence image of the subject's eye" of the present technology.

The sensors 70, 72, and 74 may be, for example, APDs (avalanche photodiodes). The beam splitters 58, 60, and 64 may be dichroic mirrors, half mirrors, or the like.

The OCT system is a three-dimensional image acquisition device realized by the control device 16, OCT unit 20, and imaging optical system 19 shown in FIG. 2. The OCT unit 20 includes a light source 20A, a sensor (detection element) 20B, a first optical coupler 20C, a reference optical system 20D, a collimating lens 20E, and a second optical coupler 20F.

The light source 20A generates light for optical coherence tomography. For example, a super luminescent diode (SLD) can be used as the light source 20A. The light source 20A generates low-coherence light of a broadband light source having a wide spectral width. The light emitted from the light source 20A is split by the first optical coupler 20C. One of the split lights is collimated by the collimating lens 20E as a measurement light, and then enters the imaging optical system 19. The measurement light is scanned in the X and Y directions by the scanning unit (148, 142) described later. The scanning light is irradiated to the anterior segment of the test eye and the posterior segment via the pupil 27. The measurement light reflected by the anterior or posterior eye segment is incident on the OCT unit 20 via the imaging optical system 19, and then incident on the second optical coupler 20F via the collimator lens 20E and the first optical coupler 20C. Note that in this embodiment, SD-OCT using an SLD as the light source 20A is exemplified, but this is not limited thereto, and SS-OCT using a wavelength swept light source instead of an SLD may also be used.

The other light emitted from the light source 20A and branched by the first optical coupler 20C is incident on the reference optical system 20D as reference light, and passes through the reference optical system 20D to be incident on the second optical coupler 20F.

The measurement light (return light) reflected and scattered by the test eye 12 and the reference light are combined by the second optical coupler 20F to generate interference light. The interference light is detected by the sensor 20B. The image processing device 16G generates a tomographic image of the test eye 12 based on the detection signal (OCT data) from the sensor 20B.

In this embodiment, the OCT system generates a tomographic image of the anterior or posterior segment of the test eye 12.

The anterior segment of the subject's eye 12 includes, as the anterior segment, the cornea, iris, angle, crystalline lens, ciliary body, and part of the vitreous body. The posterior segment of the subject's eye 12 includes, as the posterior segment, the remaining part of the vitreous body, the retina, choroid, and sclera. The vitreous body belonging to the anterior segment is the part of the vitreous body on the cornea side, with the X-Y plane passing through the point of the crystalline lens closest to the center of the eye as its boundary, and the vitreous body belonging to the posterior segment is the part of the vitreous body other than the vitreous body belonging to the anterior segment.

When the anterior segment of the subject's eye 12 is the area to be imaged, the OCT system generates, for example, a tomographic image of the cornea. When the posterior segment of the subject's eye 12 is the area to be imaged, the OCT system generates, for example, a tomographic image of the retina.

The imaging optical system 19 includes a first optical scanner 22, a second optical scanner 24, and a wide-angle optical system 30.

The first optical scanner 22 performs two-dimensional scanning in the X and Y directions with the light emitted from the SLO unit 18. The second optical scanner 24 performs two-dimensional scanning in the X and Y directions with the light emitted from the OCT unit 20. The first optical scanner 22 and the second optical scanner 24 may be optical elements capable of deflecting a light beam, such as a polygon mirror or a galvanometer mirror. Alternatively, a combination of these may be used.

The wide-angle optical system 30 includes an objective optical system having a common optical system 28, and a combining unit 26 that combines light from the SLO unit 18 and light from the OCT unit 20.

The objective optical system of the common optical system 28 may be a reflective optical system using a concave mirror such as an elliptical mirror, a refractive optical system using a wide-angle lens, or a catadioptric system combining concave mirrors and lenses. By using a wide-angle optical system using an elliptical mirror or a wide-angle lens, it is possible to photograph the retina not only in the center of the fundus but also in the peripheral part of the fundus.

When using a system including an elliptical mirror, the system using the elliptical mirror described in International Publication WO2016/103484 or International Publication WO2016/103489 may be used. The disclosures of International Publication WO2016/103484 and International Publication WO2016/103489 are each incorporated herein by reference in their entirety.

The wide-angle optical system 30 realizes observation of the fundus with a wide field of view (FOV) 12A. The FOV 12A indicates the range that can be photographed by the photographing device 14. The FOV 12A can be expressed as a field of view. In this embodiment, the field of view can be defined by an internal irradiation angle and an external irradiation angle. The external irradiation angle is the irradiation angle of the light beam irradiated from the ophthalmic device 110 to the subject's eye 12, which is defined based on the pupil 27. The internal irradiation angle is the irradiation angle of the light beam irradiated to the fundus F, which is defined based on the center O of the eyeball. The external irradiation angle and the internal irradiation angle are in a corresponding relationship. For example, when the external irradiation angle is 120 degrees, the internal irradiation angle corresponds to approximately 160 degrees. In this embodiment, the internal irradiation angle is 200 degrees.

The SLO unit 18 and the imaging optical system 19 are an example of an "illumination section" of the technology disclosed herein. The first sensor 70 to the third sensor 74 are an example of a "detector section" of the technology disclosed herein. The control device 16 is an example of a "control section" of the technology disclosed herein. The input/display device 16E is an example of a "display section" and a "selection section" of the technology disclosed herein.

Next, the axial length measuring device 120 will be described. The axial length measuring device 120 has two modes, a first mode and a second mode, for measuring the axial length, which is the length in the axial direction of the test eye 12. In the first mode, light from a light source (not shown) is guided to the test eye 12, and then the interference light between the reflected light from the fundus and the reflected light from the cornea is received, and the axial length is measured based on an interference signal indicating the received interference light. The second mode is a mode for measuring the axial length using ultrasound (not shown).

The axial length measuring device 120 transmits the axial length measured in the first mode or the second mode to the server 140. The axial length may be measured in both the first mode and the second mode, in which case the average of the axial lengths measured in both modes is transmitted to the server 140 as the axial length.

Next, various functions that are realized by the CPU 16A of the ophthalmic device 110 executing the image capture processing program will be described with reference to FIG. 3. The image capture processing program has a pattern presentation function, an image capture control function, an image processing control function, and a processing function. When the CPU 16A executes the image capture processing program having each of these functions, the CPU 16A functions as a pattern presentation unit 302, an image capture control unit 304, an image processing unit 306, and a processing unit 308, as shown in FIG. 3.

Next, the photographing process including the fluorescent image generation process by the CPU 16A of the ophthalmic device 110 will be described in detail with reference to FIG. 4. FIG. 4 shows a flowchart of the photographing process program. The CPU 16A of the ophthalmic device 110 executes the photographing process program to realize the photographing process method including the fluorescent image generation process method shown in the flowchart of FIG. 4. Here, FIG. 4 is a flowchart for photographing a fundus fluorescent image (angiography image produced by fundus fluorescence) of the subject eye.

In this embodiment, fluorescein has a high fluorescence efficiency but may cause allergies (e.g., anaphylactic shock) in the subject, but instead of using it as is, the present invention aims to generate a fundus fluorescence image of the subject's eye with the same image quality as that obtained when only fluorescein is used.

The imaging processing program shown in FIG. 4 starts when the patient ID, patient name, patient age, patient visual acuity, and left or right eye information are entered and a start button (not shown) is operated.

In step 402, the pattern presentation unit 302 displays a list of combination patterns of fluorescent materials on the display of the input/display device 16E. The list of combination patterns is stored in the ROM 16C (or a storage device, not shown).

Here, a list of combination patterns of fluorescent substances 500 will be described with reference to Fig. 5A. As shown in Fig. 5A, the list of combination patterns 500 includes buttons for selecting a pattern as shown in a pattern selection column 501, and a plurality of patterns, for example, five patterns 1 to 5 as shown in a pattern column 502. Each pattern column in the list of combination patterns 500 includes a combination of two fluorescent substances, a first fluorescent substance to be administered to a patient and a second fluorescent substance having excitation characteristics different from that of the first fluorescent substance, as shown in a fluorescent substance column 504.
The information on the phosphor string 504 is an example of the "combined information" of the technique of the present disclosure.

The first combination pattern of two fluorescent substances is for visible fluorescent imaging using fluorescent substances that are safe for the human body. The first pattern is a combination of multiple types of fluorescent contrast agents that are safe for the human body and have a fluorescence intensity comparable to that of fluorescein. For example, as shown in pattern 1, it is a combination of riboflavin and phycoerythrin.

The second pattern is for near-infrared fluorescence imaging using fluorescent substances that are safe for the human body. The second pattern is a combination of multiple types of fluorescent contrast agents that are safe for the human body and have a fluorescence intensity comparable to that of indocyanine green. For example, as shown in pattern 2, it is a combination of chlorophyll and phycocyanin. It is also possible to use a combination of indocyanine green and fucoxanthin as shown in pattern 5. The concentration of indocyanine green is reduced to a level that does not affect the human body.

Thirdly, in order to mitigate the adverse effects of fluorescein on the human body, the concentration of fluorescein is reduced to a level that does not affect the human body, and instead a substance with an equivalent fluorescent wavelength is combined. For example, as shown in pattern 3, there is a combination of fluorescein and riboflavin, and as shown in pattern 4, there is a combination of fluorescein and phycoerythrin.

The column for each pattern in the combination pattern list 500 further includes the molecular weight of each fluorescent substance, as shown in the molecular weight column 506. For example, pattern 1 includes a molecular weight of 478.33 for riboflavin and a molecular weight of 30.97 for phycoerythrin. Note that the larger the molecular weight, the slower the speed at which the fluorescent substance flows through the blood vessels.

The column for each pattern in the combination pattern list 500 further includes the wavelength of the excitation light (light source wavelength, excitation wavelength) that excites each fluorescent substance to generate fluorescence, as shown in the light source wavelength column 508. For example, in pattern 1, the light source wavelength for riboflavin is 448 nm, and the light source wavelength for phycoerythrin is 488 nm. Note that the light source wavelengths for riboflavin and phycoerythrin are included in the wavelength band of light emitted from the first light source 40 (see FIG. 5B). Therefore, in the case of pattern 1, only the first light source 40 generates light (excitation light).

The column for each pattern in the combination pattern list 500 further includes the wavelength (detector wavelength, fluorescence wavelength) at which the fluorescence emitted when irradiated with excitation light of the light source wavelength corresponding to each fluorescent substance is detected, as shown in the detector wavelength column 510. For example, in pattern 1, the wavelength at which the fluorescence from riboflavin is detected is 550 nm, and the wavelength at which the fluorescence from phycoerythrin is detected is 577 nm. The wavelengths at which the fluorescence from riboflavin and phycoerythrin is detected are included in the light receiving band of the first sensor 70. Therefore, in pattern 1, only the first sensor 70 is operated.

In the present embodiment, as shown in FIG. 5D, there are two shooting patterns for each fluorescent material pattern in the combination pattern list 500 as described above. A shooting pattern table 550 of the two shooting patterns for each fluorescent material pattern is stored in the ROM 16C (or a storage device, not shown). In step 402, the pattern presenting unit 302 may display the shooting pattern table 550 together with the fluorescent material combination pattern list on the display of the input/display device 16E.

For each pattern shown in pattern column 522, shooting pattern table 550 has a simultaneous shooting pattern as shown in first shooting pattern column 524, and an asymmetric shooting pattern as shown in second shooting pattern column 526. In the simultaneous shooting pattern, two fluorescent substances are administered to a patient at different times, and an image is taken of the state in which each of the two fluorescent substances flows simultaneously through the blood vessels in the fundus of the patient's test eye. In the asymmetric shooting pattern, two fluorescent substances are administered to a patient at the same time, and an image is taken of the state in which each of the two fluorescent substances flows at different times through the blood vessels in the fundus of the patient's test eye.

For example, the simultaneous imaging pattern in pattern 1 will be described. Riboflavin has a larger molecular weight than phycoerythrin, and therefore flows through the blood vessels at a slower rate. In order for the two fluorescent substances to flow through the blood vessels of the patient's test eye at the same time, riboflavin must be injected into the patient's arm before phycoerythrin. Therefore, in pattern 1, the administration order column 532 specifies the timing for administering riboflavin and phycoerythrin to the patient, with phycoerythrin being injected after riboflavin ("riboflavin → phycoerythrin").

The time from when each fluorescent substance is injected into the patient's elbow until it reaches the patient's examined eye is predetermined. Therefore, in the simultaneous imaging pattern of pattern 1, it is also predetermined how much time T after the injection of riboflavin that phycoerythrin must be injected so that these two fluorescent substances flow simultaneously through the blood vessels in the fundus of the examined eye. This time T is also stored in pattern 1.

The light source wavelengths of riboflavin and phycoerythrin are 448 nm and 488 nm (see FIG. 5A), and 448 nm and 488 nm are the wavelength bands of the first light source 40 and the second light source 42 (see P1 in FIG. 5B). Therefore, in the simultaneous shooting pattern of pattern 1, as shown in FIG. 5D, the light source operation order field 534 specifies that the first light source 40 and the second light source 42 are operated simultaneously (see FIG. 5D "first light source + second light source"). The detector wavelengths of riboflavin and phycoerythrin are 550 nm and 577 nm (see FIG. 5A), and 550 nm and 577 nm are the wavelength bands of the first sensor 70 (second light receiving element, third light receiving element) (see P1 in FIG. 5C). Therefore, in the simultaneous shooting pattern of pattern 1, as shown in FIG. 5D, the sensor operation order field 536 specifies that only the first sensor 70 is operated (see FIG. 5D "first sensor").

Next, the asymmetric imaging pattern in pattern 1 will be described. In the asymmetric imaging pattern, two fluorescent substances are administered simultaneously (injected into the patient's elbow vein) as described above. Since the asymmetric imaging pattern administers two fluorescent substances simultaneously, as shown in FIG. 5D, the administration order field 532 contains information on the simultaneous administration of two fluorescent substances as the timing for administering each of the two fluorescent substances to the patient. The molecular weights of the two fluorescent substances are different. Thus, the two fluorescent substances reach the blood vessels of the patient's subject's eye at different times. In the asymmetric imaging pattern, the subject's eye is photographed at each time (different times) when each fluorescent substance flows through the blood vessels of the subject's eye. The order in which each fluorescent substance arrives at the subject's eye is determined in advance based on the molecular weight of each fluorescent substance. Therefore, the order in which the light sources and sensors are operated according to that order is also determined in advance.

In pattern 1, phycoerythrin, which has a smaller molecular weight, reaches the subject's eye earlier than riboflavin, which has a larger molecular weight. Therefore, the order of irradiating the light of the second light source 42 followed by the light of the first light source 40 and the order of the sensors that receive the fluorescence from the irradiation of each light are determined. In the different-time photography pattern in pattern 1, the first sensor 70 is determined to operate at each time (different time) when the excitation light is irradiated. Specifically, as shown in FIG. 5D, the light source operation order column 534 determines that the first light source 40 is operated after the second light source 42 (see FIG. 5D "second light source -> first light source"). The sensor operation order column 536 determines that the first sensor 70 is operated at each of the above times (see FIG. 5D "first sensor -> first sensor").

The time from when each fluorescent substance of each pattern is injected into the patient until it reaches the blood vessels of the examinee's eye is determined in advance. The amount of time that should elapse from when each fluorescent substance is injected into the patient before imaging should begin is also determined in advance. The time between when each fluorescent substance is injected into the patient and when imaging should begin is also stored in the imaging asymmetric pattern.

As described above, when the list of fluorescent material combination patterns 500 is displayed, the operator uses the mouse to operate button 501 corresponding to any one of patterns 1 to 5. When button 501 is operated, in step 404, processing unit 308 accepts the selection of the fluorescent material combination pattern. In the example shown in FIG. 5A, pattern 1 is shown to have been selected.

In step 406, the processing unit 308 displays an imaging timing selection screen. As shown in Fig. 6A, the imaging timing selection screen 600 has an imaging timing selection field 602 and an administration order display field 604. The imaging timing selection field 602 is provided with a button for selection as shown in a selection button column 612, and a field indicating whether the imaging timing is simultaneous or different as shown in an imaging timing display column 614. In step 406, the processing unit 308 may display (output) at least one of the information in the light source operation order field 534 and the sensor operation order field 536 corresponding to the selected pattern in the imaging pattern table 550 (see Fig. 5D).
The information in the administration order field 532 is an example of "administration timing information" of the technology of the present disclosure. The information in the light source operation order field 534 is an example of "light source designation information" of the technology of the present disclosure. The information in the sensor operation order field 536 is an example of "detector designation information" of the technology of the present disclosure.

When the image capture timing selection screen 600 is displayed, the operator operates a button in the selection button row 612 that corresponds to simultaneous or different times. For example, as shown in FIG. 6B, the operator operates the button that corresponds to simultaneous as the image capture timing. In step 408, the selection of the image capture timing is accepted.

When the selection of the imaging timing is accepted, in step 410, the processing unit 308 displays the administration order of the two fluorescent substances of the selected pattern in the administration order display field 616 based on the imaging pattern table 550 and the selected fluorescent substance pattern and imaging timing.

For example, when pattern 1 is selected as the fluorescent substance pattern as shown in FIG. 5A and simultaneous is selected as the imaging timing as shown in FIG. 6B, the imaging pattern table 550 shown in FIG. 5D displays "Administer phycoerythrin T minutes after administration of riboflavin" as the administration order of the two fluorescent substances in pattern 1.

If the asychronologic imaging pattern is selected, the administration order column 616 will display "Administer riboflavin and phycoerythrin simultaneously."

Once the administration order is displayed, the operator administers each fluorescent substance into the patient's cubital vein in the appropriate administration order.

In step 412, the processing unit 308 checks the fluorescent substance to be administered (administered substance). An IC chip containing the identification data of the administered substance is attached to each administered substance container. The identification data of each fluorescent substance is stored in advance in the ROM 16C (or storage device). Before injecting the fluorescent substance into the syringe, the operator has the IC chip reader 16F read the IC chip attached to the fluorescent substance container. When the IC chip reader 16F reads the identification data of the fluorescent substance, the IC chip reader 16F inputs the read identification data of the fluorescent substance. In step 412, the processing unit 308 judges whether the administered substance is correct by checking whether the identification data of the fluorescent substance input by the IC chip reader 16F matches the identification data of the fluorescent substance according to the administration order. If the administered substance is not judged to be correct, in step 416, the processing unit 308 displays on the display that the administered substance is incorrect, and the imaging process returns to step 412.

If it is determined that the administered substance is correct, in step 418, the processing unit 308 instructs the display to administer. In step 420, the processing unit 308 determines whether administration is complete. When administration is instructed on the display and the operator has completed administration of the fluorescent substance, he or she operates an administration completion button (not shown). When the administration completion button is operated, step 420 is judged as positive.

In the next step 422, the imaging control unit 304 judges whether or not it is time to capture an image. As described above, the time from when the administered substance is administered until it reaches the subject's eye is stored, so the imaging control unit 304 judges whether or not the stored time has elapsed since the time when step 420 was determined to be positive. If it is determined that the administration time has come, in step 424, the imaging control unit 304 turns on the light source determined by the administration timing associated with the selected imaging timing of the selected combination pattern. For example, as described above, when simultaneous imaging is selected in pattern 1, the administration order field 532 associates the order of administration to the patient, such as injecting phycoerythrin after riboflavin, with pattern 1 and simultaneous imaging. Each of riboflavin and phycoerythrin is associated with the first light source 40. Therefore, when simultaneous imaging is selected in pattern 1, the imaging control unit 304 turns on only the first light source 40.
The first light source 40 is an example of "the first light source and the second light source" in "controlling the light emission timing of the first light source and the second light source" of the technology disclosed herein.

In step 426, the imaging control unit 304 acquires imaging data from the sensors determined by the selected combination pattern. For example, in pattern 1, imaging data is acquired from each second light receiving element and each third light receiving element of the first sensor 70. The imaging data is image data of a moving image. It may also be image data of a still image.

In step 428, the shooting control unit 304 turns off the light source.

In step 430, it is determined whether or not imaging has been completed for all administered substances in the selected pattern. For example, if simultaneous imaging has been selected, and the processing of steps 412 to 428 has been performed once, step 430 will be determined as positive. On the other hand, if different-time imaging has been selected, and the processing of steps 412 to 430 has been performed for the first administered substance, step 430 will be determined as negative, and the imaging processing will return to step 412. If the processing of steps 412 to 428 has been performed for the second fluorescent substance, step 430 will be determined as positive.

In step 432, the image processing unit 306 performs image processing. For example, when pattern 1 is selected, the image processing unit 306 controls the image processing device 16G, so that the image processing device 16G generates second image data of a fluorescent image based on the fluorescence of riboflavin based on the signals output from each second light receiving element, and generates third image data of a fluorescent image based on the fluorescence of phycoerythrin based on the signals output from each third light receiving element. Furthermore, the image processing device 16G generates image data of a fundus fluorescent image of the test eye from the second image data of the fluorescent image based on the fluorescence of riboflavin and the third image data of the fluorescent image based on the fluorescence of phycoerythrin.

In step 434, the processing unit 308 outputs image data of the fundus fluorescence image of the test eye to the server 140 in correspondence with the fluorescent material in the selected fluorescent material pattern, the patient name ID, the patient name, the patient's age, the patient's visual acuity, and information on whether the eye is left or right. The server 140 stores the image data of the fundus fluorescence image of the test eye in correspondence with the fluorescent material, the patient name ID, the patient's name, the patient's age, the patient's visual acuity, information on whether the eye is left or right, and the date of imaging.

The patient's axial length is transmitted from the axial length measuring device 120 to the server 140 in association with the patient name ID. The server 140 stores the patient's axial length in association with the patient name ID.

In this embodiment, the imaging process shown in FIG. 4 is performed for multiple patterns of fluorescent material. For example, the imaging process shown in FIG. 4 is performed for one or more of patterns 1 to 4 and pattern 5. For example, the imaging process shown in FIG. 4 is performed for patterns 1, 2, and 5.

When an ophthalmologist examines a patient's eye to be examined, the ophthalmologist inputs the patient name ID into the viewer 150. The viewer 150 instructs the server 140 to transmit image data of the fundus fluorescent image of the eye to be examined that corresponds to the patient name ID. The server 140 transmits to the viewer 150 the fluorescent substance, patient name, patient age, patient visual acuity, information on whether the eye is left or right, axial length, date of photography, and image data of the fundus fluorescent image that corresponds to the patient name ID, together with the patient name ID.

The viewer 150 receives the fluorescent material, patient ID, patient name, patient age, patient visual acuity, left or right eye information, axial length, date of photography, and image data of the fundus fluorescence image, and displays the first fundus image display screen 700A shown in Figure 7 on the display.

As shown in FIG. 7, the first fundus image display screen 700A includes a patient information display field 702 and a first fundus image information display field 704A.

The patient information display field 702 has display fields 712 to 722 for displaying the patient name ID, the patient name, the patient's age, the patient's visual acuity, information on whether the eye is left or right, and the axial length, and a screen switching button 724. The received patient name ID, patient name, patient's age, the patient's visual acuity, information on whether the eye is left or right, and the axial length are displayed in the display fields 712 to 722.

The first fundus image information display field 704A includes a photographing date display field 730, a display field 732 for the fluorescent material of the selected pattern, an SLO image display field 734A, a fluorescent photographed image display field 736, and an information display field 738.

The date of photography (YYYY/MM/DD) is displayed in the photography date display field 730. The information display field 738 displays comments and notes made by the user (ophthalmologist) at the time of the examination as text.

SLO photography is performed, for example, by turning on the second light source 42 and detecting light reflected from the fundus of the test eye with one of the first sensor 70 to the third sensor 74, and the image processing device 16G creates a fundus image of the test eye (SLO image) based on a signal from one of the first sensor 70 to the third sensor 74. The created fundus image of the test eye (SLO image) is displayed in the SLO image display field 734A.

The fluorescent substances of the selected pattern are displayed in display field 732. For example, in the example shown in FIG. 7, riboflavin and phycoerythrin of pattern 1 are displayed.

The fluorescent photographed image display section 736 displays a fundus fluorescent image (moving image) of the subject's eye.

The fundus image (SLO image) and fundus fluorescence image of the test eye are aligned using the optic disc position and the blood vessels seen radially around it as reference points, and the positional deviation of the images acquired with a time lag is corrected. The optic disc and the fovea may also be used as reference points for alignment.

In pattern 1, riboflavin and phycoerythrin have low fluorescence wavelengths and are in the same wavelength band, so the fundus fluorescence image of the test eye displays a moving image of the retina of the test eye.

As shown in FIG. 7, a fundus image (SLO image) and a fundus fluorescence image of the test eye are displayed side by side when the excitation wavelengths or fluorescence wavelengths are similar, such as in patterns 1, 3, and 4.

For example, when the screen switching button 724 is operated while the first fundus image information display field 704A is displayed, the display screen of the viewer 150 is switched to the second fundus image display screen 700B (see FIG. 8).

The first fundus image display screen 700A and the second fundus image display screen 700B are substantially similar, so only the differences will be explained.

The second fundus image display screen 700B includes a second fundus image information display field 704B. The second fundus image information display field 704B includes an OCT-A (Angiography) image display field 734B, which is an angiography image obtained from OCT data, instead of (or together with) the SLO image display field 734A. The OCT-A image display field 734B displays an OCT-A photographed image of a designated rectangular region 736R of a fluorescent image of the fundus of the subject's eye. The rectangular region 736R is, for example, a range of 12 mm*12 mm including the macula of the fundus.
The ophthalmic device 110 obtains OCT data of the entire test eye, and when a user (e.g., an ophthalmologist) specifies a rectangular area 736R in the fluorescent photographic image display field 736, an OCT-A image is displayed in the OCT-A image display field 734B based on the OCT data of the fundus of the test eye corresponding to this rectangular area 736R.
In addition, the position and size of rectangular region 736R are not limited to the area including the macula; the user can move the position of rectangular region 736R or change the size of rectangular region 736R, thereby specifying the area in which the OCT-A image is to be displayed.

The fluorescent photographed image display field 736 displays a fundus fluorescent image of the retina of the test eye obtained using chlorophyll and phycocyanin of pattern 2 as the fluorescent substances, as shown in display field 732.

Furthermore, for example, when the screen switching button 724 is operated while the second fundus image display screen 700B is displayed, it switches to the third fundus image display screen 700C (see FIG. 9). The third fundus image display screen 700C (see FIG. 9) has a fluorescent material pattern corresponding to pattern 5.

The second fundus image display screen 700B and the third fundus image display screen 700C are substantially similar, so only the differences will be explained.

In the third fundus image information display field 704C of the third fundus image display screen 700C, a first fluorescent image display field 734C is displayed instead of (or together with) the OCT-A captured image display field 734B. In the third fundus image information display field 704C, a second fluorescent image display field 736C is displayed.

When the fluorescent substance is indocyanine green (ICG), the excitation wavelength is 774 nm, which is a wavelength in the near-infrared region and therefore reaches the choroid. Then, by receiving the fluorescence emitted by indocyanine green that has flowed into the blood vessels of the choroid of the test eye (fluorescence wavelength of 805 nm), a fluorescent image of the choroidal blood vessels is obtained. In the first fluorescent image display field 734C, a fluorescent image of the choroidal blood vessels obtained using indocyanine green (ICG) as the fluorescent substance is displayed, as shown in display field 732C1.

When the fluorescent substance is fucoxanthin, the excitation wavelength is 425 nm, which is a wavelength of visible light in the blue region, and so it reaches the retinal surface. Then, by receiving the fluorescence emitted by the fucoxanthin that has flowed into the retinal blood vessels of the test eye (fluorescence wavelength of 660 to 700 nm), a fluorescent image of the retinal blood vessels is obtained. In the second fluorescent shadow image display field 736C, a fluorescent image of the retinal blood vessels obtained using fucoxanthin as the fluorescent substance is displayed, as shown in display field 732C2.

In this way, fluorescent images of blood vessels in different layers of the fundus are displayed side by side in display areas 734C and 736C.

The choroidal vessel image and fundus fluorescence image are aligned using image alignment as described above.

In the embodiment described above, in the simultaneous shooting pattern, the two fluorescent substances of a pattern selected from a plurality of patterns of two fluorescent substances flow simultaneously through the blood vessels of the fundus of the test eye, and the test eye is irradiated with excitation light corresponding to the flowing fluorescent substances. Then, the fluorescence from the two fluorescent substances is received, image data of each of the fluorescent substances is created, and a fundus fluorescent image of the test eye is generated from the image data of each of the fluorescent substances created. Therefore, even if fluorescein, which has high fluorescence efficiency but may cause allergies (e.g., anaphylactic shock) in the test subject, is not used as the two fluorescent substances of the selected pattern, or the concentration of fluorescein is reduced to a level that does not affect the human body, a fundus fluorescent image of the test eye of the same image quality as that obtained when only fluorescein is used can be generated.

In this embodiment, a dynamic image of the fundus fluorescence image of the subject's eye is acquired and displayed. This makes it possible to grasp, for example, a situation in which blood is leaking from blood vessels in the fundus.

The first sensors 70 to 74 in this embodiment have a relatively high sensitivity to fluorescence light, so even in the case of an asynchronous shooting pattern, a fundus fluorescence image of the test eye of similar image quality to that obtained when only fluorescein is used can be generated. However, when the light sensitivity of the first sensors 70 to 74 is relatively low and in the case of an asynchronous shooting pattern, the fundus of the test eye may be photographed multiple times, and a fundus fluorescence image (still image) of the test eye may be generated from the image data obtained from the multiple photographs.

In the above embodiment, the fluorescent substance is administered into the elbow vein, but the technology disclosed herein is not limited to this and may be administered orally.

In the above embodiment, each pattern of fluorescent material is a pattern of two fluorescent materials, but the technology disclosed herein is not limited to this, and may be a pattern of three or more fluorescent materials.

In the above embodiment, an ophthalmic device equipped with an SLO system is used, but the technology disclosed herein is not limited to this and may be a fundus camera. In this case, the fundus camera is equipped with an illumination unit such as a light source for illuminating the subject's eye with excitation light.

In the above embodiment, the following measures may be taken to improve the concentration of riboflavin in the body by oral administration: Riboflavin has a weaker fluorescence intensity than fluorescein, but oral administration plus image processing can compensate for the weak fluorescence.
Weak fluorescence leads to a dark overall fluorescence image, but image processing such as averaging and integrating multiple fluorescence images can compensate for the low riboflavin fluorescence intensity, allowing the concentration (dosage) of riboflavin to be reduced.
In addition, to suppress the effects of fluorescent substances other than riboflavin that cause noise (for example, lipofuscin, an aging substance), the patient may take a supplement that reduces fluorescent substances other than riboflavin (lutein, which reduces lipofuscin) for a certain period of time (for example, one week) before the image is taken.

In each of the above described examples, the photographing process is realized by a software configuration using a computer, but the technology of the present disclosure is not limited to this. For example, instead of a software configuration using a computer, the photographing process may be executed only by a hardware configuration such as an FPGA (Field-Programmable Gate Array) or an ASIC (Application Specific Integrated Circuit). A part of the photographing process may be executed by a software configuration, and the remaining process may be executed by a hardware configuration.

As such, the technology disclosed herein includes cases in which the shooting process is realized by a software configuration using a computer, and cases in which the shooting process is realized by a configuration that is not a software configuration using a computer, and therefore includes the following first and second technologies.
(First Technology)
an irradiation unit control unit that controls the irradiation unit so that a first excitation light that excites a first fluorescent material and a second excitation light that excites a second fluorescent material different from the first fluorescent material are irradiated onto the subject's eye;
a detector unit control unit that controls the detector unit so that a first fluorescence from the first fluorescent material excited by the first excitation light and a second fluorescence from the second fluorescent material excited by the second excitation light are received from the subject's eye;
An imaging device including:

The imaging control unit 304 in the above embodiment is an example of the "illumination unit control unit" and "detector unit control unit" of the first technology.

(Second Technology)
As described above, the following second technology is proposed from the above disclosure: an irradiation unit control unit controls the irradiation unit so that a first excitation light for exciting a first fluorescent material and a second excitation light for exciting a second fluorescent material different from the first fluorescent material are irradiated onto the subject's eye;
a detector unit control unit controls the detector unit so that a first fluorescence from the first fluorescent material excited by the first excitation light and a second fluorescence from the second fluorescent material excited by the second excitation light are received from the subject's eye;
A method of shooting including.

Based on the above disclosure, the following third technique is proposed.
A computer program product for photographing and processing, comprising:
The computer program product comprises a computer-readable storage medium that is not itself a transitory signal;
The computer-readable storage medium stores a program for causing a control unit to perform an imaging process of an eye to be examined,
The photographing process includes:
controlling an irradiation unit so that a first excitation light that excites a first fluorescent material and a second excitation light that excites a second fluorescent material different from the first fluorescent material are irradiated onto the subject's eye;
controlling a detector unit so that a first fluorescence from the first fluorescent material excited by the first excitation light and a second fluorescence from the second fluorescent material excited by the second excitation light are received from the subject's eye;
including,
Computer program products.

In each of the examples described above, excitation light is irradiated onto the subject's eye to excite the fluorescent substance, but the technology disclosed herein is not limited to this, and electromagnetic waves other than light, such as an electric field or a magnetic field, may also be applied to the subject's eye.

The shooting process described above is merely one example. It goes without saying that unnecessary steps may be deleted, new steps may be added, or the processing order may be changed without departing from the spirit of the invention.

All publications, patent applications, and technical standards described in this specification are incorporated by reference into this specification to the same extent as if each individual publication, patent application, and technical standard was specifically and individually indicated to be incorporated by reference.

18 SLO unit 19 Imaging optical system 40 First light source 42 Second light source 44 Third light source 46 Fourth light source 70 First sensor 72 Second sensor 74 Third sensor 16 Control device 16E Input/display device 504 Fluorescent substance array 532 Administration order field 534 Light source operation order field 536 Sensor operation order field

Claims (3)

an irradiation unit that irradiates the subject's eye with a first excitation light having a first wavelength that excites a first fluorescent substance different from indocinian green and fluorescein, and a second excitation light having a second wavelength longer than the first wavelength that excites a second fluorescent substance different from the first fluorescent substance and different from indocinian green and fluorescein;
a detector unit that receives, from the subject's eye, first fluorescence having a near-infrared wavelength from the first fluorescent substance excited by the first excitation light and second fluorescence having a near-infrared wavelength from the second fluorescent substance excited by the second excitation light;
a generating unit that generates first fluorescence image data based on the first fluorescence and related to a first layer located on a fundus surface side of the subject's eye, and second fluorescence image data based on the second fluorescence and related to a second layer deeper than the first layer;
a control unit that performs registration between the first fluorescence image data and the second fluorescence image data based on a position of a predetermined tissue of the subject's eye that spans from the first layer to the second layer on the first and second fluorescence image data;
An ophthalmic apparatus comprising: The ophthalmic device according to claim 1, wherein the irradiation unit includes a laser light source that emits the first excitation light and the second excitation light, which are laser beams. The ophthalmic device according to claim 1 or 2, wherein the irradiation unit controls the timing of irradiation of the first excitation light and the second excitation light to the subject's eye based on the administration timing of the first fluorescent substance and the administration timing of the second fluorescent substance.