JPH0838428A - Cornea endothelial cell observing/photographing device - Google Patents

Abstract

PURPOSE:To improve the accuracy of cornea endothelial cell density evaluation while simply and easily confirming the rough number of cornea endothelial cell images on the spot when cornea endothelial cells are photographed. CONSTITUTION:The cornea endothelial cell images (s) of a photographed tested eye on a screen 4 are displayed on a screen 4, the cornea endothelial cell images (s) displayed on the screen 4 are partitioned into preset prescribed areas by squares 4d serving as partitioning means, and the cornea endothelial cell images (s) in a region partitioned by a magnifying means are magnified and displayed on the screen 4. The cornea endothelial cell number (s) closed in the region is stored in a memory means, prescribed calculation is made by a calculating means based on the cornea endothelial cell number stored by the memory means to calculate the cornea endothelial cell number, then the cornea endothelial cell number for unit area is calculated.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a corneal endothelial cell observation / photographing apparatus for illuminating the cornea of an eye to be examined with illumination light to observe and photograph a corneal endothelial cell image of the eye to be examined.

[0002]

^2. Description of the Related Art Generally, the corneal endothelium has 4,000 to 5,000 substantially hexagonal corneal endothelial cells per unit area (1 mm ² ) in infancy. When one of the large number of corneal endothelial cells dies, the dead corneal endothelial cells are absorbed by the adjacent corneal endothelial cells, and the number of corneal endothelial cells gradually decreases, and at the same time, the size of the corneal endothelial cells is reduced. 6
It becomes larger while maintaining the square shape.

On the other hand, when the corneal endothelial cells die and the number of corneal endothelial cells per unit area becomes, for example, 500 or less, a part of the corneal endothelial cells is cut into a scalpel during ophthalmic surgery. Due to the artificial cell death of the cornea, it becomes difficult to supply nutrients to the cornea, which may lead to corneal diseases such as infection. Therefore, surgery is not performed.

Therefore, before ophthalmic surgery, the shape of corneal endothelial cells and the number of corneal endothelial cells per unit area are measured to confirm their deterioration, etc., and the artificial corneal endothelial cells are killed by corneal surgery. It was necessary to confirm in advance whether or not the number of corneal endothelial cells was within a range that did not adversely affect. Further, it is necessary to confirm the progress of the damaged state of corneal endothelial cells even after the operation of the cornea.

As a device for confirming such corneal endothelial cells, a contact type corneal endothelial cell observing / photographing device for observing and photographing a corneal endothelium image by attaching an optical attachment for observing corneal endothelium to a slit lamp Is being developed.

The number of corneal endothelial cells of the corneal endothelial cells was obtained by plotting a photographed image of the corneal endothelial cells with a plotter and determining the number of corneal endothelial cells from the coordinate axis of the plotter.

However, when the plotter is used as described above, the number of plot points for one corneal endothelial cell is large because the shape of the corneal endothelial cell is approximately hexagonal.
The plotting work is very complicated and complicated calculations must be performed using an expensive arithmetic processing circuit.

Therefore, for example, by using corneal endothelial cell sample patterns having different densities in units of 500 cells, the approximate number of corneal endothelial cells can be easily calculated from the size of the pattern that substantially matches the size of the corneal endothelial cells after photographing. By checking, it is considered that a plotting operation and an expensive arithmetic processing circuit are unnecessary.

[0009]

By the way, in the corneal endothelial cell observation and photographing device configured as described above, an expensive device such as a circuit for measuring and calculating the number of corneal endothelial cells and an image analysis device is used. However, when sample patterns with different densities in units of 500 are used, it is rare that the size of the corneal endothelial cells after imaging and the pattern size of the sample pattern completely match, and the corneal endothelial cell density is There was a new problem that the evaluation accuracy was low.

The present invention has been made in view of the above circumstances, and while it is possible to easily and inexpensively confirm the approximate number of corneal endothelial cells on the spot where the corneal endothelial cells are photographed, It is an object of the present invention to provide a corneal endothelial cell observation and imaging device capable of increasing the accuracy of corneal endothelial cell density evaluation.

[0011]

In order to achieve the above-mentioned object, the invention according to claim 1 is a screen for displaying a corneal endothelial cell image of a photographed eye, and a corneal endothelium displayed on the screen. Partitioning means for partitioning the cell image into a preset predetermined area, enlarging means for enlarging and displaying the corneal endothelial cell image in the partitioned area on the screen, and storing the number of corneal endothelial cells closed in the area The present invention is characterized in that the storage means and the calculating means for calculating the number of corneal endothelial cells per unit area by performing a predetermined calculation based on the number of corneal endothelial cells stored in the storage means.

[0012]

In the above-mentioned structure according to claim 1,
A corneal endothelial cell image of the eye to be inspected is displayed on the screen,
The corneal endothelial cell image displayed on the screen by the partition means is partitioned into a predetermined area, and the corneal endothelial cell image in the area partitioned by the magnifying means is magnified and displayed on the screen, and the storage means closes the area. The number of corneal endothelial cells is stored, and the calculation unit calculates a number of corneal endothelial cells per unit area by performing a predetermined calculation based on the number of corneal endothelial cells stored in the storage unit.

[0013]

EXAMPLE Next, an example of the corneal endothelial cell observation and photographing apparatus of the present invention will be described with reference to FIGS.

(First Embodiment) In FIG. 4, reference numeral 1 denotes an illuminating illuminating system which is illuminated by an illuminating optical system (not shown) from an illuminating light source for observation toward the cornea of an eye to be inspected to reflect corneal endothelium cells of the cornea. An image receiving element (CCD) that receives the reflected image guided by the system.

The image of corneal endothelial cells received by CCD1 is
Multiple frame memories that correspond one-to-one with the shooting
The image control device 3 is temporarily stored in 2 ...
And is displayed on the screen 4. Incidentally, during the photographing, the corneal endothelial cell image is displayed on the screen 4 in real time.

The image control device 3 has a xenon switch 5 for switching the light amount of a light source between HIGH and LOW at the time of shooting, a mode switch 6 for switching between a shooting mode and an observation mode, and a device for displacing the device main body in the front-rear direction. The display state of the screen 4 is controlled by the operation after shooting of various switches such as the shooting switch 7a for performing shooting provided on the joystick switch 7 and the clear switch 8 for canceling the storage of the corneal endothelial cell image stored in the frame memory 2. To do. Further, the image control device 3 includes an arithmetic processing circuit (calculating means).
A corneal endothelial cell information signal is output to 9. Arithmetic processing circuit 9
A RAM 10 serving as a storage unit that stores the number of corneal endothelial cells designated under a specific condition described later is connected to the.

As shown in FIG. 3A, the screen 4 includes masks 4a, 4a, a display section 4b for displaying a reflected image received by the CCD 1, and three square-shaped cells (dividing means) 4.
c, 4d, 4e.

On the display section 4b, as shown in FIG.
The image received by the CCD 1 is displayed as a corneal endothelial cell image s. Further, as shown in FIG. 3C, squares 4c, 4d and 4e are combined and displayed on the display unit 4b.

The cells 4c, 4d, 4e are, for example, cells of a predetermined area of 0.1 mm × 0.1 mm magnified to the same magnification as the display magnification of the corneal endothelial cell image s, and the positions to be magnified are designated. The squares in the state of being square (the square 4d in the figure) and the squares in the state of making the enlarged position recognized (the square 4 in the figure
c, 4e) are different from each other.

The number of the squares 4c, 4d, 4e is not particularly limited. In addition, squares 4c, 4d, 4e
Although it is disclosed that the cells are simultaneously displayed on the display section 4b in different states, one cell is displayed on the display section 4b corresponding to the positions of the cells 4c, 4d, 4e or freely moved. You may.

On the other hand, on the display section 4b, as shown in FIG. 3 (D), the selected square (here, square 4d) among the squares 4c, 4d and 4e and the corneal endothelial cells located in this square 4d. The images s and s are displayed enlarged.

The examiner causes the arithmetic processing circuit 9 to calculate the number of corneal endothelial cells in the squares 4d having a predetermined area based on the corneal endothelial cell image S enlarged and displayed on the display unit 4b, and further the corneal endothelium having a predetermined area. By calculating the number of corneal endothelial cells per unit area based on the number of cell images S, the number of corneal endothelial cells close to the actual value can be obtained.

Various switches 5, 6, 7, 7a, 8
Is operated when the mode is switched from the photographing mode to the observation mode by operating the mode selector switch 6.
When the squares 4c, 4d, and 4e are combined and displayed on b, the function is automatically switched when the enlarged corneal endothelial cell image S is displayed on the display unit 4b.

Next, a process of photographing a corneal endothelial cell of an eye to be examined (not shown) with such a corneal endothelial cell observing / photographing device and then obtaining the number of corneal endothelial cells of the corneal endothelial cell after the photographing is illustrated. A description will be given based on the flowchart of FIG.

(Step 1) In this step 1, the corneal endothelial cells of the subject's eye guided to the CCD 1 by the illumination optical system and the observation optical system (not shown) are photographed by operating the photographing switch 7a. The photographed corneal endothelial cells are stored in the frame memory 2, and the photographing is performed an arbitrary number of times (the maximum number is the same as the number of the frame memories installed), and the corneal endothelial cells are stored in another frame memory 2. Move to 2.

(Step 2) In step 2, the mode changeover switch 6 is operated to change the display state of the display section 4b from the real-time display state to a still image of the corneal endothelial cell image s stored in the frame memory 2. Then, the process shifts to step 3.

The corneal endothelial cell image s displayed on the display unit 4b when the display is switched is the one corresponding to the frame memory 2 storing the corneal endothelial cells captured last. .

(Step 3) In step 3, the imaged corneal endothelial cell images s on the plurality of frame memories 2 are sequentially called up on the display section 4b by operating the imaging switch 7a, and the best one is selected. And the frame memory 2
When the selection of is completed, the process proceeds to step 4.

(Step 4) In step 4, by operating the xenon switch 5, as shown in FIG. 3C, the corneal endothelial cell image s and the squares 4c, 4 are displayed on the display section 4b.
The display shows a state in which d and 4e are combined, and step 5
Move to.

(Step 5) In step 5, the mode changeover switch 6 is operated to select the area in which the corneal endothelial cell image s is enlarged based on the squares 4c, 4d, 4e, and the process proceeds to step 6.

(Step 6) In step 6, the corneal endothelial cell image s in the grid 4d as an enlarged area is displayed on the display portion 4b by operating the clear switch 8 as shown in FIG. 3 (D). The image S of corneal endothelial cells is enlarged and displayed, and the process proceeds to step 7.

(Step 7) In Step 7, out of the corneal endothelial cell image S enlarged and displayed on the display unit 4b in Step 6, the corneal endothelial cells wholly located (closed) in the squares 4d are designated.

At this time, for example, the joystick switch 7 is operated to move a plot (not shown) of arrows, coordinate points, etc. displayed on the display section 4b, and the corneal endothelial cell alone is closed. When it is located inside, the photographing switch 7a is pressed to specify the corneal endothelial cells.

Whenever the photographing switch 7a is pressed,
That is, every time the closed corneal endothelial cells are designated on the display unit 4b, the number of closed corneal endothelial cells is counted by the arithmetic processing circuit 9, and the designation of all the closed corneal endothelial cells is completed (the end judgment is the examiner). Then, the process proceeds to step 8.

The closed corneal endothelial cell image S on the display section 4b is marked with a black dot or the like as shown in FIG. 1 (A) so that the designation can be confirmed. The designation operation may be performed by connecting the mouse to the screen 4.

(Step 8) In step 8, the number of corneal endothelial cells counted by the operation of the mode changeover switch 6 is stored in the RAM 10 and the process proceeds to step 9.

(Step 9) In step 9, by the same operation as the designation operation in step 7, a part is located inside the grid 4d and another part is detached (opened) from the display section 4b.
Designate corneal endothelial cells.

Then, each time the photographing switch 7a is pressed,
That is, the number of opened corneal endothelial cells is counted in the arithmetic processing circuit 9 every time the opened corneal endothelial cells are designated on the display unit 4b, and the designation of all the opened corneal endothelial cells is completed (the examiner judges the end). Then, the process proceeds to step 10.

The open corneal endothelial cells on the display section 4b are marked with white dots or the like as shown in FIG. 1 (B) so that the designation can be confirmed. Further, the designated display states of the closed corneal endothelial cells and the open corneal endothelial cells are made different, so that they can be distinguished from each other.

(Step 10) In Step 10, the number of open corneal endothelial cells counted by the arithmetic processing circuit 9 is subtracted by a predetermined rate (for example, 1/2), and then Step 11
Transition to.

(Step 11) In Step 11, RA
4d by adding the number of open corneal endothelial cells subtracted to the number of closed corneal endothelial cells stored in M10
The number of corneal endothelial cells in the inside was calculated, and the calculated squares 4d
The number of corneal endothelial cells per unit area is finally calculated based on the number of corneal endothelial cells in the inside, and the number of corneal endothelial cells per unit area is displayed on the screen 4, and the process proceeds to step 12.

For example, in the state shown in FIG. 1B, the predetermined area is 0.1 mm × 0.1 mm = 0.01 mm ² , and the unit area is 1 mm ^2. The number of corneal endothelium cells was [closed corneal endothelial cell number + open corneal endothelial cell number / 2]
Since it is obtained by × 100, [13 + 14/2] × 100 = [13 + 7] × 100 =
It will be 2000 (pieces).

(Step 12) In step 12, the examiner judges whether or not to print the enlarged corneal endothelial cell image S, and if printing, proceeds to step 13 and if not prints, step Move to 14.

(Step 13) In step 13, the corneal endothelial cell image S on the display 4b is printed by operating a print execution switch (not shown), and the process proceeds to step 14. It is also possible to print the corneal endothelial cell image s before enlarging, but in this case, printing is executed by operating the print execution switch before proceeding to step 4. It is also possible to print the calculated number of corneal endothelial cells together with the printed image S (s) of corneal endothelial cells.

(Step 14) In Step 14, the xenon switch 5 is operated to change the display state of the display unit 4b from the state in which the corneal endothelial cell image S shown in FIG. The corneal endothelial cell image s shown in (B) is returned to the normally displayed state, and the process proceeds to step 15. The calculated number of corneal endothelial cells is continuously displayed as it is on the screen 4 returned to the state where the corneal endothelial cell image s after calculating the number of corneal endothelial cells per unit area is normally displayed. You may let me.

(Step 15) In Step 15, it is judged by the examiner whether or not all the work is finished. When the work is finished, the procedure goes to Step 16, and when the work is repeated, that is, in another frame. When the corneal endothelial cells stored in the memory 2 are called and expanded, the process loops to step 3.

(Step 16) In step 16, the clear switch 8 is operated to erase all the corneal endothelial cell images stored in the frame memory 2 and the operation is completed.

(Second Embodiment) By the way, in the above-mentioned embodiment, corneal endothelial cells within a region (in a square) based on the number of closed corneal endothelial cells and open corneal endothelial cells in the enlarged corneal endothelial cell image S. Although the calculation of the number is disclosed, it is also possible to calculate the number of corneal endothelial cells in the region based on the area of the corneal endothelial cells closed in the region.

FIG. 5 and FIG. 6 show an example of calculating the number of corneal endothelial cells in the area based on such an area. Hereinafter, an example of calculating the area will be described based on the flowchart of FIG. In the flowchart of FIG. 6, the description of the same steps as those in the flowchart of FIG. 3 of the first embodiment will be partially omitted.

(Steps 7 and 8) As shown in FIG. 5 (A), arithmetic processing is performed by designating closed corneal endothelial cells in the corneal endothelial cell image S enlarged and displayed on the display unit 4b in Step 7. The number of closed corneal endothelial cells is counted in the circuit 9, and in step 8, the number of closed corneal endothelial cells is R.
It is stored in the AM 10 and the process proceeds to step 21.

(Step 21) In Step 21, RA
The normalization process of the closed corneal endothelial cells is performed based on the number of closed corneal endothelial cells stored in M10, and step 22 is performed.
Transition to. As shown in FIG. 6B, this normalization is replaced with a regular hexagon S ′ that has the same number as the stored number and that fits neatly into the squares 4d. Incidentally, FIG.
(B) is for schematically explaining the normalization of closed corneal endothelial cells and is not actually displayed on the display unit 4d.

(Step 22) In Step 22, FIG.
As shown in (C), the lengths of two sides of a quadrangle, which is supposed to contain one of the normalized regular hexagons, x and y [x = (√3)
r], [y = 2r], and based on the lengths x and y, the number n of the normalized regular hexagon, the coefficient β, and the total area Sn of the number n After obtaining the length r from 0.1 × 0.1 / β × n = ΔSn ′ ΔSn ′ = x × y = 2 (√3) r ² , the area Sr of the regular hexagon simple substance is given by Sr = [3 (√3) / 2] r ² and the total area Sn of the regular hexagon is calculated from this area Sr by Sn = n × Sr, and the process proceeds to step 23.

(Step 23) In step 23, the ratio αn of the total area Sn of the regular hexagon to the predetermined area (area of the grid 4d) is obtained by αn = 1 / Sn, and the process proceeds to step 24.

(Step 24) In step 24, the number n'of corneal endothelial cells that can be included in a predetermined area is obtained from n '= n × αn, and then the number of corneal endothelial cells per unit area is calculated based on this number n'. The number of corneal endothelial cells is calculated and the process proceeds to step 12 (after step 12, the same as in the first embodiment). The number of corneal endothelial cells per unit area obtained here is displayed on the screen 4.

By the way, in the second embodiment, the total area of the regular hexagons normalized from the number of closed cells was obtained, but in the first place, the number of corneal endothelial cells was 500 to 500 described above.
Since the range of 0 is limited to some extent, it is possible to limit the number of corneal endothelial cells that can enter the square 5d in consideration of an error in this range.

Therefore, the total area of a regular hexagon corresponding to the number (for example, 3 to 50) of corneal endothelial cells that can enter the grid 5d is stored in advance in a storage means (not shown) such as a ROM different from the RAM 10. You can also keep it. In this case, the information stored in the ROM is not limited to the above-described regular hexagonal area such as the total area of the regular hexagon corresponding to the designated number.

Third Embodiment On the other hand, in the above embodiment, a regular hexagonal total area is calculated from a predetermined area, and a regular hexagonal corneal endothelial cell capable of entering a predetermined area from the area ratio of the total area to the predetermined area. After calculating the number, the number of corneal endothelial cells per unit area was calculated based on the number of regular hexagonal corneal endothelial cells that can be included in the predetermined area.
The total area Sn of the regular hexagon obtained in step 22 is subtracted from m ² ) to calculate the remaining area in which the regular hexagon does not exist in the predetermined area, and the area of the regular hexagon alone obtained in step 22 as well. The number of regular hexagons that can be included in the remaining area is calculated based on Sr, and the number of regular hexagons that can be included in the calculated remaining area is added to the number of closed corneal endothelial cells stored in the RAM 10 to calculate a square 4d. It is also possible to calculate the number of corneal endothelial cells per unit area after calculating the number of corneal endothelial cells inside.

In each of the above embodiments, in order to make the obtained number of corneal endothelial cells more precise, the opened cells are designated as closed according to the display condition on the enlarged display section 4b. Alternatively, the sensory increase / decrease information of the examiner may be added such as numerically increasing / decreasing the number of closed corneal endothelial cells.

[0059]

As described above, in the corneal endothelial cell observation and photographing device of the present invention, the screen displaying the image of the corneal endothelial cells of the photographed eye, and the corneal endothelial cells displayed on the screen. Compartment means for compartmentalizing the image into a predetermined area, enlarging means for enlarging and displaying an image of corneal endothelial cells in the compartmented area on the screen, and storing the number of corneal endothelial cells closed in the area By providing a storage unit and a calculation unit that calculates the number of corneal endothelial cells per unit area by performing a predetermined calculation based on the number of corneal endothelial cells stored in the storage unit, While the approximate number of corneal endothelial cells can be easily and easily confirmed on the spot where the image is taken, the accuracy of the corneal endothelial cell density evaluation can be increased.

[Brief description of drawings]

FIG. 1 shows a corneal endothelial cell observation and imaging device of the present invention,
(A) is a front view of an enlarged screen in which a closed corneal endothelial cell is designated, and (B) is a front view of an enlarged screen in which an opened corneal endothelial cell is designated.

FIG. 2 is likewise a flow chart showing the operation.

FIG. 3 is likewise a time series showing a magnified display of a corneal endothelial cell image, (A) a front view of the screen before displaying the corneal endothelial cell image, and (B) a corneal endothelial cell image. Is a front view of a screen displaying ,, (C) is a front view of a screen in which squares are combined and displayed on the corneal endothelial cell image, and (D) is a front view of an enlarged screen of the corneal endothelial cell image.

FIG. 4 is likewise a block diagram of a main part.

FIG. 5 is a flow chart showing the operation of the second embodiment of the corneal endothelial cell observation and imaging device of the present invention, showing the operation.

6A is a front view of a magnified screen in which closed corneal endothelial cells are designated, FIG. 6B is an explanatory view of a normalized regular hexagon, and FIG. 6C is an explanatory view showing a residual area portion. is there.

[Explanation of symbols]

 4 ... Screen 4c ... Cell (compartment means) 4d ... Cell (compartment means) 4e ... Cell (compartment means) s ... Corneal endothelial cell image (before expansion) S ... Corneal endothelial cell image (enlarged state)

Claims (5)

[Claims] 1. A screen for displaying a photographed corneal endothelial cell image of an eye to be inspected, partitioning means for partitioning the corneal endothelial cell image displayed on the screen into a preset predetermined area, and the partitioned region. A magnifying means for magnifying and displaying an image of corneal endothelial cells in the inside, a memory means for storing the number of corneal endothelial cells closed in the area, and a predetermined number based on the number of corneal endothelial cells stored in the memory means. A corneal endothelial cell observation and photographing device, comprising: a calculating unit that calculates the number of corneal endothelial cells per unit area by performing a calculation. 2. A screen for displaying a photographed corneal endothelial cell image of an eye to be examined, a partitioning means for partitioning the corneal endothelial cell image displayed on the screen into a preset predetermined area, and closing within the region. The storage means for storing the number of corneal endothelial cells, the number of corneal endothelial cells opened in the area is subtracted at a predetermined rate, and the subtracted number of corneal endothelial cells and the number of corneal endothelial cells stored in the storage means are stored. A corneal endothelial cell observing and photographing apparatus, comprising: a calculating unit that calculates the number of corneal endothelial cells per unit area by adding and performing a predetermined calculation. 3. A screen for displaying a captured corneal endothelial cell image of an eye to be examined, a partition means for partitioning the corneal endothelial cell image displayed on the screen into a preset predetermined area, and closing within the region. Storage means for storing the number of corneal endothelial cells, and a regular hexagon having the same number as the number of corneal endothelial cells stored in the storage means and which is said to be in order within the area, and the area of the area and the regular hexagon The number of regular hexagons that can fit in the region is calculated based on the ratio to the total area of the cells and a predetermined calculation is performed to calculate the number of corneal endothelial cells per unit area. Corneal endothelial cell observation and imaging device. 4. A screen for displaying a captured corneal endothelial cell image of an eye to be examined, partition means for partitioning the corneal endothelial cell image displayed on the screen into a preset predetermined area, and closing within the region. Storage means for storing the number of corneal endothelial cells, and a regular hexagon having the same number as the number of corneal endothelial cells stored in the storage means and which is said to be in order within the area, and the regular hexagon from the area of the area. After calculating the residual area by subtracting the total area of the regular hexagons, the number of regular hexagons that can fit in the residual area is calculated, and the number of regular hexagons that can fit in the residual area is stored in the storage means. A corneal endothelial cell observation and photographing device, comprising: a calculation unit that calculates the number of corneal endothelial cells per unit area by adding the number of corneal endothelial cells and performing a predetermined calculation. 5. A corneal endothelium which is provided with an enlarging means for enlarging and displaying an image of corneal endothelial cells in a region partitioned by the partitioning means on the screen, and which is closed based on the image of corneal endothelial cells magnified and displayed by the enlarging means. The corneal endothelial cell observation and imaging device according to claim 2, wherein a cell is designated.