KR102191633B1 - An ophthalmic treatment apparatus and method for controlling that - Google Patents

Abstract

The present invention relates to an ophthalmic treatment device and a control method thereof, comprising a treatment light irradiation unit for irradiating treatment light to a treatment position located in an eye tissue, at least two detection units, and the at least two Ophthalmic treatment comprising a monitoring unit for monitoring state change information of the tissue located at the treatment location using a signal detected by the detection unit, and a control unit for controlling the treatment light irradiation unit based on the information monitored by the monitoring unit A device and a control method thereof are provided.

Description

Ophthalmic treatment device and its control method {AN OPHTHALMIC TREATMENT APPARATUS AND METHOD FOR CONTROLLING THAT}

The present invention relates to an ophthalmic treatment apparatus and a control method thereof, and more particularly, to an ophthalmic treatment apparatus and a control method thereof for controlling treatment contents by detecting a state of a target tissue during treatment.

In recent years, a technique for treating lesions by irradiating light to human tissues to change the state of the tissues has been widely applied. In particular, treatment techniques using lasers are widely used for various ophthalmic lesions. For example, a device for treating anterior segment lesions such as corneal plastic surgery, glaucoma treatment, and cataract surgery has been widely commercialized, and recently, a device for treating lesions occurring in the fundus region such as macular degeneration has been developed.

Such a treatment device transmits energy by irradiating a laser to a target tissue, thereby inducing a change in the state of the tissue. However, excessive energy transfer to the target tissue may cause damage to adjacent tissues. In particular, in the treatment of ophthalmic lesions, it may cause visual damage, which may be fatal. On the other hand, if sufficient energy is not delivered to the target tissue, there is a problem in that treatment is not performed properly. Therefore, there is a need for a technology that precisely monitors the condition of the target tissue during treatment so that unnecessary damage can be prevented and appropriate treatment can be performed.

An object of the present invention is to provide an ophthalmic treatment device and a control method thereof capable of monitoring a change in a state of a treatment area during treatment in real time, and performing treatment based thereon.

In order to achieve the above object, the present invention provides a treatment light irradiation unit that irradiates a treatment light to a treatment position located in an eye tissue, and irradiates monitoring light to the treatment position while the treatment light is irradiated and is reflected from the treatment position. An ophthalmic treatment apparatus comprising a monitoring unit for monitoring state change information of a tissue located at the treatment location using some of the monitoring light, and a control unit for controlling the treatment light irradiation unit based on the information monitored by the monitoring unit. to provide.

In this case, the monitoring unit may monitor a change in the state of the tissue by selectively receiving some light based on a cross-section of the reflected monitoring light. Specifically, the monitoring unit may monitor a change in the state of the tissue by selectively receiving light distributed outside of the reflected monitoring light based on a cross section.

That is, the monitoring unit may selectively receive light in a region having a relatively high spatial frequency on a plane perpendicular to the optical axis, among the reflected monitoring light, and monitor the state change information of the tissue. This is, by selectively receiving light in an area relatively affected by scattering among the reflected monitoring light to monitor changes in the state information of the tissue, thereby improving accuracy of signal detection.

Specifically, the monitoring unit includes a monitoring light source that generates monitoring light irradiated to the treatment location while the treatment light is irradiated, a detection unit that receives monitoring light reflected from the treatment location, and an optical path of the reflected monitoring light. And a limiting member that is disposed on and restricts some of the reflected monitoring light from being received by the detection unit.

The limiting member is configured to limit a portion of the reflected monitoring light that travels along the cross-sectional center of the light from reaching the detection unit.

As an example, the limiting member is disposed along the optical axis of the reflected monitoring light, and includes a rod unit having a circular cross section, and the surface in the direction in which the reflected monitoring light is incident is the reflected monitoring light. It may be configured to block some light traveling along the center of the middle section or change a traveling path. In addition, the limiting member further includes a window unit disposed outside the load unit in a radial direction, and among the reflected monitoring light, light that is not incident on the surface of the load unit passes through the window unit and is received by the detection unit. Can be.

As another example, the limiting member may be composed of an optical fiber composed of a plurality of layers along a radial direction, and some of the reflected monitoring light incident through the center layer may be configured to be limited to receive light from the detection unit. . Specifically, the limiting member is configured to further include an inner cladding layer configured outside the center layer and an outer cladding layer configured outside the inner cladding layer, and through the inner cladding layer among the reflected monitoring light It may be configured such that incident light is received by the detection unit.

In addition, when it is determined that the tissue has reached a target state change through the monitoring unit, the control unit may control the treatment light irradiation unit to end treatment for the treatment location.

On the other hand, the object of the present invention as described above, including a treatment light irradiation unit for irradiating the treatment light to the treatment location, and a monitoring unit for monitoring state change information of the tissue located at the treatment location while the treatment light is irradiated, the monitoring The unit is disposed on a monitoring light source for generating monitoring light irradiated to the treatment position while the treatment light is irradiated, a detection unit receiving the monitoring light reflected from the treatment position, and an optical path of the reflected monitoring light It can also be achieved by a treatment apparatus comprising a limiting member that limits some of the reflected monitoring light from being received by the detection unit.

In addition, the object of the present invention described above, the step of irradiating the treatment light to the treatment position of the eye tissue by operating the treatment light irradiation unit, irradiating the monitoring light to the treatment position while the treatment light is irradiated, the treatment position Receiving some of the monitoring light reflected from the detection unit through the detection unit, monitoring the status information of the tissue using the signal detected through the detection unit, and controlling the treatment light irradiation unit according to the status information of the monitored tissue It can also be achieved by a control method of the ophthalmic treatment device comprising the step of.

According to the present invention, since it is possible to more accurately check the change in the state of the tissue due to the treatment light while the treatment light is irradiated, it is possible to check in real time whether or not the treatment is normally performed.

In addition, while the treatment light is repeatedly irradiated, the treatment is performed while monitoring the treatment completion point at the treatment location, thereby minimizing damage to adjacent tissues and performing optimal treatment.

1 is a view showing an ophthalmic treatment device according to an embodiment of the present invention,
Figure 2 is a block diagram schematically showing the components of the ophthalmic treatment device of Figure 1;
3 is an enlarged cross-sectional view of area A of FIG. 2;
4 is an image measuring the distribution of light reflected from the fundus when light scattering does not occur;
5 is an image measuring the distribution of light reflected from the fundus when light scattering occurs;
6 is a graph showing the distribution of light reflected from a sample that simulates a case in which a change in tissue state occurs in the fundus;
7 is a diagram showing a cross section of reflected monitoring light;
8 is a graph showing a signal detected by a detection unit when irradiating an optical pulse;
9 is a diagram schematically showing a main optical system including the monitoring unit of FIG. 2;
10 is a perspective view showing the limiting member of FIG. 9;
11 is a graph showing contents in which a controller controls irradiation of treatment light based on monitoring information;
12 is a perspective view showing another example of the limiting member of FIG. 9;
13 is a perspective view showing another example of the limiting member;
14 is a flow chart showing a control method of the ophthalmic treatment device according to the present embodiment;
15 is a flow chart showing a sequence of steps of treating the first position of FIG. 11;
16 is a view showing in more detail the contents of the monitoring step of FIG. 15.

Hereinafter, an ophthalmic treatment apparatus and a control method thereof according to an embodiment of the present invention will be described in detail with reference to the drawings. In the following description, the positional relationship of each component will be described based on the drawings in principle. The drawings may simplify the structure of the invention for convenience of explanation or may be exaggerated if necessary. However, the present invention is not limited thereto, and it goes without saying that various devices may be added, changed, or omitted.

The ophthalmic treatment apparatus described below is mainly described with an apparatus for treating a fundus lesion, but the present invention can be applied to a treatment apparatus for treating other ophthalmic lesions other than a fundus lesion. For example, it may be applied to a device for treating an anterior segment lesion such as glaucoma, or may be applied to a device for treating lesions occurring in the lens such as cataract. Furthermore, it is revealed that the present invention can be widely used in a treatment apparatus for treating lesions of other medical subjects such as skin lesions in addition to ophthalmic lesions.

In the following, the term'treatment area' is an area that needs treatment, and may mean an area as a predetermined area or a predetermined length section. In addition, the'treatment location' refers to a location where treatment is performed in the treatment area, and may mean a location as a spot located at a specific coordinate. Furthermore, the'target tissue' refers to the tissue to be treated. When a plurality of tissues form a layered structure according to the depth at a specific treatment location, the target tissue may be a tissue located in all or part of the depth section.

That is, when light is irradiated in the form of a spot to a specific'treatment location', most of the energy can be transferred to the'target tissue' located in a specific depth section of the corresponding treatment location. In addition, in order to treat the'treatment area' of a predetermined area, the treatment may be performed by sequentially irradiating light to a plurality of'treatment locations' located in the treatment area.

1 is a view schematically showing an ophthalmic treatment apparatus according to an embodiment of the present invention. The ophthalmic treatment device according to the present embodiment is a device for performing treatment by irradiating treatment light to the fundus, and includes a slit lamp 10 and an interface unit 20 as shown in FIG. 1.

The slit lamp 10 is a device in which the user observes the patient's eyes and performs treatment. One side of the main body of the slit lamp 10 is provided with an object part 180 for fixing the position of the patient's eyes. The other side is provided with an eyepiece part 170 on which the user's eyes are located to observe the patient's eyes. In addition, various components for performing a treatment operation are provided inside the slit lamp 10, which will be described in more detail below. In addition, an operation unit 30 for controlling the operation of the treatment device may be provided outside the slit lamp. The operation unit 30 is configured using a structure such as a keyboard, a joystick, and a pedal, and a user can manipulate the viewing direction of the slit lamp or the treatment operation of the treatment device by manipulating the operation unit 30.

The interface unit 20 is provided at a position adjacent to the slit lamp 10 and is configured to display various types of information necessary for the user during treatment, or to input/set commands and information by the user. 1, the interface unit 20 is configured to include a display device such as a monitor. In addition, the display device may be configured to input information through a touch screen function, or a separate input device such as a keyboard or a mouse may be provided.

2 is a block diagram schematically showing the internal components of the ophthalmic treatment apparatus of FIG. 1. The slit lamp 10 includes a treatment light irradiation unit that generates treatment light and irradiates the treatment light to the fundus. The treatment light irradiation unit includes a treatment light generation unit 110 for generating a treatment beam and a beam delivery unit 130 for transmitting the treatment light generated by the treatment light generation unit to the fundus. In addition, it may further include a collimating light generating unit 120 for displaying a position to which the treatment light is irradiated. Further, further includes an imaging unit 140 for capturing an image of the patient's fundus, a monitoring unit 150 for detecting tissue state change information by the treatment light, and a control unit 160 for controlling various components. can do.

The treatment light generator 110 includes a treatment light source (not shown) and various optical elements (not shown) that control characteristics of treatment light generated from the treatment light source. The treatment light source of the present embodiment includes a laser medium such as Nd:YAG, Ho:YAG, or a laser diode, and generates a laser as treatment light. Parameters such as wavelength, pulse width, and output of the treatment light may be determined or adjusted in consideration of the lesion content and characteristics of the target tissue.

The beam delivery unit 130 is composed of a plurality of optical elements, and forms an optical path through which the treatment light travels. Accordingly, the treatment light generated by the treatment light generation unit 110 proceeds along the beam delivery unit 130 and is irradiated in the fundus direction.

In addition to the treatment light, the beam delivery unit 130 may form an optical path through which the aiming light and/or the photographing light to be described later travel. As shown in Figure 2, the beam delivery unit 130 is provided with at least one or more beam combiner (beam combiner) 131, the collimating light and/or the photographing light are joined on the optical path, and the fundus direction Can be investigated. In addition, the collimating light and/or photographing light reflected from the fundus may proceed in the reverse direction through the beam delivery unit 130, proceed to the eyepiece 170, or may be received by the imaging unit 140. However, the present invention is not limited thereto, and the aiming light and/or the photographing light may be implemented by forming or omitting a separate optical path separate from the irradiation path of the treatment light.

The beam delivery unit 130 includes a scanner 132 that changes a position to which light is irradiated. The scanner 132 includes at least one reflective member and a driving unit that rotates it. The scanner 132 may change the irradiation position of light reflected by the reflective member while rotating the reflective member. In addition, although not shown in FIG. 2, the beam delivery unit 130 may further include optical elements such as a plurality of optical lenses and optical filters for focusing or dispersing light. The beam delivery unit 130 may adjust various parameters including a spot size to which the treatment light is irradiated onto the treatment area using these optical elements.

An object part 180 is provided at an end of the beam delivery unit 130. The alternative unit 180 is a configuration in which an eye of a patient to be treated is positioned, and includes an objective lens or a contact lens in contact with the eye of the patient. Further, the alternative unit may further include a suction device for inhaling and fixing the anterior segment of the patient so that the eye of the patient may be fixed.

Meanwhile, the aiming light generator 120 generates an aiming beam. The aiming light is a configuration in which the treatment light is irradiated to the treatment position to display the corresponding position so that the operator can check the position to which the treatment light is irradiated before or while the treatment light is irradiated. The aiming light generated by the aiming light generating unit 120 is irradiated to the treatment area of the fundus through the beam delivery unit 130 and then reflected. At this time, the aiming light has a wavelength in the visible light band, and the user can confirm the position of the aiming light by checking it through the eyepiece.

However, if the position to which the treatment light is irradiated can be confirmed on the fundus image displayed on the interface unit, it is possible to omit the aiming light generation unit.

Meanwhile, the imaging unit 140 is a component that acquires an image of a treatment area of a patient. The imaging unit 140 includes an imaging device, and acquires a fundus image by receiving photographing light irradiated from a photographing light source (not shown) reflected from the fundus. The imaging unit 140 according to the present embodiment is configured to acquire a fundus image including the entire treatment area. However, in addition to this, the irradiation position of the photographing light may be changed through a scanner like the treatment light, so that an image of an area adjacent to the irradiation position of the treatment light may be obtained. In addition, although the present embodiment describes an ophthalmic treatment apparatus including an imaging unit, it is not limited thereto, and a configuration corresponding to the imaging unit may be omitted.

In addition, the monitoring unit 150 is a configuration that detects the state change information of the tissue located at the treatment position while the treatment light is irradiated to the treatment position, a detailed configuration and operation will be described in more detail below.

The control unit 160 is configured to control various components including the treatment light generation unit 110, the aiming light generation unit 120, the beam delivery unit 130, and the imaging unit 140, and the user can control the operation unit 30 Controls various components based on the contents operated through) or the contents input or set through the interface unit 20. In addition, the control unit 160 receives image information captured by the imaging unit 140 and information sensed by the monitoring unit 150, and processes and calculates such information, and transfers the information to other components, or It plays the role of controlling the operation of components.

Meanwhile, the interface unit 20 includes a display unit 210 and an input unit 220. Here, the display unit 210 is a component for displaying and transmitting various types of information to a user, and the input unit 220 is a component through which the user can transmit information and commands.

Here, the display unit 210 is configured as a display device capable of displaying various types of information including images. The fundus image captured by the above-described imaging unit 140 or a fundus image previously captured by a separate fundus camera is transmitted through the control unit 160 and displayed on the display unit 210, and the user can use the display unit 210 You can check the image of the patient's fundus. The fundus image can be used in various ways to confirm the location of the lesion before treatment, to set the irradiation position of the treatment light, or to confirm the treatment result. In addition, in addition to the fundus image, various pieces of information may be displayed to the user through the display unit.

The input unit 220 is a component through which the user transmits various information or commands to the treatment device. Accordingly, the user may input patient information and treatment information through the input unit 220, command a treatment operation, and select a desired one of various options provided by the treatment device. For example, the user may use the input unit 220 to set the treatment area on the fundus image displayed on the display unit 210, and select any one of the treatment modes suggested by the treatment device, or treatment stored in the treatment device. It is also possible to select any one of the light irradiation patterns. The input unit 220 may be configured to input various types of information using a separate input device such as a keyboard or a mouse, or using a touch screen function of a display forming the display unit 210.

In such an ophthalmic treatment device, a user determines a treatment location and parameters of a treatment light through the input unit 220 or the operation unit 30, and the control unit 160 controls the treatment operation of the treatment device based on this.

3 is an enlarged cross-sectional view of area A of FIG. 2. 3A is a diagram showing a patient's fundus tissue, particularly a retinal tissue, corresponding to a treatment area. These tissues of the retina are generally internal limiting layer, nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, and external reticular layer. It consists of 10 layers: the outer plexiform layer, the outer nuclear layer, the external limiting layer, the photo receptor layer, and the RPE layer (retinal pigment epithelial layer). Inward depth direction).

Among them, the RPE cell layer forms a boundary layer in the posterior direction among the above 10 layers, and is formed in a tight junction structure. And Bruch's membrane is located under the RPE layer. The RPE layer receives nutrients and oxygen from blood vessels located in the choroid, supplies nutrients to a photo receptor, and discharges waste products generated from the photoreceptors through the Bruck membrane.

When some of the PRE cells forming the RPE layer fail to perform their normal functions, the photoreceptors located in front of the RPE cells are not normally supplied with nutrients and oxygen and may die. In order to treat this, the ophthalmic treatment device according to the present embodiment performs a treatment that induces regeneration of new RPE cells by selectively irradiating therapeutic light to the RPE cell layer to deliver energy.

More specifically, the treatment light has a wavelength in the visible or near-infrared region. Such therapeutic light is hardly absorbed by the cell layer (first cell layer to ninth cell layer) located in front of the retina, but is transmitted through it, and is then absorbed by the melanosomes present inside the RPE cells. As the amount of energy absorbed by the melanosomes increases, the RPE cells change their state as the temperature rises, and the RPE cells whose state has changed are replaced by healthy RPE cells. It is expected that as the temperature rises, microbubbles are generated on the surface of melanosomes and gradually grow, thereby selectively necrosis of the corresponding RPE cells, leading to new RPE cells.

However, if an excessive amount of energy is transmitted to the RPE cells by the therapeutic light, not only the RPE cells corresponding to the target tissue but also adjacent photoreceptors may be damaged, resulting in visual damage. On the other hand, when the energy delivered to the RPE cells by the treatment light is not sufficient, treatment may not be performed without changing the state of the RPE cells. Therefore, the ophthalmic treatment device according to the present embodiment includes a monitoring unit 150 to control the treatment contents while monitoring the state change of the tissue located at the treatment location, more specifically, the target tissue in real time while the treatment is in progress. It is possible to do.

The monitoring unit 150 according to the present embodiment irradiates the monitoring light to the treatment position, and receives the monitoring light reflected from the treatment position using a detection unit 155 such as a photo detector. Thereby, the state change information of the target tissue is monitored using the signal detected by the detection unit. When the state of the tissue is the same, the characteristics of the reflected monitoring light remain constant, whereas when the state of the tissue changes, the characteristics of the reflected monitoring light change as the light is scattered by microbubbles. .

When light is received, the detection unit 155 generates an electric signal thereby. The magnitude of the generated signal has a correlation with the intensity of light. However, among the intensity of the reflected monitoring light, the change in the intensity of the light due to the change in the state of the tissue is relatively small, so it is not easy to recognize the change in the state of the tissue only with the signal detected by the detection unit, and it is inaccurate due to misrecognition of noise. There is a fear of making a judgment. Accordingly, the monitoring unit according to the present exemplary embodiment may selectively receive light traveling along a portion of the monitoring light that is sensitive to the influence of scattering of light due to the change in the state of the tissue to monitor the change in the state of the tissue.

4 is an image measuring the distribution of light reflected from the fundus when light scattering does not occur, and FIG. 5 is an image measuring the distribution of light reflected from the fundus when light scattering occurs.

The monitoring light irradiated to the treatment position of the fundus is reflected from the treatment position and proceeds to the beam delivery side of the treatment device. At this time, if the specular reflection is made by the surface of the tissue at the treatment location or the interface inside the tissue without the effect of separate scattering, as shown in FIG. 4, the reflected light observed on the observation surface P formed perpendicular to the optical axis The distribution is concentrated in the low spatial frequency region, that is, the inner central region adjacent to the optical axis. That is, when viewed from the x-axis and y-axis of the observation plane, a distribution similar to the Gaussian distribution is followed based on the center of the optical axis.

On the other hand, when light scattering occurs due to a change in the state of the tissue, the distribution of light observed on the same observation surface P has a light distribution characteristic that is significantly different from that of FIG. 4. Specifically, as shown in FIG. 5, the distribution of light in the low spatial frequency region is remarkably reduced, and the distribution of light in the high spatial frequency region, that is, the outer portion spaced apart from the optical axis, increases.

6 is a graph showing the distribution of light reflected from a sample that simulates a case in which a tissue state change occurs in the fundus. Specifically, light distribution information on the x-axis of the observation surface is shown in a state in which spherical microbubbles having a radius of 10 um, 30 um, and 50 um are formed at a location to which light is irradiated. Accordingly, through FIG. 6, characteristics of light distribution according to light scattering when the state of the tissue is changed can be more specifically identified.

As described above, when the specular reflection occurred, the distribution of light was concentrated at the center (see Fig. 4), but in Fig. 6 there is a difference depending on the size of the microbubbles, but the concentration of light in the center region is lower as the scattering of light occurs. As a result, it can be seen that the distribution of light to the outer portion (a portion away from the optical axis) having a high spatial frequency increases. From this, as for the distribution characteristic of light on the spatial frequency plane, it can be confirmed that the distribution of light due to regular reflection is high in the center region where the spatial frequency is low, and the distribution of light due to scattering of light is high in the outer region where the spatial frequency is high.

Therefore, the monitoring unit 150 of the present embodiment does not receive the entire reflected monitoring light to detect a signal, but selects only the light passing through the cross-sectional area in which the distribution of light is sensitively changed by the scattering of light generated when the tissue state changes. It can be configured to detect a signal by receiving light. Since the detection unit 155 of the monitoring unit 150 generates an electrical signal based on the total intensity of the received light, compared to the case of receiving the entire reflected monitoring light, the change in the signal according to the change in the tissue state more accurately Can be monitored.

7 is a diagram illustrating a cross section of reflected monitoring light. As described above, the monitoring unit 150 selectively uses light passing through a partial area based on the cross-sectional area of the reflected monitoring light. Specifically, some of the light L1 passing through the low spatial frequency cross-sectional area where the distribution of light due to specular reflection is concentrated is limited to being received by the detection unit 155, and a high spatial frequency where the distribution of light is sensitively changed by scattering. Only a portion of the light L2 passing through the cross-sectional area may be selectively received by the detection unit 155. In the present embodiment, some light L1 and some light L2 to which the light is received by the detection unit 155 are expressed using a spatial frequency cross section, but the limited light L1 is Among the cross-sectional areas of the reflected monitoring light, light passes through an area adjacent to the center of the optical axis located inside the cross-section, and some of the received light (L2) is described as light passing through an area separated by a predetermined distance from the center of the optical axis located outside the cross-section. Can be. Here, some of the light L1, which is restricted from being received by the detection unit 155, may be variously configured to change a path of light or block the progress of light.

8 is a graph showing a signal detected by a detection unit when irradiating an optical pulse. FIG. 8A shows a signal detected by receiving the entire reflected monitoring light, and FIG. 8B shows a signal detected by selectively receiving some light passing through an area having a high spatial frequency among reflected monitoring lights. Is shown. For each case, a detected signal was measured by irradiating a laser pulse having energy of 35mJ, 42.5mJ, 50mJ, 57.5mJ, and 75mJ.

In this case, as shown in FIG. 8, the signal of (b) detected by selectively receiving only some of the reflected light during laser pulse irradiation is compared to the signal of (a) detected by receiving the entire reflected light. It represents a larger variation. In particular, it can be seen that as the energy of the optical pulse increases and approaches the tissue state change, the variation in (a) versus (b) increases significantly. As such, the monitoring unit 150 of the present embodiment selectively receives only some of the light sensitively affected by the scattering of light caused when the tissue state change occurs, so that the information on the change in the state of the tissue is more accurately and clearly understood. It is possible.

9 is a diagram schematically illustrating a main optical system including the monitoring unit of FIG. 2. In FIG. 9, for convenience of explanation, some components are omitted and simplified around the treatment light generator 110, the beam delivery unit 130, and the monitoring unit 150, and the configuration of the present invention is limited thereto. no. As shown in FIG. 9, the monitoring unit 150 according to the present embodiment includes a monitoring light source 151, a limiting member 152, a detection unit 155, and a processor 156.

The monitoring light source 151 generates monitoring light irradiated to the treatment location while the treatment light is irradiated to the treatment location. The monitoring light generated by the monitoring light source 151 is irradiated to the treatment position through the beam delivery unit 130, is reflected from the treatment position, and transmitted to the detection unit 155 of the monitoring unit through the beam delivery unit 130. In this case, the monitoring light may be light having a wavelength capable of reaching not only the surface of the treatment location, but also a target tissue located inside the treatment location, and as an example, light having a wavelength of 830 nm may be used. Accordingly, the monitoring light reflected from the treatment location may include state information of the target tissue located inside as well as the surface tissue of the treatment location.

The limiting member 152 is disposed on the optical path through which the reflected monitoring light travels. The limiting member 152 is a component that restricts some of the reflected monitoring light from being received by the detection unit. The limiting member 152 of the present embodiment is configured to limit the light L1 of the low spatial frequency region traveling along the center of the optical axis from traveling along the light-receiving path, as described above.

10 is a perspective view showing the limiting member of FIG. 9. As shown in FIG. 10, the limiting member includes a rod unit 152a and a window unit 152b formed outside the rod unit. The load unit 152a is composed of a cylindrical member having a circular cross section, and is disposed along the optical axis of the reflected monitoring light. The surface R to which the light of the load unit 152a is incident is formed of a reflective material and forms an inclined surface. Accordingly, the traveling path of the light L1 traveling along the low spatial frequency region among the reflected monitoring light is changed to limit the light L1 from being received by the detection unit. The window unit 152b is formed of a light-transmitting material outside the load unit 152a in the radial direction. Accordingly, the light L2 traveling along a region of a high spatial frequency among the reflected monitoring light may pass through the window unit and be received by the detection unit.

Again, referring to FIG. 9, the reflected monitoring light passes through the above-described limiting member 152 and only light L2 having excellent sensitivity to changes in tissue state is selectively received by the detection unit 155. The detection unit 155 is configured to receive the reflected monitoring light and convert it into an electrical signal, and is configured as a photo detector. A condensing element 153 and an optical fiber 154 are disposed in front of the detection unit, and some of the light L2 selected by the limiting member passes through the optical fiber in a state focused by the condensing element and is received by the detection unit. . Then, the detection unit generates an electric signal according to the intensity of the received light.

The processor 156 of the monitoring unit receives the electrical signal generated by each detection unit 155 and determines a change in the state of the tissue based on this. Specifically, the processor 156 receives a signal detected in real time from the detection unit 155 while the treatment is in progress, and compares the signal with a preset reference value to determine whether the state of the tissue has changed. In this case, the reference value may be set to a value corresponding to the fluctuation width or magnitude of the signal detected by the detection unit. When the signal value transmitted in real time is less than the reference value, the processor 156 may determine that a change in the state of the organization has not occurred, and when the signal value is greater than the reference value, it may determine that a target state change has occurred in the organization. However, in addition to this, the processor may set the reference value in various ways depending on the treatment area and lesion in addition to the above-described examples, and further, after separately processing the transmitted signal value, it may determine whether or not the state of the tissue has changed through a separate algorithm. .

At this time, the monitoring unit 150 according to the present embodiment selectively receives light passing through a region having a large light distribution change according to a change in a state of a tissue, that is, a region having a high spatial frequency, among the reflected monitoring light, thereby changing the tissue state. Since it is possible to obtain a signal with improved sensitivity to, it is possible to accurately monitor changes in the state of the tissue during treatment.

However, the monitoring unit according to the present embodiment has a monitoring light source that irradiates a separate monitoring light, and the detection unit receives some of the reflected monitoring light to detect tissue state change information, but the present invention is limited thereto. It does not become. As another embodiment, the monitoring unit may not include a separate monitoring light source, and may be configured to detect a change in the state of the tissue using the reflected treatment light. Specifically, the treatment light irradiated to the treatment position during treatment may be reflected at the treatment position to enter the beam delivery unit inside the device, and the reflected treatment light may be received by the detection unit through the limiting unit. Here, the light distribution characteristics (distribution characteristics on a plane perpendicular to the optical axis) of the reflected treatment light according to the change in the state of the tissue are the same as those described in FIGS. 4 to 7. Accordingly, the reflected therapeutic light is limited from being received by the limiting unit in the low spatial frequency region toward the detection unit side, and the remaining part of the light is received by the detection unit. In addition, the detection unit may be configured to detect a signal as a part of the reflected treatment light is received, and the processor to determine tissue state change information based on this. Even when monitoring is performed using the treatment light, the basic configuration and technical principle are substantially the same as or similar to those described in FIG. 9, and thus detailed descriptions are omitted.

11 is a graph showing contents in which a control unit controls irradiation of treatment light based on monitoring information. As described above, the controller 160 controls various components including the treatment light irradiation unit, and may control the treatment contents based on information on changes in the state of the tissue monitored by the monitoring unit 150 during treatment.

Specifically, as shown in FIG. 11, in treating a tissue at one treatment location, the treatment light irradiation unit may be controlled to irradiate a plurality of treatment light pulses sequentially increasing in intensity to the treatment location. At this time, while the treatment light is irradiated, the monitoring unit 150 irradiates the monitoring light to the corresponding treatment location, and monitors information on changes in the state of the tissue using a part of the reflected light. When it is determined that a target state change has occurred in the tissue at the treatment location through monitoring, the controller 160 may be controlled to stop irradiating additional treatment light to the treatment location and terminate the treatment. Therefore, it is possible to prevent damage to adjacent tissues due to excessive energy transfer while performing sufficient treatment at the corresponding treatment location.

However, the control content shown in FIG. 11 is only an example, and it goes without saying that the control unit can control the treatment light irradiation in various ways based on the monitoring information.

In addition, in FIG. 9, it has been described that the processor is configured as a sub-element of the monitoring unit to determine the change in the state of the tissue by receiving a signal from the detection unit, but the present invention is not limited thereto, and the processor is composed of sub-elements of the control unit. Thus, it is possible to configure the control unit to determine the change in the state of the tissue using the signal detected by the detection unit.

Meanwhile, in the above-described embodiment, the limiting member of the type shown in FIG. 10 is described as an example, but the configuration of the limiting member may be changed in various ways. Hereinafter, some of various examples of the limiting member will be described in detail with reference to FIGS. 12 and 13.

12 is a perspective view illustrating another example of the limiting member of FIG. 9. The limiting member shown in FIG. 12 is configured to include a load unit 152a and a window unit 152b like the limiting member of FIG. 9. However, unlike the limiting member shown in FIG. 10 to limit the light received by the detection unit by changing the path by reflecting light L1 passing through the low spatial frequency region of the front end of the load unit, In the load unit 152a of the limiting member 152, the front surface B is composed of a light absorbing member or a light blocking member, blocking the progress of the corresponding light L1 and only the remaining selected light L2 through the window unit. It is also possible to configure the detection unit to receive light.

The above-described limiting member of FIGS. 10 and 12 has been described with a focus on the structure of the limiting member disposed in front of the light collecting element shown in FIG. 9, but in addition to this, the limiting member is configured using the light collecting element or optical fiber of FIG. 9. It is also possible to do.

As an example, light L1 passing through a low spatial frequency region proceeds by using a filter or a coating material capable of blocking light from advancing to the central region of the condensing element 153 including the optical axis among the condensing elements of FIG. 9 Can be configured to block

Alternatively, as shown in FIG. 13, the optical fiber is composed of a plurality of tube layers along the radial direction, forming different paths for each layer, but light traveling along some paths proceeds to the detection unit. It may serve as a limiting member 152 that limits what is to be done.

Specifically, as shown in FIG. 13, the limiting member 152 configured in the form of an optical fiber includes a core layer 152c, an inner clad layer 152d, and an outer clad layer. It may be composed of a clad layer) 152e. Here, the outer cladding layer 152e forms an outer wall of the optical fiber, and the center layer 152c forms a path through which light L1 passing through a low frequency region adjacent to the optical axis among reflected monitoring light proceeds, and the inner clad The layer 152d forms a path through which the light L2 passing through the high spatial frequency region spaced apart from the optical axis by a predetermined distance travels. Accordingly, the light L2 traveling along the inner cladding layer 152d of the optical fiber forms a path to be received by the detection unit 155, and the center layer 152c forms a separate path to proceed along the path. (L1) can also be configured to limit the light received by the detection unit. However, instead of forming a separate optical path in the center layer as shown in FIG. 13, it is configured to block the light (L1) incident to the area adjacent to the optical axis (for example, the area where L1 proceeds is off-set alignment It is also possible to configure it to reflect in different directions using the optical fiber.

As described above, the limiting member according to the present invention can be configured in various ways, and in addition to the above-described embodiments, it is changed in various ways to limit the light traveling along the low spatial frequency region from being received by the detection unit. It should be noted that this can be done.

Hereinafter, a control method of the ophthalmic treatment apparatus according to the present embodiment will be described in detail with reference to FIGS. 14 to 16.

14 is a flow chart showing a control method of the ophthalmic treatment device according to the present embodiment. As shown in FIG. 14, the user first diagnoses the lesion of the patient and then determines the treatment area and treatment contents of the fundus (S100). Then, a plurality of treatment positions to be treated are determined by irradiating treatment light in the treatment area (S200). The step of determining the treatment area and treatment content, and the step of determining the treatment location may be determined through the interface 20 described above. In addition, the number and interval of treatment locations may be determined according to the patient's lesion state and the irradiation intensity of the treatment light.

Accordingly, when a plurality of treatment positions are determined, treatment for the first position is performed (S300). Then, when the treatment for the first position is finished, the treatment position is changed to the second position and the treatment is performed in the same manner as the first position (S400). In addition, the remaining treatment locations may also be sequentially treated in the same manner.

FIG. 15 is a flow chart illustrating a procedure of treating the first position of FIG. 11. In the step of treating the first position, the position to which the treatment light is irradiated is aligned to the first position, and the treatment light is irradiated by controlling the treatment light irradiation unit (S310). In this case, the control unit 160 controls the beam delivery unit 130 to determine a position to which the treatment light is irradiated, and controls the treatment light generation unit 110 to adjust the pattern and parameters of the irradiated treatment light.

As described above, the treatment light is composed of a laser having a wavelength capable of selectively transferring energy to the RPE cell layer, which is a target tissue at the first location. In addition, a plurality of treatment light pulses are sequentially irradiated to the first position to cause a target state change of the target tissue with minimum energy, and the output of the plurality of treatment light pulses sequentially irradiated is sequentially increased. It can be investigated in form.

Meanwhile, while the treatment light is irradiated, the monitoring unit 150 performs a step of monitoring state change information of the tissue at the first location by the treatment light (S320). 16 is a view showing in more detail the contents of the monitoring step of FIG. 15.

In order to monitor the state information of the tissue located at the first location, the monitoring unit 150 first irradiates the monitoring light to the first location (S321). The monitoring light irradiated from the monitoring light source may be irradiated at the same period as the period in which the treatment light pulse is irradiated, or it may be irradiated at a shorter period than the period in which the treatment light pulse is irradiated.

The monitoring light irradiated to the first position is transmitted to the inside of the tissue at the first position, and then reflected again and received by the detection unit of the ophthalmic treatment device (S322). At this time, a limiting member 152 is provided on the path through which the reflected monitoring light travels, restricting some of the light from being received by the detection unit 155, and configured to receive the remaining part of the light by the detection unit 155 do. At this time, the limiting member 152 restricts the light L1 passing through the light cross-sectional reference center region (low spatial frequency region) with little light distribution influence due to the scattering of light due to the change in the tissue state from being received by the detection unit. Accordingly, the light L2 passing through a region (high spatial frequency region) outside the optical cross-sectional reference in which the light distribution change due to light scattering is relatively large is received by the detection unit.

The detection unit 155 generates an electrical signal corresponding to the intensity of the received light. Then, the monitoring unit 150 monitors the state information of the tissue located at the first location by using the electrical signal generated by the detection unit (S323). Since the signal sensitivity of the signal detected by the detection unit according to the change of the tissue state is improved by the limiting member, the monitoring unit may more accurately determine whether the state of the tissue is changed.

Again, referring to FIG. 15, a change in the state of the tissue is monitored through the monitoring step, and the controller 160 controls the irradiation content of the treatment light based on the monitored state information of the tissue. For example, if it occurs that no change in the state of the tissue has occurred while monitoring is performed during treatment, the controller 160 increases the intensity of the treatment light pulse to irradiate the treatment light pulse at the first position. On the other hand, if it is monitored that a target state change has occurred in the tissue at the first location, the control unit 160 controls the treatment light irradiation unit to stop irradiating the treatment light pulse to the first location, and terminates the treatment at the first location. Do (S330).

When the step of treating the first position is completed through the above-described steps, the control unit 160 changes the irradiation position of the treatment light to the second position, thereby treating the second position in the same manner as the treatment step of the first position. Thereafter, treatment is performed for the remaining treatment sites.

However, in FIGS. 15 and 16, each step is sequentially illustrated, but this is illustrated as such for convenience of explanation, and some steps (eg, a treatment light irradiation step and a monitoring step) are different components. It can be done simultaneously or in parallel by

In the above, an ophthalmic treatment device and treatment that selectively uses some of the light that progresses along a cross-sectional area with a large change in light distribution due to light scattering to improve signal sensitivity according to changes in tissue conditions. The method was described. In this case, in monitoring the change in the state of the tissue during treatment in real time, the difference in the monitoring signal before and after the occurrence of the change in the state of the tissue is clearly revealed, so that the timing of the change in the state of the tissue can be accurately identified. Accordingly, it is possible to optimally treat a corresponding treatment location, and prevent damage to adjacent tissues due to excessive irradiation of the treatment light.

However, in the above-described embodiment, a treatment device for treating a fundus lesion has been mainly described, but the present invention can also be applied to a treatment device for treating lesions other than the fundus such as glaucoma treatment and skin treatment. In this case, it is carried out around the apparatus described in the above-described embodiment, but it can be easily implemented by changing and applying the monitoring signal generation method and the reference value for detecting tissue state change information according to the lesion.

In the above, although one embodiment of the present invention has been described in detail, the present invention is not limited to the above embodiment. It has been found that those of ordinary skill in the technical field to which the present invention belongs can perform various modifications or changes to the present invention without departing from the scope of the technical features of the present invention defined in the appended claims. Put.

Claims (19)

A treatment light irradiation unit for irradiating treatment light to a treatment location located in the eye tissue;
A monitoring unit that irradiates monitoring light to the treatment location while the treatment light is irradiated, and monitors state change information of a tissue located at the treatment location using some of the monitoring light reflected from the treatment location; And
Including; a control unit for controlling the treatment light irradiation unit based on the information monitored by the monitoring unit,
The monitoring unit may include a monitoring light source generating monitoring light irradiated to the treatment location while the treatment light is irradiated, a detection unit receiving monitoring light reflected from the treatment location, and disposed on an optical path of the reflected monitoring light And a limiting member for restricting a portion of the reflected monitoring light from being received by the detection unit. The method of claim 1,
The monitoring unit selectively receives some of the reflected monitoring light based on a cross-section to monitor a change in the state of the tissue. The method of claim 2,
The monitoring unit selectively receives light distributed outside of the reflected monitoring light based on a cross-section to monitor a change in the state of the tissue. The method of claim 1,
The monitoring unit selectively receives light in a region having a relatively high spatial frequency on a plane perpendicular to the optical axis, among the reflected monitoring light, and monitors the state change information of the tissue. The method of claim 1,
The monitoring unit selectively receives the light of a region affected by scattering among the reflected monitoring light and monitors the change of state information of the tissue. delete The method of claim 1,
The limiting member is an ophthalmic treatment apparatus, characterized in that for limiting a portion of the reflected monitoring light that travels along a cross-sectional center of the light to reach the detection unit. The method of claim 7,
The limiting member is disposed along the optical axis of the reflected monitoring light, and comprises a rod unit having a circular cross section, and a surface in the direction in which the reflected monitoring light is incident is a cross section of the reflected monitoring light. Ophthalmic treatment apparatus, characterized in that configured to block some light proceeding along the center or change the progression path. The method of claim 8,
The limiting member further includes a window unit disposed outside the load unit in a radial direction, and among the reflected monitoring light, light that is not incident on the surface of the load unit passes through the window unit and is received by the detection unit. Ophthalmic treatment device, characterized in that. The method of claim 7,
The limiting member is composed of an optical fiber consisting of a plurality of layers along a radial direction, and a part of the reflected monitoring light incident through the center layer is restricted from being received by the detection unit. Device. The method of claim 10,
The limiting member is configured to further include an inner clad layer configured outside the center layer and an outer clad layer configured outside the inner clad layer,
Ophthalmic treatment apparatus, characterized in that the light incident through the inner cladding layer among the reflected monitoring light is received by the detection unit. The method of claim 1,
The control unit controls the treatment light irradiation unit to end treatment for the treatment location when it is determined that the tissue has reached a target state change through the monitoring unit. A treatment light irradiation unit that irradiates the treatment light to the treatment location; And
Includes a monitoring unit for monitoring state change information of the tissue located at the treatment location while the treatment light is irradiated,
The monitoring unit may include a monitoring light source for generating monitoring light irradiated to the treatment position while the treatment light is irradiated, a detection unit receiving the monitoring light reflected from the treatment position, and on an optical path of the reflected monitoring light. A treatment apparatus comprising a limiting member that is disposed and restricts some of the reflected monitoring light from being received by the detection unit. The method of claim 13,
The limiting member prevents that light in a region having a relatively high spatial frequency on a plane perpendicular to an optical axis among the reflected monitoring light reaches the detection unit, but light in a region having a relatively low spatial frequency reaches the detection unit. Treatment device, characterized in that limiting. A treatment light irradiation unit for irradiating treatment light to a treatment location located in the eye tissue;
A monitoring unit for monitoring state change information of a tissue located at the treatment location using some of the treatment light reflected from the treatment location while the treatment light is irradiated; And
Including; a control unit for controlling the treatment light irradiation unit based on the information monitored by the monitoring unit,
The monitoring unit may include a monitoring light source generating monitoring light irradiated to the treatment location while the treatment light is irradiated, a detection unit receiving monitoring light reflected from the treatment location, and disposed on an optical path of the reflected monitoring light And a limiting member for restricting a portion of the reflected monitoring light from being received by the detection unit. delete delete delete delete

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