KR20200097591A - 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. More specifically, provided are an ophthalmic treatment device and a control method thereof. The ophthalmic treatment device comprises: a treatment light irradiation unit for irradiating treatment light to a treatment position located in an eye tissue; a monitoring unit including at least two detection units, and monitoring state change information of the tissue located at the treatment location using a signal detected by the at least two detection units while the treatment light is irradiated; and a control unit for controlling the treatment light irradiation unit based on the information monitored by the monitoring unit.

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 includes a treatment light irradiation unit for irradiating treatment light to a treatment location located in an eye tissue, at least two detection units, and in the at least two detection units while the treatment light is irradiated. Providing an ophthalmic treatment device comprising a monitoring unit for monitoring state change information of the tissue located at the treatment location using the detected signal, and a control unit for controlling the treatment light irradiation unit based on the information monitored by the monitoring unit do.

Here, the monitoring unit further includes a monitoring light source for generating monitoring light irradiated to the treatment position while the treatment light is irradiated, and the at least two detection units are configured to receive the monitoring light reflected from the treatment position. . And, further comprising a light splitter disposed on the path of the reflected monitoring light to divide the reflected monitoring light into at least two, wherein the at least two detection units each receive the light split by the light splitter do.

Here, the optical splitter may be configured to divide the reflected monitoring light into at least two or more based on a cross-sectional area, and specifically, to divide the reflected monitoring light into two lights each having a half cross-sectional area. . The optical splitter may be composed of a right angle prism mirror, for example.

In addition, a condensing element and an optical fiber are disposed between the optical splitter and the at least two detection units, and configured to condense the divided light and transmit it to each of the detection units.

Meanwhile, the monitoring unit may monitor the state change information of the tissue by extracting an asymmetric signal from among signals detected by the at least two detection units. To this end, it is possible to monitor by using the difference between the signal values detected by at least two detection units.

Specifically, at least two detection units are composed of a first detection unit and a second detection unit, and the monitoring unit detects a first signal value detected by the first detection unit and a second signal value detected by the second detection unit. It is possible to monitor the status change information of the organization based on the monitoring value calculated through a preset calculation formula. The monitoring unit may determine the state change information of the tissue by comparing the calculated monitoring value with a preset reference value.

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

On the other hand, the object of the present invention described above, including a treatment light irradiation unit for irradiating the treatment light to the treatment position and a monitoring unit for monitoring state change information of the tissue located at the treatment position while the treatment light is irradiated, the monitoring unit And a monitoring light source for generating monitoring light irradiated to the treatment location while the treatment light is irradiated, and at least two detection units for receiving the monitoring light reflected from the treatment location, and the monitoring unit It can also be achieved by a treatment apparatus that monitors the change in the state of the tissue by extracting an asymmetric signal from the signals detected by the dog 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 the monitoring light reflected from the at least two detection units through at least two detection units, monitoring tissue status information using signals detected by the at least two detection units, and treatment light according to the monitored tissue status information It can also be achieved by a control method of the ophthalmic treatment device including the step of controlling the irradiation unit.

In this case, in the receiving step, the reflected monitoring light is divided into at least two by a light splitter disposed on a traveling path, and the at least two detection units respectively receive the divided light. Here, the light splitter is configured to divide the reflected monitoring light into two lights each having a half cross-sectional area based on the cross-sectional area.

In addition, the monitoring of the tissue status information may include extracting an asymmetric signal from among signals detected by the at least two detection units to monitor the tissue status change information.

Specifically, the step of monitoring the state information of the tissue may include detecting a signal through the at least two detection units, a monitoring value through a preset calculation equation using signals detected through the at least two detection units It may be performed including the step of calculating and determining a change in the state information of the tissue based on the calculated monitoring value.

In the controlling of the treatment light irradiation unit, if it is determined that the tissue has reached a target state change through the monitoring step, the treatment light irradiation unit may be controlled to end treatment for the treatment location.

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 main components of the ophthalmic treatment device of Figure 1;
3 is an enlarged cross-sectional view of area A of FIG. 2;
4 is a diagram showing the results of monitoring a sample that simulates a state before a state change of a tissue;
5 is a diagram showing a result of monitoring a sample that simulates a state in which a change in the state of an organization is made;
6 is a view schematically showing a main optical system including the monitoring unit of FIG. 2;
7 is a graph showing signals acquired during treatment in the monitoring unit of FIG. 6;
8 is a graph showing contents in which a control unit controls irradiation of treatment light based on monitoring information;
9 is a flow chart showing a control method of the ophthalmic treatment device according to the present embodiment;
FIG. 10 is a flow chart showing a procedure of treating the first position of FIG. 9;
11 is a flow chart showing the contents of the monitoring step of FIG. 10 in more detail.

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 retina. 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 by the signal detected by the detection unit, and it is inaccurate due to misrecognition of noise, etc. There is a fear of making a judgment. Accordingly, the monitoring unit 150 according to the present embodiment includes at least two detection units 155a and 155b, and each detection unit 155a and 155b receives the reflected monitoring light and uses a signal generated. Changes in the state of the organization can be monitored.

FIG. 4 is a result of monitoring a sample that simulates a state before a change in the state of a tissue, and FIG. 5 shows a result of monitoring a sample that simulates a state in which the state of a tissue is changed. Hereinafter, technical matters applied to the monitoring unit according to the present embodiment will be described with reference to FIGS. 4 and 5.

4 and 5, the light reflected from one sample position is received by each detection unit 155a and 155b. At this time, the reflected light is divided into half based on the cross section of the light and received by each detection unit.

At this time, as shown in FIG. 4, in a state in which no change in the state of the tissue has occurred, since the sample as the reflector maintains the same characteristics, the signal detected by each detection unit is substantially the same as the DC signal (including minute changes due to noise, etc.) To maintain a constant signal value. In addition, when the reflected light is accurately divided into two based on the cross-section, the cross-section of the reflected light forms a symmetrical wavefront, so even if the detection units 155a and 155b receive light passing through different cross-sectional areas, each The signals acquired by the detection unit may maintain substantially the same shape.

On the other hand, when a change in the state of the tissue occurs as shown in FIG. 5 and the tissue characteristics change or scattering occurs due to microbubbles, the signal detected by each detection unit generates jitter and generates a weak AC signal. It represents the fluctuation to be included. In particular, when light scattering occurs due to the occurrence of bubbles due to changes in the state of the tissue, the wavefront characteristics of the reflected light are randomly changed, and the signals detected by each detection unit 155a, 155b are asymmetric. Has characteristics.

At this time, when observing the difference between the signals detected by the two detection units 155a and 155b, the difference between the two signals is substantially constant and symmetrical signal values in a state where no tissue state change occurs as shown in FIG. 4. It shows a relatively small and constant value. On the other hand, as shown in FIG. 5, since each signal value shows a random and asymmetric fluctuation in a state in which a change in the state of the tissue has occurred, the difference between the two signals is relatively large and the variability is large. Accordingly, in the case of this, it is possible to easily identify changes in the state of the tissue, and the monitoring unit according to the present embodiment may be configured to monitor the change of the state of the tissue by using this principle.

6 is a diagram schematically illustrating a main optical system including the monitoring unit of FIG. 2. In FIG. 6, 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. 6, the monitoring unit 150 according to the present embodiment includes a monitoring light source 151, an optical splitter 152, at least two detection units 155a and 155b, and a processor 156. do. At this time, the light splitter 152 divides the reflected monitoring light into a number corresponding to the number of detection units 155, and each detection unit 155a, 155b is configured to receive the divided light to detect a signal. Although the number of detection units 155 can be variously configured, as shown in FIG. 6, in this embodiment, as an example, two detection units are used.

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 optical splitter 152 is disposed on the optical path through which the reflected monitoring light travels. The light splitter 152 divides the reflected monitoring light so that the reflected monitoring light is received by each detection unit. In this case, the light splitter 152 divides the reflected monitoring light into at least two lights based on the cross-sectional area of the light, and specifically, is configured to divide into two pieces of light by dividing each in half based on the cross-sectional area of the light. As an example, the light splitter may be composed of a right-angled prism mirror, and may be arranged such that a boundary of a reflective surface of the right-angled prism mirror crosses the center of a cross-section of light.

In addition, the detection unit 155 receives the reflected monitoring light and converts it into an electrical signal, and is configured as a photo detector. 6, the detection unit 155 of this embodiment includes two detection units 155a, 155b, and each detection unit 155a, 155b can receive light divided by the optical splitter. Are arranged so that Specifically, when the reflected monitoring light is divided into half based on the cross-section of the light by the optical splitter, light passing through the first half of the cross-section is received by the first detection unit 155a and passes through the second half area. The light is received by the second detection unit 155b. A light condensing element 153 and an optical fiber 154 are disposed between the light splitter 152 and each of the detection units 155a and 155b, so that the divided light is focused by the light condensing element and is transferred to each detection unit 155. Light is received, and the detection unit 155 generates an electrical signal according to the intensity of the received light.

The processor 156 of the monitoring unit receives the electrical signals generated by the detection units 155a and 155b, and determines a change in the state of the tissue based on this. As described above, the processor 156 monitors tissue state change information by extracting an asymmetric signal from the signals detected by each detection unit 155a and 155b. As an example, the signal value detected by each detection unit is You can use the difference.

Specifically, the processor 156 includes a first signal A detected in real time by the first detection unit 155a and a second signal B detected in real time by the second detection unit 155b while treatment is in progress. Is transmitted, and by using this, a monitoring signal S may be obtained through a preset equation. At this time, the preset calculation formula is set to reflect a value corresponding to the difference between each signal value, and in this embodiment, a monitoring signal is obtained using the following calculation formula.

(S : 모니터링 신호값, A : 제1 신호값, B : 제2 신호값)[expression]

(S: monitoring signal value, A: first signal value, B: second signal value)

The equation is set to normalize a value corresponding to the difference between each signal value, and a monitoring signal may be obtained using various equations.

7 is a graph showing signals acquired while treatment is in progress by the monitoring unit of FIG. 6. As shown in Fig. 7, the signals detected by the first detection unit 155a and the second detection unit 155b maintain a constant signal value at the initial stage of treatment, and the signal value fluctuates at the time when a change in tissue state occurs. This happens. However, it can be seen that the variation of the monitoring signal obtained by calculating the first signal and the second signal has a large variation at the time of tissue state change, while the variation is not easy to identify because the variation is small.

Accordingly, the processor 156 compares the monitoring signal with a preset reference value to determine whether the state of the tissue has changed. At this time, the reference value may be set to a value corresponding to the fluctuation width of the monitoring signal. If the fluctuation width of the monitoring signal is less than the reference value, it is determined that no change in the state of the organization has occurred, and if the fluctuation width is greater than the reference value, the target It can be determined that one state change has occurred. However, the processor of the present embodiment has set the reference value as a value corresponding to the fluctuation width of the monitoring signal, but it is of course possible to set the reference value in various ways according to the treatment area, lesion, or an equation for deriving the monitoring signal.

As such, the monitoring unit 150 according to the present embodiment uses the point of asymmetry among changes in the state of the tissue in the signal obtained from the at least two detection units 155a and 155b, and maximizes the monitoring signal. As a result, it is possible to accurately monitor changes in tissue conditions during treatment.

However, the monitoring unit according to the present embodiment has been described as having a monitoring light source that irradiates separate monitoring light, and at least two detection units receive the reflected monitoring light to detect tissue state change information. This is not limited to this. As another embodiment, the monitoring unit may not include a separate monitoring light source, and may be configured to detect tissue state change information using 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 divided by a light splitter to be received by each detection unit. In addition, each detection unit may be configured to detect a signal as the reflected treatment light is received, and the processor to determine tissue state change information based on each detected signal. Even when monitoring is performed using the treatment light, the basic configuration and the technical principle are substantially the same as or similar to those described in FIG. 6, and thus a detailed description thereof will be omitted.

8 is a graph showing contents of the control unit 160 controlling 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. 8, 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 position, generates a monitoring signal using signals detected by at least two detection units 155a and 155b, and based on this You can monitor information about changes in the state of the organization. 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 illustrated in FIG. 8 is only an example, and it goes without saying that the controller may control the treatment light irradiation in various ways based on the monitoring information.

In addition, in FIG. 6, it has been described that the processor is composed of sub-elements of the monitoring unit to generate a monitoring signal and determine the change in the state of the organization, but the present invention is not limited thereto, and the processor is configured as a sub-element of the control unit to detect each It is also possible to configure the control unit to determine the change in the state of the tissue using the signal detected by the unit.

Hereinafter, a control method of the ophthalmic treatment apparatus according to the present embodiment will be described in detail with reference to FIGS. 9 to 11.

9 is a flow chart showing a control method of the ophthalmic treatment device according to the present embodiment. As shown in FIG. 9, 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. 10 is a flow chart illustrating a procedure of treating the first position of FIG. 9. 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). 11 is a diagram showing in more detail the contents of the monitoring step of FIG. 10.

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 light splitter is disposed on the path of the reflected monitoring light, and the reflected monitoring light is divided into two spatially identical lights by the light splitter 152, and the first detection unit 155a and the second detection are respectively Light is received by the unit 155b. In this case, the optical splitter divides the reflected monitoring light into two pieces of light passing through half of the cross-sectional area based on the cross-section of the reflected monitoring light as described above.

When the divided two light is received by each of the detection units 155a and 155b, each detection unit 155a and 155b generates an electrical signal corresponding to the received light. Then, the monitoring unit 150 monitors the state information of the tissue located in the first location by using the electrical signal generated by each detection unit (S323). At this time, the tissue status information may use the asymmetry of the signal detected by each detection unit when the tissue status change occurs, as described above. Therefore, the monitoring unit monitors based on the difference between the signals detected by each detection unit. Perform.

Specifically, the processor 156 of the monitoring unit 150 uses a first signal value detected by the first detection unit 155a and a second signal value detected by the second detection unit 155b, and performs a preset operation. A monitoring signal (S) is generated by the equation. In this case, the generated monitoring signal is configured in a form of normalizing a difference value between the first signal and the second signal, and a specific calculation formula may be used as described above. The monitoring signal obtained from this has very low fluctuation in the signal when there is no change in the state of the tissue, but fluctuation of the signal increases rapidly as the state of the tissue changes. Therefore, while monitoring is performed in real time while treatment is in progress to the first location, it is possible to monitor whether a target state change of the tissue at the first location has occurred by comparing whether the monitoring signal exceeds a preset reference value. .

Again, referring to FIG. 10, changes in the state of the tissue are monitored through the monitoring step, and the control unit 160 controls the irradiation content of the treatment light based on the monitored tissue state information. 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. 10 and 11, each step is sequentially illustrated, but this is illustrated as such for convenience of description, 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 apparatus and a treatment method for monitoring a change in a state of a tissue using at least two detection units have been described using asymmetry of a signal generated when a state of the tissue is changed. 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 (21)

A treatment light irradiation unit that irradiates the treatment light to a treatment location located in the eye tissue;
A monitoring unit including at least two detection units, and monitoring state change information of a tissue located at the treatment location by using signals detected by the at least two detection units while the treatment light is irradiated; And
Ophthalmic treatment apparatus comprising a control unit for controlling the treatment light irradiation unit based on the information monitored by the monitoring unit. The method of claim 1,
The monitoring unit further comprises a monitoring light source for generating monitoring light irradiated to the treatment location while the treatment light is irradiated,
The at least two detection units receive the monitoring light reflected from the treatment position. The method of claim 2,
Further comprising a light splitter disposed on the path through which the reflected monitoring light travels to divide the reflected monitoring light into at least two,
The at least two detection units respectively receive the light divided by the light splitter. The method of claim 3,
The optical splitter divides the reflected monitoring light into at least two or more based on a cross-sectional area. The method of claim 4,
The optical splitter divides the reflected monitoring light into two lights each having half a cross-sectional area based on a cross-sectional area. The method of claim 3,
The optical splitter is an ophthalmic treatment device, characterized in that consisting of a right angle prism mirror. The method of claim 3,
A condensing element and an optical fiber are disposed between the optical splitter and the at least two detection units, and condensing the divided light and transmitting the collected light to each of the detection units. The method of claim 2,
The monitoring unit extracts an asymmetric signal from among the signals detected by the at least two detection units and monitors information on changes in the state of the tissue. The method of claim 2,
The monitoring unit monitors the state change information of the tissue by using a difference between the signal values detected by the at least two detection units. The method of claim 2,
The at least two detection units are composed of a first detection unit and a second detection unit, and the monitoring unit uses a first signal value detected by the first detection unit and a second signal value detected by the second detection unit. Ophthalmic treatment device for monitoring the state change information of the tissue based on a monitoring signal value calculated through a preset formula. The method of claim 10,
The monitoring unit compares the calculated monitoring signal value with a preset reference value to monitor the state change information of the tissue. The method of claim 10,
The monitoring signal value S is,
Ophthalmology, characterized in that it is calculated by the formula S=(AB) / (A+B) [A: the first signal value detected by the first detection unit, B: the second signal value detected by the second detection unit] Treatment device. 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. The method of claim 1,
The at least two detection units receive the treatment light reflected from the treatment position while the treatment light is irradiated,
The monitoring unit monitors the state change information of the tissue located at the treatment location using signals detected by the at least two detection units receiving the reflected treatment light. 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 includes a monitoring light source for generating monitoring light irradiated to the treatment location while the treatment light is irradiated, and at least two detection units receiving the monitoring light reflected from the treatment location,
And the monitoring unit extracts an asymmetric signal from among signals detected by the at least two detection units and monitors a change in the state of the tissue. Irradiating the treatment light to the treatment location of the eye tissue by operating the treatment light irradiation unit;
Irradiating monitoring light to the treatment location while the treatment light is irradiated;
Receiving monitoring light reflected from the treatment position through at least two detection units;
Monitoring tissue status information using signals detected by the at least two detection units; And
Controlling the treatment light irradiation unit according to the state information of the monitored tissue; control method of the ophthalmic treatment device comprising a. The method of claim 16, wherein in the receiving step,
The reflected monitoring light is divided into at least two by a light splitter disposed on a traveling path, and the at least two detection units respectively receive the divided light. The method of claim 17,
The optical splitter divides the reflected monitoring light into two lights each having half a cross-sectional area based on a cross-sectional area. The method of claim 16,
The monitoring of the tissue state information comprises extracting an asymmetric signal from among signals detected by the at least two detection units and monitoring the change information of the tissue state. The method of claim 16, wherein monitoring the state information of the organization,
Detecting a signal through the at least two detection units;
Calculating a monitoring signal value by using a signal detected through the at least two detection units through a preset equation; And
And determining a change in tissue state information based on the calculated monitoring signal value. The method of claim 16,
The controlling of the treatment light irradiation unit comprises controlling 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 step. Control method of treatment device.

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