WO2017002380A1

WO2017002380A1 - Ophthalmological microscope

Info

Publication number: WO2017002380A1
Application number: PCT/JP2016/053284
Authority: WO
Inventors: 諭史山本; 石鍋　郁夫; 美智子中西
Original assignee: 株式会社トプコン
Priority date: 2015-06-30
Filing date: 2016-02-03
Publication date: 2017-01-05
Also published as: JP2017012431A; JP6505527B2

Abstract

Provided is an ophthalmological microscope that can, by means of a simple configuration, achieve selective presentation, clear observational images, and clear photographic images. The ophthalmological microscope according to the embodiments is provided with an illumination system, a light-receiving system, an ocular system, a processing unit, and a display control unit. The illumination system emits illumination light at a patient's eye. The light-receiving system guides return light that is illumination light from the patient's eye to an imaging element. The ocular system includes a display unit and an ocular lens that is arranged on a display-surface side of the display unit. The processing unit processes output from the imaging element. The display control unit executes first display control that causes an observational image that is a moving image based on repetitive output from the imaging element to be displayed on the display unit and second display control that causes a processed image that has been generated by the processing unit to be displayed on the display unit.

Description

Ophthalmic microscope

The present invention relates to an ophthalmic microscope.

In the field of ophthalmology, various microscopes are used for magnifying the eyes. As such an ophthalmic microscope, there are a slit lamp microscope and a surgical microscope. There are also ophthalmic microscopes equipped with an imaging device for photographing patient's eyes. Furthermore, an apparatus that can detect a lesion by analyzing a captured image of a patient's eye has been proposed. In this image analysis, contrast processing, RGB division, or the like is used. In addition, wearable devices are being applied to the medical field. For example, a technique for presenting a captured image using a head-up display or a head-mounted display has been proposed.

International Publication No. 2012/172907 JP 2013-39148 A Japanese Patent No. 5160958 JP 2015-43920 A

A conventional ophthalmic microscope capable of photographing a patient's eye includes an observation system that guides return light from the patient's eye to an eyepiece, and an imaging system that guides return light branched from the observation system to an imaging device. Therefore, light loss due to branching occurs in both the light guided to the eyepiece lens and the light guided to the imaging device. Even when a photographic image or the like is presented using a head-up display, a member for synthesizing a light beam such as a photographic image with a light beam of an observation image is required, and thus light loss occurs similarly.

Also, when using the head-up display, the observation image is always presented to the user, and a photographed image or the like is presented to assist the observation work. For this reason, the observation image cannot be erased even if only the photographed image or the like is to be confirmed. Further, in such a configuration, the contrast of the presented image is lowered, and it is difficult to perform surgery or medical treatment while observing a captured image or the like. Although it is possible to erase the observation image by using the shutter mechanism, new problems such as an increase in complexity and size of the apparatus and an increase in weight arise.

An object of the present invention is to provide an ophthalmic microscope capable of realizing clear and selective presentation of an observation image and a captured image with a simple configuration.

The ophthalmic microscope of the embodiment includes an illumination system, a light receiving system, an eyepiece system, a processing unit, and a display control unit. The illumination system irradiates patient eyes with illumination light. The light receiving system guides the return light of the illumination light from the patient's eye to the image sensor. The eyepiece system includes a display unit and an eyepiece lens arranged on the display surface side of the display unit. The processing unit processes output from the image sensor. The display control unit includes a first display control for displaying an observation image, which is a moving image based on repetitive output from the image sensor, on the display unit, and a second display control for displaying the processed image generated by the processing unit on the display unit. And execute.

According to the ophthalmic microscope of the embodiment, selective presentation of a clear observation image and a clear captured image can be realized with a simple configuration.

It is a schematic diagram showing an example of composition of an ophthalmic microscope concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmic microscope concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmic microscope concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmic microscope concerning an embodiment. It is a flowchart showing an example of the usage pattern of the ophthalmic microscope which concerns on embodiment. It is a flowchart showing an example of the usage pattern of the ophthalmic microscope which concerns on embodiment.

Examples of embodiments of an ophthalmic microscope according to the present invention will be described in detail with reference to the drawings. In addition, the content of the literature referred by this specification and arbitrary well-known techniques can be used for embodiment of this invention.

The ophthalmic microscope is used for observing and photographing a magnified image of a patient's eye in medical treatment and surgery in the ophthalmic field. The target site for observation or imaging may be any part of the patient's eye. For example, the anterior segment may be the cornea, corner, vitreous body, crystalline lens, ciliary body, etc. It may be the retina, choroid or vitreous. Further, the target part may be a peripheral part of the eye such as a eyelid or an eye socket.

Although the ophthalmic microscope of the embodiment described below includes a Greenough-type stereomicroscope, other embodiments may include a Galileo-type stereomicroscope. The Greenough-type stereomicroscope is characterized by the fact that the left and right optical systems are equipped with individual objective lenses and the fact that the left and right optical axes are non-parallel, so that it is easy to obtain a stereoscopic image and has a high degree of freedom in design. Have On the other hand, the Galileo stereomicroscope is characterized by the fact that the left and right optical systems have a common objective lens and the right and left optical axes are parallel, and has the advantage that it is easy to combine other optical systems and optical elements. Have.

In addition, the ophthalmic microscope of the embodiment described below has an optical coherence tomography (OCT) function in addition to a function of observing and photographing a magnified image of a patient's eye, but in other embodiments, the OCT function is It does not have to be provided. Further, instead of or in addition to the OCT function, any measurement function, imaging function, measurement function, treatment function, and the like that can be used in the ophthalmic field may be provided.

[Constitution]
The configuration of the ophthalmic microscope according to the embodiment is shown in FIGS. 1 to 3 show the configuration of the optical system. FIG. 1 shows an optical system for observing the posterior eye part, and FIG. 2 shows an optical system for observing the anterior eye part. FIG. 3 shows an optical system for providing the OCT function. FIG. 4 shows the configuration of the processing system.

The ophthalmic microscope 1 includes an illumination system 10 (10L, 10R), a light receiving system 20 (20L, 20R), an eyepiece system 30 (30L, 30R), an irradiation system 40, and an OCT system 60. When observing the posterior eye part (retinal or the like), the front lens 90 is disposed immediately before the patient's eye E. A contact lens or the like can be used instead of the non-contact front lens 90 as shown in FIG. In addition, when observing the corner angle, a contact mirror (three-sided mirror or the like) can be used.

(Lighting system 10)
The illumination system 10 irradiates the patient's eye E with illumination light. Although not shown, the illumination system 10 includes a light source that emits illumination light, a diaphragm that defines an illumination field, a lens system, and the like. The configuration of the illumination system may be the same as that of a conventional ophthalmologic apparatus (for example, an ophthalmic surgical microscope, a slit lamp microscope, etc.).

The

illumination systems

10L and 10R of the present embodiment are configured coaxially with the

light receiving systems

20L and 20R, respectively. Specifically, the left light receiving system 20L for acquiring an image presented to the left eye E ₀ L of the observer is obliquely provided with a beam splitter 11L made of, for example, a half mirror. The beam splitter 11L couples the optical path of the left illumination system 10L to the optical path of the left light receiving system 20L. The illumination light output from the left illumination system 10L is reflected by the beam splitter 10L and illuminates the patient's eye E coaxially with the left light receiving system 20L. Similarly, the right light receiving system 20R for acquiring an image presented to the right eye E ₀ R of the observer is obliquely provided with a beam splitter 11R that couples the optical path of the right illumination system 10R to the optical path of the right light receiving system 20R. Has been.

The position of the illumination light with respect to the optical axis of the light receiving system 20L (20R) can be changed. This configuration is realized, for example, by providing means for changing the irradiation position of the illumination light with respect to the beam splitter 11L (11R) as in the conventional microscope for ophthalmic surgery.

In this example, the beam splitter 11L (11R) is arranged between the objective lens 21L (21R) and the patient's eye E, but the position where the optical path of the illumination light is coupled to the light receiving system 20L (20R) is received. It can be at any position in the system 20L (20R). Further, the illumination system and the light receiving system may be arranged non-coaxially. This configuration is applied to a slit lamp microscope, an ophthalmic surgical microscope, and the like.

(Light receiving system 20)
In the present embodiment, a pair of left and right

light receiving systems

20L and 20R are provided. The left light receiving system 20L has a configuration for acquiring an image presented to the left eye E ₀ L of the observer, and the right light receiving system 20R is used to acquire an image presented to the right eye E ₀ R. It has a configuration. The left light receiving system 20L and the right light receiving system 20R have the same configuration. The left light receiving system 20L (right light receiving system 20R) includes an objective lens 21L (21R), an imaging lens 22L (22R), and an image sensor 23L (23R).

Note that a configuration in which the imaging lens 22L (22R) is not provided may be applied. When the imaging lens 22L (22R) is provided as in the present embodiment, an afocal optical path (parallel optical path) is formed between the objective lens 21L (21R) and the imaging lens 22L (22R). It is easy to arrange optical elements such as filters and to couple optical paths from other optical systems by arranging optical path coupling members (that is, the degree of freedom and expandability of the optical configuration is improved). )

Symbol AL1 indicates the optical axis (objective optical axis) of the objective lens 21L of the left light receiving system 20L, and symbol AR1 indicates the optical axis (objective optical axis) of the objective lens 21R of the right light receiving system 20R. The light receiving element 23L (23R) is an area sensor such as a CCD image sensor or a CMOS image sensor.

The above is the configuration of the light receiving system 20 when observing the posterior segment (fundus) of the patient's eye E (FIG. 1). On the other hand, when observing the anterior segment, as shown in FIG. 2, the focus lens 24L (24R) and the wedge prism 25L (25R) are arranged at the position on the patient's eye E side with respect to the objective lens 21L (21R). Is done. The focus lens 24L (24R) of this example is a concave lens, and acts to extend the focal length of the objective lens 21L (21R). The wedge prism 25L (25R) deflects the optical path (objective optical axis AL1 (AR1)) of the left light receiving system 20L (right light receiving system 20R) outward by a predetermined angle (indicated by symbols AL2 and AR2). As described above, the focus lens 24L and the wedge prism 25L are arranged in the left light receiving system 20L, and the focus lens 24R and the wedge prism 25R are arranged in the right light receiving system 20R, whereby the focal position F1 for observing the posterior eye part is observed. To the focal position F2 for anterior ocular segment observation.

A convex lens can be used as the focus lens. In this case, the focus lens is disposed in the optical path when observing the posterior eye part, and is retracted from the optical path when observing the anterior eye part. Instead of switching the focal length by inserting / retracting the focus lens, for example, by providing a focus lens that can move in the optical axis direction, the focal length can be changed continuously or stepwise.

In the example shown in FIG. 2, the wedge prism 25L (25R) has a base direction outside (that is, a base-out arrangement), but a base-in arrangement wedge prism can be used. In this case, the wedge prism is disposed in the optical path when observing the posterior eye part, and is retracted from the optical path when observing the anterior eye part. Instead of switching the direction of the optical path by inserting / retracting the wedge prism, it is possible to change the direction of the optical path continuously or stepwise by providing a prism with a variable prism amount (and prism direction). is there.

(Eyepiece 30)
In the present embodiment, a pair of left and

right eyepiece systems

30L and 30R are provided. Acquiring left eyepiece system 30L has a configuration to present an image of the obtained patient's eye E by the left light receiving system 20L on the viewer's left eye E _{0 L,} right ocular system 30R is the right light receiving system 20R having a configuration for presenting an image of the patient's eye E, which is the right eye E _{0 R.} The left eyepiece system 30L and the right eyepiece system 30R have the same configuration. The left eyepiece system 30L (right eyepiece system 30R) includes a display unit 31L (31R) and an eyepiece lens 32L (32R). Display unit 31L (31R) is a flat panel display such as an LCD, for example.

It is possible to change the interval between the left eyepiece system 30L and the right eyepiece system 30R. Thereby, the interval between the left eyepiece system 30L and the right eyepiece system 30R can be adjusted according to the eye width of the observer. In addition, the relative orientation of the left eyepiece system 30L and the right eyepiece system 30R can be changed. That is, the angle formed by the optical axis of the left eyepiece system 30L and the optical axis of the right eyepiece system 30R can be changed. Thereby, the convergence of both eyes E ₀ L and E ₀ R can be induced, and stereoscopic viewing by the observer can be supported.

(Irradiation system 40)
The irradiation system 40 irradiates the patient's eye E with light (measurement light) for performing OCT measurement from a direction different from the objective optical axes (AL1 and AR1, and AL2 and AR2) of the light receiving system 20. In other embodiments, the illumination system may be capable of irradiating the patient's eye with other light in addition to the measurement light for OCT. Specific examples thereof include light for laser treatment (aiming light, treatment laser light).

The irradiation system 40 includes an optical scanner 41, an imaging lens 42, a relay lens 43, and a deflection mirror 44. Light from the OCT unit 60 is guided to the optical scanner 41.

The light (measurement light) from the OCT section 60 is guided by the optical fiber 51 and emitted from the end face of the fiber. A collimating lens 52 is disposed at a position facing the fiber end face. The measurement light converted into a parallel light beam by the collimator lens 52 is guided to the optical scanner 41.

The optical scanner 41 is a two-dimensional optical scanner, and includes an x scanner 41H that deflects light in the horizontal direction (x direction) and a y scanner 41V that deflects light in the vertical direction (y direction). Each of the x scanner 41H and the y scanner 41V may be an arbitrary type of optical scanner, and for example, a galvanometer mirror is used. The optical scanner 41 is disposed, for example, at the exit pupil position of the collimating lens 52 or a position in the vicinity thereof. Furthermore, the optical scanner 41 is disposed, for example, at the entrance pupil position of the imaging lens 42 or a position in the vicinity thereof.

When a two-dimensional optical scanner is configured by combining two one-dimensional optical scanners as in this example, the two one-dimensional optical scanners are arranged apart from each other by a predetermined distance (for example, about 10 mm). A one-dimensional optical scanner can be placed at the exit pupil position and / or the entrance pupil position.

The imaging lens 42 once forms an image of the parallel light flux (measurement light) that has passed through the optical scanner 41. Further, in order to re-image this measurement light in the patient's eye E (observation site such as fundus and cornea), this light is relayed by the relay lens 43 and reflected by the deflection mirror 44 toward the patient's eye E.

The position of the deflection mirror 44 is determined in advance so that the measurement light guided by the irradiation system 40 is irradiated to the patient's eye E from a direction different from the objective optical axis (AL1 and AR1, and AL2 and AR2) of the light receiving system 20. Has been. In this example, the deflection mirror 44 is disposed at a position between the left light receiving system 20L and the right light receiving system 20R where the respective objective optical axes are disposed non-parallel. One of the factors enabling such an arrangement is an improvement in the degree of freedom of the optical configuration due to the arrangement of the relay lens 43. Further, for example, the distance between the position conjugate with the horizontal optical scanner (x scanner 41H in this example) and the

objective lenses

21L and 21R can be designed to be sufficiently small. Can be achieved.

In general, since the scanable range (scannable angle) by the optical scanner 41 is limited, the scanable range can be expanded by applying the imaging lens 42 (or imaging lens system) having a variable focal length. Is possible. In addition, any configuration for expanding the scannable range can be applied. Further, as an example of means for changing the focal length (focus position in OCT measurement), any one or more of the collimating lens 52, the imaging lens 42, and the relay lens 43 can be moved along the optical axis. There is a configuration.

(OCT section 60)
The OCT unit 60 includes an interference optical system for performing OCT. An example of the configuration of the OCT unit 60 is shown in FIG. The optical system shown in FIG. 3 is an example of a swept source OCT, which divides light from a wavelength sweep type light source (wavelength variable light source) into measurement light and reference light, and returns return light of measurement light from the patient eye E. Interference light is generated by interfering with the reference light passing through the reference light path, and this interference light is detected. The detection result (detection signal) of the interference light by the interference optical system is a signal indicating the spectrum of the interference light, and is sent to the control unit 100.

The light source unit 61 includes a wavelength swept light source capable of scanning (sweeping) the wavelength of the emitted light, as in a general swept source type OCT apparatus. The light source unit 61 temporally changes the output wavelength in the near-infrared wavelength band that cannot be visually recognized by the human eye.

The light L0 output from the light source unit 61 is guided to the polarization controller 63 by the optical fiber 62 and its polarization state is adjusted. The light L0 is guided to the fiber coupler 65 by the optical fiber 64 and converted into the measurement light LS and the reference light LR. Divided.

The reference light LR is guided to a collimator 67 by an optical fiber 66A, converted into a parallel light beam, and guided to a corner cube 70 via an optical path length correction member 68 and a dispersion compensation member 69. The optical path length correction member 68 functions as a delay unit for matching the optical path length (optical distance) of the reference light LR with the optical path length of the measurement light LS. The dispersion compensation member 69 acts as a dispersion compensation means for matching the dispersion characteristics between the reference light LR and the measurement light LS.

The corner cube 70 folds the traveling direction of the reference light LR in the reverse direction. The corner cube 70 is movable in a direction along the incident optical path and the outgoing optical path of the reference light LR, thereby changing the length of the optical path of the reference light LR. Note that any one of a means for changing the length of the optical path of the measurement light LS and a means for changing the length of the optical path of the reference light LR may be provided.

The reference light LR that has passed through the corner cube 70 passes through the dispersion compensation member 69 and the optical path length correction member 68, is converted from a parallel light beam into a focused light beam by the collimator 71, enters the optical fiber 72, and is guided to the polarization controller 73. Accordingly, the polarization state of the reference light LR is adjusted. Further, the reference light LR is guided to the attenuator 75 by the optical fiber 74, and the light amount is adjusted under the control of the control unit 100. The reference light LR whose light amount has been adjusted is guided to the fiber coupler 77 by the optical fiber 76.

On the other hand, the measurement light LS generated by the fiber coupler 65 is guided by the optical fiber 51 and emitted from the end face of the fiber, and is converted into a parallel light beam by the collimator lens 52. The measurement light LS converted into a parallel light beam is irradiated to the patient's eye E via the optical scanner 41, the imaging lens 42, the relay lens 43, and the deflection mirror 44. The measurement light LS is reflected and scattered at various depth positions of the patient's eye E. The return light of the measurement light LS from the patient's eye E includes reflected light and backscattered light, travels in the same direction as the forward path in the reverse direction, is guided to the fiber coupler 65, and passes through the optical fiber 66B to the fiber coupler 77. To reach.

The fiber coupler 77 combines the measurement light LS incident through the optical fiber 66B and the reference light LR incident through the optical fiber 76 to generate interference light. The fiber coupler 77 generates a pair of interference light LC by dividing the interference light at a predetermined branching ratio (for example, 1: 1). The pair of interference lights LC emitted from the fiber coupler 77 are guided to the detector 79 by optical fibers 78A and 78B, respectively.

The detector 79 is, for example, a balanced photodiode (Balanced Photo Diode) that includes a pair of photodetectors that respectively detect a pair of interference light LC and outputs a difference between detection results obtained by these. The detector 79 sends the detection result (detection signal) to the control unit 100.

In this example, the swept source OCT is applied, but other types of OCT, such as a spectral domain OCT, can be applied.

(Control unit 100)
The control unit 100 executes control of each unit of the ophthalmic microscope 1 (see FIG. 4). Examples of control of the illumination system 10 include the following: turning on / off the light source, adjusting the amount of light; adjusting the diaphragm; adjusting the slit width when slit illumination is possible. Control of the image sensor 23 includes exposure adjustment, gain adjustment, and shooting rate adjustment.

The control unit 100 displays various information on the display unit 31. For example, the control unit 100 displays an image (or an image or data obtained by processing the image) acquired by the image sensor 23L on the display unit 31L, and an image (or the image acquired by the image sensor 23R). The image or data obtained by processing is displayed on the display unit 31R.

The control of the optical scanner 41 is to sequentially deflect the measurement light LS so that the measurement light LS is irradiated to a plurality of positions according to a preset OCT scan pattern, for example.

Control targets included in the OCT unit 60 include a light source unit 61, a polarization controller 63, a corner cube 70, a polarization controller 73, an attenuator 75, a detector 79, and the like.

Furthermore, the control unit 100 controls various mechanisms. As such a mechanism, a stereo angle changing unit 20A, a focusing unit 24A, an optical path deflecting unit 25A, an interval changing unit 30A, and an orientation changing unit 30B are provided.

The stereo angle changing unit 20A relatively rotates and moves the left light receiving system 20L and the right light receiving system 20R. That is, the stereo angle changing unit 20A relatively moves the left light receiving system 20L and the right light receiving system 20R so as to change the angle formed by the objective optical axes (for example, AL1 and AR1). This relative movement is, for example, to move the left light receiving system 20L and the right light receiving system 20R by the same angle in opposite rotational directions. In this movement mode, the direction of the angle bisector formed by the objective optical axes (for example, AL1 and AR1) is constant. On the other hand, it is also possible to perform the relative movement so that the direction of the bisector changes.

The focusing unit 24A inserts / withdraws the left and

right focus lenses

24L and 24R from the optical path. The focusing unit 24A may be configured to simultaneously insert / retract the left and

right focus lenses

24L and 24R. In another example, the focusing unit 24A may be configured to change the focal position by moving the left and

right focus lenses

24L and 24R in the optical axis direction (simultaneously), or the left and

right focus lenses

24L and 24R It may be configured to change the focal length by changing the refractive power of 24R (simultaneously).

The optical path deflecting unit 25A inserts / withdraws the left and

right wedge prisms

25L and 25R with respect to the optical path. The optical path deflecting unit 25A may be configured to simultaneously insert / retract the left and

right wedge prisms

25L and 25R. In another example, the optical path deflecting unit 25A changes the direction of the optical paths of the left and right

light receiving systems

20L and 20R by changing the prism amounts (and prism directions) of the left and

right wedge prisms

25L and 25R (simultaneously). May be configured.

The interval changing unit 30A changes the interval between the left and

right eyepiece systems

30L and 30R. The interval changing unit 30A may be configured to relatively move the left and

right eyepiece systems

30L and 30R without changing the relative directions of the optical axes of each other.

The orientation changing unit 30B changes the relative orientation of the left and

right eyepiece systems

30L and 30R. The direction changing unit 30B relatively moves the left eyepiece system 30L and the right eyepiece system 30R so as to change the angle formed by the optical axes of each other. This relative movement is, for example, to move the left eyepiece system 30L and the right eyepiece system 30R by the same angle in opposite rotation directions. In this movement mode, the direction of the bisector of the angle formed by the optical axes of each other is constant. On the other hand, it is also possible to perform the relative movement so that the direction of the bisector changes.

The control unit 100 includes a processor. In this specification, “processor” means, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an ASIC (Application Specific Integrated Circuit), a programmable logic device (eg, SPLD (Simple ProGLD)). It means a circuit such as Programmable Logic Device (FPGA) or Field Programmable Gate Array (FPGA). The control unit 100 implements the functions according to the embodiment by reading and executing a program stored in a storage circuit or a storage device, for example.

The control unit 100 may include a storage device that stores images acquired by the ophthalmic microscope 1 and information (images, electronic medical record information, etc.) generated by other devices. In addition, the control unit 100 can acquire an image stored in an external storage device by controlling the communication unit 400.

(Data processing unit 200)
The data processing unit 200 executes various types of data processing. This data processing includes processing for forming an image, processing for processing an image, and the like. In addition, the data processing unit 200 may be capable of executing processing for analyzing images, inspection results, and measurement results, and processing for information related to the subject (electronic medical record information, etc.). The data processing unit 200 includes a processor. The data processing unit 200 includes a magnification changing unit 210, an image processing unit 220, and an OCT image forming unit 230.

(Magnification change unit 210)
The magnification changing unit 210 enlarges the image acquired by the image sensor 23. This process is a so-called digital zoom process, and includes a process of cutting out a part of an image acquired by the image sensor 23 and a process of creating an enlarged image of the part. The image clipping range is set by the observer or by the control unit 100. The magnification changing unit 210 performs the same processing on the image (left image) acquired by the image sensor 23L of the left light receiving system 20L and the image (right image) acquired by the image sensor 23R of the right light receiving system 20R. Apply. Thereby, images of the same magnification are presented to the left eye E ₀ L and the right eye E ₀ R of the observer. In this way, the magnification changing unit 210 functions to change the display magnification of the image presented to the observer by processing the output from the image sensor 23 (23L, 23R).

In addition to such a digital zoom function, a so-called optical zoom function can be provided. The optical zoom function is realized by providing a variable magnification lens (variable lens system) in each of the left and right

light receiving systems

20L and 20R. As a specific example, there is a configuration in which the variable magnification lens is (selectively) inserted / retracted with respect to the optical path, or a configuration in which the variable magnification lens is moved in the optical axis direction. Control related to the optical zoom function is executed by the control unit 100.

(Image processing unit 220)
The image processing unit 220 processes signals output from the

image sensors

23L and 23R. That is, the image processing unit 220 performs processing on the image of the patient's eye E obtained by the

imaging elements

23L and 23R.

The processing executed by the image processing unit 220 is arbitrary. The image processing unit 220 can execute arbitrary image processing and arbitrary analysis processing. For example, the image processing unit 220 can execute image correction (contrast correction, color correction, sharpening, etc.), feature detection (feature extraction), pattern matching, and the like. Further, the image processing unit 220 can perform RGB division of a color image and composition processing of single-color images (R image, G image, and B image) obtained thereby.

The processor included in the image processing unit 220 executes the above-described processing, for example, by executing application software stored in advance in the ophthalmic microscope 1 or application software available via a network.

The image generated by the image processing unit 220 based on the outputs from the

image sensors

23L and 23R is referred to as a “processed image”. Examples of processed images include image-corrected images (contrast-enhanced images, color-corrected images, sharpened images, etc.), images obtained by enhancing or extracting regions detected by feature detection, and monochromatic image synthesis There is a red free image (a composite image of a G image and a B image) obtained by the above.

The light receiving system 20 of the present embodiment includes a left light receiving system 20L and a right light receiving system 20R. The left image acquired by the imaging device 23L (left imaging device) of the left light receiving system 20L and the right image acquired by the imaging device 23R (right imaging device) of the right light receiving system 20R are separately sent to the image processing unit 220. Entered. The image processing unit 220 processes the left image and the right image separately. At this time, the image processing unit 220 performs the same process or different processes on the left image and the right image. When the left image and the right image are moving images, each of the left imaging element 23L and the right imaging element 23R repeatedly outputs a signal (video signal). Repetitive outputs (at least a part thereof) from each of the left imaging element 23L and the right imaging element 23R are sequentially input to the image processing unit 220 via the control unit 100. A signal sequentially input to the image processing unit 220 corresponds to a frame of a moving image. The image processing unit 220 can perform processing on each frame. Alternatively, the image processing unit 220 can perform processing on one or more representative frames. For example, the image processing unit 220 can apply a thinning process to frames constituting a moving image, and perform a process on each frame obtained thereby. In addition, the image processing unit 220 can select one or more frames from the frames constituting the moving image, and perform processing on each selected frame.

(OCT image forming unit 230)
The OCT image forming unit 230 forms an image of the patient's eye E based on the detection result of the interference light LC obtained by the detector 79 of the OCT unit 60. The control unit 100 sends detection signals sequentially output from the detector 79 to the OCT image forming unit 230. The OCT image forming unit 230 performs, for example, a Fourier transform or the like on the spectrum distribution based on the detection result obtained by the detector 79 for each series of wavelength scans (for each A line), thereby reflecting the reflection intensity profile in each A line. Form. Further, the OCT image forming unit 230 forms image data by imaging each A-line profile. Thereby, a B-scan image (cross-sectional image) and volume data (three-dimensional image data) are obtained.

The data processing unit 200 may have a function of analyzing the image (OCT image) formed by the OCT image forming unit 230. This analysis function includes retinal thickness analysis and comparative analysis with normal eyes. Such an analysis function is executed using known application software. Further, the data processing unit 200 may have a function of analyzing an image acquired by the light receiving system 20. The data processing unit 200 may include an analysis function that combines analysis of an image acquired by the light receiving system 20 and analysis of an OCT image.

(User interface 300)
The user interface (UI) 300 has a function for exchanging information between an observer or the like and the ophthalmic microscope 1. The user interface 300 includes a display device and an operation device (input device). The display device may include the display unit 31 and may include other display devices. The operation device includes various hardware keys and / or software keys. It is possible to integrally configure at least a part of the operation device and at least a part of the display device. A touch panel display is an example.

(Communication unit 400)
The communication unit 400 performs a process for transmitting information to another apparatus and a process for receiving information transmitted from the other apparatus. The communication unit 400 may include a communication device that conforms to a predetermined network (LAN, Internet, etc.). For example, the communication unit 400 acquires information from an electronic medical record database or a medical image database via a LAN provided in a medical institution. When an external monitor is provided, the communication unit 400 transmits images acquired by the ophthalmic microscope 1 (images acquired by the light receiving system 20, OCT images, etc.) to the external monitor substantially in real time. can do.

[Usage form]
A usage pattern of the ophthalmic microscope of the present embodiment will be described. An example of the usage form of the ophthalmic microscope is shown in FIG.

(S1: Start observation of patient's eyes)
When the user performs a predetermined operation, the control unit 100 controls the left and

right illumination systems

10L and 10R to start irradiation of illumination light to the patient's eye E, and is acquired by the left imaging element 23L at a predetermined rate. An image (left observation image) is displayed on the left display unit 31L at a predetermined frame rate, and an image (right observation image) acquired by the right imaging element 23R at a predetermined frame rate is displayed on the right display unit 31R at a predetermined frame rate. . At this time, the display control of the left observation image and the display control of the right observation image are synchronized. The user can perform binocular observation (stereoscopic observation) of the patient's eye E in real time via the left and

right eyepiece systems

30L and 30R.

The user operates the left and right

light receiving systems

20L and 20R so that a desired observation field is obtained. At this time, the observation magnification (the magnification of the observation image displayed on the

display units

31L and 31R) is also adjusted. The observation magnification is changed by a digital zoom (magnification changing unit 210).

(S2: Photograph patient's eyes)
The user aligns the observation field with a desired part of the patient's eye E and performs an operation for instructing photographing at a desired timing. This operation is a predetermined operation using the user interface 300. The left and right captured images acquired by the left imaging element 23L and the right imaging element 23R in response to the imaging instruction operation are sent to the image processing unit 220 via the control unit 100.

(S3: Process the captured image)
The image processing unit 220 performs one or more preset processes on each of the left and right captured images acquired in step S2. Thereby, a left processed image and a right processed image are generated.

(S4: Store the processed image)
The control unit 100 stores the left processed image and the right processed image generated in step S3. These images are stored in the above-described storage device provided in the control unit 100, for example.

(S5: The user instructs presentation of the processed image)
At this stage, left and right observation images (moving images) are presented. The user performs an operation to instruct the presentation of the processed image at a desired timing. This operation is a predetermined operation using the user interface 300.

(S6: Stop presenting the observed image and present the processed image)
In response to the operation performed in step S5, the control unit 100 reads the left processed image and the right processed image stored in step S4 from the storage device. Further, the control unit 100 displays the left processed image instead of the left observed image displayed on the left display unit 31L, and displays the right processed image instead of the right observed image displayed on the right display unit 31R. Display. Thereby, the left processed image and the right processed image are presented to the user.

The control unit 100 can display a list of information (information that can be presented by a user instruction) stored in the storage device on the left display unit 31L and the right display unit 31R (list on other display devices). May be displayed). This list is displayed, for example, outside the observation image. This information includes at least the processed image. Further, this information may include an OCT image acquired up to this stage, an OCT image acquired in the past, analysis data based on the OCT image (layer thickness distribution, etc.), electronic medical record information of the patient, and the like. . The user can specify desired information from this list using the user interface 300. The control unit 100 reads the designated information from the storage device and displays it on the left display unit 31L and the right display unit 31R. According to this configuration, desired information can be presented at a desired timing.

(S7: The user gives an instruction to resume observation)
When the confirmation of the processed image is completed, the user performs an operation for instructing presentation of an observation image, that is, an operation for instructing resumption of observation. This operation is a predetermined operation using the user interface 300.

(S8: End the presentation of the processed image and restart the presentation of the observation image)
In response to the operation performed in step S7, the control unit 100 displays the left observation image instead of the left processing image displayed on the left display unit 31L, and the right processing displayed on the right display unit 31R. A right observation image is displayed instead of the image. Thereby, the real-time observation of the patient's eye E can be resumed.

(Other usage patterns)
In the usage pattern shown in FIG. 5, the observation image and the processed image are displayed exclusively with each other. That is, the observation image and the processed image are switched and displayed. On the other hand, it is also possible to display the observation image and the processed image in parallel. An example of such usage is shown in FIG. Steps S11 to S15 are performed in the same manner as steps S1 to S5 in FIG.

(S16: The processed image is presented together with the observation image)
In response to the operation performed in step S15, the control unit 100 reads the left processed image and the right processed image stored in step S14 from the storage device. Further, the control unit 100 displays the left processed image together with the left observation image displayed on the left display unit 31L, and displays the right processed image together with the right observation image displayed on the right display unit 31R.

At this time, the processed image can be displayed on the observation image. This process is executed using a layer function, for example. That is, the observation image is displayed on the first layer, and the processed image is displayed on the second layer. The opacity (alpha value) is arbitrarily set and can be adjusted by the user, for example.

Alternatively, the observation image and the processed image can be displayed in different areas. In this case, the display size of the observation image and the display size of the processed image may be changeable. For example, if you want to pay attention to the observed image, enlarge the size of the observed image (and reduce the size of the processed image), and if you want to pay attention to the processed image, increase the size of the processed image (and reduce the size of the observed image). Can do.

(S17: The user instructs the end of the presentation of the processed image)
When the confirmation of the processed image is completed, the user performs an operation for instructing to end the presentation of the processed image, that is, an operation for instructing to resume observation. This operation is a predetermined operation using the user interface 300.

(S18: Resume observation of patient's eyes)
In response to the operation performed in step S17, the control unit 100 ends the display of the left processed image displayed on the left display unit 31L, and displays the right processed image displayed on the right display unit 31R. Terminate. Thereby, the real-time observation of the patient's eye E can be resumed.

[Action / Effect]
The operation and effect of the ophthalmic microscope of the present embodiment will be described.

The ophthalmic microscope of the present embodiment includes an illumination system (10L, 10R), a light receiving system (20L, 20R), an eyepiece system (30L, 30R), a processing unit (image processing unit 220), and a display control unit ( A control unit 100).

The illumination system illuminates the patient's eyes with illumination light. The light receiving system guides the return light of the illumination light irradiated to the patient's eye to the imaging elements (23L, 23R). Here, the imaging device may be an external device connected to an ophthalmic microscope. The eyepiece system includes a display unit (31L, 31R) and an eyepiece lens (32L, 32R) arranged on the display surface side of the display unit. The processing unit processes output from the image sensor. The display control unit controls the display unit to display an observation image, which is a moving image based on repetitive output from the image sensor (first display control), and the image (processed image) generated by the processing unit to the display unit. Control to display (second display control) is executed. The processed image may be an image obtained by processing an image (captured image) captured by the image sensor, or a captured image itself.

In the embodiment, the light receiving system (20L, 20R) may be configured to guide the return light of the illumination light from the patient's eye to each of the left imaging element (23L) and the right imaging element (23R). The eyepiece system may include a left eyepiece system (31L) and a right eyepiece system (30R). The left eyepiece system includes a left display unit (31L) and a left eyepiece lens (32L) disposed on the display surface side of the left display unit. The right eyepiece system includes a right display unit (31R) and a right eyepiece lens (32R) disposed on the display surface side of the right display unit. In the first display control, the display control unit (control unit 100) controls the left display unit (31L) to display a left observation image that is a moving image based on repetitive output from the left imaging element (23L), Control for causing the right display unit (31R) to display a right observation image, which is a moving image based on repetitive output from the image sensor (23R), is executed synchronously. Further, in the second display control, the display control unit controls the left display unit (31L) to display the left processed image generated by the processing unit (data processing unit 220) based on the output from the left imaging element (23L). And control for causing the right display unit (31R) to display the right processed image generated by the processing unit based on the output from the right imaging device (23R).

Here, “synchronously execute” means that two control timings are associated with each other. For example, the display timing of the left and right observation images (or left and right processed images) is controlled so that the left observation image (or left processed image) and the right observation image (or right processed image) are displayed substantially simultaneously. The

Furthermore, the light receiving system may include a left light receiving system (20L) and a right light receiving system (20R). The left light receiving system includes a left objective lens (21L), and guides return light of illumination light from the patient's eye to the left imaging element (23L) via the left objective lens. The right light receiving system includes a right objective lens (21L), and guides return light of illumination light from the patient's eye to the right imaging element (23R) via the right objective lens. Furthermore, the optical axis of the left objective lens (21L) and the optical axis of the right objective lens (21R) are arranged non-parallel to each other.

In the embodiment, a processed image including a moving image can be presented to the user. Therefore, the display control unit (control unit 100) displays the moving image generated by the processing unit (image processing unit 220) on the display unit (31L, 31R) based on the repetitive output from the image sensor (23L, 23R). The second display control can be executed so as to display.

In the embodiment, the observation image and the processed image can be displayed separately. For this purpose, the ophthalmic microscope includes an operation unit (user interface 300). The display control unit (control unit 100) is configured to be able to switch and execute the first display control and the second display control in response to an operation using the operation unit. The flowchart shown in FIG. 5 shows an example of a usage pattern realized by such a configuration.

In the embodiment, the observation image and the processed image can be displayed in parallel. For example, the observation image and the processed image can be displayed side by side or superimposed. Therefore, the display control unit (control unit 100) is configured to execute the first display control and the second display control in parallel.

As an example of such parallel display, it is possible to configure the display of the processed image to be turned on / off according to an instruction from the user while always displaying the observation image. For this purpose, the ophthalmic microscope includes an operation unit (user interface 300). The display control unit (control unit 100) continuously executes the first display control. Further, the display control unit operates to start the second display control when the first operation is performed using the operation unit, and to end the second display control when the second operation is performed. . The flowchart shown in FIG. 6 shows an example of a usage pattern realized by such a configuration.

In the embodiment, patient eye data obtained by OCT can be presented to the user via the eyepiece system. For example, it is possible to present an OCT image or analysis data of a patient's eye. In addition, settings and conditions related to OCT can be presented to the user via the eyepiece system. For example, it is possible to present information representing the range of the OCT scan superimposed on the observation image or the captured image.

As described above, the ophthalmic microscope according to the present embodiment is configured to acquire an observation image and a captured image using the same image sensor, and an observation system and an imaging system as in a conventional ophthalmic microscope. Therefore, there is no light loss due to branching, and the contrast of the presented image is not deteriorated. In addition, it is possible to switch between an observation image and a captured image (processed image) or present them together. Since the control for that purpose is only display control for the eyepiece system, it does not cause problems such as complication and enlargement of the apparatus and increase in weight. Thus, according to the present embodiment, clear and selective presentation of an observation image and a captured image can be realized with a simple configuration.

The above embodiment is merely an example for carrying out the present invention. A person who intends to implement the present invention can make arbitrary modifications, omissions, additions, substitutions and the like within the scope of the present invention.

1

Ophthalmic Microscope

10L,

10R Illumination System

20L, 20R

Light Receiving System

23L,

23R Image Sensor

30L,

30R Eyepiece System

31L,

31R Display Unit

32L, 32R Eyepiece 100 Control Unit 220 Image Processing Unit

Claims

An illumination system that emits illumination light to the patient's eyes;
A light receiving system for guiding the return light of the illumination light from the patient's eye to an image sensor;
An eyepiece system including a display unit and an eyepiece disposed on a display surface side of the display unit;
A processing unit for processing the output from the image sensor;
A first display control for displaying an observation image, which is a moving image based on repetitive output from the image sensor, on the display unit; a second display control for displaying the processed image generated by the processing unit on the display unit; An ophthalmic microscope comprising: a display control unit that executes
The light receiving system guides the return light of the illumination light from the patient's eye to each of the left image sensor and the right image sensor,
The eyepiece system is
A left eyepiece system including a left display portion and a left eyepiece lens disposed on the display surface side of the left display portion;
A right eyepiece system including a right display portion and a right eyepiece lens disposed on the display surface side of the right display portion,
The display control unit
In the first display control, the left display image, which is a moving image based on repetitive output from the left image sensor, is displayed on the left display unit, and the moving image is based on repetitive output from the right image sensor. A control to display a right observation image on the right display unit synchronously,
In the second display control, the left processing image generated by the processing unit based on the output from the left imaging device is displayed on the left display unit, and the processing unit based on the output from the right imaging device. 2. The ophthalmic microscope according to claim 1, wherein control for displaying the generated right processed image on the right display unit is executed synchronously.
The light receiving system is
A left light receiving system that includes a left objective lens and guides the return light of the illumination light from the patient's eye to the left imaging element via the left objective lens;
A right light receiving system that includes a right objective lens and guides the return light of the illumination light from the patient's eye to the right imaging element through the right objective lens,
The ophthalmic microscope according to claim 2, wherein the optical axis of the left objective lens and the optical axis of the right objective lens are arranged non-parallel to each other.
The display control unit causes the display unit to display a moving image generated by the processing unit based on repetitive output from the imaging device in the second display control. The ophthalmic microscope according to any one of 3.
It further includes an operation unit,
5. The display control unit according to claim 1, wherein the display control unit switches between the first display control and the second display control in response to an operation using the operation unit. The ophthalmic microscope according to Item.
The ophthalmic microscope according to any one of claims 1 to 4, wherein the display control unit is capable of executing the first display control and the second display control in parallel.
It further includes an operation unit,
The display control unit continuously executes the first display control,
The second display control is started when a first operation is performed using the operation unit, and the second display control is ended when a second operation is performed. The ophthalmic microscope according to 6.
An OCT system that splits light from an OCT light source into measurement light and reference light, and detects interference light between the return light of the measurement light from the patient's eye and the reference light;
An OCT data generation unit that processes the detection result of the interference light and generates data;
8. The display control unit according to claim 1, wherein the display control unit executes a third display control for causing the display unit to display data generated by the OCT data generation unit. Ophthalmic microscope.