WO2019065219A1 - Dispositif ophtalmologique - Google Patents

Dispositif ophtalmologique Download PDF

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Publication number
WO2019065219A1
WO2019065219A1 PCT/JP2018/033651 JP2018033651W WO2019065219A1 WO 2019065219 A1 WO2019065219 A1 WO 2019065219A1 JP 2018033651 W JP2018033651 W JP 2018033651W WO 2019065219 A1 WO2019065219 A1 WO 2019065219A1
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Prior art keywords
image
light
patient
eye
color
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PCT/JP2018/033651
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English (en)
Japanese (ja)
Inventor
雅裕 北川
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株式会社ニデック
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Priority to JP2019544542A priority Critical patent/JP7347212B2/ja
Publication of WO2019065219A1 publication Critical patent/WO2019065219A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions

Definitions

  • the present disclosure relates to an ophthalmologic apparatus for imaging a patient's eye.
  • Patent Document 1 There is known an ophthalmoscope which emits therapeutic laser light to a patient's eye (see, for example, Patent Document 1).
  • the ophthalmoscope of Patent Document 1 illuminates eyes with infrared light during observation to generate a real-time image, and when irradiated with a therapeutic laser beam, the eyes are illuminated with a light pulse of visible light before and after irradiation Generate an instant image of
  • illumination by visible light tends to impose a burden on the patient's eye.
  • the burden on the patient's eye tends to increase.
  • the burden on the patient's eye tends to increase.
  • the burden of the patient's eye due to the illumination of visible light for example, glare, influence on light hazard, etc. can be considered.
  • the present disclosure is to solve the problems described above, and it is an object of the present disclosure to provide an ophthalmologic apparatus capable of suppressing a burden on a patient's eye due to illumination of visible light.
  • this indication is characterized by having the following composition.
  • the ophthalmologic apparatus for imaging a patient's eye illuminates the patient's eye with infrared light, and the first imaging means for imaging the patient's eye, and illuminates the patient's eye with visible light to illuminate the patient's eye
  • an ophthalmologic apparatus capable of suppressing the burden on the patient's eye due to the illumination of visible light.
  • the ophthalmologic apparatus 1 of the present embodiment can observe a patient's eye E (or an eye to be examined).
  • the ophthalmologic apparatus 1 according to the present embodiment can irradiate the patient's eye E with the treatment laser light (treatment light) to treat the treatment site of the patient's eye E.
  • the ophthalmologic apparatus 1 of the present embodiment has a photographing means (observation means) for photographing (observing) the patient's eye E with at least one of visible light and infrared light.
  • This observation means has the same function as a scanning laser ophthalmoscope (hereinafter, SLO apparatus).
  • a line scan SLO line scanning ophthalmoscope
  • a confocal image of the patient's eye E can be obtained by scanning a linear beam, and a confocal optical system is formed in the short direction of the linear beam.
  • the application of the present embodiment is also possible to target the anterior segment of the patient's eye E.
  • the ophthalmologic apparatus 1 includes a light projecting optical system 10, a light receiving optical system 20, an optical path separating member 30, an imaging lens 35, an optical scanner 40, an objective lens 45, a drive mechanism 50 (actuator), and treatment laser light irradiation optical A system 60 and a control unit 70 (arithmetic control unit) are provided.
  • a light projecting optical system 10 a light receiving optical system 20
  • an optical path separating member 30 an imaging lens 35
  • an optical scanner 40 an objective lens 45
  • a drive mechanism 50 actuator
  • a system 60 and a control unit 70 (arithmetic control unit)
  • the projection optical system 10 of the present embodiment is provided to project a linear luminous flux onto the fundus Er via the objective lens 45.
  • an SLO light source 12 illumination light source
  • a cylindrical lens 14 are provided as an example of the light projecting optical system 10.
  • the SLO light source 12 may be, for example, a laser light source or an SLD (super luminescent diode) light source.
  • the SLO light source 12 may be disposed at a position conjugate to the fundus Er of the patient's eye E.
  • the SLO light source 12 of the present embodiment emits at least one of infrared light and visible light. Further, the SLO light source 12 of the present embodiment can emit white light.
  • the SLO light source 12 when the SLO light source 12 emits infrared light, it is suitable for imaging (observation) in the non-mydriasis state, and when the SLO light source 12 emits white light, it is suitable for color imaging (observation).
  • the cylindrical lens 14 of the present embodiment is provided to converge the light from the SLO light source 12 in one-dimensional direction.
  • the above configuration can be modified by the configuration of the entire optical system. ⁇ Light receiving optical system>
  • the light receiving optical system 20 of the present embodiment is provided to receive light (return light) from the patient's eye E by the linear light flux through the objective lens 45.
  • the light receiving optical system 20 of the present embodiment includes a light detector 22.
  • the photodetector 22 of the present embodiment is disposed at a position conjugate with the fundus Er of the patient's eye E.
  • FIG. 3 is a view of the light detector 22 of the present embodiment as viewed from the light receiving surface side (the left side in FIG. 1).
  • the photodetector 22 of the present embodiment has a plurality of pixels (light receiving elements), and the plurality of pixels are arranged in two rows.
  • a color filter is disposed at each pixel.
  • each pixel of the light detector 22 incorporates at least one of an R filter (symbol R in FIG. 3), a G filter (symbol G in FIG. 3), and a B filter (symbol B in FIG. 3). There is.
  • Each pixel of the light detector 22 receives light through a color filter.
  • the R filter of the present embodiment transmits light in the red band (visible light) and light in the infrared band (infrared light), and the G filter transmits light in the green band (visible light) and light in the infrared band (red)
  • the B filter has a spectral transmission characteristic of transmitting light in the blue band (visible light) and light in the infrared band (infrared light).
  • Each pixel of the light detector 22 has the same size, and has sensitivity to infrared light and visible light.
  • the arrangement of the color filters of this embodiment may be referred to as a Bayer arrangement.
  • the color filters are arranged in the order of R, G, R, G,... In the upper line in FIG. 3, and the color filters are arranged in the order of G, B, G, B,. ing.
  • the photodetector 22 of the present embodiment has the largest number of pixels capable of receiving infrared light, and then has the largest number of pixels capable of receiving green visible light.
  • the control unit 70 of the present embodiment performs interpolation processing on the output signal of each pixel arranged in the Bayer array to generate one color image.
  • the photodetector 22 of this embodiment is an example, and may be, for example, a one-line sensor system, or color filters may be arrayed in the order of R, G, B, R,.
  • the light detector 22 may be, for example, a single-plate type two-dimensional imaging device provided with a Bayer-arranged color filter. Further, it may be a photodetector in which a plurality of light receiving elements and an optical element for color separation are combined, as in a system called a so-called three-plate type (3 CCD, 3 CMOS, etc.).
  • the light from the light path separation member 30 is received by the light detector 22 through the plane mirror 24.
  • the optical path separating member 30 of the present embodiment is provided to separate the optical path of the light projecting optical system 10 and the optical path of the light receiving optical system 20.
  • the optical path separating member 30 is arranged such that the optical axis of the light projecting optical system 10 and the optical axis of the light receiving optical system 20 are coaxial on the downstream side of the optical path separating member 30.
  • the SLO light source 12 and the light detector 22 are disposed on the extension of the optical axis of the imaging lens 35 via the light path separation member 30.
  • the optical path separation member 30 of the present embodiment has a property of reflecting one of the light from the SLO light source 12 and the light from the patient's eye E and transmitting the other (including the passage of light).
  • the optical path separation member 30 transmits the light from the SLO light source 12 to guide it to the patient's eye E, and reflects the light from the patient's eye E to guide it to the light detector 22.
  • the imaging lens 35 of this embodiment focuses light from the SLO light source 12 once at the front focal position of the objective lens 45 and also focuses light from the patient's eye E on the light detector 22. It is provided.
  • the imaging lens 35 of the present embodiment is disposed between the light scanner 40 and the optical path separation member 30.
  • the SLO light source 12 side is the upstream side
  • the patient's eye E side is the downstream side
  • the light receiving optical system 20 is the upstream side of the light detector 22, and the patient eye E side. It will be downstream.
  • the light scanner 40 (scanning means) of the present embodiment is provided to scan the patient's eye E with a linear light flux.
  • the scanning direction may be, for example, the vertical direction or the horizontal direction.
  • the optical scanner 40 of this embodiment is a galvano mirror, and the reflection angle of the mirror is arbitrarily adjusted by the drive mechanism.
  • the reflection (travelling) direction of the light emitted from the SLO light source 12 is changed by the light scanner 40 and scanned on the patient's eye E.
  • the optical scanner 40 of the present embodiment is disposed in a common optical path between the light projecting optical system 10 and the light receiving optical system 20.
  • the light scanner 40 scans light from the SLO light source 12 and descans light from the patient's eye E.
  • the objective lens 45 of the present embodiment is provided to guide the light from the optical scanner 40 to the patient's eye E (fundus oculi Er) and to return the reflected light from the patient's eye E (fundus oculi Er) to the optical scanner 40. .
  • the objective lens 45 of the present embodiment is disposed in a common optical path of the light projecting optical system 10 and the light receiving optical system 20.
  • the drive mechanism 50 of the present embodiment is provided to adjust the focus on the fundus Er of the patient's eye E at the time of imaging (observation) of the fundus.
  • the drive mechanism 50 of the present embodiment can move the optical member group 55 including at least the SLO light source 12 and the light detector 22 with respect to the light scanner 40 and the objective lens 45.
  • Light e.g., laser light
  • the cylindrical lens 14 In one-dimensional direction, and then passes through the optical path separation member 30.
  • the light transmitted through the optical path separation member 30 is converged by the imaging lens 35, and then the reflection direction is changed by the light scanner 40.
  • the light deflected by the optical scanner 40 is irradiated to the fundus Er of the patient's eye E through the mirror 42, the objective lens 45, and the beam splitter 62.
  • the light from the optical scanner 40 is once condensed through the mirror 42, and then the fundus of the patient's eye E through the objective lens 45 and the beam splitter 62. Focused on Er.
  • light from the cylindrical lens 14 is once condensed on the optical scanner 40 by the imaging lens 35 in the direction orthogonal to the scanning direction of the optical scanner 40, and then reflected by the mirror 42.
  • the light reflected by the mirror 42 is once condensed on the pupil through the objective lens 45 and the beam splitter 62, and then irradiated to the fundus Er of the patient's eye E.
  • a line of light is projected onto the fundus Er of the patient's eye E.
  • a linear light flux is scanned in the scanning direction of the light scanner 40.
  • the light reflected by the fundus oculi Er passes through a beam splitter 62, an objective lens 45, a mirror 42, an optical scanner 40, an imaging lens 35, an optical path separating member 30, and a plane mirror 24, and is received by the photodetector 22.
  • the light from the optical path separation member 30 is detected by the light detector 22 without passing through the confocal opening, but the light detector 22 is disposed at the fundus conjugate position, so that Focus is maintained.
  • a slit hole may be disposed in front of the light detector 22.
  • the light reception signal detected by the light detector 22 (that is, the output signal of the light detector 22) is input to the control unit 70 (see FIG. 2).
  • the control unit 70 generates a photographed image (a front image, and in this embodiment, a fundus image) of the patient's eye E based on the light reception signal obtained by the light detector 22.
  • the light detector 22 of the present embodiment has sensitivity to infrared light and visible light
  • the light detector 22 has photographed image data (first image data) based on infrared light and photographed image data based on visible light ( At least one of the second image data can be output. That is, the control unit 70 of the present embodiment can obtain, from the light detector 22, at least one of the first image data of the patient's eye E based on infrared light and the second image data of the patient's eye E based on visible light.
  • the generated photographed image is stored in the memory 72.
  • acquisition of a photographed image is performed by scanning of the optical scanner 40.
  • the captured image may be generated based on the positional relationship between the scanning position of the light scanner 40 and the light reception signal.
  • the control unit 70 according to the present embodiment can obtain a moving image of a captured image by repeatedly driving the optical scanner 40.
  • the ophthalmologic apparatus 1 of the present embodiment illuminates the patient's eye E with infrared light, and the first imaging means for imaging the patient's eye E, and illuminates the patient's eye E with visible light to image the patient's eye E And the second imaging means.
  • the light emitting optical system 10 and the light receiving optical system 20 constitute a first photographing means
  • the light emitting optical system 10 and the light receiving optical system 20 constitute a second photographing means.
  • the control unit 70 can acquire the monochrome observation image IMGa (first image data) using the first imaging unit, and can acquire the color observation image IMGb (second image data) using the second imaging unit.
  • the first photographing means and the second photographing means share the light detector 22 having sensitivity to infrared light and visible light, and the first photographing means acquires the monochrome observation image IMGa using the output signal of the light detector 22
  • the second imaging means can obtain a color observation image IMGb using the output signal of the light detector 22.
  • the treatment laser beam irradiation optical system 60 of the present embodiment is provided to irradiate the patient's eye E with the treatment laser beam.
  • the treatment laser beam irradiation optical system 60 of the present embodiment includes a laser light source 61, a scanner 63, and a beam splitter 62.
  • the laser light source 61 emits a treatment laser beam.
  • the laser light source 61 may emit, for example, green laser light as the treatment laser light.
  • the scanner 63 can deflect the treatment laser light emitted from the laser light source 61.
  • the beam splitter 62 directs the treatment laser light emitted from the laser light source 61 to the patient's eye E.
  • the treatment laser beam can be scanned on the fundus Er by driving the scanner 63.
  • a plurality of spots of a predetermined pattern may be formed on the fundus Er by controlling the intermittent irradiation of the treatment laser light and the drive of the scanner 63 in synchronization with each other.
  • the present embodiment is an example, and the treatment laser beam irradiation optical system 60 may not include the scanner 63.
  • the treatment laser beam irradiation optical system 60 of the present embodiment has a sighting optical system (sighting means) not shown.
  • the aiming means comprises an aiming light source.
  • the aiming light source emits aiming light, and the aiming light is infrared light.
  • the optical axis of the treatment laser beam and the optical axis of the aiming beam are coaxial with the scanner 63 on the downstream side (the patient's eye E side). Thereby, the treatment laser beam irradiation optical system 60 of the present embodiment can form the spot of the treatment laser beam at the position where the spot of the aiming beam is formed.
  • the control unit 70 of the present embodiment includes a CPU 76 (processor), a RAM 77, a ROM 78, and the like (see FIG. 2).
  • the CPU 76 controls the ophthalmologic apparatus 1.
  • the RAM 77 temporarily stores various information.
  • the ROM 78 stores various programs for controlling the operation of the ophthalmologic apparatus 1, initial values and the like.
  • a memory 72, an operation unit 74, a display unit 75 and the like are electrically connected to the control unit 70.
  • a non-transitory storage medium capable of retaining the stored contents even when the supply of power is shut off is used.
  • a hard disk drive, a flash ROM, and a USB memory detachably attached to the ophthalmologic apparatus 1 may be used as the memory 72.
  • a photographed image may be stored in the RAM 77 or the memory 72 as storage means.
  • the photographed image stored in the storage means includes at least one of a monochrome observation image IMGa (first image data), a color observation image IMGb (second image data), and a pseudo color observation image IMGc (registration image) described later.
  • the control unit 70 of the present embodiment controls the display unit 75, and displays the generated photographed image on the display unit 75.
  • Various operation instructions by the examiner are input to the operation unit 74.
  • a user interface for example, a mouse, a touch panel, a joystick, or the like
  • the operation unit 74 is used, for example, as a focus adjustment switch for the patient's eye E, a release switch for starting irradiation of the treatment laser light, and a release switch for releasing the pseudo color observation mode.
  • the timing chart at the top of FIG. 4 shows an operation signal of the trigger switch.
  • the second timing chart from the top of the figure shows the irradiation state of the treatment laser light to the patient's eye E.
  • the third timing chart from the top of the figure shows the illumination state of the illumination light to the patient's eye E and the type of illumination light.
  • the fourth timing chart from the top of the drawing indicates the type of color image data used when generating the pseudo color observation image IMGc.
  • the fifth timing chart from the top of the drawing indicates the type of observation image (moving image) displayed on the display unit 75.
  • FIG. 5 is a display of the display unit 75 before irradiation of the treatment laser light.
  • FIG. 5 corresponds to the section indicated by the symbol M1 in FIG. That is, the monochrome observation moving image is displayed on the display unit 75.
  • FIG. 6 is a display of the display unit 75 after irradiation of the treatment laser light.
  • the display of the display unit 75 shown in FIG. 6 corresponds to the section indicated by the symbol M2 in FIG. That is, the color observation moving image is displayed on the display unit 75.
  • the operator places a mydriatic agent on the patient's eye E.
  • the operator (user, examiner, etc.) aligns the imaging optical axis on the patient's eye E so that the imaging optical axis coincides with the patient's eye E on the screen captured by the unshown anterior segment camera.
  • the operator causes the patient (or the subject) to gaze at the fixation lamp projected by the fixation target projection optical system (not shown) and guides the fixation lamp to a desired imaging site.
  • a monochrome observation image IMGa SLO image and first image data
  • the operator uses the operation unit 74 to display monochrome on the display unit 75.
  • the fundus Er is focused based on the observation image IMGa.
  • the monochrome observation image IMGa (see FIG. 5) displayed on the display unit 75 is updated at a predetermined timing and displayed as a moving image. Further, the control unit 70 sequentially stores the acquired monochrome observation image IMGa in the RAM 77.
  • control unit 70 controls the drive of the drive mechanism 50 based on the operation signal from the operation unit 74.
  • the control unit 70 controls the drive mechanism 50 in the plus direction or the minus direction of the patient's eye E according to the operation direction and the amount of operation input from the operation unit 74 (e.g. Move toward or away from the By driving the drive mechanism 50, the focus state of the line luminous flux with respect to the fundus Er and the light detector 22 is adjusted. Thereby, the focus state of the monochrome observation image IMGa is adjusted, and the monochrome observation image IMGa in focus is obtained.
  • FIG. 5 is an example of the monochrome observation image IMGa displayed on the display unit 75.
  • the monochrome observation image IMGa of the present embodiment includes the fundus Er (monochrome fundus image) of the patient's eye E and the aiming spot AM which is a spot of the aiming light.
  • the fundus Er is based on illumination of infrared light
  • the aiming spot AM is based on illumination of aiming light (infrared light).
  • the monochrome fundus oculi image of this embodiment is achromatic, it may be achromatic (for example, purple).
  • infrared light is continuously lit. In the observation with infrared light, the burden on the patient's eye E (for example, discomfort due to glare) is suppressed.
  • the operator When the operator aligns the aiming spot AM on the irradiation planned site of the treatment laser light, the operator operates the trigger switch (operation unit 74) to start the irradiation of the treatment laser light (see timing T1 in FIG. 4).
  • the patient's eye E is irradiated with the treatment laser light of green (visible light).
  • the treatment laser beam When the treatment laser beam is irradiated, a spot of the treatment laser beam is formed on the fundus Er.
  • a treatment trace SP coagulated eyebrows photocoagulated by the treatment laser beam is formed at the site of the fundus oculi Er where the spot of the treatment laser beam is formed.
  • one visible illumination light is emitted to the patient eye E in a pulse (for example, 30 ms).
  • the patient's eye E is illuminated with infrared light. That is, in the present embodiment, the type of illumination light emitted to the patient's eye E temporarily switches from infrared light to visible light only immediately after the irradiation of the treatment laser light.
  • the patient's eye E may be illuminated with infrared light while the patient's eye E is illuminated with visible light.
  • imaging photography by visible light is performed immediately after irradiation of a treatment laser beam in this embodiment
  • a photographic image is taken with visible light after irradiation with the treatment laser light.
  • one pulse of visible illumination light is emitted, but the present invention is not limited to this.
  • the illumination time of the visible light to the patient's eye E may be shortened as compared with the method of performing color observation of the patient's eye E while continuously illuminating the visible illumination light.
  • the control unit 70 acquires a first color observation image IMGb based on the above-described visible illumination light. Next, the control unit 70 stores the acquired first color observation image IMGb in the RAM 77. When visible illumination on the patient's eye E is complete, infrared illumination is resumed on the patient's eye E (see timing T3 in FIG. 4).
  • the observation image (moving image) displayed on the display unit 75 switches from the monochrome observation image IMGa to the pseudo color observation image IMGc. In other words, the pseudo color observation image IMGc (see FIG. 6) displayed on the display unit 75 is updated at a predetermined timing and displayed as a moving image.
  • the pseudo color observation image IMGc is updated each time the captured image is acquired by infrared light (for example, every 30 ms).
  • the pseudo color observation image IMGc of the present embodiment is a registration image in which the monochrome observation image IMGa (first image data) and the color observation image IMGb (second image data) are superimposed.
  • the pseudo color observation image IMGc is referred to as a pseudo color observation image in order to identify the color observation image IMGb in the present embodiment, but the pseudo color observation image IMGc may be referred to as a color image, a composite image, a calculation image or the like.
  • FIG. 6 is an example of the pseudo color observation image IMGc displayed on the display unit 75.
  • the pseudo color observation image IMGc of the present embodiment includes a fundus Er (color fundus image), a treatment trace SP (coagulation) by a treatment laser beam, and an aiming spot AM which is return light of aiming light reflected by the fundus Er. Is superimposed.
  • the operator can confirm the fundus site such as the treatment trace SP by a color image (moving image).
  • the pseudo color observation image IMGc is displayed as a moving image on the display unit 75 of the present embodiment while the patient eye E is illuminated with infrared light.
  • the ophthalmologic apparatus 1 of the present embodiment displays the pseudo color observation image IMGc as a moving image, there is no need to constantly or periodically illuminate visible light in order to express (display) the pseudo color observation image IMGc as a moving image.
  • the pseudo color observation image IMGc is displayed as a moving image using the update information of the monochrome observation image IMGa.
  • color information (still image) obtained by irradiating the patient's eye E with visible light and motion information (luminance information obtained by irradiating the patient's eye E obtained after acquisition of the color information by infrared light) Change) is combined to form a color moving image.
  • the control unit 70 uses the common color observation image IMGb when generating the pseudo color observation image IMGc for each of the monochrome observation images IMGa captured at different timings. Thereby, for example, the time of visible light to the patient's eye E can be suppressed. Further, in the present embodiment, a plurality of pseudo color observation images IMGc generated using the common color observation image IMGb are displayed as a moving image. Thereby, for example, the burden (glare) of the patient's eye E is suppressed by infrared illumination, and the operator can easily grasp the treatment trace SP by a color moving image.
  • the operator aligns the aiming spot AM to the next planned treatment site while observing the treatment trace SP in color animation.
  • the operator operates the trigger switch (operation unit 74) to start irradiation of the treatment laser light (see timing T4 in FIG. 4).
  • the patient eye E is irradiated with the second treatment laser beam, and pulse irradiation of visible illumination light is started immediately after the treatment laser beam irradiation (see timing T5 in FIG. 4). That is, in the present embodiment, irradiation of visible light for updating the color observation image IMGb used for the pseudo color observation image IMGc is performed triggered by a change in the irradiation state of the treatment laser light.
  • the control unit 70 acquires a second color observation image IMGb (second image data) based on the visible light, and stores the acquired second color observation image IMGb in the RAM 77.
  • the type of illumination light to the patient's eye E switches from visible light to infrared light (see timing T6 in FIG. 4).
  • the pseudo color observation image IMGc displayed on the display unit 75 based on the restart of the infrared light irradiation is simulated from the pseudo color observation image IMGc using the first color observation image IMGb to the second color observation image IMGb. Switch to color observation image IMGc.
  • illustration is omitted, in the pseudo color observation image IMGc after the second irradiation of the treatment laser light is performed, the first treatment mark SP based on the first treatment laser light and the second treatment laser light And a first treatment trace SP based on.
  • the color observation image IMGb (second image data) used to generate the pseudo color observation image IMGc is updated every time the treatment laser light is irradiated.
  • FIG. 7 is a diagram for explaining the concept of the registration process performed by the control unit 70 (image processing means) of the present embodiment.
  • 8 to 11 show a flow of control executed by the control unit 70.
  • step S101 the control unit 70 causes the SLO light source 12 to emit infrared light, and sets the operation mode of the ophthalmologic apparatus 1 to the monochrome observation mode.
  • step S102 the control unit 70 causes the display unit 75 to display an observation image.
  • the operation mode of the ophthalmologic apparatus 1 is set to the monochrome observation mode
  • the monochrome observation image IMGa is displayed on the display unit 75
  • the operation mode of the ophthalmologic apparatus 1 is set to the color observation mode.
  • the pseudo color observation image IMGc is displayed on the display unit 75.
  • step S201 the control unit 70 captures an image of the patient's eye E with infrared light.
  • the control unit 70 uses the infrared light emitted from the SLO light source 12 to acquire a monochrome observation image IMGa (two-dimensional image) of the patient's eye E.
  • the acquired monochrome observation image IMGa is stored in the RAM 77.
  • step S202 the control unit 70 determines whether the observation mode (the operation mode of the ophthalmologic apparatus 1) is a pseudo color. If the observation mode is set to the pseudo color, the process proceeds to step S204. If the observation mode is not set to the pseudo color, the process proceeds to step S203.
  • step S203 the control unit 70 causes the display unit 75 to display the monochrome observation image IMGa acquired in step S201. That is, in step S202, the control unit 70 determines whether to perform a registration process described later based on the operation mode of the ophthalmologic apparatus 1.
  • the control unit 70 detects the operation state of the trigger switch (operation unit 74) in step S103 after the transition from step S102 (step S203).
  • the trigger switch is used when the operator starts irradiation of the treatment laser light.
  • the control unit 70 proceeds to step S105 when detecting that the trigger switch is pressed, and proceeds to step S104 when detecting that the trigger switch is not pressed.
  • step S105 the control unit 70 controls the laser light source 61 to irradiate the patient's eye E with the treatment laser light.
  • the treatment laser beam is irradiated under preset irradiation conditions.
  • the control unit 70 captures the patient's eye E with visible light. Specifically, the control unit 70 causes the SLO light source 12 to emit visible light (white light in the present embodiment) to acquire a color observation image IMGb (two-dimensional image) of the patient's eye E. The control unit 70 stores the acquired color observation image IMGb in the RAM 77. When the acquisition of the color observation image IMGb is completed, the control unit 70 changes the emitted light from the SLO light source 12 from visible light to infrared light. That is, the control unit 70 of the present embodiment illuminates the patient's eye E with visible light only when acquiring a color observation image IMGb used to generate a pseudo color observation image IMGc described later.
  • FIG. 11 shows a part of the process performed by the control unit 70 in step S106, and shows the flow of the pre-process performed when acquiring the color observation image IMGb.
  • FIG. 7 the inside of the dashed-line frame surrounding FIG. 7B and FIG. 7C is the pre-processing of this embodiment.
  • FIG. 7 will be described.
  • FIG. 7A is a monochrome observation image IMGa acquired by the control unit 70 by infrared imaging.
  • the monochrome observation image IMGa is acquired in step S201 (FIG. 9).
  • FIG. 7B is a RAW image IMGr acquired by the control unit 70 in the visible imaging.
  • the RAW image IMGr is acquired in step S106 (FIG. 8).
  • the monochrome observation image IMGa and the RAW image IMGr are generated using the output signal of the light detector 22.
  • FIG. 7C is a color observation image IMGb after the binning process, the color interpolation process, and the color space conversion process are performed on the RAW image IMGr of FIG. 7B.
  • FIG. 7 (d) is a color observation image IMGb 'obtained by enlarging the color observation image IMGb of FIG. 7 (c).
  • FIG. 7E is a pseudo color observation image IMGc (color image) in which the monochrome observation image IMGa and the color observation image IMGb 'are superimposed.
  • the same fundus area is included in the thick frames in FIGS. 7 (a) to 7 (e).
  • the grids of FIGS. 7 (a) to 7 (e) indicate the boundaries of each pixel forming each two-dimensional image.
  • step S401 the control unit 70 uses the output signal of the light detector 22 to generate a RAW image IMGr, which is a type of color image.
  • Each pixel (pixel) of the RAW image IMGr includes any one of a red tone value, a green tone value, and a blue tone value (see FIG. 7A).
  • the color of each pixel (pixel) of the RAW image IMGr is a Bayer array based on the configuration of each light receiving element of the light detector 22.
  • step S402 the control unit 70 performs binning processing on the RAW image IMGr.
  • tone values of at least two pixels are summed. For example, if the tone values of two pixels to be summed are the same, the tone value after binning will be doubled.
  • the size (total number of pixels) of the RAW image IMGr is compressed to 1 ⁇ 4 in the binning process while maintaining the Bayer arrangement.
  • the area of the light receiving element of the light detector 22 used to form the unit pixel is more compressed than the monochrome observation image IMGa
  • the color image of is larger.
  • the number of light receiving elements of the light detector 22 used to form a unit pixel is larger in the color image after compression than in the monochrome observation image IMGa.
  • the number of pixels in the vertical direction is compressed to 1/2
  • the number of pixels in the horizontal direction is also compressed to 1/2. That is, in the present embodiment, the binning process is performed to gain the sensitivity of the light detector 22. Thereby, the illumination light quantity at the time of imaging
  • the compression method in the binning process is not limited to this, and may be changed as appropriate.
  • step S403 the control unit 70 performs color interpolation processing on the image of the Bayer array subjected to the binning processing (compression) in step S402.
  • a red tone value, a green tone value, and a blue tone value are included in each pixel of the color-interpolated image (referred to as an RGB image).
  • the process performed by the control unit 70 in step S403 may be called CFA interpolation, conversion of a Bayer array image to an RGB image, or the like.
  • the binning process may be performed after the color interpolation process.
  • step S404 the control unit 70 performs color space conversion processing on the image (RGB image) after the color interpolation processing.
  • Each pixel of the RGB image includes a red tone value, a green tone value, and a blue tone value.
  • the control unit 70 converts the values (R value, G value, B value) of each pixel of the RGB image into values (L * value, a * value, b * value) in the Lab color space. That is, a luminance value (luminance information) and a color value (color information) are respectively provided as the values of the pixels constituting the color observation image IMGb.
  • the control unit 70 generates a color observation image IMGb in which the value of each pixel is configured by the Lab space value.
  • the processing of steps S401 to S404 may be performed at the time of registration processing (step S205) described later.
  • step S107 the control unit 70 sets the observation mode to pseudo color. Specifically, the control unit 70 changes the monochrome observation mode set in step S101 to a pseudo color mode. When the process of step S107 is completed, the control unit 70 proceeds to step S102.
  • step S102 which has been shifted from step S107, the control unit 70 performs imaging of the patient's eye E with infrared light (that is, acquisition of the monochrome observation image IMGa) and a pseudo color observation image using the monochrome observation image IMGa and the color observation image IMGb Generation of IMGc (that is, registration processing) and display of a pseudo color observation image IMGc are performed.
  • IMGa infrared light
  • IMGc that is, registration processing
  • display of a pseudo color observation image IMGc display of a pseudo color observation image IMGc are performed.
  • step S201 and step S202 are omitted since they have already been described. If the observation mode is set to pseudo color, the process proceeds from step S202 to step S204.
  • step S204 the control unit 70 acquires a color observation image IMGb.
  • the control unit 70 of the present embodiment reads (acquires) the color observation image IMGb stored in the RAM 77.
  • the color observation image IMGb is acquired in advance in step S106 (see FIG. 8).
  • the control unit 70 proceeds to step S205.
  • step S205 the control unit 70 performs registration processing (generation of a registration image).
  • FIG. 7 is a conceptual view of the registration process of the present embodiment.
  • FIG. 10 shows the flow of the registration process performed by the control unit 70.
  • the control unit 70 of the present embodiment superimposes the monochrome observation image IMGa (first image data) acquired using infrared light and the color observation image IMGb (second image data) acquired using visible light.
  • a pseudo color observation image IMGc registration image
  • the control unit 70 treats the value of each pixel constituting the monochrome observation image IMGa as an L * value, and the value of each pixel constituting the color observation image IMGb is a Lab value (only a * value and b * value in this embodiment) Treat as used.
  • the L * value and the Lab value described above are parameters that constitute a known CIE 1976 (L *, a *, b *) color space. L * can be said to be luminance information, and a * and b * can be said to be chromaticity information. In the following description, this color space is referred to as CIELAB.
  • step S301 the control unit 70 enlarges the color observation image IMGb.
  • the control unit 70 doubles the number of pixels in the horizontal direction of the color observation image IMGb and doubles the number of pixels in the vertical direction. That is, the same number of vertical and horizontal pixels as the monochrome observation image IMGa are set.
  • the color observation image IMGb is enlarged so that the fundus area corresponding to one pixel constituting the monochrome observation image IMGa matches the fundus area corresponding to one pixel constituting the color observation image IMGb.
  • the number of pixels in the bold frame of FIG. 7A is the same as the number of pixels in the bold frame of FIG. 7D.
  • the same Lab value is accommodated (interpolated) in each pixel generated by enlargement.
  • the values (a * value, b * value) of the pixels to which the symbol PQ is attached in FIG. 7C, and the values (a of the pixels to which the symbols PCa to PCd are attached in FIG. * Value, b * value) are the same.
  • step S302 the control unit 70 registers (superposes) the monochrome observation image IMGa and the color observation image IMGb.
  • the control unit 70 constructs each pixel constituting the pseudo color observation image IMGc as follows.
  • the L * value of the pseudo color observation image IMGc uses the L * value of the monochrome observation image IMGa, and the a * value and the b * value use the a * value and the b * value of the color observation image IMGb after enlargement.
  • the 7E is the L * value of the pixel indicated by symbol PMa (FIG. 7A), and the a * value and b of the pixel indicated by symbol PFa are used.
  • the * value the a * value and the b * value of the pixel PCa (FIG. 7 (d)) are used. That is, the luminance information of the monochrome observation image IMGa is adopted as the luminance information constituting the pseudo color observation image IMGc, and the color information (chromaticity information) constituting the pseudo color observation image IMGc is the color information of the color observation image IMGb adopt.
  • the resolution (resolution of luminance) of the pseudo color observation image IMGc is obtained.
  • symbol PFa-PFd in FIG.7 (e) differs in L * value (it depends on each L * value of code PMa-PMd of FIG. 7 (a) in detail), but a The * and b * values are the same.
  • the control unit 70 of the present embodiment When superimposing the monochrome observation image IMGa and the color observation image IMGb, the control unit 70 of the present embodiment performs alignment processing so that the fundus site matches.
  • the alignment processing includes relative movement and rotation in the vertical and horizontal directions.
  • the control unit 70 may analyze each image, evaluate the relative positional deviation of each image, and determine whether the superposition is possible.
  • the control unit 70 may evaluate the image quality of each image and determine whether the superposition is possible.
  • the control unit 70 may automatically reacquire an observation image (for example, visible light).
  • the L * b * c * value of the pseudo color observation image IMGc is obtained by combining the luminance information (L * value) of the monochrome observation image IMGa and the color information (a * value, b * value) of the color observation image IMGb '
  • the luminance information of the color observation image IMGb ′ may be considered in the L * b * c * value of the pseudo color observation image IMGc.
  • a color image (registration image) may be generated using luminance information of a monochrome image higher in resolution than a color image.
  • the visible light image and the infrared light image are obtained using the infrared light image acquired using the infrared light, which has higher resolution (high resolution) than the visible light image acquired using the visible light.
  • a superimposed registration image may be generated.
  • a pseudo color image with improved resolution (resolution) by superimposing a low resolution (low resolution) color image and a high resolution (high resolution) monochrome image.
  • a binning process is performed to generate a color observation image IMGb for registration.
  • IMGb color observation image
  • the ophthalmologic apparatus 1 can capture a color image with high-definition luminance information while reducing the burden on the patient.
  • step S203 the control unit 70 causes the display unit 75 to display the pseudo color observation image IMGc generated in step S205.
  • the control unit 70 according to the present embodiment performs the registration process each time the observation process (step S102) is performed until the observation mode is switched to monochrome (return). Therefore, the pseudo color observation image IMGc is displayed on the display unit 75 as a moving image.
  • the monochrome observation image IMGa used to generate the pseudo color observation image IMGc is sequentially updated in step S201, and the color observation image IMGb used to generate the pseudo color observation image IMGc is updated each time the treatment laser light is irradiated. (See step S106 in FIG. 8).
  • step S104 the control unit 70 detects the operation state of the release switch (operation unit 74).
  • the release switch of this embodiment is provided in the operation unit 74, and is used by the operator to release the pseudo color observation mode (that is, return to the monochrome observation mode).
  • the control unit 70 gets out of the flow of FIG. 8 if it determines that the release switch is pressed, and returns to step S102 if it determines that the release switch is not pressed. That is, as long as the release switch is not operated, the pseudo color observation image IMGc is displayed on the display unit 75 as a moving image.
  • the pseudo color observation image IMGc it is considered preferable to continue the observation using the pseudo color observation image IMGc during treatment of the same eye.
  • the treatment eye for example, the left eye to the right eye, the eyes of other patients
  • it is considered preferable to release the pseudo color observation state that is, return to the monochrome observation state
  • step S104 Since the control unit 70 of the present embodiment repeats the flow of FIG. 8, if it is determined in step S104 that the release switch is pressed, the process returns to step S101. That is, the observation mode of the ophthalmologic apparatus 1 returns to the monochrome observation state. After returning to the monochrome observation state, steps S102 to S104 are looped until the trigger switch is pressed. That is, the monochrome observation moving image is displayed on the display unit 75.
  • the ophthalmologic apparatus 1 of the present embodiment can suppress the burden (glare, light hazard, etc.) of the patient's eye E due to the illumination of visible light.
  • the ophthalmologic apparatus 1 can obtain a color image while reducing the burden on the patient by combining the images captured by the visible light and the infrared light.
  • FIG. 12 is a flowchart of the ophthalmologic apparatus of the modification example.
  • the ophthalmologic apparatus 1 described above and the ophthalmologic apparatus of the modification differ only in whether or not the treatment laser light irradiation optical system 60 is provided. That is, the ophthalmologic apparatus according to the modification includes only an imaging unit for imaging the patient's eye E.
  • the modified ophthalmologic apparatus may be, for example, a non-mydriatic fundus camera. In this case, for example, a two-dimensional color sensor having sensitivity to infrared light and visible light may be used.
  • the modified ophthalmologic apparatus may be, for example, a mydriatic fundus camera or a slit lamp microscope (slit lamp microscope).
  • the operator can observe with color moving images (false color moving images) while suppressing glare or light hazards of the patient.
  • color moving image technology of the ophthalmologic apparatus 1 described above may be applied to the scanning laser ophthalmoscope.
  • step S301 the control unit 70 performs imaging with infrared light (acquisition of a monochrome image).
  • step S302 the control unit 70 displays the acquired monochrome image on the display unit 75.
  • step S303 the control unit 70 detects the operation state of the trigger switch (shooting start means). If the control unit 70 detects that the trigger switch is operated, the process proceeds to step 304, and if it is detected that the trigger switch is not operated, the process returns to step 301. That is, as long as the trigger switch is not operated, the control unit 70 repeats monochrome shooting, and the display unit 75 displays an observation moving image using infrared light.
  • step S304 the control unit 70 performs imaging with infrared light (acquisition of a monochrome image).
  • step S305 the control unit 70 performs photographing with visible light (acquisition of a color image).
  • step S306 the control unit 70 generates a registration image (pseudo color image) using the acquired monochrome image and color image.
  • step S307 the control unit 70 displays the generated registration image on the display unit 75.
  • step S304 may be omitted, and the monochrome image acquired in step S301 may be used at the time of registration processing in step S306.
  • step S304 may be omitted, and the monochrome image acquired in step S301 may be used at the time of registration processing in step S306.
  • the ophthalmologic apparatus of the modification example also adopts, for example, luminance information of a monochrome image as luminance information constituting a registration image, and adopts color information of a color image as color information constituting a registration image. In this way, the resolution (resolution of luminance) of the registration image can be gained.
  • Ophthalmic apparatus 10 Flooding optical system 20: Light receiving optical system 70: Control part IMGa: Monochrome observation image IMGb: Color observation image IMGc: Pseudo color observation image

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Abstract

L'invention concerne un dispositif ophtalmologique pour photographier l'œil d'un patient, comprenant : un premier moyen de photographie pour éclairer l'œil d'un patient avec une lumière infrarouge et photographier l'œil du patient ; un second moyen de photographie pour éclairer l'œil du patient avec une lumière visible et photographier l'œil du patient ; et un moyen de traitement d'image pour générer une image d'enregistrement, des premières données d'image acquises à l'aide du premier moyen de photographie et des secondes données d'image acquises à l'aide du second moyen de photographie étant superposées. Le premier moyen de photographie et le second moyen de photographie partagent un élément photorécepteur qui est sensible à la fois à la lumière infrarouge et à la lumière visible. Le premier moyen de photographie acquiert les premières données d'image à l'aide d'un signal de sortie provenant de l'élément photorécepteur, et le second moyen de photographie acquiert les secondes données d'image à l'aide du signal de sortie provenant de l'élément photorécepteur.
PCT/JP2018/033651 2017-09-29 2018-09-11 Dispositif ophtalmologique WO2019065219A1 (fr)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPWO2020217409A1 (fr) * 2019-04-25 2020-10-29

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2012026597A1 (fr) * 2010-08-27 2012-03-01 ソニー株式会社 Appareil et procédé de traitement d'image
JP2013505751A (ja) * 2009-09-29 2013-02-21 オーデー−オーエス ゲーエムベーハー レーザー装置を備える検眼鏡
JP2017064547A (ja) * 2012-02-28 2017-04-06 株式会社トプコン 眼底観察装置

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2013505751A (ja) * 2009-09-29 2013-02-21 オーデー−オーエス ゲーエムベーハー レーザー装置を備える検眼鏡
WO2012026597A1 (fr) * 2010-08-27 2012-03-01 ソニー株式会社 Appareil et procédé de traitement d'image
JP2017064547A (ja) * 2012-02-28 2017-04-06 株式会社トプコン 眼底観察装置

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPWO2020217409A1 (fr) * 2019-04-25 2020-10-29

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