WO2019192108A1 - 一种视野计 - Google Patents

一种视野计 Download PDF

Info

Publication number
WO2019192108A1
WO2019192108A1 PCT/CN2018/097852 CN2018097852W WO2019192108A1 WO 2019192108 A1 WO2019192108 A1 WO 2019192108A1 CN 2018097852 W CN2018097852 W CN 2018097852W WO 2019192108 A1 WO2019192108 A1 WO 2019192108A1
Authority
WO
WIPO (PCT)
Prior art keywords
visual field
perimeter
display
fixation
forced
Prior art date
Application number
PCT/CN2018/097852
Other languages
English (en)
French (fr)
Inventor
林臣
Original Assignee
林臣
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 林臣 filed Critical 林臣
Priority to JP2020517262A priority Critical patent/JP6921313B2/ja
Priority to EP18913958.7A priority patent/EP3620102B1/en
Priority to US16/961,547 priority patent/US11737664B2/en
Priority to CN201880091969.0A priority patent/CN111970956B/zh
Publication of WO2019192108A1 publication Critical patent/WO2019192108A1/zh

Links

Images

Classifications

    • 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
    • A61B3/0091—Fixation targets for viewing direction
    • 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
    • A61B3/0083—Apparatus for testing the eyes; Instruments for examining the eyes provided with means for patient positioning
    • 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
    • A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/024—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for determining the visual field, e.g. perimeter types
    • 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
    • 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
    • A61B3/113—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining or recording eye movement

Definitions

  • the present invention relates to a perimetry that measures the field of view of a subject.
  • Vision is the range of space that can be seen when the eye is fixed in the head and the eyeball is fixed.
  • the size and shape of the field of view are related to the distribution of sensory cells on the retina. To determine the extent of the field of view.
  • visual field examination plays an important role in the diagnosis and follow-up of eye diseases such as glaucoma and optic nerve diseases.
  • the visual field examination is divided into dynamic visual field examination and static visual field examination.
  • Dynamic visual field examination (kineticperimetry): the traditional visual field examination method, using different sizes of test marks, moving from different directions to the center, recording the points where the patient can just feel the appearance or disappearance of the test mark, these points with the same light sensitivity It constitutes an equal line of sight for a certain test mark, and the line of sight detected by several different test marks is formed as a "view island" similar to the contour line.
  • the advantage of dynamic field of view is that the inspection speed is fast and it is suitable for inspection of peripheral vision.
  • the disadvantage is that the small, side-centered relative dark spots are found to be low.
  • Static perimetry At each set point of the screen, the brightness of the test is increased from weak to strong, and the brightness that the patient can just feel is the retinal sensitivity or threshold at that point.
  • the visual field examination used in clinical practice belongs to psychophysical examination, which reflects the subjective feeling of the patient.
  • the computerized automatic perimetry currently used in clinical practice is mainly used for the diagnosis and follow-up of glaucoma and partial retinal optic nerve diseases.
  • the earliest field of vision cannot be found by routine computer vision test. Defect change. Therefore, ophthalmologists have been trying to develop a new type of perimeter to achieve earlier, more stable, more sensitive and specific detection of pathological changes.
  • Currently developed a variety of new visual field inspection methods including short-wavelength field of view, kinesthetic field of view, frequency-doubled field of view, high-pass resolution and model discrimination field of view, automatic pupil field of view, scintillation field of view, micro field of view, etc. are specially designed to reflect different eye diarrhea functions. Damage characteristics.
  • These new perimeters have improved the performance of traditional perimeters to a certain extent through different principles, but all of these vision inspection devices still have the following problems:
  • the impact of fixation point In the process of measurement, the inspection time is longer, affected by the surrounding signals, it is difficult for patients to concentrate on the fixation point while observing the surrounding signal lights and responding in time to press the signal collector. Patients tend to have offsets in fixation points that affect the accuracy and repeatability of the results.
  • some inspection equipment adopts tracking technology, the position of the fixation signal can be automatically adjusted with the fixation point movement, but the signal adjustment of the computer still lags behind the movement of the fixation point of the human eye, and it is still difficult to fundamentally eliminate the influence of the fixation point change. .
  • the micro-perimeter since it is impossible to perform long-term fixation, it is difficult to collect data of a large amount of rapid repeated stimulation, and it is impossible to obtain more accurate electrophysiological data.
  • the patient's subjective influence different patients' response to the stimulus is inconsistent, some patients can respond in time after seeing the signal light and press the signal collector, but some patients respond slowly, see the signal light After the response is not made in time, the signal collector is pressed when the next time the signal light is on, resulting in an error in the inspection result.
  • the current computer automatic perimetry is designed with a "capture experiment" program to detect the false positive rate, false negative rate and fixation loss rate of each test.
  • the computer automatic visual field has a proportional sound of mechanical sound without light stimulation, and if the patient responds, it is a false positive. An extremely bright light stimulus is present in the area where the threshold has been established. If the patient is unable to respond, it indicates that the attention is dispersed and is false negative.
  • the photoelectric is randomly projected into the physiological blind spot area, if the number of times the patient answers exceeds a certain limit, there is no central fixation.
  • the eyeball is a bipolar sphere.
  • the cornea exhibits a positive potential relative to the retina. There is a potential difference between the two, forming an electric field around the eye.
  • the eyeball rotates, the spatial phase of the electric field changes. Eye movement can produce bioelectrical phenomena, there is a potential difference between the cornea and the omentum, and the cornea is positively charged to the omentum.
  • a stable reference potential can be recorded.
  • the eye moves in the horizontal direction
  • the potential difference between the left and right skin of the eye changes.
  • the potential of the upper and lower sides of the eye changes.
  • the change in potential is introduced into the amplifier by an electrode placed at the corresponding position on the skin.
  • the galvanometer with the amplifier is displayed or displayed on the oscilloscope, which is the EO signal.
  • the electrophysiological apparatus provides an objective basis for the diagnosis of the retinal and visual pathways by analyzing the bioelectrical changes of the visual system for light stimulation, reflecting the functional status of the retina and visual pathway, and adjusting the stimulation conditions and acceptance methods.
  • electrophysiological examination technology is applied to the early detection of glaucoma.
  • the damage or progression of glaucoma is mainly determined by the waveform of the electrophysiological signal.
  • the objective inspection equipment can objectively reflect the patient's retinal damage, but because it requires the patient to always fix the screen during the whole examination, the change of the patient's eye position may cause the waveform to change and cause the same patient to check the result multiple times. Larger, in addition, in the crowd can not vary the waveform between individuals, it is difficult to determine the normal value, abnormal range and other issues, it is difficult to apply to the detection of glaucoma.
  • an object of the present invention is to provide a visual field meter capable of eliminating the influence of a fixation point on a visual field inspection.
  • a perimeter is divided into two types according to different feedback devices: one is a forced fixation type visual field meter, and the other is an objective visual field meter combined with electrophysiology under forced fixation.
  • the perimeter includes a forced fixation device, a display conduction device, a visual field inspection display device, a feedback device for recording feedback information, and a control center for controlling the visual field inspection display device and collecting feedback information, the forcible fixation device
  • the eyeball is held in a fixation state during the visual field inspection, and the display conduction device is respectively connected to the forced fixation device and the visual field inspection display device.
  • the forced fixation device is adsorbed on the eyeball of the subject by a negative pressure, and the eye can observe the visual field inspection display device through the display conduction device, and the control center controls the visual field to check the image displayed on the display device through a predetermined control program, and the subject according to the
  • the visual field inspection displays corresponding feedback on the changing image on the device, and the feedback information is recorded in the feedback device to achieve measurement of the subject's field of view. Since the relative position of the forced fixation device and the eyeball is fixed, the relative position of the visual field inspection display device and the forced fixation device is fixed, and when the eyeball moves, the relative position of the visual field inspection display device and the eyeball does not change. Thereby eliminating the influence of the traditional visual field fixed point problem on the result, and improving the accuracy and repeatability of the visual field inspection.
  • the forced fixation device includes a negative pressure ring, a hole is formed in a middle portion of the negative pressure ring, and the display conduction device is fixedly disposed at the hole.
  • the negative pressure device is connected to the negative pressure device through the negative pressure tube to form a certain negative pressure between the eyeball and the negative pressure ring, thereby fixing the negative pressure ring on the eyeball.
  • the forced fixation device includes a negative pressure ring and a negative pressure tube connected to the negative pressure ring, and a middle portion of the negative pressure ring is connected with an observation tube, and the observation tube has one end and the The negative pressure ring is connected in the middle, and the other end is fixedly provided with display conduction means, and the display conduction means can conduct an inspection of the image on the display device.
  • the observation tube has a viewing hole in the center, and a mirror group is disposed in the observation hole.
  • the negative pressure ring is forcibly fixed on the eyeball, and the subject looks at the visual field inspection display device through the observation tube and the display conduction device, and the negative pressure ring is adsorbed on the eyeball, and can move synchronously with the rotation of the eyeball without adjusting the illumination angle.
  • the image is always in front of the eye, and the patient only needs to respond to the light stimulus without having to distract to fix a certain point. Since the relative position of the eyeball and the visual field inspection display device is fixed, the influence of the fixation point on the patient examination result is eliminated, and the examination is greatly improved in terms of repeatability, specificity, sensitivity, and accuracy.
  • the display conduction device comprises two types, one type includes a projection screen and a light guiding fiber connected to the projection screen, and the projection screen is connected to the forced fixation device, the light guiding One end of the fiber is connected to the projection screen, the other end is connected to the visual field inspection display device, and the projection field of view is used to inspect the image on the display device in the eye; the other type is only the light guiding fiber, and the light guiding fiber is arranged in a certain manner. Connected to the forced fixation device, the other end is connected to the point source, and the spot light source is directly projected into the eye.
  • the feedback device is a signal collector, and when the subject observes the image on the visual field inspection display device, the subject triggers the signal collector, the signal collector The feedback information of the subject was recorded.
  • the feedback device is an electrophysiological examination instrument for recording an electrophysiological signal generated by the subject observing an image on the visual field inspection display device, thereby A check on the subject's field of view is achieved.
  • the subject After being fixed to the eyeball by the negative pressure ring, the subject is forced to perform the visual field inspection display device, which can enhance the time, frequency and range of the light stimulation, and can realize single-point light repeated stimulation similar to the visual field detection, and analyze the single point light.
  • the frequency and time of stimulation and whether the patient produces electrophysiological signals to judge the patient's visual field.
  • This mode does not require any operation by the patient, eliminating the influence of the fixation point and the subjective operation of the subject, realizing the objective objective visual field and greatly checking the body.
  • the accuracy and repeatability of the inspection is not require any operation by the patient, eliminating the influence of the fixation point and the subjective operation of the subject, realizing the objective objective visual field and greatly checking the body.
  • control center is a computer
  • the artificial intelligence algorithm is added to the computer
  • the personalized display adjustment can be automatically performed according to the age of the patient and the previous inspection status, and the collected feedback data is personalized.
  • the personalized display adjustment includes highlighting areas of previously existing blind areas of the field of view and/or areas where there is a greater likelihood of blind areas.
  • the negative pressure device is used to adsorb the display conduction device on the eyeball, and the image is transmitted through the light guiding fiber, and the relative position of the visual field inspection display device and the eyeball is fixed, and is constantly located in front of the eyeball, thereby eliminating the fixation point to the perimetry. The impact of the results.
  • the traditional electrophysiological examination instruments cannot obtain the corresponding electrophysiological signals because the single point stimulation is too weak. Repeated measurement is difficult to obtain the infinite number of signal superpositions of the same position due to the influence of the fixation point.
  • the fixation point is fixed, and a single point repetition infinite number of times can be acquired to obtain an infinite amplification of the single point stimulation signal to obtain a clear electrophysiological signal.
  • Figure 1 is a schematic view of the adsorption device of the present invention
  • FIG. 2 is a schematic view showing the cooperation of the visual field meter and the multifunctional chair of the present invention
  • Figure 3 is a schematic view showing a modification of the adsorption device
  • Fig. 4 is a schematic view when the screen is viewed.
  • projection screen 1 negative pressure ring 2, negative pressure tube 3, observation tube 4, mirror group 5, light guiding fiber 6, button 7, multifunctional chair 8, support rod 9.
  • a perimeter meter includes a projection screen 1, a computer (control center) for controlling an image displayed on the projection screen 1, and a feedback device for recording feedback information, and the periscope is further
  • the invention comprises a negative pressure ring 2, a negative pressure tube 3 connected to the negative pressure ring 2 and an observation cylinder 4 located in the middle of the negative pressure ring.
  • the observation tube 4 has a viewing hole in the center, and the observation tube 4 has one end and the negative side.
  • the middle of the pressure ring 2 is connected, and the other end is fixedly provided with a projection screen 1 , and a mirror group is disposed in the observation hole from above the negative pressure ring, and the projection screen 1 is connected to the visual field inspection display device through the light guiding fiber 6 ( Not shown), the projection screen 1 projects and displays the content displayed by the visual field inspection display device.
  • the negative pressure tube 3 is connected to a negative pressure pump (not shown), and the negative pressure pump provides an adsorption force for the negative pressure ring, so that the negative pressure ring 2 can be reliably adsorbed on the eyeball, and the main function of the lens group 5 is to correct the refractive state of the patient. , the patient can clearly look at the image on the projection screen 1.
  • FIG. 2 shows an embodiment in which the field of view of the present invention is placed on a multifunctional chair.
  • the angle of the multifunctional chair 8 is adjusted to control the negative pressure of the negative pressure pump and the switch. Adjust the support rod 9 directly above the patient's eye.
  • the image type, intensity, stimulation frequency, stimulation time, etc. on the display device are checked by a computer to control the visual field, and then the negative pressure ring 2 is adsorbed on the eyeball, and the patient looks at the image projected by the light guiding fiber 6, and presses and presses when the image is seen.
  • Button 7 is marked as +.
  • button 7 If button 7 is not pressed, it is not seen as -, and all feedback information is fed back to the signal collector for calculation and recording, and finally the patient's field of view is derived.
  • the signal collector may be the above computer or a separately provided mechanism.
  • the negative pressure ring 2 has a hole in the middle thereof, and the projection screen 1 is directly fixedly disposed at the circular hole, and the projection screen 1 is connected with the light guiding fiber 6.
  • the guide The other end of the optical fiber is directly connected to the point source, and each bundle of light guiding fibers is an independent stimulation point, which is connected to an independent point source. See the dotted line shown in Figure 4 for the distribution of the guiding fiber, by controlling each point source. Adjust the position and intensity of the stimulating light on the projection screen.
  • the negative pressure ring is adsorbed on the eyeball by self-adsorption, or adsorbed on the eyeball by means of a negative pressure pump.
  • the self-adsorption method can eliminate the mechanism such as a negative pressure tube and a negative pressure pump, which is advantageous for simplifying the adsorption device.
  • a transparent layer may be provided at the aperture to isolate the eyeball from the screen to avoid direct contact of the eyeball to the screen.
  • the projection screen 1 can be cancelled, the light guiding fibers are arranged and connected in a certain manner and connected to the forced fixation device, and the other end is connected to the point light source, and the spot light source is directly projected into the eye.
  • the arrangement may be The manner in which the center is scattered around the center as shown in FIG.
  • the feedback device is replaced by an electrophysiological examination instrument (not shown) for recording an image observed by the subject on the visual field inspection display device.
  • the electrophysiological signal so as to achieve the examination of the subject's field of vision, without the patient's response to the stimulus, to achieve the objectification of the examination.
  • the visual field meter of the present invention can be used alone, and does not have to be placed on the multifunctional chair; wherein the projection screen can also adopt a curved screen that is more suitable for the eyeball, such as an OLED screen; the observation area on the forced fixation device; It may be set to any shape; the forced fixation device is not necessarily limited to a ring shape as long as it can be attached to the eyeball and the display conduction device is fixed to the forced fixation device.
  • the perimeter of the present invention is adsorbed on the eyeball by the forced fixation device.
  • the device follows the synchronous movement, so that the eyeball always looks at the same position of the visual field inspection display device, that is, the eyeball gaze position and the visual field inspection display device position.
  • Fixed while the traditional perimetry requires the patient to try to keep the gaze visual inspection display device center to achieve the relative fixation of the eye gaze position and the visual field inspection display device position. In the process, the patient needs to be multi-purpose, often causing deviations in the inspection result.
  • the patient checks the same position of the passive gaze visual field inspection display device during the whole process, thereby eliminating the multi-purpose use caused by active gaze, thereby improving the degree of cooperation of the patient examination and improving the accuracy of the examination result.
  • the display conducting device is formed by arranging light guiding fibers to conduct an image.
  • the feedback device of the perimeter meter can adopt traditional push-type feedback, and the feedback device can also adopt an electrophysiological examination instrument, that is, an objective visual field meter. In this mode, the patient does not need any response, and the subjective cooperation factor of the patient is completely eliminated.
  • the vision meter was completely transformed into an objective inspection equipment to achieve another major breakthrough in the field of view.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Biophysics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Ophthalmology & Optometry (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Human Computer Interaction (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

一种视野计，分为两型：一型为强制固视式视野计，另一型为强制固视下与电生理相结合的客观视野计；它们均包括有强制固视装置、显示传导装置、视野检查显示装置、用于记录反馈信息的反馈装置和用于控制视野检查显示装置和收集反馈信息的控制中心；强制固视装置包括有负压环(2)和负压管(3)，通过负压吸附于眼球上，当眼球移动时，强制固视装置跟随同步移动，强制固视同一位置，从而消除了固视点对视野计检查结果的影响；客观视野计中，强制固视后的电生理信号由电生理仪自动记录，消除了患者的主观应答，检查结果客观化，同时采用电生理信号做为分析指标，能更早期发现视野改变。

Description

一种视野计 技术领域
本发明涉及一种测量受检者视野的视野计。
背景技术
视野是指人的头部和眼球固定不动的情况下，眼睛观看正前方物体时所能看得见的空间范围，视野的大小和形状与视网膜上感觉细胞的分布状况有关，可以用视野计来测定视野的范围。视野检查作为眼科临床主要的视功能检测手段之一，在青光眼、视神经疾病等眼病的诊断与随访中发挥着重要作用。视野检查分为动态视野检查和静态视野检查。动态视野检查(kineticperimetry)：即传统的视野检查法，用不同大小的试标，从周边不同方位向中心移动，记录下患者刚能感受到试标出现或消失的点，这些光敏感度相同的点构成了某一试标检测的等视线，由几种不同试标检测的等视线绘成了类似等高线描绘的"视野岛"。动态视野的优点是检查速度快，适用周边视野的检查。缺点是小的、旁中心相对暗点发现率低。静态视野检查(staticperimetry)：在视屏的各个设定点上，由弱至强增加试标亮度，病人刚能感受到的亮度即为该点的视网膜敏感度或阈值。目前临床使用的视野检查属于心理物理学检查，反映的是病人的主观感觉。
目前临床使用的计算机自动视野计，主要用于青光眼及部分视网膜视神经疾病的诊断与随访，但对于一些较早期或无临床表现的眼部疾病，通过常规的计算机视野检测仍然无法发现最早期的视野缺损变化。因此，眼科研究人员一直努力试图开发出一种新型视野计以达到更早期、更稳定、更高敏感性和特异性的检测到病理改变。目前开发的包括短波长视野、运动觉视野、倍频视野、高通分辨和模型辨别视野、自动瞳孔视野、闪烁视野、微视野等多种新型视野检查方法均通过特殊的设计以反映不同眼疾视功能损害特征。这些新型视野计通过不同的原理在一定程度上提升了传统视野计的性能，但所有这些视野检查设备都仍存在以下问题：
一、固视点的影响：在测量的过程中，检查时间较长，受周边信号的影响，患者难以集中精力同时注视固视点的同时观察周边信号灯并及时作出反应按下信号收集器。患者往往会出现固视点的偏移，从而影响检查结果的准确性和可重复性。虽然有部分检查设备采用了追踪技术，可随固视点移动自动调整注视信号投射位置，但计算机的信号调整仍然滞后于人眼固视点的移动，仍难以从根本上消除固视点变化所造成的影响。另外对于微视野计，由于无法做到长期固视，难以采集超大量快速重复刺激时的数据，无法获得更为精确的电生理数据。
二、患者主观的影响：不同的患者对刺激所作出的反应速度是不一致的，部分患者在看到信号灯后能及时作出反应并按下信号收集器，但部分患者反应速度慢，在看到信号灯后未及时作出反应，而在下次信号灯亮起时才按下信号收集器，而导致检查结果的错误。
为降低这些不良影响，目前计算机自动视野计设计有“捕捉实验”程序，检测每次检查的假阳性率、假阴性率和固视丢失率。为避免由于机械声响及病人习惯的影响，电脑自动视野计有比例的出现无光点刺激的机械声，若病人予以应答即为假阳性。在已建立了阈值的区域呈现一个极亮的光刺激，若病人不能应答，表明其注意力分散，为假阴性。将光电随机的投射到生理盲点区时，若病人回答的次数超过一定的限度，则没有中心固视。虽然通过这种方式可以降低由于固视点影响和患者主观操作的影响，但仍然无法从根本上解决这一问题，导致其在可重复性、特异性、敏感性、精确性方面的不足。
眼球是一个双极性的球体，角膜相对于视网膜呈现正电位，两者之间有电位差，在眼睛的周围形成一个电场，当眼球转动时，该电场的空间相位发生变化。眼球运动可以产生生物电现象，角膜和网膜之间存在一个电位差，角膜对网膜是带正电的。当眼睛注视前方不动时，可以记录到稳定的基准电位。眼睛在水平方向上运动时，眼睛左侧和右侧的皮肤之间的电位差会发生变化，在垂直方向上运动时，眼睛的上下侧的电位会发生变化。电位的变化由置于皮肤相应位置的电极导入放大器，有放大器的电流计显示出来或在示波器上显示，就是眼电信号。眼电生理仪通过评析视觉系统对光刺激的生物电变化，反映视网膜和视通路的功能状态，调节刺激条件和接受方式，可对视网膜各层和视通路各节段疾患客观地提供诊断依据。目前临床上有将电生理检查技术应用于青光眼早期的检测。主要通过电生理信号的波形来判断青光眼的受损或进展情况。其虽为客观检查设备可以客观反映患者的视网膜受损情况，但由于其要求患者在整个检查过程中始终固视屏幕，患者眼位的改变可能造成波形的改变而导致同一患者多次检查结果变异较大，另外在人群中不能个体之间其波形变异较大，难以确定正常值、异常范围等问题，故难以真正应用于青光眼的检测。
发明内容
为了解决上述技术问题，本发明的目的在于提供一种能够消除了固视点对视野检查影响的视野计。具体技术方案如下。
一种视野计，依据反馈装置的不同，分为两型：一型为强制固视式视野计，另一型为强制固视下与电生理相结合的客观视野计。视野计包括有强制固视装置、显示传导装置、视野检查显示装置、用于记录反馈信息的反馈装置和用于控制视野检查显示装置和收集反馈信息的控制中心，所述的强制固视装置用于在视野检查过程中强制眼球保持固视状态，所述显示传导装置分别与所述强制固视装置和所述视野检查显示装置相连。强制固视装置通过负压吸 附在受试者的眼球上，眼睛可以通过显示传导装置观察到视野检查显示装置，控制中心通过既定的控制程序控制视野检查显示装置上显示的图像，受试者根据视野检查显示装置上不断变化的图像做出相应的反馈，反馈信息被记录在反馈装置中，实现对受试者视野的测定。由于强制固视装置与眼球的相对位置是固定的，视野检查显示装置与强制固视装置的相对位置是固定的，当眼球移动时，所注视的视野检查显示装置与眼球的相对位置不变，从而消除了传统视野计固视点的问题对结果的影响，提高视野检查的准确性和可重复性。
上述技术方案中，所述的强制固视装置包括负压环，所述负压环的中部有孔，所述显示传导装置固定设置在所述孔处。负压装置通过负压管连接负压装置使得眼球和负压环之间形成一定的负压，从而将该负压环固定在眼球上。当测试结束，关闭负压装置即可将负压环从眼球上取下。上述技术方案中，所述的强制固视装置包括负压环和与所述负压环连接的负压管，所述负压环的中部连接有观察筒，所述的观察筒一端与所述负压环中部连接，另一端固定设置有显示传导装置，所述显示传导装置可传导视野检查显示装置上的图像。所述观察筒中央具有观察孔，所述观察孔内设置有镜组。所述负压环强制固定在眼球上，受试者通过观察筒及显示传导装置注视视野检查显示装置，因负压环吸附于眼球之上，可随眼球转动而同步移动，无需调整照射角度，而图像始终位于眼正前方，患者仅需对光刺激作出应答，而无需分神去固视某一点。由于眼球与视野检查显示装置相对位置固定，消除了固视点对患者检查结果的影响后该检查在可重复性、特异性、敏感性和精确性方面得到较大的提升。
上述技术方案中，所述显示传导装置包括有两种类型，一种类型包括投射屏幕和与所述投射屏幕相连的导光纤维，所述投射屏幕连接在强制固视装置上，所述导光纤维的一端连接投射屏幕，另一端连接在视野检查显示装置上，投射视野检查显示装置上的图像于眼内；另一种类型仅有导光纤维，所述导光纤维按一定的方式排列组合连接于强制固视装置上，另一端连接点光源，直接投射点光源的光点于眼内。
上述技术方案中，为强制固视式视野计时，所述的反馈装置为信号收集器，当受试者观察到视野检查显示装置上的图像时，受试者触发该信号收集器，信号收集器将受试者的反馈信息进行记录。
上述技术方案中，为客观视野计时，所述的反馈装置为电生理检查仪器，所述电生理检查仪器用于记录受试者观察到视野检查显示装置上的图像而产生的电生理信号，从而实现对受试者视野的检查。通过负压环固定于眼球后，强制受试者固视视野检查显示装置，可强化给予光刺激的时间、频率和范围，可实现类似于视野检测的单点光反复刺激，通过分析单点光刺激的频率、时间以及患者是否产生电生理信号来判断患者的视野情况，该模式下无需患者进行任何操作，消除了固视点和受试者主观操作的影响，实现真正的客观视野计，大大体 检检查的准确性和可重复性。
上述技术方案中，所述的控制中心为计算机，所述计算机中加入人工智能算法，可依据患者年龄及以前的检查状况自动进行个性化显示调整，并对收集的反馈数据进行个性化处理。该个性化显示调整包括重点显示以前存在的视野盲区的区域和/或存在盲区较大可能性的区域。
技术效果
1.采用负压装置将显示传导装置吸附于眼球上，通过导光纤维传导图像，视野检查显示装置与眼球的相对位置固定不动，恒定位于眼球注视前方，从而消除了固视点对视野计检查结果的影响。
2.负压环中央有观察孔，孔内径固定，可以保障所有患者在相同的观察孔径状况下进行检查，有助于不同患者之间的对比观察和同一患者不同时期的自身对比观察以判断疾病的转归。
3.可与电生理检查仪器相结合，传统的电生理检查仪器由于单点刺激太弱无法获得相应的电生理信号，重复测量由于固视点影响难以获得相同位置的无限次信号叠加，本发明由于固视点固定，可以采集单点重复无限次的方式以获得单点刺激信号的无限放大而获得清晰的电生理信号。与电生理仪器结合后，可实现视野检查的重大突破即实现视野检查的客观化。
附图说明
图1为本发明吸附装置的示意图；
图2为本发明视野计与多功能椅配合的示意图；
图3为吸附装置变形例的示意图；
图4为观察屏幕时的示意图。
图中:投射屏幕1、负压环2、负压管3、观察筒4、镜组5、导光纤维6、按钮7、多功能椅8、支撑杆9。
具体实施方式
下面结合附图对本发明作进一步详细描述。
实施例1，参见图1-2、4，视野计其包括有投射屏幕1、用于控制投射屏幕1上显示的图像的计算机(控制中心)和用于记录反馈信息的反馈装置，视野计还包括有负压环2、与负压环2连接的负压管3和位于负压环中部的观察筒4，所述观察筒4中央具有观察孔，所述的观察筒4一端与所述负压环2中部连接，另一端固定设置有投射屏幕1，所述观察孔内距离所述负压环上方设置有镜组，所述的投射屏幕1通过导光纤维6连接至视野检查显示装 置(未图示)，投射屏幕1投射显示视野检查显示装置所显示内容。负压管3连接至负压泵(未图示)，负压泵为负压环提供吸附力，使得负压环2能够可靠吸附在眼球上，镜组5的主要作用是矫正患者屈光状态，将患者能清晰注视到投射屏幕1上图像。投射屏幕1内容可通过计算机更改视野检查显示装置显示内容而获得不同的图像。图2中示出了将本发明的视野计设置在多功能椅上的实施方式，对患者进行视野测试时，调整多功能椅8背靠的角度，控制负压泵的负压大小和开关，调整支撑杆9至患者眼部正上方。首先通过计算机控制视野检查显示装置上的图像类型、强度、刺激频率、刺激时间等，再将负压环2吸附在眼球上，患者注视导光纤维6投射的图像，在看见图像时按下按压按钮7即记为+，若未按下按钮7即为未看到记为-，所有反馈信息反馈到信号收集器中进行结果运算并记录，最终导出患者的视野范围。需要说明的是该信号收集器可以是上述的计算机，也可以是单独设置的机构。
实施例2，参见图3及图4，所述负压环2的中部有孔，投射屏幕1直接固定设置在所述圆孔处，投射屏幕1与导光纤维6相连，该模式下，导光纤维另一端直接连接点光源，每一束导光纤维为一个独立的刺激点，均连接独立的点光源，参见图4所示虚线即为导光纤维分布方式，通过控制每一个点光源来调节投射屏幕上刺激光的位置和强度。负压环采用自吸附方式吸附在眼球上，或者采用负压泵的方式吸附在眼球上。采用自吸附方式能够省去负压管和负压泵等机构，有利于简化吸附装置。可选地，孔处可以设置透明层将眼球和屏幕进行隔离以避免眼球直接接触到屏幕。需要说明的是：投射屏幕1可以取消，导光纤维按一定的方式排列组合连接于强制固视装置上，另一端连接点光源，直接投射点光源的光点于眼内，该排列方式可以是如图4所示的中心向四周散射的方式。
上述技术方案中，为客观视野计时，所述的反馈装置替代为电生理检查仪器(未图示)，所述电生理检查仪器用于记录受试者观察到视野检查显示装置上的图像而产生的电生理信号，从而实现对受试者视野的检查，无需患者对刺激作出应答，实现检查的客观化。
需要说明的是，本发明的视野计可以单独使用，不是必须安置在多功能椅上；其中投射屏幕也可以采用更加贴合眼球的曲面屏，如OLED屏幕等；强制固视装置上的观察区可以设置为任意形状；强制固视装置也不是必须限定为环状，只要能够吸附在眼球上并将显示传导装置与强制固视装置固定即可。
本发明的视野计通过强制固视装置吸附于眼球上，当眼球移动时，该装置跟随同步移动，从而使眼球始终注视在视野检查显示装置的相同位置，即眼球注视位置与视野检查显示装置位置固定，而传统视野计要求患者努力保持注视视野检查显示装置中心而达到眼球注视位置与视野检查显示装置位置的相对固定，在此过程中，患者需一心多用，常常顾此失彼而导致检查结果出现偏差，采用本视野计的固视装置后，患者检查全程中被动注视视野检查显 示装置相同位置，消除了主动注视造成的一心多用，从而提高患者检查的配合程度以及提高检查结果的准确性。所述显示传导装置是由导光纤维排列而成，可传导图像。所述视野计的反馈装置可采用传统的按压式反馈，反馈装置也可以采用电生理检查仪器即客观视野计，该种模式下，不需患者做任何应答，将完全消除患者的主观配合因素，将视野计彻底改造为客观检查设备，实现视野计的另一重大突破。

Claims (7)

  1. 一种视野计，其特征在于，包括有强制固视装置、显示传导装置、视野检查显示装置、用于记录反馈信息的反馈装置和用于控制视野检查显示装置和收集反馈信息的控制中心，所述的强制固视装置用于在视野检查过程中强制眼球保持固视状态，所述显示传导装置分别与所述强制固视装置和所述视野检查显示装置相连。
  2. 根据权利要求1所述的视野计，其特征在于，所述强制固视装置包括负压环，所述负压环的中部有孔，所述显示传导装置固定设置在所述孔处。
  3. 根据权利要求1或2所述的视野计，其特征在于，所述显示传导装置为导光纤维，所述导光纤维按一定的方式排列组合连接于强制固视装置上，另一端连接点光源，直接投射点光源的光点于眼内。
  4. 根据权利要求1或2所述的视野计，其特征在于，所述显示传导装置包括投射屏幕和与所述投射屏幕相连的导光纤维，所述投射屏幕连接在强制固视装置上，所述导光纤维的一端连接投射屏幕，另一端连接在视野检查显示装置上，投射视野检查显示装置上的图像于眼内。
  5. 根据权利要求1或2所述的视野计，其特征在于，所述的反馈装置为按压式触控反馈装置。
  6. 根据权利要求1或2所述的视野计，其特征在于，所述的反馈装置为电生理检查仪器，所述电生理检查仪器用于记录受试者观察到视野检查显示装置上的图像而产生的电生理信号。
  7. 根据权利要求1或2所述的视野计，其特征在于，所述的控制中心为计算机，所述计算机中加入人工智能算法，可依据患者年龄及以前的检查状况自动进行个性化显示调整，并对收集的反馈数据进行个性化处理。
PCT/CN2018/097852 2018-04-03 2018-08-01 一种视野计 WO2019192108A1 (zh)

Priority Applications (4)

Application Number Priority Date Filing Date Title
JP2020517262A JP6921313B2 (ja) 2018-04-03 2018-08-01 視野計
EP18913958.7A EP3620102B1 (en) 2018-04-03 2018-08-01 Perimeter
US16/961,547 US11737664B2 (en) 2018-04-03 2018-08-01 Perimeter
CN201880091969.0A CN111970956B (zh) 2018-04-03 2018-08-01 一种视野计

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201820462284.X 2018-04-03
CN201820462284.XU CN209404742U (zh) 2018-04-03 2018-04-03 一种视野计

Publications (1)

Publication Number Publication Date
WO2019192108A1 true WO2019192108A1 (zh) 2019-10-10

Family

ID=67929216

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2018/097852 WO2019192108A1 (zh) 2018-04-03 2018-08-01 一种视野计

Country Status (5)

Country Link
US (1) US11737664B2 (zh)
EP (1) EP3620102B1 (zh)
JP (1) JP6921313B2 (zh)
CN (2) CN209404742U (zh)
WO (1) WO2019192108A1 (zh)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN209404742U (zh) * 2018-04-03 2019-09-20 林臣 一种视野计

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6161931A (en) * 1999-06-14 2000-12-19 University Of New Mexico Fiberoptic fundoscope coupler
JP2005143684A (ja) * 2003-11-13 2005-06-09 Kao Corp リラックス感評価用瞳孔対光反応計測具
CN101342072A (zh) * 2008-08-29 2009-01-14 天津医科大学 四点视野检测装置及检测方法
CN103037754A (zh) * 2010-06-25 2013-04-10 爱尔康手术激光股份有限公司 自适应患者接口
JP2016198387A (ja) * 2015-04-13 2016-12-01 株式会社クリュートメディカルシステムズ 視覚検査装置、視覚検査装置の視標補正方法、および表示装置
CN206026294U (zh) * 2016-07-12 2017-03-22 吴越 一种头戴式视野检查仪

Family Cites Families (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1581835A (en) * 1977-10-24 1980-12-31 Spurrett A J Fibre optic variable luminance perimetry wand
WO1984000677A1 (en) * 1982-08-20 1984-03-01 Charles J Koester Image stabilization method and apparatus
US4852988A (en) * 1988-09-12 1989-08-01 Applied Science Laboratories Visor and camera providing a parallax-free field-of-view image for a head-mounted eye movement measurement system
JPH07255770A (ja) * 1994-03-23 1995-10-09 Juichi Yamauchi 白内障用視力補助具及び該白内障用視力補助具と光量調整具との組合せ
JPH08140933A (ja) * 1994-11-18 1996-06-04 Browning Johannes 視覚機能の検査装置及び検査方法
JPH08266466A (ja) * 1995-03-29 1996-10-15 Canon Inc 視野測定装置
US6607527B1 (en) * 2000-10-17 2003-08-19 Luis Antonio Ruiz Method and apparatus for precision laser surgery
US6835179B2 (en) * 2000-11-22 2004-12-28 Carl Zeiss Jena Gmbh Optical stimulation of the human eye
US20050020896A1 (en) * 2003-07-24 2005-01-27 Fuller Terry A. Apparatus and method of intraocular pressure determination
CN101208055A (zh) * 2005-04-26 2008-06-25 生物雷射科技股份有限公司 治疗眼疾的方法
EP1731120B1 (de) * 2005-06-09 2008-05-07 SIE AG, Surgical Instrument Engineering Ophthalmologische Vorrichtung für die Auflösung von Augengewebe
DE102005040337A1 (de) * 2005-08-25 2007-03-01 Carl Zeiss Meditec Ag Kontaktglas für die Augenchirurgie
US7927344B2 (en) * 2006-10-13 2011-04-19 Burba Thomas A Eye positioner
CN201481388U (zh) * 2009-02-18 2010-05-26 复旦大学附属眼耳鼻喉科医院 一种具有眼球跟踪和屈光补偿功能的电子视野计
RU2420223C2 (ru) * 2009-03-06 2011-06-10 Федеральное Государственное Унитарное Предприятие "Государственный Рязанский Приборный Завод" Устройство для исследования поля зрения
CN102283633A (zh) * 2011-07-19 2011-12-21 中国科学院光电技术研究所 一种自适应光学微视野计
CN202821808U (zh) * 2012-10-12 2013-03-27 南阳医学高等专科学校第一附属医院 一种眼科开睑器
JP6053574B2 (ja) * 2013-02-28 2016-12-27 国立大学法人 東京大学 視野検査支援装置
JP2015061595A (ja) * 2013-09-19 2015-04-02 ジーエヌ オトメトリックス エー／エスＧＮ Ｏｔｏｍｅｔｒｉｃｓ Ａ／Ｓ 目の動きを観察するためのヘッドギア
WO2015166551A1 (ja) * 2014-04-30 2015-11-05 株式会社クリュートメディカルシステムズ 視覚機能計測装置
US20150327764A1 (en) * 2014-05-14 2015-11-19 Ocular Instruments, Inc. Flexible contact lens
JP6431443B2 (ja) * 2015-06-05 2018-11-28 株式会社クリュートメディカルシステムズ 視覚検査装置
CN106037626B (zh) * 2016-07-12 2017-11-03 吴越 一种头戴式视野检查仪
CN209404742U (zh) * 2018-04-03 2019-09-20 林臣 一种视野计

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6161931A (en) * 1999-06-14 2000-12-19 University Of New Mexico Fiberoptic fundoscope coupler
JP2005143684A (ja) * 2003-11-13 2005-06-09 Kao Corp リラックス感評価用瞳孔対光反応計測具
CN101342072A (zh) * 2008-08-29 2009-01-14 天津医科大学 四点视野检测装置及检测方法
CN103037754A (zh) * 2010-06-25 2013-04-10 爱尔康手术激光股份有限公司 自适应患者接口
JP2016198387A (ja) * 2015-04-13 2016-12-01 株式会社クリュートメディカルシステムズ 視覚検査装置、視覚検査装置の視標補正方法、および表示装置
CN206026294U (zh) * 2016-07-12 2017-03-22 吴越 一种头戴式视野检查仪

Also Published As

Publication number Publication date
JP6921313B2 (ja) 2021-08-18
CN209404742U (zh) 2019-09-20
US11737664B2 (en) 2023-08-29
CN111970956B (zh) 2024-05-24
EP3620102A4 (en) 2020-12-23
US20210059516A1 (en) 2021-03-04
CN111970956A (zh) 2020-11-20
JP2020521620A (ja) 2020-07-27
EP3620102B1 (en) 2024-10-09
EP3620102A1 (en) 2020-03-11

Similar Documents

Publication Publication Date Title
JP5498375B2 (ja) 視野検査システム、視野検査装置の駆動方法、コンピュータプログラム、情報媒体もしくはコンピュータ読取可能媒体およびプロセッサ
CN105662343B (zh) 一种干眼检测手持成像装置及干眼检测设备
JP2018508254A (ja) 自動視力診断の方法およびシステム
JP2008503244A (ja) 網膜損傷を評価するための装置及び方法
RU2634682C1 (ru) Портативное устройство для исследования зрительных функций
JPH01312902A (ja) 眼球運動検査装置
JPWO2006030658A1 (ja) 視野計
JP2004283609A (ja) 瞳孔不規則性検出・瞳孔追跡・瞳孔反応検出機能、緑内障検査機能、角膜解剖学的測定機能、頭蓋内圧検出機能、および、眼異常測定機能を備えた瞳孔計
JP2005131393A (ja) 光学的に識別可能な眼の症状の診断のための装置及び方法
JP2001509693A (ja) 視野検査方法および装置
US9572486B2 (en) Device and method for checking human vision
CN105520713A (zh) 双目瞳孔对光反射测量设备
WO2019192108A1 (zh) 一种视野计
Kunumpol et al. GlauCUTU: Virtual reality visual field test
CN116172507A (zh) 一种眼部动作捕捉及泪膜检测系统及设备
JP2024525811A (ja) 複数の機能的な眼のパラメーターを決定するためのコンピュータープログラム、方法、及び装置
KR20140111157A (ko) 스마트폰용 동공반응 검사 장치 및 방법
CN209826666U (zh) 一种基于显示设备的反馈交互的非接触式视野计
CN109431453B (zh) 一种用于客观视觉普查的眼视光仪器
RU2409306C1 (ru) Устройство для исследования поля зрения
JP2021516085A (ja) 視覚系診査装置
US11596302B2 (en) Eye examination apparatus for use with a smartphone
KR20220168883A (ko) 사시선별검사 방법 및 이를 위한 장치
JPH03215243A (ja) 眼球運動解析装置
Murray Saccadic vector optokinetic perimetry: a technique and system for automated static perimetry in children using eye tracking

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18913958

Country of ref document: EP

Kind code of ref document: A1

ENP Entry into the national phase

Ref document number: 2020517262

Country of ref document: JP

Kind code of ref document: A

ENP Entry into the national phase

Ref document number: 2018913958

Country of ref document: EP

Effective date: 20191204

NENP Non-entry into the national phase

Ref country code: DE