WO2022168259A1 - 眼科情報処理装置、眼科装置、眼科情報処理方法、及びプログラム - Google Patents

眼科情報処理装置、眼科装置、眼科情報処理方法、及びプログラム Download PDF

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WO2022168259A1
WO2022168259A1 PCT/JP2021/004244 JP2021004244W WO2022168259A1 WO 2022168259 A1 WO2022168259 A1 WO 2022168259A1 JP 2021004244 W JP2021004244 W JP 2021004244W WO 2022168259 A1 WO2022168259 A1 WO 2022168259A1
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Prior art keywords
eye
subject
data
shape
unit
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PCT/JP2021/004244
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English (en)
French (fr)
Japanese (ja)
Inventor
聡大 三野
シュイン イェ
将 中島
康文 福間
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Topcon Corp
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Topcon Corp
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Priority to PCT/JP2021/004244 priority Critical patent/WO2022168259A1/ja
Priority to EP21924654.3A priority patent/EP4289338A4/en
Priority to CN202180092967.5A priority patent/CN116829049A/zh
Priority to JP2022579258A priority patent/JPWO2022168259A1/ja
Publication of WO2022168259A1 publication Critical patent/WO2022168259A1/ja
Priority to US18/226,802 priority patent/US20240000310A1/en
Anticipated expiration legal-status Critical
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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
    • A61B3/107—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining the shape or measuring the curvature of the cornea
    • 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
    • A61B3/0016—Operational features thereof
    • A61B3/0025—Operational features thereof characterised by electronic signal processing, e.g. eye models
    • 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
    • A61B3/0016—Operational features thereof
    • A61B3/0041—Operational features thereof characterised by display arrangements
    • A61B3/0058—Operational features thereof characterised by display arrangements for multiple images
    • 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
    • A61B3/1005—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring distances inside the eye, e.g. thickness of the cornea
    • 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
    • A61B3/102—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for optical coherence tomography [OCT]
    • 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
    • A61B3/103—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
    • 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
    • A61B3/117—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
    • 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
    • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • 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
    • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • A61B3/1225—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes using coherent radiation
    • 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
    • A61B3/13—Ophthalmic microscopes
    • A61B3/135—Slit-lamp microscopes
    • 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
    • A61B3/18—Arrangement of plural eye-testing or -examining apparatus
    • A61B3/185—Arrangement of plural eye-testing or -examining apparatus characterised by modular construction

Definitions

  • the present invention relates to an ophthalmic information processing device, an ophthalmic device, an ophthalmic information processing method, and a program.
  • Non-Patent Document 1 discloses various types of eyeball shapes. By specifying the type of eyeball shape, there is a possibility that an appropriate treatment method corresponding to the specified type can be selected.
  • the shape of the eyeball changes as it grows. Therefore, it is very difficult to determine whether the change in the shape of the eyeball is due to growth or is accompanied by the progression of myopia. unable to comprehend.
  • the present invention has been made in view of such circumstances, and one of its purposes is to provide a new technique for specifying the shape of the eyeball or its change with good reproducibility and high accuracy. .
  • An aspect of some embodiments is an acquisition unit that acquires eyeball shape data or intraocular distance of an eye of a subject; and a normalization unit that normalizes the eyeball shape data or the intraocular distance.
  • a normalizer that normalizes the subject's eye measurement data based on the subject's physical data or the subject's eye refractive power
  • an ophthalmologic information processing apparatus comprising: a calculation unit that calculates normalized eyeball shape data or normalized intraocular distance of the subject's eye based on the measurement data normalized by the normalization unit. is.
  • Another aspect of some embodiments is an ophthalmologic apparatus including a measurement system that measures the eyeball shape or intraocular distance of the subject's eye, and any of the ophthalmologic information processing apparatuses described above.
  • Another aspect of some embodiments is obtaining eye shape data or intraocular distance of an eye of a subject; and a normalizing step of normalizing the eyeball shape data or the intraocular distance by using the ophthalmologic information processing method.
  • Another aspect of some embodiments is a normalizing step of normalizing measurement data of the subject's eye based on physical data of the subject or refractive power of the eye of the subject; a calculation step of calculating normalized eyeball shape data or normalized intraocular distance of the subject's eye based on the measurement data normalized in the normalization step. is.
  • Another aspect of some embodiments is a program that causes a computer to execute each step of the ophthalmologic information processing method described above.
  • FIG. 1 is a schematic diagram showing a configuration example of an optical system of an ophthalmologic apparatus according to an embodiment
  • FIG. 1 is a schematic diagram showing a configuration example of an optical system of an ophthalmologic apparatus according to an embodiment
  • FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment
  • FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment
  • FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment
  • FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment
  • FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment
  • FIG. 1 is a schematic diagram showing a configuration example of a processing system of an ophthalmologic apparatus according to an embodiment
  • FIG. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment;
  • FIG. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment;
  • FIG. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment;
  • FIG. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment;
  • FIG. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment;
  • FIG. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment.
  • myopia progression is related to how the shape of the eyeball changes. Strictly speaking, however, the shape of the eyeball is not a perfect sphere, and in addition, it may change due to the growth of the subject (subject's eye), or may progress to myopia due to factors other than growth. known to change.
  • the ophthalmologic information processing apparatus changes data representing the shape of the eyeball (or the intraocular distance) calculated from the measurement data obtained by measuring the subject's eye due to the growth of the subject. Normalized data is obtained by normalizing using the parameter or the refractive power of the eye to be examined. Alternatively, the ophthalmologic information processing apparatus according to the embodiment normalizes the measurement data by scaling using a parameter that changes due to the growth of the subject or the refractive power of the eye to be examined, and converts the normalized measurement data to Calculate normalized data representing the shape of the eyeball (or intraocular distance).
  • the normalized data obtained by normalizing using the parameters that change due to the growth of the subject or the refractive power of the eye to be inspected in this way are the eyeball shape (or eye shape) caused by factors other than growth. Inner distance) represents the degree of change.
  • eyeball shape types (change patterns) are classified based on normalized data, and treatment strategies corresponding to the classified eyeball shape types are determined. In some embodiments, future eye shape changes are predicted based on the normalized data.
  • Data representing the shape of the eyeball include data representing the shape of the anterior segment, data representing the shape of the posterior segment, data representing the shape of the equatorial segment of the eyeball (the portion between the anterior segment and the posterior segment), For example, there is data representing the outer wall of the eyeball.
  • Data representing the shape of the anterior segment include data representing the shape of the cornea (corneal curvature, corneal curvature radius), and the like.
  • Data representing the shape of the posterior segment include data representing the shape of a predetermined layer region in the fundus (retina) (fundus curvature, fundus curvature radius), and the like.
  • Data representing the shape of the equator of the eyeball include data representing the shape of the sclera at the equator (scleral curvature, radius of curvature of the sclera).
  • Data representing the outer wall of the eyeball include data representing the shape of the sclera.
  • the intraocular distance is the distance between predetermined sites in the anterior segment (e.g., the distance from the corneal vertex to a predetermined position on the anterior surface of the cornea), the distance between predetermined sites in the posterior segment (e.g., the distance between the macula and the optic papilla). distance between layers), distance between predetermined layer regions in the fundus, axial length of the eye, and the like.
  • Measurement data is acquired by an ophthalmic device.
  • the measurement data of the anterior segment is acquired by a known corneal topography measuring device (keratometer, placido corneal topography measuring device), an anterior segment image analyzer, an anterior segment optical coherence tomography (OCT) device, or the like. be.
  • the measurement data of the equatorial portion and the measurement data of the posterior portion of the eye are acquired by an OCT apparatus.
  • Physical data and the like are parameters that change due to the subject's growth.
  • a parameter other than the corneal curvature is adopted as a parameter that changes due to growth of the subject.
  • the intraocular distance for example, the axial length of the eye
  • the physical data may include the intraocular distance.
  • subject data that change due to the subject's growth, including those included in the intraocular distance may be referred to as "physical data.”
  • the shape of the anterior segment is simplified, and it is assumed that the original eyeball is spherical (perfect sphere).
  • the fundus curvature is normalized by the axial length to obtain normalized data representing the degree of change in the shape of the eyeball.
  • the shape of the fundus the shape of the retinal pigment epithelium (RPE) layer in the retina will be described as an example.
  • the ophthalmologic apparatus implements the functions of the ophthalmologic information processing apparatus according to the embodiment.
  • An ophthalmologic information processing method according to an embodiment is implemented by an ophthalmologic information processing apparatus according to an embodiment.
  • a program according to an embodiment causes a processor (computer) to execute each step of an ophthalmologic information processing method according to an embodiment.
  • a recording medium according to the embodiment is a computer-readable non-temporary recording medium (storage medium) in which the program according to the embodiment is recorded.
  • the "processor” is, for example, CPU (Central Processing Unit), GPU (Graphics Processing Unit), ASIC (Application Specific Integrated Circuit), programmable logic device (for example, SPLD (Simple Programmable Logic Device (CPLD) Programmable Logic Device), FPGA (Field Programmable Gate Array)) and other circuits.
  • the processor implements the functions according to the embodiment by, for example, reading and executing a program stored in a storage circuit or storage device.
  • the ophthalmologic apparatus according to the embodiment includes an OCT optical system that performs OCT on an eye to be examined, the configuration of the ophthalmologic apparatus according to the embodiment is not limited to this.
  • the ophthalmologic apparatus according to the embodiment may be configured to acquire measurement data of the subject's eye from an external OCT apparatus.
  • the ophthalmic device includes not only the functionality of an OCT device for performing OCT, but also the functionality of at least one of a fundus camera, a scanning laser ophthalmoscope, a slit lamp microscope, and a surgical microscope. Furthermore, the ophthalmic apparatus according to some embodiments has the capability to measure optical properties of the subject's eye. Ophthalmologic devices with a function of measuring optical characteristics of an eye to be examined include tonometers, wavefront analyzers, specular microscopes, perimeters, and the like. The ophthalmic device according to some embodiments has the functionality of a laser therapy device used for laser therapy.
  • FIG. 1 and 2 show configuration examples of an optical system of an ophthalmologic apparatus according to an embodiment.
  • FIG. 1 shows a configuration example of the entire optical system of an ophthalmologic apparatus 1000 according to an embodiment.
  • FIG. 2 shows a configuration example of the optical system of the OCT unit 100 of FIG.
  • the ophthalmologic apparatus 1000 includes an optical system for observing the eye E to be examined, an optical system for examining the eye E to be examined, and a dichroic mirror for wavelength-separating the optical paths of these optical systems.
  • An anterior segment observation system 5 is provided as an optical system for observing the eye E to be examined.
  • An OCT optical system and a reflector measurement optical system are provided as an optical system for examining the eye E to be examined.
  • the ophthalmologic apparatus 1000 includes an alignment system 1 , a keratometry system 3 , a fixation projection system 4 , an anterior segment observation system 5 , a reflector measurement projection system 6 , a reflector measurement light receiving system 7 , and an OCT optical system 8 .
  • the anterior segment observation system 5 uses light of 940 nm to 1000 nm
  • the reflector measurement optical system uses light of 850 nm to 880 nm
  • the fixation projection system 4 uses light of 400 nm to 700 nm.
  • the OCT optical system 8 uses light of 840 nm. That is, the OCT optical system 8 performs OCT measurement (OCT scan) with a measurement wavelength of 840 nm.
  • the alignment system 1 is used for Z alignment and XY alignment of the optical system with respect to the eye E to be examined.
  • the Z alignment is alignment in the Z direction (back and forth direction, working distance direction) parallel to the optical axis of the anterior segment observation system 5 (for example, the objective lens 51).
  • XY alignment is alignment in directions perpendicular to the optical axis (horizontal direction (X direction) and vertical direction (Y direction)).
  • the alignment system 1 includes two or more anterior eye cameras 14 .
  • the two or more anterior segment cameras 14 capture the anterior segment of the subject's eye E substantially simultaneously from different directions, and send the acquired two or more captured images (anterior segment images) to the processing unit 9, which will be described later. Output.
  • the processing unit 9 analyzes two or more captured images from the two or more anterior eye cameras 14 to identify the three-dimensional position of the eye E to be examined (specifically, the characteristic part of the eye E to be examined), and identifies the identified three-dimensional position. Alignment of the optical system in the XY direction and the Z direction with respect to the subject's eye E (characteristic region) is performed based on the three-dimensional position obtained.
  • the alignment system 1 includes two anterior eye cameras 14 .
  • the alignment system 1 may include three or more anterior eye cameras 14 .
  • one function of the two anterior eye cameras 14 may be realized by an imaging element 59 provided in the anterior eye observation system 5, which will be described later.
  • the anterior segment observation system 5 captures a moving image of the anterior segment of the eye E to be examined.
  • the imaging plane of the imaging element 59 is arranged at a pupil conjugate position (a position substantially optically conjugate with the pupil of the subject's eye E).
  • the anterior segment illumination light source 50 irradiates the anterior segment of the eye E to be examined with illumination light (for example, infrared light).
  • illumination light for example, infrared light.
  • the light reflected by the anterior segment of the subject's eye E passes through an objective lens 51, passes through a dichroic mirror 52, passes through a hole formed in a diaphragm (telecentric diaphragm) 53, and passes through relay lenses 55 and 56.
  • the dichroic mirror 52 synthesizes (separates) the optical path of the reflex measurement optical system and the optical path of the anterior eye observation system 5 .
  • the dichroic mirror 52 is arranged such that the optical path synthesizing surface for synthesizing these optical paths is inclined with respect to the optical axis of the objective lens 51 .
  • the light transmitted through the dichroic mirror 76 is imaged on the imaging surface of the imaging element 59 (area sensor) by the imaging lens 58 .
  • the imaging element 59 performs imaging and signal output at a predetermined rate.
  • the output (video signal) of the imaging device 59 is input to the processing section 9 which will be described later.
  • the processing unit 9 displays an anterior segment image E' based on this video signal on a display screen 10a of the display unit 10, which will be described later.
  • the anterior segment image E' is, for example, an infrared moving image.
  • the keratometry system 3 projects a ring-shaped light beam (infrared light) for measuring the shape of the cornea Cr of the eye E to be examined onto the cornea Cr.
  • the keratoplate 31 is arranged between the objective lens 51 and the eye E to be examined.
  • a kerato ring light source 32 is provided on the back side of the kerato plate 31 (on the objective lens 51 side).
  • the keratoplate 31 has a keratopattern (transmissive portion) formed along a circumference centered on the optical axis of the objective lens 51 to transmit the light from the keratometry light source 32 .
  • the keratopattern may be formed in an arc shape (part of the circumference) centering on the optical axis of the objective lens 51 .
  • a ring-shaped light flux (arc-shaped or circumferential measurement pattern) is projected onto the cornea Cr of the eye E to be examined.
  • Reflected light (keratling image) from the cornea Cr of the subject's eye E is detected by the imaging element 59 together with the anterior segment image E'.
  • the processing unit 9 calculates a corneal shape parameter representing the shape of the cornea Cr by performing a known calculation based on this keratling image.
  • the ref measurement optical system includes a ref measurement projection system 6 and a ref measurement light receiving system 7 used for refractive power measurement.
  • the ref measurement projection system 6 projects a refractive power measurement light beam (for example, a ring-shaped light beam) (infrared light) onto the fundus oculi Ef.
  • the ref measurement light-receiving system 7 receives the return light from the subject's eye E of this luminous flux.
  • the reflector measurement projection system 6 is provided on an optical path branched by a perforated prism 65 provided in the optical path of the reflector measurement light receiving system 7 .
  • the aperture formed in the apertured prism 65 is arranged at the pupil conjugate position.
  • the imaging surface of the imaging element 59 is arranged at a fundus conjugate position (a position substantially optically conjugate with the fundus Ef of the subject's eye E).
  • the ref measurement light source 61 is an SLD (Superluminescent Diode) light source, which is a high luminance light source.
  • the ref measurement light source 61 is movable in the optical axis direction.
  • a reflex measurement light source 61 is arranged at a fundus conjugate position.
  • the light output from the ref measurement light source 61 passes through the relay lens 62 and enters the conical surface of the conical prism 63 .
  • Light incident on the conical surface is deflected and emitted from the bottom surface of the conical prism 63 .
  • Light emitted from the bottom surface of the conical prism 63 passes through a ring-shaped transparent portion of the ring aperture 64 .
  • the light (ring-shaped luminous flux) that has passed through the transparent portion of the ring diaphragm 64 is reflected by the reflecting surface formed around the hole of the apertured prism 65, passes through the rotary prism 66, and is reflected by the dichroic mirror 67. be.
  • the light reflected by the dichroic mirror 67 is reflected by the dichroic mirror 52, passes through the objective lens 51, and is projected onto the eye E to be examined.
  • the rotary prism 66 is used for averaging the light quantity distribution of the ring-shaped light flux for blood vessels and diseased areas of the fundus oculi Ef and for reducing speckle noise caused by the light source.
  • the return light of the ring-shaped luminous flux projected onto the fundus oculi Ef passes through the objective lens 51 and is reflected by the dichroic mirrors 52 and 67 .
  • the return light reflected by the dichroic mirror 67 passes through the rotary prism 66, passes through the aperture of the perforated prism 65, passes through the relay lens 71, is reflected by the reflecting mirror 72, and passes through the relay lens 73 and the focusing lens.
  • the focusing lens 74 is movable along the optical axis of the ref measurement light receiving system 7 .
  • the processing unit 9 calculates the refractive power value of the subject's eye E by performing a known calculation based on the output from the imaging device 59 .
  • power values include spherical power, cylinder power and cylinder axis angle, or equivalent spherical power.
  • An OCT optical system 8 which will be described later, is provided in an optical path separated by a dichroic mirror 67 from the optical path of the reflective measurement optical system.
  • a fixation projection system 4 is provided on an optical path branched from the optical path of the OCT optical system 8 by a dichroic mirror 83 .
  • the fixation projection system 4 presents the eye E to be examined with a fixation target.
  • a fixation unit 40 is arranged in the optical path of the fixation projection system 4 .
  • the fixation unit 40 can move along the optical path of the fixation projection system 4 under the control of the processing section 9 which will be described later.
  • the fixation unit 40 includes a liquid crystal panel 41 .
  • a relay lens 42 is arranged between the dichroic mirror 83 and the fixation unit 40 .
  • the liquid crystal panel 41 controlled by the processing unit 9 displays a pattern representing the fixation target.
  • the fixation position of the subject's eye E includes a position for acquiring an image centered on the macula of the fundus oculi Ef, a position for acquiring an image centered on the optic papilla, and a position between the macula and the optic papilla. There is a position for acquiring an image centered on the center of the fundus in between. It is possible to arbitrarily change the display position of the pattern representing the fixation target.
  • each of the liquid crystal panel 41 and the relay lens 42 is independently movable in the optical axis direction.
  • the OCT optical system 8 is an optical system for performing OCT measurement.
  • the position of the focusing lens 87 is adjusted so that the end surface of the optical fiber f1 is conjugated to the OCT measurement site and the optical system based on the result of the reflector measurement performed prior to the OCT measurement.
  • the OCT measurement site may be any site of the subject's eye E, such as the fundus oculi Ef or the anterior segment of the eye.
  • the OCT optical system 8 is provided on an optical path separated by a dichroic mirror 67 from the optical path of the ref measurement optical system.
  • the optical path of the fixation projection system 4 is coupled to the optical path of the OCT optical system 8 by a dichroic mirror 83 . Thereby, the respective optical axes of the OCT optical system 8 and the fixation projection system 4 can be coaxially coupled.
  • the OCT optical system 8 includes an OCT unit 100. As shown in FIG. 2, the OCT unit 100 is provided with an optical system for performing OCT measurement (OCT imaging, OCT scanning) on the eye E to be examined.
  • This optical system has a configuration similar to that of a conventional spectral domain type OCT apparatus. That is, this optical system splits the light (low coherence light) from the broadband light source into the reference light and the measurement light, and divides the measurement light through the eye E (OCT measurement site) and the reference light through the reference optical path. to generate interference light and to detect spectral components of the interference light. This detection result (detection signal) is sent to the processing unit 9 .
  • the light source unit 101 outputs broadband low-coherence light L0.
  • the low-coherence light L0 has, for example, a wavelength component in the near-infrared wavelength band (approximately 800 nm to 900 nm), and has a temporal coherence length of approximately several tens of micrometers. Further, near-infrared light having a wavelength band invisible to the human eye, for example, a center wavelength of about 1040 to 1060 nm may be used as the low coherence light L0.
  • the light source unit 101 outputs low coherence light L0 having a wavelength component of 840 nm.
  • the light source unit 101 includes a light output device such as a Super Luminescent Diode (SLD), an LED, or an SOA (Semiconductor Optical Amplifier).
  • a light output device such as a Super Luminescent Diode (SLD), an LED, or an SOA (Semiconductor Optical Amplifier).
  • the low-coherence light L0 output from the light source unit 101 is guided by the optical fiber 102 to the fiber coupler 103 and split into the measurement light LS and the reference light LR.
  • the reference light LR is guided by an optical fiber 104 and reaches an attenuator (optical attenuator) 105 .
  • the attenuator 105 automatically adjusts the light amount of the reference light LR guided by the optical fiber 104 under the control of the processing unit 9 using a known technique.
  • the reference light LR whose light amount has been adjusted by the attenuator 105 is guided by the optical fiber 104 and reaches the polarization controller (polarization adjuster) 106 .
  • the polarization controller 106 is, for example, a device that adjusts the polarization state of the reference light LR guided through the optical fiber 104 by applying external stress to the looped optical fiber 104 . Note that the configuration of the polarization controller 106 is not limited to this, and any known technique can be used.
  • the reference light LR whose polarization state has been adjusted by the polarization controller 106 reaches the fiber coupler 109 .
  • the measurement light LS generated by the fiber coupler 103 is guided to the collimator lens 90 (FIG. 1) by the optical fiber f1, and made into a parallel beam by the collimator lens 90. Furthermore, the measurement light LS reaches the dichroic mirror 83 via the optical path length changing section 89 , the optical scanner 88 , the focusing lens 87 , the relay lens 85 and the reflecting mirror 84 .
  • the focusing lens 87 and the optical scanner 88 are housed in one unit movable in the optical axis direction. This allows the focusing lens 87 and the optical scanner 88 to move in the optical axis direction while maintaining the optical positional relationship. By configuring the focusing lens 87 and the optical scanner 88 to be integrally movable in this manner, it is possible to adjust the optical system while maintaining the conjugate relationship between the optical scanner 88 and the eye E to be examined.
  • the focusing lens 87 and the optical scanner 88 are independently moved along the optical axis within the unit. In some embodiments, the focusing lens 87 and the optical scanner 88 are independently or jointly moved along the optical axis under the control of the processor 9 .
  • the pupil of the subject's eye E is arranged at the focal position of the objective lens 51
  • the deflection surface of the optical scanner 88 is arranged at the focal position of the focusing lens 87
  • the deflection plane of the optical scanner 88 is arranged at the pupil conjugate position.
  • the optical path length changing section 89 changes the optical path length of the measurement light LS.
  • the optical path length changing unit 89 includes a retroreflector movable along the optical path of the measurement light LS and the optical path of the return light of the measurement light LS, and moving the retroreflector changes the optical path length of the measurement light LS. to change
  • the light scanner 88 deflects the measurement light LS one-dimensionally or two-dimensionally.
  • the optical scanner 88 includes a first galvanometer mirror and a second galvanometer mirror.
  • the first galvanomirror deflects the measurement light LS so as to scan the OCT measurement site in the horizontal direction perpendicular to the optical axis of the OCT optical system 8 .
  • the second galvanomirror deflects the measurement light LS deflected by the first galvanomirror so as to scan the imaging region in the vertical direction perpendicular to the optical axis of the OCT optical system 8 .
  • Scanning modes of the measurement light LS by the light scanner 88 include, for example, horizontal scanning, vertical scanning, cross scanning, radial scanning, circular scanning, concentric scanning, and spiral scanning.
  • the light scanner 88 includes a MEMS scanner (MEMS mirror scanner) that two-dimensionally deflects the measurement light LS.
  • the MEMS scanner deflects the measurement light LS so as to scan the OCT measurement site in horizontal and vertical directions orthogonal to the optical axis of the OCT optical system 8 .
  • the optical scanner 88 may include a polygon mirror, a rotating mirror, a dowel prism, a double dowel prism, a rotation prism, etc., in addition to the galvanomirror and the MEMS scanner.
  • the measurement light LS that has reached the dichroic mirror 83 is reflected by the dichroic mirror 83 , passes through the relay lens 82 , and is reflected by the reflecting mirror 81 .
  • the measurement light LS reflected by the reflecting mirror 81 is reflected by the dichroic mirror 52, refracted by the objective lens 51, and irradiated to the OCT measurement site.
  • the measurement light LS is scattered (including reflected) at various depth positions of the OCT measurement site.
  • the backscattered light of the measurement light LS from the OCT measurement site travels in the opposite direction along the same path as the forward path, is guided to the fiber coupler 103 , and reaches the fiber coupler 109 via the optical fiber 108 .
  • the fiber coupler 109 causes interference between the backscattered light of the measurement light LS and the reference light LR that has passed through the attenuator 105 or the like.
  • the interference light LC thus generated is guided by the optical fiber 110 and emitted from the emission end 111 . Further, the interference light LC is converted into a parallel beam by a collimator lens 112, dispersed (spectrally resolved) by a diffraction grating (spectroscope) 113, condensed by a zoom optical system 114, and projected onto a light receiving surface of a CCD image sensor 115.
  • the diffraction grating 113 shown in FIG. 2 is of a transmissive type, it is also possible to use other types of spectral elements such as a reflective diffraction grating.
  • the CCD image sensor 115 is, for example, a line sensor, in which two or more light receiving elements (detection elements) are arranged, detects each spectral component of the dispersed interference light LC, and converts it into an electric charge.
  • the CCD image sensor 115 accumulates this charge to generate a detection signal and sends it to the processing section 9 .
  • CMOS Complementary Metal Oxide Semiconductor
  • the optical path length of the measurement light LS is changed by the optical path length changing section 89, thereby changing the difference between the optical path length of the measurement light LS and the optical path length of the reference light LR.
  • the configuration according to the embodiment is not limited to this.
  • the difference between the optical path length of the measurement light LS and the optical path length of the reference light LR may be changed.
  • the processing unit 9 calculates a refractive power value from the measurement result obtained using the reflector measurement optical system, and based on the calculated refractive power value, the fundus oculi Ef, the reflector measurement light source 61, and the image sensor 59 are conjugated.
  • the ref measurement light source 61 and the focusing lens 74 are moved in the optical axis direction to the respective positions.
  • the processing unit 9 moves the focusing lens 87 and the optical scanner 88 along their optical axes in conjunction with the movement of the focusing lens 74 .
  • the processing section 9 moves the liquid crystal panel 41 (fixation unit 40) along its optical axis in conjunction with the movement of the ref measurement light source 61 and the focusing lens 74.
  • At least one function of the focusing lenses 74, 87 may be realized by liquid crystal lenses or liquid lenses.
  • FIG. 3 shows an example of a functional block diagram of the processing system of the ophthalmologic apparatus 1000.
  • FIG. 4 shows an example of a functional block diagram of the OCT optical system 8 of FIG.
  • FIG. 5 represents an example of a functional block diagram of the data processing unit 250 of FIG.
  • FIG. 6 represents an example of a functional block diagram of the local analysis unit 260 in FIG.
  • the processing unit 9 controls each unit of the ophthalmologic apparatus 1000 .
  • the processing unit 9 can execute various arithmetic processing.
  • the processing unit 9 includes a processor.
  • the processing unit 9 implements the functions according to the embodiment by, for example, reading and executing a program stored in a storage circuit or storage device.
  • the processing unit 9 includes a control unit 210 and an arithmetic processing unit 220.
  • the ophthalmologic apparatus 1000 also includes moving mechanisms 40D, 74D, 87D, and 200, a display section 270, an operation section 280, and a communication section 290.
  • the moving mechanism 200 is a mechanism for moving the head section housing the optical system in the X, Y and Z directions.
  • the moving mechanism 200 is provided with an actuator that generates driving force for moving the head section and a transmission mechanism that transmits this driving force.
  • the actuator is composed of, for example, a pulse motor.
  • the transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like.
  • the control unit 210 main control unit 211) controls the movement mechanism 200 by sending control signals to the actuators.
  • the moving mechanism 40D is a mechanism for moving the fixation unit 40 in the optical axis direction of the fixation projection system 4 (the optical axis direction of the objective lens 51).
  • the movement mechanism 40D is provided with an actuator that generates driving force for moving the fixation unit 40 and a transmission mechanism that transmits this driving force.
  • the actuator is composed of, for example, a pulse motor.
  • the transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like.
  • the control unit 210 main control unit 211) controls the moving mechanism 40D by sending a control signal to the actuator.
  • the moving mechanism 74D is a mechanism for moving the focusing lens 74 in the optical axis direction of the ref measurement light receiving system 7.
  • the moving mechanism 74D is provided with an actuator that generates driving force for moving the focusing lens 74 and a transmission mechanism that transmits this driving force.
  • the actuator is composed of, for example, a pulse motor.
  • the transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like.
  • the controller 210 main controller 211) controls the moving mechanism 74D by sending a control signal to the actuator.
  • the moving mechanism 87D is a mechanism for moving the focusing lens 87 in the optical axis direction of the OCT optical system 8 (the optical axis direction of the objective lens 51).
  • the moving mechanism 87D is provided with an actuator that generates driving force for moving the focusing lens 87 and a transmission mechanism that transmits this driving force.
  • the actuator is composed of, for example, a pulse motor.
  • the transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like.
  • the controller 210 main controller 211) controls the moving mechanism 87D by sending a control signal to the actuator.
  • control of the moving mechanism 87D includes movement control of the focusing lens 87 in the optical axis direction, movement control of the focusing lens 87 to the focus reference position corresponding to the imaging region, There is movement control within the corresponding movement range (focusing range).
  • the main controller 211 controls the moving mechanism 87D by sending a control signal to the actuator to move the focusing lens 87 in the optical axis direction.
  • the control unit 210 includes a processor and controls each unit of the ophthalmologic apparatus.
  • Control unit 210 includes a main control unit 211 and a storage unit 212 .
  • a computer program for controlling the ophthalmologic apparatus 1000 is stored in advance in the storage unit 212 .
  • the computer programs include an alignment system control program, a keratosystem control program, a fixation system control program, an anterior ocular segment observation system control program, a reflex measurement projection system control program, a reflex measurement light receiving system control program, and OCT. It includes an optical system control program, an arithmetic processing program, a user interface program, and the like.
  • the main control unit 211 operates according to such a computer program, so that the control unit 210 executes control processing.
  • the main control unit 211 performs various controls of the ophthalmologic apparatus as a measurement control unit.
  • Control of the alignment system 1 includes control of the anterior eye camera 14 and the like.
  • Control of the anterior eye cameras 14 includes exposure adjustment, gain adjustment, and detection rate adjustment of each anterior eye camera, and synchronous control of photographing of the two anterior eye cameras 14.
  • the two anterior cameras 14 are controlled such that the exposure conditions, gains, and detection rates of the two anterior cameras are substantially identical.
  • Control of the keratometry system 3 includes control of the keratometry light source 32 and the like.
  • the control of the keratling light source 32 includes turning on and off the light source, adjusting the amount of light, and adjusting the aperture. Thereby, lighting and non-lighting of the keratling light source 32 are switched, or the amount of light is changed.
  • the main control unit 211 causes the arithmetic processing unit 220 to perform a known arithmetic operation on the keratling image detected by the imaging device 59 . Thereby, the corneal shape parameter of the eye E to be examined is obtained.
  • Control of the fixation projection system 4 includes control of the liquid crystal panel 41 and movement control of the fixation unit 40 .
  • the control of the liquid crystal panel 41 includes turning on/off the display of the fixation target, switching the fixation target according to the type of inspection or measurement, and switching the display position of the fixation target.
  • the main controller 211 controls the moving mechanism 40D by sending a control signal to the actuator, and moves at least the liquid crystal panel 41 in the optical axis direction. Thereby, the position of the liquid crystal panel 41 is adjusted so that the liquid crystal panel 41 and the fundus oculi Ef are optically conjugated.
  • the control for the anterior segment observation system 5 includes control of the anterior segment illumination light source 50, control of the imaging element 59, and the like.
  • the control of the anterior ocular segment illumination light source 50 includes turning on and off the light source, adjusting the amount of light, and adjusting the aperture. As a result, the lighting and non-lighting of the anterior segment illumination light source 50 is switched, or the amount of light is changed.
  • Control of the imaging element 59 includes exposure adjustment, gain adjustment, detection rate adjustment, and the like of the imaging element 59 .
  • the main control unit 211 captures the signals detected by the imaging device 59 and causes the arithmetic processing unit 220 to execute processing such as formation of an image based on the captured signals.
  • the control of the ref measurement projection system 6 includes control of the ref measurement light source 61, control of the rotary prism 66, and the like.
  • the control of the ref measurement light source 61 includes lighting and extinguishing of the light source, light amount adjustment, aperture adjustment, and the like. Thereby, lighting and non-lighting of the ref measurement light source 61 are switched, or the amount of light is changed.
  • the reflector measurement projection system 6 includes a moving mechanism that moves the reflector measurement light source 61 in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force.
  • the main control unit 211 controls the moving mechanism by sending a control signal to the actuator to move the ref measurement light source 61 in the optical axis direction.
  • Control of the rotary prism 66 includes rotation control of the rotary prism 66 and the like.
  • a rotation mechanism for rotating the rotary prism 66 is provided, and the main controller 211 rotates the rotary prism 66 by controlling this rotation mechanism.
  • the refractometer light source 61 and the focusing lens are adjusted according to the refractive power of the eye E to be examined, for example, so that the refractometer light source 61, the fundus Ef, and the imaging element 59 are optically conjugated.
  • 74 are included in the control to move in the direction of the optical axis.
  • the main control unit 211 controls the movement mechanism 74D and the like according to the refractive power of the eye E to be examined, so that the ref measurement light source 61, the fundus oculi Ef, and the imaging device 59 are arranged at optically substantially conjugate positions.
  • Control of the OCT optical system 8 includes control of the optical scanner 88, control of the optical path length changing section 89, control of the OCT unit 100, and the like.
  • Control of the OCT unit 100 includes control of the light source unit 101, control of the attenuator 105, control of the polarization controller 106, control of the zoom optical system 114, control of the CCD image sensor 115, and the like.
  • the control of the optical scanner 88 includes the setting of the scan mode for scanning the measurement site with a predetermined scan pattern, the control of the scan range, the control of the scan speed, and the like.
  • the scan range scan start position and scan end position
  • the main controller 211 controls at least one of the scan mode, scan range, and scan speed by outputting control signals to the optical scanner 88 .
  • the control of the optical path length changing unit 89 includes control of the optical path length of the measurement light LS.
  • the optical path length of light LS is changed.
  • Control of the light source unit 101 includes turning on and off the light source, adjusting the amount of light, and adjusting the aperture.
  • Control of the attenuator 105 includes adjustment of the light amount of the reference light LR.
  • Control by the polarization controller 106 includes adjustment of the polarization state of the reference light LR.
  • Control of the zoom optical system 114 includes control of optical magnification.
  • Control of the CCD image sensor 115 includes exposure adjustment, gain adjustment, and detection rate adjustment of the CCD image sensor 115 .
  • the main control unit 211 captures the signal detected by the image sensor 115 and causes the arithmetic processing unit 220 to execute processing such as formation of an image based on the captured signal.
  • the main control unit 211 also performs processing for writing data to the storage unit 212 and processing for reading data from the storage unit 212 .
  • the storage unit 212 stores various data.
  • the data stored in the storage unit 212 includes, for example, objective measurement results (OCT measurement results), image data of OCT images, image data of anterior segment images, results of subjective examinations, and eye information to be examined.
  • OCT measurement results objective measurement results
  • image data of OCT images image data of anterior segment images
  • results of subjective examinations results of subjective examinations
  • eye information to be examined includes information about the subject such as patient ID and name, and information about the eye to be examined such as left/right eye identification information.
  • the storage unit 212 also stores various programs and data for operating the ophthalmologic apparatus.
  • the arithmetic processing unit 220 includes a processor and executes various kinds of arithmetic processing.
  • a storage unit (for example, the storage unit 212) (not shown) stores in advance a computer program for executing various kinds of arithmetic processing.
  • the processor realizes the function of each part that executes various arithmetic processes by operating according to this computer program.
  • the arithmetic processing section 220 includes an eye refractive power calculation section 230 , an image forming section 240 and a data processing section 250 .
  • the eye refractive power calculator 230 calculates the eye refractive power of the eye E to be examined.
  • the image forming unit 240 forms an OCT image based on the detection result of the interference light LC obtained using the OCT optical system 8 .
  • the data processing unit 250 performs various data processing (image processing) and analysis processing.
  • the eye refractive power calculator 230 calculates a ring image (pattern image ). For example, the eye refractive power calculation unit 230 obtains the barycentric position of the ring image from the luminance distribution in the obtained image in which the ring image is rendered, and obtains the luminance distribution along a plurality of scanning directions radially extending from this barycentric position. , the ring image is specified from this luminance distribution.
  • the eye refractive power calculation unit 230 obtains an approximate ellipse of the specified ring image, and substitutes the major axis and minor axis of this approximate ellipse into a known formula to obtain the refractive power (spherical power, cylindrical power, and cylindrical axis angle).
  • the eye refractive power calculator 230 can obtain the eye refractive power parameter (refractive power) based on the deformation and displacement of the ring image with respect to the reference pattern.
  • the eye refractive power calculator 230 calculates the corneal refractive power, the corneal astigmatism degree, and the corneal astigmatism axis angle based on the keratling image acquired by the anterior eye observation system 5 .
  • the eye refractive power calculator 230 calculates the corneal curvature radii of the strong and weak principal meridians of the corneal front surface by analyzing the keratling image, and calculates the above parameters based on the corneal curvature radii.
  • the image forming unit 240 forms image data of an OCT image of the subject's eye E based on the detection signal of the interference light LC obtained by the CCD image sensor 115 . That is, the image forming unit 240 forms image data of the subject's eye E based on the detection result of the interference light LC by the interference optical system.
  • This processing includes processing such as filter processing and FFT (Fast Fourier Transform), as in conventional spectral domain type OCT.
  • the image data acquired in this manner is a data set containing a group of image data formed by imaging reflection intensity profiles in a plurality of A-lines (paths of each measuring light LS in the eye E to be examined). be.
  • the data processing unit 250 performs various data processing (image processing) and analysis processing on the OCT image formed by the image forming unit 240 or the detection signal of the interference light LC obtained by the CCD image sensor 115 .
  • the data processing unit 250 executes correction processing such as luminance correction and dispersion correction of an image.
  • the data processing unit 250 performs various image processing and analysis processing on images (anterior segment images, etc.) obtained using the anterior segment observation system 5 .
  • the data processing unit 250 executes known image processing such as interpolation processing for interpolating pixels between the OCT images (tomographic images) formed by the image forming unit 240 to obtain a three-dimensional image of the fundus oculi Ef or the anterior segment.
  • image data can be formed.
  • image data of a three-dimensional image means image data in which pixel positions are defined by a three-dimensional coordinate system.
  • Image data of a three-dimensional image includes image data composed of voxels arranged three-dimensionally. This image data is called volume data or voxel data.
  • the data processing unit 250 When displaying an image based on volume data, the data processing unit 250 performs rendering processing (volume rendering, MIP (Maximum Intensity Projection: maximum intensity projection), etc.) on this volume data so that it can be viewed from a specific line-of-sight direction.
  • rendering processing volume rendering, MIP (Maximum Intensity Projection: maximum intensity projection), etc.
  • Image data of a pseudo three-dimensional image is formed. This pseudo three-dimensional image is displayed on a display device such as the display unit 270 .
  • stack data of a plurality of tomographic images is image data of a three-dimensional image.
  • Stacked data is image data obtained by three-dimensionally arranging a plurality of tomographic images obtained along a plurality of scan lines based on the positional relationship of the scan lines. That is, stack data is image data obtained by expressing a plurality of tomographic images, which were originally defined by individual two-dimensional coordinate systems, by one three-dimensional coordinate system (that is, embedding them in one three-dimensional space).
  • the data processing unit 250 performs various renderings on the acquired three-dimensional data set (volume data, stack data, etc.) to obtain a B-mode image (longitudinal cross-sectional image, axial cross-sectional image) at an arbitrary cross section, C-mode images (cross-sectional images, horizontal cross-sectional images), projection images, shadowgrams, etc. can be formed.
  • An arbitrary cross-sectional image such as a B-mode image or a C-mode image, is formed by selecting pixels (pixels, voxels) on a specified cross-section from a three-dimensional data set.
  • a projection image is formed by projecting a three-dimensional data set in a predetermined direction (Z direction, depth direction, axial direction).
  • a shadowgram is formed by projecting a portion of the three-dimensional data set (for example, partial data corresponding to a specific layer) in a predetermined direction.
  • An image such as a C-mode image, a projection image, or a shadowgram whose viewpoint is the front side of the subject's eye is called an en-face image.
  • the data processing unit 250 generates a B-mode image or a front image (vessel-enhanced image, angiogram) in which retinal vessels and choroidal vessels are emphasized based on data (for example, B-scan image data) collected in time series by OCT scanning. ) can be constructed.
  • data for example, B-scan image data
  • time-series OCT data can be collected by repeatedly scanning substantially the same portion of the eye E to be examined.
  • the data processing unit 250 compares time-series B-scan images obtained by B-scans of substantially the same site, and converts the pixel values of the portions where the signal intensity changes to the pixel values corresponding to the changes.
  • An enhanced image in which the changed portion is emphasized is constructed by the conversion.
  • the data processing unit 250 extracts information of a predetermined thickness in a desired region from the constructed enhanced images and constructs an en-face image to form an OCTA image.
  • Images generated by the data processing unit 250 are also included in OCT images.
  • the data processing unit 250 identifies the characteristic position corresponding to the characteristic region of the anterior segment by analyzing each of the two captured images obtained substantially simultaneously by the two anterior segment cameras 14 .
  • the characteristic site of the anterior segment is, for example, the center of the pupil (the center of gravity of the pupil).
  • the data processing unit 250 applies a known trigonometric method to the positions of the two anterior eye cameras 14 and the feature positions corresponding to the feature sites in the two specified photographed images, thereby obtaining the three positions of the feature sites.
  • a dimensional position that is, a three-dimensional position of the subject's eye E
  • the calculated three-dimensional position can be used for alignment of the optical system with respect to the eye E to be examined.
  • the data processing unit 250 can perform predetermined analysis processing on OCT data, OCT images, or fundus images.
  • Predetermined analysis processing includes identification of a predetermined site (tissue, lesion) in the eye E to be examined, calculation of the distance between the designated sites (interlayer distance), area, angle, ratio, and density; specification of the shape of a predetermined site; calculation of these statistical values; calculation of the distribution of the measured values and statistical values; and image processing based on these analysis processing results.
  • Predetermined parts include blood vessels and lesions.
  • lesions include abrasions, edema, hemorrhages, tumors, drusen, and the like.
  • the data processing unit 250 identifies a predetermined portion or a predetermined layer region in the three-dimensional OCT data, identifies a cross-sectional position based on the identified predetermined portion or layer region, and obtains a desired cross-sectional position at the identified cross-sectional position. It is possible to generate a tomogram at a desired cross-sectional position by selecting or interpolating pixels in the cross-sectional direction. Note that in this tomographic image generation processing, a tomographic image in a desired cross-sectional direction at a cross-sectional position specified by the user using the operation unit 280, which will be described later, may be generated.
  • the data processing unit 250 uses shape data representing the shape of the fundus oculi Ef, or It is possible to calculate the intraocular distance at the fundus oculi Ef. Further, the data processing unit 250 can normalize the calculated shape data or intraocular distance by the ocular axial length of the eye to be examined E as physical data to calculate the normalized shape data or intraocular distance. be. Axial length can be calculated from one-dimensional, two-dimensional, or three-dimensional OCT data. In some embodiments, the data processing unit 250 scales (normalizes) the OCT data by the axial length of the eye, and calculates the shape data representing the shape of the fundus oculi Ef or the intraocular distance from the scaled OCT data. to calculate the normalized shape data or the intraocular distance.
  • Such a data processing unit 250 includes a segmentation processing unit 251, an intraocular distance calculation unit 252, a fundus shape calculation unit 253, a first normalization unit 254, and a local analysis unit 260, as shown in FIG. , a determination unit 255 , a classification unit 256 , and a report generation unit 257 .
  • the local analysis unit 260 includes a local shape calculation unit 261 and a second normalization unit 262, as shown in FIG.
  • the segmentation processing unit 251 identifies a predetermined layer region in the anterior segment or the fundus oculi Ef based on the OCT data.
  • the predetermined layer region include the inner limiting membrane, the nerve fiber layer, the ganglion cell layer, the inner reticular layer, the inner nuclear layer, the outer reticular layer, the outer nuclear layer, the outer limiting membrane, the photoreceptor layer, the RPE layer, and the Bruch's membrane. , choroid, sclera, and vitreous.
  • the segmentation processing unit 251 identifies multiple layer regions in the A-scan direction by analyzing one-dimensional, two-dimensional, or three-dimensional OCT data. For example, the segmentation processing unit 251 obtains gradients of pixel values (brightness values) in each A-scan image included in OCT data, and identifies positions with large gradients as tissue boundaries. The segmentation processing unit 251 identifies, for example, a layer structure of a predetermined number of pixels on the scleral side of the identified RPE layer as Bruch's membrane.
  • the A-scan image is one-dimensional image data extending in the depth direction of the fundus.
  • the depth direction of the fundus is defined as, for example, the Z direction, the incident direction of the OCT measurement light, the axial direction, the optical axis direction of the interference optical system, and the like.
  • the intraocular distance calculator 252 calculates the intraocular distance of the subject's eye E by analyzing one-dimensional, two-dimensional, or three-dimensional OCT data.
  • the intraocular distance includes an intraocular distance in the Z direction, an intraocular distance in the XY directions, and the like.
  • the intraocular distance in the Z direction includes the axial length of the eye, the distance (thickness) between predetermined layer regions in the cornea or the fundus Ef, and the like.
  • the distance between predetermined parts in the anterior segment for example, the distance from the corneal vertex to a predetermined position on the front surface of the cornea
  • the distance between predetermined parts in the fundus oculi Ef for example, the macula and the optic papilla. distance between
  • the intraocular distance calculation unit 252 calculates the distance between two desired regions specified by the data processing unit 250 based on the OCT data, OCT image, anterior segment image, or fundus image. Calculate the distance of When calculating the intraocular distance in the Z direction, the intraocular distance calculation unit 252 calculates the distance between two desired layer regions (sites) specified by the segmentation processing unit 251 based on OCT data or OCT images. .
  • the fundus shape calculator 253 calculates shape data representing the shape of the fundus oculi Ef by analyzing two-dimensional or three-dimensional OCT data. For example, the fundus shape calculation unit 253 identifies from the OCT data a shape profile (depth profile) representing changes in the depth position (Z position) of the fundus oculi Ef in a predetermined range in a direction perpendicular to (intersecting) the Z direction, Based on the specified shape profile, the radius of curvature (or curvature) of the fundus oculi Ef is calculated as the shape data of the fundus oculi Ef.
  • a shape profile depth profile representing changes in the depth position (Z position) of the fundus oculi Ef in a predetermined range in a direction perpendicular to (intersecting) the Z direction
  • the fundus shape calculator 253 obtains a circle (ellipse) passing through a plurality of points on the specified shape profile by a known method, and calculates the fundus Ef based on the obtained circle (ellipse). Calculate the radius of curvature (or curvature) of In some embodiments, the fundus shape calculator 253 performs circle fitting (ellipse fitting) on the identified shape profile, and calculates the radius of curvature (or curvature). In some embodiments, the fundus shape calculator 253 performs polynomial fitting on the specified shape profile, and calculates the curvature radius (or curvature) of the fundus oculi Ef based on the obtained approximate polynomial.
  • the fundus shape calculator 253 calculates shape data representing the shape of the RPE layer. That is, the fundus shape calculator 253 identifies the shape profile of the RPE layer from the OCT data, and calculates the radius of curvature (or curvature) of the RPE layer as the shape data of the fundus oculi Ef based on the identified shape profile.
  • the first normalization unit 254 calculates the shape data representing the shape of the fundus oculi Ef calculated by the fundus shape calculation unit 253 based on the physical data of the subject or the refractive power of the eye to be examined E, or the intraocular distance calculation unit 252 The calculated intraocular distance in the XY directions is normalized.
  • the refractive power of the subject's eye E may be the refractive power calculated by the eye refractive power calculator 230 or the refractive power measured by an external ophthalmologic apparatus.
  • the first normalization unit 254 normalizes the radius of curvature r (or curvature) as shape data of the fundus oculi Ef according to Equation (1) based on the axial length AL as physical data of the subject, and normalizes calculated radius of curvature r' (normalized shape data).
  • the first normalization unit 254 converts the radius of curvature r (or curvature) as the shape data of the fundus oculi Ef to Equation (2) based on the eye axial length AL as physical data of the subject. is normalized to calculate the normalized radius of curvature r' (normalized shape data).
  • the first normalization unit 254 can normalize the shape data of the fundus oculi Ef based on the physical data other than the axial length of the eye or the refractive power of the eye to be examined E, as in formula (1) or (2). It is possible.
  • the multiplier of the curvature radius r may be other than "2".
  • the local analysis unit 260 locally analyzes the shape of the fundus oculi Ef. Specifically, the local analysis unit 260 obtains shape data representing the local shape of the fundus oculi Ef (or the intraocular distance of the eye to be examined E) based on the physical data of the subject or the refractive power of the eye to be examined E. Normalize to obtain normalized local shape data. For example, when it is determined that it is necessary to analyze the shape of the fundus oculi Ef in detail based on the normalized shape data or the intraocular distance obtained by the first normalization unit 254, the local analysis unit 260 Detailed analysis can be performed using the normalized local shape data obtained by
  • the fundus shape calculator 253 described above can calculate the radius of curvature (or curvature) of the fundus oculi Ef from one shape profile in a predetermined range in the direction perpendicular to the Z direction.
  • the local shape calculation unit 261 calculates a plurality of curvatures of the fundus oculi Ef for each range from each of a plurality of shape profiles in a plurality of ranges obtained by dividing a predetermined range in a direction orthogonal to the Z direction. It is possible to calculate the radius (or curvature).
  • the local curvature (or radius of curvature) in each range can be calculated in the same manner as the fundus shape calculator 253 .
  • the local shape calculator 261 identifies the local shape profile of the RPE layer from the OCT data, and calculates the local curvature radius (or curvature) of the RPE layer based on the identified local shape profile. Calculate Thereby, the local shape calculation unit 261 calculates a plurality of local curvature radii (or curvatures) of the RPE layer in a predetermined range by calculating the local curvature radii (or curvatures) of the RPE layer for each range. can do.
  • the second normalization unit 262 calculates the shape data representing the local shape of the fundus oculi Ef calculated by the local shape calculation unit 261 based on the physical data of the subject or the refractive power of the eye E to be examined, or calculates the intraocular distance.
  • the local intraocular distance in the XY directions calculated by the unit 252 is normalized.
  • the second normalization unit 262 based on the eye axial length AL as physical data of the subject, local curvature radius r (or curvature radius r) as shape data of the fundus oculi Ef. ) is normalized according to formula (1) or formula (2) to calculate the normalized radius of curvature r′ (normalized shape data).
  • the determination unit 255 determines the eyeball shape of the subject eye E based on the shape data of the fundus oculi Ef normalized by the first normalization unit 254 (or the shape data of the fundus oculi Ef calculated from the normalized measurement data). is abnormal (normal). For example, the determining unit 255 compares the normalized shape data of the fundus oculi Ef with standard data (Normative Data) indicating the relationship between the shape data of the fundus oculi and an abnormality in the eyeball shape to determine the shape of the eye E to be examined. It is determined whether or not the eyeball shape is abnormal. Note that the standard data is generated by investigating the relationship between the shape data of the fundus and the abnormality of the eyeball shape for a plurality of eyes to be examined in advance.
  • the determination unit 255 determines whether the eyeball shape of the subject's eye E is abnormal based on time-series data of the normalized shape data of the fundus oculi Ef. For example, the determining unit 255 determines whether or not the eyeball shape of the subject eye E is abnormal by comparing the time-series data of the fundus shape data with standard data indicating the relationship between the eyeball shape abnormality and the eyeball shape abnormality. do.
  • the control unit 210 can notify the determination result obtained by the determination unit 255 as a notification unit. For example, when the determination unit 255 determines that the eyeball shape of the eye to be examined E is abnormal based on the normalized shape data of the fundus oculi Ef, the control unit 210 determines that the eyeball shape of the eye to be examined E is abnormal. Information indicating that the determination has been made is notified. For example, when the determination unit 255 determines that the eyeball shape of the subject eye E is abnormal or is approaching an abnormality based on the time-series data of the normalized shape data of the fundus oculi Ef, the control unit 210 Information indicating that the eyeball shape of eye examination E is determined to be abnormal is notified. The notification includes image display on the display unit 270, sound output, light output, and the like.
  • classification unit 256 Based on the shape data (or intraocular distance) normalized by the first normalization unit 254 or the second normalization unit 262, the classification unit 256 determines in advance the eyeball shape (or its change) of the eye E to be examined. classified into one of several eyeball shape types.
  • the classification unit 256 can perform the above classification using the shape data or the like normalized by the first normalization unit 254 as a single index.
  • the classification unit 256 can perform the above classification using the statistical values of the plurality of shape data normalized by the second normalization unit 262 as a single index.
  • Statistics include mean, minimum, maximum, median, mode, standard deviation, variance, and average.
  • FIG. 7 shows an explanatory diagram of the eyeball shape type according to the embodiment.
  • FIG. 7 schematically shows four eyeball shape types of the eyeball shape (see Non-Patent Document 1).
  • Eyeball shape type 1 is a uniform expansion type (global expansion) in which the shape of the eyeball changes so as to expand uniformly over a wide range including the equatorial part and the posterior part of the eyeball.
  • Eyeball shape type 2 is a parallel expansion type (Equatorial expansion) in which the shape of the eyeball changes so that the equator of the eyeball expands parallel to the direction of the eye axis.
  • Eyeball shape type 3 is a posterior polar expansion type in which the vicinity of the posterior pole of the fundus of the eye expands in the direction of the eye axis.
  • Eyeball shape type 4 is an axial expansion type in which the fundus of the eyeball extends in the direction of the eye axis. It is possible to define eyeball shape type 3 and eyeball shape type 4 as the same eyeball shape type.
  • the classification unit 256 classifies the eyeball shape of the subject eye E based on the shape data (or intraocular distance) normalized by the first normalization unit 254 or the second normalization unit 262 into eyeball shape type 1 to eyeball shape type It is classified into one of four types of 4. In some embodiments, the classification unit 256 classifies the eyeball shape of the subject eye E into eyeball shape type 1, eyeball shape type 2, and eyeball shape type 3 (or eyeball shape type 3) based on normalized shape data and the like. It is classified into one of three types of shape type 4).
  • FIG. 8 schematically shows the relationship between the shape data normalized by the axial length of the eye by the first normalization unit 254 and the axial length of the eye.
  • the horizontal axis represents the axial length [mm]
  • the classification unit 256 can classify the eyeball shape of the subject's eye E into eyeball shape type 1 when the normalized shape data is included in the characteristic line C1 or the range P1 including the characteristic line C1.
  • the range P1 is a range that includes the characteristic line C1 and is enclosed by a dashed line, and can be arbitrarily changed.
  • the classification unit 256 can classify the eyeball shape of the subject's eye E into eyeball shape type 2 when the normalized shape data is included in the characteristic line C2 or the range P2 including the characteristic line C2.
  • the range P2 is a range that includes the characteristic line C2 and is surrounded by a dashed line, and can be arbitrarily changed.
  • eyeball shape type 3 tends to have larger normalized shape data than eyeball shape type 4. Therefore, for example, when the characteristic line C3 for classifying the eyeball shape type 3 and the eyeball shape type 4 is determined based on the standard data, the classification unit 256 determines that the normalized shape data is in the range above the characteristic line C3.
  • the eyeball shape of the subject's eye E can be classified into either eyeball shape type 3 or eyeball shape type 4 by determining whether it is included in the lower range.
  • the classification unit 256 classifies the eyeball shape of the subject eye E into eyeball shape type 3, and the normalized shape
  • the eyeball shape of the eye to be examined E is classified into the eyeball shape type 4.
  • FIGS. 9 and 10 show explanatory diagrams of the local analysis unit 260.
  • FIG. FIG. 9 schematically represents an example of an actual eyeball shape.
  • FIG. 10 shows an example of normalized local shape data obtained by the local analysis unit 260.
  • the upper graph represents the shape profile of the RPE layer, in which the horizontal axis represents the lateral (horizontal) position [mm] and the vertical axis represents the depth position [mm].
  • the profile of the local shape data normalized by the eye axial length by the second normalization unit 262 is schematically shown.
  • the horizontal axis represents the horizontal position [mm]
  • the shape of the eyeball may have an asymmetrical shape with respect to the visual axis (or measurement axis).
  • a shape profile similar to that of an eyeball having a shape symmetrical with respect to the visual axis may be obtained.
  • the second normalization unit 262 by normalizing the local shape data by the second normalization unit 262, at the position x1 shifted with respect to the visual axis, there is no change in shape caused by factors other than the growth factor. You can see what you should pay attention to.
  • the classification unit 256 can determine whether the shape of the fundus oculi Ef is eyeball shape type 3 based on the maximum value of the local shape data normalized by the second normalization unit 262. can. For example, the classification unit 256 classifies the shape of the fundus oculi Ef into eyeball shape type 3 when the maximum value of the local shape data normalized by the second normalization unit 262 is “1.5” or more.
  • the classification unit 256 classifies the shape of the eyeball of the subject eye E into four types of eyeball shape types 1 to 4. It can be classified into any of the eyeball shape types.
  • FIG. 11A to 11C schematically show the relationship between the shape profiles of eyeball shape type 1, eyeball shape type 2, and eyeball shape type 4 in FIG. 7 and the local shape data normalized by the second normalization unit 262.
  • FIG. 11A shows the relationship between the shape profile in eyeball shape type 1 and the local shape data normalized by the second normalization unit 262.
  • FIG. 11B shows the relationship between the shape profile in eyeball shape type 2 and the local shape data normalized by the second normalization unit 262 .
  • FIG. 11C shows the relationship between the shape profile in eyeball shape type 4 and the local shape data normalized by the second normalization unit 262 .
  • the horizontal axis represents the lateral (horizontal) position [mm] and the vertical axis represents the shape profile of the RPE layer representing the depth position [mm].
  • the normalized shape data shown in FIGS. 11A to 11C are reciprocals of the normalized shape data shown in FIG. 8 or FIG.
  • the normalized shape data is a predetermined value shifted from "1" for a plurality of shape profiles with different axial lengths.
  • the normalized shape data for a plurality of shape profiles with different axial lengths greatly differ depending on the position in the lateral direction.
  • the classification unit 256 classifies the eyeball shape as eyeball type 1 or eyeball shape when the curvature radius distribution normalized with respect to lateral position change is uniform (distinguishable based on standard deviation and variance). Classified as type 2. Furthermore, the classification unit 256 classifies the eyeball shape into eyeball shape type 1 when the average value of the curvature radius distribution normalized with respect to the lateral position change is within a predetermined range, and the average value is When the predetermined range is exceeded, the eyeball shape is classified into eyeball shape type 2. On the other hand, the classification unit 256 classifies the eyeball shape into eyeball shape type 4 when the curvature radius distribution normalized with respect to the lateral position change is not uniform.
  • the report generator 257 generates a report representing the data processing result by the data processor 250 .
  • the report generated by the report generating unit 257 includes an image that enables identification of the predetermined layer region specified by the segmentation processing unit 251 in the tomographic image formed by the image forming unit 240, intraocular distance, shape data normalized by the first normalization unit 254, local shape data obtained by the local analysis unit 260, local shape data normalized by the second normalization unit 262, The determination result by the determination unit 255, the classification result by the classification unit 256, and the like are included.
  • the report generator 257 generates a report including time series data of normalized shape data or time series data of normalized local shape data.
  • control unit 210 causes the display unit 270 to display the report generated by the report generation unit 257 as a display control unit. That is, the control unit 210 generates time-series data of normalized shape data (or intraocular distance) whose measurement timings are different from each other, or time-series data of normalized local shape data (or intraocular distance). Displayed on the display unit 270 .
  • the functions of the data processing unit 250 are realized by one or more processors.
  • the data processing unit 250 includes two or more processors corresponding to the respective units described above, and each processor is configured to realize the function of each unit of the data processing unit 250 .
  • Display unit 270 displays information as a user interface unit under the control of control unit 210 .
  • Display unit 270 includes display unit 10 shown in FIG. 1 and the like.
  • the operation unit 280 is used as a user interface unit to operate the ophthalmologic apparatus.
  • the operation unit 280 includes various hardware keys (joystick, button, switch, etc.) provided in the ophthalmologic apparatus.
  • the operation unit 280 may also include various software keys (buttons, icons, menus, etc.) displayed on the touch panel display screen 10a.
  • At least part of the display unit 270 and the operation unit 280 may be configured integrally.
  • a typical example is a touch panel display screen 10a.
  • the communication unit 290 has a function for communicating with an external device (not shown).
  • the communication unit 290 has a communication interface according to a connection form with an external device.
  • An example of an external device is a spectacle lens measuring device for measuring the optical properties of lenses.
  • the spectacle lens measuring device measures the dioptric power of the spectacle lens worn by the subject, and inputs this measurement data to the ophthalmologic device 1000 .
  • the external device may be any ophthalmologic device, a device (reader) that reads information from a recording medium, or a device (writer) that writes information to a recording medium.
  • the external device may be a hospital information system (HIS) server, a DICOM (Digital Imaging and Communication in Medicine) server, a doctor terminal, a mobile terminal, a personal terminal, a cloud server, or the like.
  • the communication unit 290 may be provided in the processing unit 9, for example.
  • the ophthalmologic apparatus 1000 or the data processing unit 250 and communication unit 290 are examples of the "ophthalmologic information processing apparatus" according to the embodiment.
  • the optical system (in particular, the OCT optical system 8) or the communication section 290 shown in FIGS. 1 and 2 is an example of the "acquisition section” according to the embodiment.
  • the first normalization section 254 or the second normalization section 262 is an example of a "normalization section” according to the embodiment.
  • the fundus shape calculator 253 or the local shape calculator 261 is an example of a “calculator” according to the embodiment.
  • the control unit 210 (main control unit 211) is an example of a "display control unit” according to the embodiment.
  • the control unit 210 (main control unit 211) is an example of the "notification unit” according to the embodiment.
  • the optical system (in particular, the OCT optical system 8) shown in FIGS. 1 and 2 is an example of the "measurement system” according to the embodiment.
  • the first operation example is an operation example of classifying the eyeball shape type of the subject's eye E using the normalized shape data (specifically, the fundus curvature) of the fundus oculi Ef as a single index.
  • FIG. 12 shows a first operation example of the ophthalmologic apparatus 1000.
  • FIG. FIG. 12 represents a flow diagram of a first operation example of the ophthalmologic apparatus 1000 .
  • a computer program for realizing the processing shown in FIG. 12 is stored in the storage unit 212 .
  • the main control unit 211 executes the processing shown in FIG. 12 by operating according to this computer program. In the following, it is assumed that alignment of the optical system with respect to the eye E to be examined has already been completed.
  • the storage unit 212 also stores standard data indicating the relationship between the fundus curvature normalized by the axial length and the abnormal range (normal range) of the eyeball shape.
  • the main controller 211 controls the OCT optical system 8 to perform OCT scanning on the scanning range set on the fundus Ef of the eye E to be examined.
  • the detection result of the interference light LC obtained by the OCT scanning is imaged by the image forming unit 240, and the data processing unit 250 generates two-dimensional or three-dimensional OCT data as measurement data.
  • the main control unit 211 controls the segmentation processing unit 251 to perform segmentation processing on the measurement data acquired in step S1.
  • the segmentation processing unit 251 identifies the RPE layer.
  • the main control unit 211 controls the fundus shape calculation unit 253 to calculate the curvature of the RPE layer as the fundus curvature from the shape profile of the RPE layer obtained in step S2.
  • the fundus shape calculator 253 may calculate the radius of curvature of the RPE layer from the shape profile of the RPE layer.
  • the main control unit 211 controls the first normalization unit 254 to normalize the fundus curvature calculated in step S3 with the axial length of the eye E to be examined.
  • the first normalization unit 254 normalizes the fundus curvature as shown in Equation (1) or Equation (2).
  • the axial length of the subject's eye E may be calculated by the intraocular distance calculator 252 from the measurement data acquired in step S1.
  • the axial length of the subject's eye E is acquired by the communication unit 290 from an external ophthalmologic device or an external server.
  • the main control unit 211 controls the classification unit 256 to classify the eyeball shape of the eye E to be examined into one of the eyeball shape types 1 to 4 shown in FIG.
  • the classification unit 256 determines in which of the ranges P1 to P4 shown in FIG. identify the type.
  • the main control section 211 controls the determination section 255 to refer to the standard data stored in the storage section 212 .
  • the standard data stores the fundus curvature normalized by the axial length of the range in which the eyeball shape is normal (or abnormal).
  • the main control unit 211 controls the determination unit 255 to compare the standard data referred to in step S6 and the normalized fundus curvature obtained in step S4 to determine the eyeball shape of the eye E to be examined. is within the normal range.
  • step S7 When it is determined in step S7 that the eyeball shape of the subject's eye E is within the normal range (S7: Y), the operation of the ophthalmologic apparatus 1000 ends (end). When it is determined in step S7 that the eyeball shape of the subject's eye E is not within the normal range (S7: N), the operation of the ophthalmologic apparatus 1000 proceeds to step S8.
  • step S8 When it is determined in step S7 that the eyeball shape of the eye to be examined E is not within the normal range (S7: N), the main control unit 211 outputs information indicating that the eyeball shape of the eye to be examined E is determined to be abnormal. inform.
  • the notification includes image display on the display unit 270, sound output, light output, report output, and the like. This completes the first operation example of the ophthalmologic apparatus 1000 (end).
  • the second operation example is an operation example in which the shape of the eyeball of the subject's eye E is analyzed in detail using the normalized shape data of the fundus oculi Ef as a single index.
  • FIG. 13 shows a second operation example of the ophthalmologic apparatus 1000.
  • FIG. FIG. 13 represents a flow diagram of a second operation example of the ophthalmologic apparatus 1000 .
  • a computer program for realizing the processing shown in FIG. 13 is stored in the storage unit 212 .
  • the main control unit 211 executes the processing shown in FIG. 13 by operating according to this computer program. In the following, it is assumed that alignment of the optical system with respect to the eye E to be examined has already been completed.
  • the storage unit 212 also stores standard data indicating the relationship between the fundus curvature normalized by the axial length and the abnormal range (normal range) of the eyeball shape.
  • the main controller 211 controls the OCT optical system 8 to perform OCT scanning on the scanning range set on the fundus oculi Ef of the eye E to be examined, as in step S1. Thereby, two-dimensional or three-dimensional OCT data is obtained as measurement data.
  • the main control unit 211 controls the segmentation processing unit 251 to perform segmentation processing on the measurement data acquired in step S11, as in step S2.
  • the main control unit 211 controls the fundus shape calculation unit 253 to calculate the curvature of the RPE layer as the fundus curvature from the shape profile of the RPE layer obtained in step S12, as in step S3.
  • step S14 normalization by axial length
  • the main control unit 211 controls the first normalization unit 254 to normalize the fundus curvature calculated in step S3 with the axial length of the eye E to be examined, as in step S4.
  • the main control unit 211 controls the classification unit 256 to classify the eyeball shape of the eye E to be examined into one of the eyeball shape types 1 to 4 shown in FIG.
  • the classification unit 256 determines in which of the ranges P1 to P4 shown in FIG. identify the type.
  • the main control section 211 controls the determination section 255 to refer to the standard data stored in the storage section 212, as in step S6.
  • the main control unit 211 controls the determination unit 255 in the same manner as in step S7 to compare the standard data referred to in step S16 and the normalized fundus curvature obtained in step S14, It is determined whether or not the eyeball shape of the subject's eye E is within the normal range.
  • step S17 When it is determined in step S17 that the eyeball shape of the subject's eye E is within the normal range (S17: Y), the operation of the ophthalmologic apparatus 1000 ends (end). When it is determined in step S17 that the eyeball shape of the subject's eye E is not within the normal range (S17: N), the operation of the ophthalmologic apparatus 1000 proceeds to step S18.
  • step S17 When it is determined in step S17 that the eyeball shape of the subject eye E is not within the normal range (S17: N), the main control unit 211 controls the local shape calculation unit 261 to determine the RPE layer obtained in step S12. A plurality of local curvatures of the RPE layer are calculated from the shape profile.
  • the main control unit 211 controls the second normalization unit 262 to normalize each of the plurality of local curvatures calculated in step S18 with the axial length of the eye E to be examined.
  • the second normalization unit 262 normalizes the local curvature as shown in Equation (1) or Equation (2).
  • the main control unit 211 causes the display unit 270 to display the local curvature profile normalized by the axial length in step S19.
  • an examiner, a doctor, or the like can determine whether the subject's eye E is severe myopia or pathological myopia from the shape of the abnormal portion of the eyeball shape.
  • the examiner or doctor identifies the position of the abnormal part of the eyeball shape, and if it is judged that the part is changing slowly, it is judged that it is not serious, and the subject is informed It can be treated with a prescription for glasses or contact lenses.
  • the examiner or doctor may judge that there is a possibility of posterior staphylaxis, etc. It can encourage the implementation of tests.
  • the third operation example is an operation example in which the eyeball shape of the eye to be examined E is analyzed in detail using the normalized shape data of the fundus oculi Ef as a single index, and the eyeball shape type of the eye to be examined E is specified. is.
  • FIG. 14 and 15 show a third operation example of the ophthalmologic apparatus 1000.
  • FIG. FIG. 14 represents a flow diagram of a third operation example of the ophthalmologic apparatus 1000 .
  • FIG. 15 is a flowchart of an operation example of step S29 in FIG.
  • the storage unit 212 stores computer programs for realizing the processes shown in FIGS. 14 and 15 .
  • the main control unit 211 executes the processes shown in FIGS. 14 and 15 by operating according to this computer program. In the following, it is assumed that alignment of the optical system with respect to the eye E to be examined has already been completed.
  • the storage unit 212 also stores standard data indicating the relationship between the fundus curvature normalized by the axial length and the abnormal range (normal range) of the eyeball shape.
  • the main controller 211 controls the OCT optical system 8 to perform OCT scanning on the scanning range set on the fundus oculi Ef of the eye E to be examined, as in step S1. Thereby, two-dimensional or three-dimensional OCT data is obtained as measurement data.
  • the main control unit 211 controls the segmentation processing unit 251 to perform segmentation processing on the measurement data acquired in step S21, as in step S2.
  • the main control unit 211 controls the fundus shape calculation unit 253 to calculate the curvature of the RPE layer as the fundus curvature from the shape profile of the RPE layer obtained in step S22, as in step S3.
  • the main control unit 211 controls the first normalization unit 254 to normalize the fundus curvature calculated in step S23 with the axial length of the eye E to be examined, as in step S4.
  • the main control unit 211 controls the classification unit 256 to classify the eyeball shape of the eye E to be examined into one of the eyeball shape types 1 to 4 shown in FIG.
  • the classification unit 256 determines in which of the ranges P1 to P4 shown in FIG. identify the type.
  • the main control section 211 controls the determination section 255 to refer to the standard data stored in the storage section 212, as in step S6.
  • step S27 normal range
  • the main control unit 211 controls the determination unit 255 in the same manner as in step S7 to compare the standard data referred to in step S26 and the normalized fundus curvature obtained in step S24, It is determined whether or not the eyeball shape of the subject's eye E is within the normal range.
  • step S27 When it is determined in step S27 that the eyeball shape of the subject's eye E is within the normal range (S27: Y), the operation of the ophthalmologic apparatus 1000 ends (end). When it is determined in step S27 that the eyeball shape of the subject's eye E is not within the normal range (S27: N), the operation of the ophthalmologic apparatus 1000 proceeds to step S28.
  • step S28 Calculate the local curvature of the fundus
  • the main control unit 211 controls the local shape calculation unit 261 in the same manner as in step S18, and in step S22 A plurality of local curvatures of the RPE layer are calculated from the obtained shape profile of the RPE layer.
  • step S30 classification
  • the main control unit 211 controls the classification unit 256 to obtain the eyeball shape shown in FIG. 7 based on the plurality of normalized local curvatures obtained in step S29.
  • step S30 of FIG. 14 the classification unit 256 determines whether or not the normalized local curvature distribution obtained in step S29 is uniform. For example, the classification unit 256 obtains a plurality of standard deviations or variances of the normalized local curvatures obtained in step S29, and the local curvature distribution is uniform based on the obtained standard deviations or variances. Determine whether or not there is
  • step S31 When it is determined in step S31 that the curvature distribution is uniform (S31: Y), the operation in step S30 proceeds to step S32. When it is determined in step S31 that the curvature distribution is not uniform (S31:N), the operation of step S30 proceeds to step S35.
  • step S32 Is the average value within a predetermined range
  • the classification unit 256 obtains the average value of the multiple normalized local curvatures obtained in step S29, and obtains It is determined whether the average value is within a predetermined range.
  • step S32 When it is determined in step S32 that the average value is within the predetermined range (S32: Y), the operation of step S30 proceeds to step S33. When it is determined in step S32 that the average value is not within the predetermined range (S32: N), the operation of step S30 proceeds to step S34.
  • step S33 classified as uniform expansion type
  • the classification unit 256 classifies the eyeball shape of the subject's eye E into a uniform expansion type (eyeball shape type 1).
  • eyeball shape type 1 eyeball shape type 1
  • step S34 Classified as parallel extension type
  • the classification unit 256 classifies the eyeball shape of the subject's eye E into the parallel extension type (eyeball shape type 2).
  • eyeball shape type 2 the operation of step S30 is completed (end).
  • step S31 When it is determined in step S31 that the curvature distribution is not uniform (S31: N), the classification unit 256 sets the eyeball shape of the subject eye E to the posterior pole extension type (eyeball shape type 3) or axial extension type (eyeball shape type 4). In some embodiments, the classification unit 256 further classifies the eyeball shape of the subject eye E into a posterior pole extension type (eyeball shape type 3) or an axial type based on the fundus curvature normalized by the first normalization unit 254 . It is classified as an extended type (eyeball shape type 4). Thus, the operation of step S30 is completed (end).
  • the acquired measurement data is normalized by the axial length of the eye
  • the normalized shape data of the fundus oculi Ef is calculated from the normalized measurement data
  • the calculated shape data is used as a single index. It is an operation example in the case of specifying the eyeball shape type of the eye E to be examined.
  • FIG. 16 shows a fourth operation example of the ophthalmologic apparatus 1000.
  • FIG. FIG. 16 shows a flow diagram of a fourth operation example of the ophthalmologic apparatus 1000 .
  • a computer program for realizing the processing shown in FIG. 16 is stored in the storage unit 212 .
  • the main control unit 211 executes the processing shown in FIG. 16 by operating according to this computer program. In the following, it is assumed that alignment of the optical system with respect to the eye E to be examined has already been completed.
  • the storage unit 212 also stores standard data indicating the relationship between the fundus curvature normalized by the axial length and the abnormal range (normal range) of the eyeball shape.
  • the main controller 211 controls the OCT optical system 8 to perform OCT scanning on the scanning range set on the fundus oculi Ef of the eye E to be examined, as in step S1. Thereby, two-dimensional or three-dimensional OCT data is obtained as measurement data.
  • scaling means extending the unit length of the coordinate axes in the coordinate system defining the measurement data according to the axial length of the eye, and is an example of normalization according to the embodiment.
  • the main control unit 211 controls the segmentation processing unit 251 to perform segmentation processing on the scaled measurement data in step S42. This obtains the shape profile of the RPE layer.
  • steps S42 and S43 may be exchanged.
  • the main control unit 211 controls the fundus shape calculation unit 253 to calculate the curvature of the RPE layer as the fundus curvature from the shape profile of the RPE layer obtained in step S43, as in step S3.
  • the main control unit 211 controls the classification unit 256 to classify the eyeball shape of the eye E to be examined into one of the eyeball shape types 1 to 4 shown in FIG.
  • the classification unit 256 determines in which of the ranges P1 to P4 shown in FIG. identify the type.
  • the main control section 211 controls the determination section 255 to refer to the standard data stored in the storage section 212, as in step S6.
  • the main control unit 211 controls the determination unit 255 in the same manner as in step S7 to compare the standard data referred to in step S46 and the normalized fundus curvature obtained in step S44, It is determined whether or not the eyeball shape of the subject's eye E is within the normal range.
  • step S47 When it is determined in step S47 that the eyeball shape of the subject's eye E is within the normal range (S47: Y), the operation of the ophthalmologic apparatus 1000 ends (end). When it is determined in step S47 that the eyeball shape of the subject's eye E is not within the normal range (S47: N), the operation of the ophthalmologic apparatus 1000 proceeds to step S48.
  • step S48 notification
  • the main control unit 211 determines that the eyeball shape of the eye to be examined E is abnormal, as in step S8. Information indicating that This completes the fourth operation example of the ophthalmologic apparatus 1000 (end).
  • the fifth operation example is an operation example in which the eyeball shape type of the subject's eye E is specified using the time-series data of the normalized shape data of the fundus oculi Ef as an index.
  • FIG. 17 shows a fifth operation example of the ophthalmologic apparatus 1000.
  • FIG. FIG. 17 represents a flow diagram of a fifth operation example of the ophthalmologic apparatus 1000 .
  • a computer program for realizing the processing shown in FIG. 17 is stored in the storage unit 212 .
  • the main control unit 211 executes the processing shown in FIG. 17 by operating according to this computer program. In the following, it is assumed that alignment of the optical system with respect to the eye E to be examined has already been completed.
  • the storage unit 212 also stores standard data indicating the relationship between the fundus curvature normalized by the axial length and the abnormal range (normal range) of the eyeball shape.
  • the main controller 211 controls the OCT optical system 8 to perform OCT scanning on the scanning range set on the fundus oculi Ef of the eye E to be examined, as in step S1. Thereby, two-dimensional or three-dimensional OCT data is obtained as measurement data.
  • the main control unit 211 controls the segmentation processing unit 251 to perform segmentation processing on the measurement data acquired in step S51, as in step S2.
  • the main control unit 211 controls the fundus shape calculation unit 253 to calculate the curvature of the RPE layer as the fundus curvature from the shape profile of the RPE layer obtained in step S52, as in step S3.
  • the main control unit 211 controls the first normalization unit 254 to normalize the fundus curvature calculated in step S3 with the axial length of the eye E to be examined, as in step S4.
  • the main control unit 211 controls the classification unit 256 to classify the eyeball shape of the eye E to be examined into one of the eyeball shape types 1 to 4 shown in FIG.
  • the classification unit 256 determines in which of the ranges P1 to P4 shown in FIG. identify the type.
  • the main control unit 211 controls the data processing unit 250 to generate the time-series data of the normalized fundus curvature obtained in step S54.
  • the main control section 211 controls the determination section 255 to refer to the standard data stored in the storage section 212, as in step S7.
  • step S58 normal range
  • the main control unit 211 controls the determination unit 255 in the same manner as in step S7 to convert the standard data referred to in step S57 and the normalized fundus curvature time-series data obtained in step S56 into By comparison, it is determined whether or not the eyeball shape of the subject's eye E is within the normal range.
  • step S58 When it is determined in step S58 that the eyeball shape of the subject's eye E is within the normal range (S58: Y), the operation of the ophthalmologic apparatus 1000 ends (end). When it is determined in step S58 that the eyeball shape of the subject's eye E is not within the normal range (S58: N), the operation of the ophthalmologic apparatus 1000 proceeds to step S59.
  • step S58 When it is determined in step S58 that the eyeball shape of the subject's eye E is not within the normal range (S58: N), the main control section 211 controls the report generation section 257 to generate a report.
  • the report generator 257 can generate a report indicating the classification result in step S55 or the relationship between the normalized fundus curvature and the normal range of the eyeball shape.
  • the report generator 257 can generate a report (warning, future prediction, etc.) corresponding to the relative position of the normalized fundus curvature with respect to the normal range of the eyeball shape.
  • the main control section 211 may control the report generation section 257 to generate a report.
  • the report generation unit 257 corresponds to the classification result in step S55, the relationship between the normalized fundus curvature and the normal range of the eyeball shape, and the relative position of the normalized fundus curvature with respect to the normal range of the eyeball shape. generated reports (warnings, future predictions, etc.).
  • FIG. 18A and 18B show examples of graphs included in reports generated by the report generation unit 257.
  • FIG. FIG. 18A presents a graph showing the relationship between the normalized fundus curvature and the normal range of eye shape.
  • the horizontal axis represents the axial length of the eye
  • the determination unit 255 determines whether or not the shape of the eyeball of the subject's eye E is normal based on the standard data. In addition, when the normalized fundus curvature is between the upper limit UP1 and the lower limit DN1 of the normal range, the determination unit 255 determines that the fundus shape of the subject's eye E is normal, and the normalized fundus curvature is normal. When it is above the upper limit UP1 or below the lower limit DN1 of the range, it can be determined that the fundus shape of the subject's eye E is abnormal.
  • the determination unit 255 can determine whether or not there is a future risk for changes in the eyeball shape of the subject's eye E by comparing with the standard data.
  • FIG. 18B represents a graph showing the relationship between the normalized time-series data of the fundus curvature and the normal range of the eyeball shape.
  • the determination unit 255 determines that the fundus shape of the subject's eye E is normal when the normalized time-series data of the fundus curvature is between the upper limit UP2 and the lower limit DN2 of the normal range, and determines that the fundus curvature is normalized. is above the upper limit UP2 or below the lower limit DN2 of the normal range, it can be determined that the fundus shape of the subject's eye E is abnormal.
  • the determination unit 255 analyzes the similarity between the time-series data of the fundus curvature of the subject eye E and the change in the fundus curvature characteristic of high myopia in a shape database prepared in advance, and determines the presence or absence of future risk of high myopia. can be determined. Furthermore, the determining unit 255 can determine the progress speed of future shape change or the tendency of future shape change from the time-series data of the fundus curvature.
  • the report generation unit 257 can generate a report including the determination result by the determination unit 255 as described above.
  • the ophthalmologic information processing apparatus includes an acquisition unit (optical system shown in FIGS. 1 and 2 (in particular, OCT optical system 8) or communication unit 290 ) and a normalization unit (first normalization unit 254, second normalization unit 262).
  • the acquisition unit acquires the eyeball shape data or the intraocular distance of the subject's eye (subject's eye E).
  • the normalization unit normalizes the eyeball shape data or the intraocular distance based on physical data of the subject or refractive power of the eye of the subject.
  • the ophthalmologic information processing apparatus includes a normalization unit (first normalization unit 254, second normalization unit 262) and a calculation unit (fundus It includes a shape calculator 253 and a local shape calculator 261).
  • the normalization unit normalizes the measurement data (OCT data) of the subject's eye based on the subject's physical data or the refractive power of the subject's eye (subject's eye E).
  • the calculator calculates normalized eyeball shape data or normalized intraocular distance of the subject's eye based on the measurement data normalized by the normalizer.
  • the eye shape data is the curvature of the anterior segment of the subject's eye, the radius of curvature of the anterior segment of the eye, the curvature of the posterior segment of the subject's eye, and the radius of curvature of the posterior segment of the eye. including at least one of
  • the curvature or radius of curvature of the anterior or posterior ocular segment of the subject's eye, and changes thereof, can be obtained without being affected by growth factors of the subject (subject's eye). can be specified with good reproducibility and high accuracy.
  • the intraocular distance includes the distance between the macula and the optic disc in the subject's eye.
  • the distance between the macula and the optic papilla in the subject's eye or changes in the distance can be reproducibly measured without being affected by growth factors of the subject (subject's eye). It becomes possible to specify with high precision.
  • the physical data includes the axial length of the subject's eye.
  • the display control unit (control unit 210, main control unit 211).
  • time-series changes in the eyeball shape data or the intraocular distance can be obtained easily, with good reproducibility, and with high accuracy, without being affected by growth factors of the subject (subject's eye). can be specified.
  • Some embodiments determine whether the eyeball shape of the subject's eye is abnormal based on the eyeball shape data normalized by the normalization unit or the eyeball shape data calculated by the calculation unit. It includes a determination unit (255) that determines
  • whether or not the eyeball shape of the subject's eye is abnormal can be determined with high reproducibility and high accuracy without being affected by growth factors of the subject (subject's eye). judgment becomes possible.
  • Some embodiments include a notification unit (control unit 210, main control 211).
  • the normalization unit converts the local eyeball shape data or the intraocular distance of the abnormal site to the body data or Normalize based on refractive power.
  • Some embodiments are subject to one of a plurality of predetermined eyeball shape types (eyeball shape type 1 to eyeball shape type 4) based on the local eyeball shape data normalized by the normalization unit. It includes a classifier (255) that classifies the eyeball shape of the examiner's eye.
  • a predetermined eyeball shape type is specified without being affected by growth factors of the subject (subject's eye), and an appropriate eyeball shape type corresponding to the specified eyeball shape type is identified. It becomes possible to determine a treatment policy.
  • An ophthalmologic apparatus (1000) includes a measurement system (the optical system shown in FIGS. 1 and 2 (particularly, the OCT optical system 8)) for measuring the eyeball shape or intraocular distance of a subject's eye, and any ophthalmologic information processing device.
  • a measurement system the optical system shown in FIGS. 1 and 2 (particularly, the OCT optical system 8)
  • any ophthalmologic information processing device any ophthalmologic information processing device.
  • an ophthalmologic apparatus capable of specifying the shape of an eyeball or its change with high reproducibility and high accuracy without being affected by growth factors of a subject (subject's eye) is provided. be able to provide.
  • An ophthalmologic information processing method includes an acquisition step and a normalization step.
  • the acquisition step acquires eyeball shape data or intraocular distance of the subject's eye (subject's eye E).
  • the normalizing step normalizes the eye shape data or the intraocular distance based on the subject's physical data or the subject's eye refractive power.
  • the ophthalmologic information processing method includes a normalization step and a calculation step.
  • the normalization step normalizes the measurement data (OCT data) of the subject's eye based on the subject's physical data or the refractive power of the subject's eye (subject's eye E).
  • the calculating step calculates normalized eyeball shape data or normalized intraocular distance of the subject's eye based on the measurement data normalized in the normalizing step.
  • the eye shape data is the curvature of the anterior segment of the subject's eye, the radius of curvature of the anterior segment of the eye, the curvature of the posterior segment of the subject's eye, and the radius of curvature of the posterior segment of the eye. including at least one of
  • the curvature or radius of curvature of the anterior or posterior ocular segment of the subject's eye, and changes thereof, can be obtained without being affected by growth factors of the subject (subject's eye). can be specified with good reproducibility and high accuracy.
  • the intraocular distance includes the distance between the macula and the optic disc in the subject's eye.
  • the distance between the macula and the optic papilla in the subject's eye or changes in the distance can be reproducibly measured without being affected by growth factors of the subject (subject's eye). It becomes possible to specify with high precision.
  • the physical data includes the axial length of the subject's eye.
  • Some embodiments include a display control step of displaying two or more pieces of eyeball shape data or two or more intraocular distances with different measurement timings on the display means (display unit 270) in chronological order.
  • time-series changes in the eyeball shape data or the intraocular distance can be obtained easily, with good reproducibility, and with high accuracy, without being affected by growth factors of the subject (subject's eye). can be specified.
  • Some embodiments determine whether the eyeball shape of the subject's eye is abnormal based on the eyeball shape data normalized in the normalizing step or the eyeball shape data calculated in the calculating step. including a decision step to
  • whether or not the eyeball shape of the subject's eye is abnormal can be determined with high reproducibility and high accuracy without being affected by growth factors of the subject (subject's eye). judgment becomes possible.
  • Some embodiments include a notification step of notifying an abnormality in the eyeball shape of the subject's eye when the determination step determines that the eyeball shape of the subject's eye is abnormal.
  • the local eyeball shape data or the intraocular distance of the abnormal site is determined based on the physical data or the refractive power Include a local normalization step to normalize.
  • Some embodiments select any of a plurality of predetermined eye shape types (eye shape type 1 to eye shape type 4) based on the local eye shape data normalized in the local normalization step. includes a classification step of classifying the eyeball shape of the subject's eye.
  • a predetermined eyeball shape type is specified without being affected by growth factors of the subject (subject's eye), and an appropriate eyeball shape type corresponding to the specified eyeball shape type is identified. It becomes possible to determine a treatment policy.
  • a program according to an embodiment causes a computer to execute each step of the ophthalmologic information processing method described above.
  • ⁇ Others> a method for evaluating the eyeball shape in the posterior segment of the eye (in particular, the fundus oculi Ef) or a change thereof has been described, but the configuration according to the embodiment is not limited to this.
  • a program for realizing the ophthalmologic information processing method can be stored in any computer-readable non-transitory recording medium.
  • the recording medium may be electronic media using magnetism, light, magneto-optics, semiconductors, and the like.
  • recording media are magnetic tapes, magnetic disks, optical disks, magneto-optical disks, flash memories, solid state drives, and the like.

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EP21924654.3A EP4289338A4 (en) 2021-02-05 2021-02-05 DEVICE FOR PROCESSING OPHTHALMIC INFORMATION, OPHTHALMIC DEVICE, METHOD FOR PROCESSING OPHTHALMIC INFORMATION AND PROGRAM
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