WO2022209991A1 - Dispositif ophtalmologique - Google Patents

Dispositif ophtalmologique Download PDF

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Publication number
WO2022209991A1
WO2022209991A1 PCT/JP2022/012460 JP2022012460W WO2022209991A1 WO 2022209991 A1 WO2022209991 A1 WO 2022209991A1 JP 2022012460 W JP2022012460 W JP 2022012460W WO 2022209991 A1 WO2022209991 A1 WO 2022209991A1
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Prior art keywords
eye
optical system
light
anterior segment
cross
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PCT/JP2022/012460
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English (en)
Japanese (ja)
Inventor
通浩 滝井
諒佑 廣藤
暁 片岡
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株式会社ニデック
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Priority claimed from JP2021061511A external-priority patent/JP2022157345A/ja
Priority claimed from JP2021061512A external-priority patent/JP2022157346A/ja
Application filed by 株式会社ニデック filed Critical 株式会社ニデック
Publication of WO2022209991A1 publication Critical patent/WO2022209991A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • 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
    • A61B3/13—Ophthalmic microscopes
    • A61B3/135—Slit-lamp microscopes

Definitions

  • the present disclosure relates to an ophthalmologic apparatus that acquires the axial length of an eye to be examined.
  • An ophthalmologic apparatus that illuminates the translucent body of the anterior segment of the eye to be examined in a manner that cuts the light and captures a cross-sectional image of the anterior segment.
  • the prevalence of myopia has increased significantly, mainly among young people, and the evaluation of myopia progression based on the axial length of the eye has attracted attention.
  • the inventors obtained both the ocular refractive power of the eye to be examined and the cross-sectional image of the anterior segment of the eye, and studied an apparatus configuration for obtaining the axial length based on these images.
  • the present disclosure has been made in view of the above circumstances, and a technical problem is to provide an ophthalmologic apparatus capable of accurately acquiring the axial length of an eye to be examined.
  • An ophthalmologic apparatus includes a fixation target presenting optical system for projecting fixation light onto an eye to be inspected and presenting a fixation target used for fogging the eye to be inspected, and a fundus of the eye to be inspected.
  • an eye refractive power measurement optical system for projecting a first measurement light onto the eye and acquiring the eye refractive power of the eye to be inspected based on the reflected light of the first measurement light reflected by the fundus; projecting a second measurement light onto the anterior segment of the eye to be inspected to form a light section passing through the optical axis of the eye refractive power measurement optical system in the anterior segment; a cross-sectional image capturing optical system for acquiring an anterior segment cross-sectional image of the eye to be inspected based on the light returned from the light-section surface of the eye refractive power and the anterior segment cross-sectional image; An ophthalmologic apparatus for obtaining the axial length of the subject's eye based on and an optical path coupling member that couples the measurement optical path of
  • FIG. 1 is an external view of an ophthalmologic apparatus;
  • FIG. 1 is a schematic diagram showing an optical system of an ophthalmologic apparatus;
  • FIG. 4 is a schematic diagram showing the relationship between the luminosity of an eye to be inspected and the wavelength;
  • FIG. 3 is a schematic diagram showing the relationship between light sensitivity of an image sensor and wavelength.
  • FIG. 2 is a simplified schematic diagram of a fixation target presenting optical system;
  • FIG. 2 is a simplified schematic diagram of a target projection optical system;
  • 4 is a flow chart showing the control operation of the ophthalmologic apparatus; It is an example of a cross-sectional image of the anterior segment. It is a figure explaining the analysis area
  • FIG. 4 is a diagram showing refractive power in the meridional direction; It is an example of a cross-sectional image of the anterior segment.
  • conjugated is not necessarily limited to a perfect conjugated relationship, but includes “substantially conjugated”. That is, the term “conjugated” in this embodiment also includes the case where the parts are displaced from the perfectly conjugated position within the range allowed in relation to the technical significance of each part.
  • the ophthalmologic apparatus of this embodiment is an apparatus capable of acquiring the axial length of an eye to be examined.
  • the ophthalmologic apparatus may have an optical system used for measuring the axial length of the eye, an axial length acquisition means, and the like.
  • the ophthalmologic apparatus may have shape information acquisition means, anterior segment information acquisition means, specifying means, setting means, and the like.
  • the ophthalmologic apparatus of this embodiment may include a fixation target presentation optical system (for example, the fixation target presentation optical system 150).
  • the fixation target presenting optical system may project fixation light onto the eye to be inspected and present the fixation target to the eye to be inspected.
  • the fixation target presentation optical system may be capable of changing the presentation distance of the fixation target. For example, this allows the fixation target presenting optical system to be used for fogging the eye to be inspected when the first optical system acquires the eye refractive power of the eye to be inspected. In addition, it can be used to add adjustment to the subject's eye. Thus, for example, the fixation target may be used to fog the subject's eye.
  • the ophthalmologic apparatus of this embodiment may have an eye refractive power measurement optical system (for example, the measurement optical system 100).
  • the eye refractive power measurement optical system is an optical system for acquiring the eye refractive power of the eye to be examined.
  • a configuration may be provided in which measurement light (first measurement light) is projected onto the fundus of the subject's eye, and the refractive power of the eye is obtained based on the reflected light of the measurement light reflected by the fundus. good.
  • the first measurement light may be visible light or infrared light.
  • the eye refractive power measuring optical system may be a measuring optical system used in an objective eye refractive power measuring device (autorefractometer, wavefront sensor, etc.).
  • the projection optical axis of the first measurement light in the eye refractive power measurement optical system may be arranged on the plane of the light section formed by the cross-sectional image taking optical system, which will be described later.
  • an eye refractive power measurement optical system is used to acquire the eye refractive power on the light-section plane of the anterior segment (surface eye refractive power).
  • the eye refractive power measurement optical system may be capable of acquiring eye refractive power on other planes.
  • the ophthalmologic apparatus of this embodiment may have a cross-sectional imaging optical system (for example, a cross-sectional imaging optical system).
  • the cross-sectional image capturing optical system is an optical system for acquiring an anterior segment cross-sectional image of the subject's eye. For example, measuring light is projected toward the anterior segment of the eye to be inspected, and return light (scattered light) due to scattering of the measuring light is detected from an oblique direction with respect to the projection optical axis of the measuring light.
  • a configuration for acquiring an eye cross-sectional image may be provided.
  • the measurement light (second measurement light) is projected onto the anterior segment of the subject's eye to form a light section passing through the optical axis of the eye refractive power measurement optical system in the anterior segment, 2
  • a configuration for acquiring an anterior segment cross-sectional image based on scattered light from the light-section plane of the measurement light may be provided.
  • the measurement light (second measurement light) may be visible light or infrared light.
  • the cross-sectional imaging optical system may be an optical system based on the Scheimpflug principle.
  • the projection optical axis of the first measurement light in the eye refractive power measurement optical system and the projection optical axis of the second measurement light in the cross-sectional imaging optical system may be arranged coaxially.
  • the second measurement light may be projected as slit light in the cross-sectional imaging optical system.
  • the irradiation area of the slit light is set as the light cutting plane of the anterior segment.
  • the cross-sectional image capturing optical system may have a lens system and a photodetector arranged in a Scheimpflug relationship with the light section formed in the anterior segment.
  • the photodetector may be a two-dimensional imager.
  • the light-receiving optical axis of the second measurement light is arranged so as to be inclined with respect to the light section plane.
  • the imaging range of the anterior segment cross-sectional image by the cross-sectional image capturing optical system includes from the front surface of the cornea to at least the front surface of the crystalline lens of the subject's eye.
  • the area from the anterior surface of the cornea to the posterior surface of the lens is included.
  • the axial length can be determined more appropriately. can ask.
  • the ophthalmologic apparatus of this embodiment includes a front image capturing optical system (for example, an index projection optical system 400, an alignment index projection optical system).
  • the front image capturing optical system projects the third measurement light onto the cornea of the eye to be inspected, and captures an anterior segment front image including a projected image of the third measurement light projected onto the cornea to determine the shape of the cornea. may be acquired.
  • the front imaging optical system may be a measurement optical system used in a corneal shape measuring device (autokeratometer).
  • the third measurement light in the front imaging optical system is infrared light, but it can also be visible light.
  • the fixation target presenting optical system and the cross-sectional image capturing optical system may share a common optical path. That is, part of the fixation optical path of the fixation light in the fixation target presenting optical system and the measurement optical path (projection optical path) of the second measurement light in the cross-sectional image capturing optical system may be a common optical path.
  • an optical path coupling member that couples the respective optical paths in these optical systems may be arranged. The fixation light projected from the fixation target presenting optical system is focused on the fundus, and the second measurement light projected from the cross-sectional image capturing optical system is focused on the anterior segment of the eye.
  • each optical system has a complicated configuration due to common use, but on the other hand, the optical path coupling member can be easily configured.
  • the optical path coupling member can be configured more easily.
  • Astigmatism may occur in at least one of the fixation light and the second measurement light by using an optical path coupling member for commonality of the fixation target presenting optical system and the cross-sectional image capturing optical system. Therefore, each optical system may be configured in consideration of the influence of astigmatism.
  • the optical path coupling member may be composed of at least one optical member such as a beam splitter, a dichroic mirror, a half mirror, and the like. In this case, it is possible to use either a prism type member or a planar type member for the optical path coupling member.
  • the prism-shaped member As an example of the prism-shaped member, a cube half mirror in which rectangular prisms are bonded together, a dichroic prism, or the like may be used. Since generation of astigmatism is suppressed with such a prism-shaped member, a good cross-sectional image of the anterior segment can be captured.
  • a prism-shaped member is used as the optical path coupling member, one of the fixation target presenting optical system and the cross-sectional image capturing optical system is arranged on the transmission side of the optical path coupling member, and the optical system is arranged on the reflection side of the optical path coupling member. , the other of the fixation target presenting optical system and the cross-sectional image taking optical system may be arranged.
  • a plate half mirror, a dichroic mirror, or the like may be used as an example of the planar member.
  • the fixation target presenting optical system is arranged on the transmission side of the optical path coupling member, and the cross-sectional imaging optical system is arranged on the reflection side of the optical path coupling member. is preferred.
  • the fixation target presenting optical system and the cross-sectional image capturing optical system may have a common lens arranged in their common optical path. More specifically, the common optical path of the fixation optical path of the fixation light in the fixation target presenting optical system and the measurement optical path of the second measurement light in the cross-sectional imaging optical system has a common optical path with different functions for each optical system.
  • a lens may be arranged.
  • the common lens may function as a total length shortening lens for shortening the total length of the fixation target presenting optical system.
  • the partial focal length including the total length shortening lens is shortened without changing the entire focal length (composite focal length) of the fixation target presenting optical system.
  • the common lens may function as a field lens for changing the traveling direction of the second measurement light in the cross-sectional imaging optical system. More specifically, it may function as a field lens for changing the traveling direction of the second measurement light passing off the optical axis of the cross-sectional imaging optical system. In other words, it may substantially coincide with the image plane of the cross-sectional imaging optical system and function as a field lens for transmitting the second measurement light without eclipse.
  • the optical system for presenting a fixation target includes a lens with a shortened total length. It becomes possible to provide an optical member (for example, an objective lens) located downstream of the lens without increasing the diameter thereof. By arranging a common lens having these functions, the entire optical system can be space-saving, and as a result, the ophthalmic apparatus can be miniaturized.
  • an optical member for example, an objective lens
  • the ophthalmologic apparatus of this embodiment may include shape information acquisition means (for example, the control unit 50).
  • the shape information obtaining means may obtain the anterior segment shape information regarding the shape of the anterior segment by analyzing the anterior segment cross-sectional image.
  • the plurality of parameters are parameters including at least the cornea and the lens.
  • the shape information may be any information that can specify the shape of the translucent body included in the anterior segment.
  • coordinates at which each transparent body is located, equations representing the shape of each transparent body, and values obtained from the equations for example, curvature, thickness, depth, etc.
  • a plurality of parameters included in the shape information may include parameters related to the shape of the cornea. Examples include the radius of curvature of the anterior surface of the cornea, the radius of curvature of the posterior surface of the cornea, the corneal thickness, and the like. Also, the plurality of parameters may include parameters relating to the shape of the lens. For example, the radius of curvature of the anterior surface of the lens, the radius of curvature of the posterior surface of the lens, the thickness of the lens, and the like. Also, the plurality of parameters may include a parameter relating to the depth of the anterior segment. For example, an anterior chamber depth and the like can be mentioned.
  • the shape information acquisition means may perform analysis using a point on the optical axis of the second measurement light in the cross-sectional image capturing optical system in the anterior segment cross-sectional image. Further, the shape information obtaining means may perform analysis using a point on the optical axis of the first measurement light in the eye refractive power measurement optical system in the anterior segment cross-sectional image. Since the optical axis of the first measurement light is an axis that passes through the center of the pupil (that is, the center of each translucent body), it is easy to capture the vertex of the translucent body. can be obtained well.
  • the shape information acquisition means may acquire the anterior segment shape information by analyzing an analysis region that does not include a reflected image in the anterior segment cross-sectional image set by the setting means.
  • the anterior segment shape information may be acquired by changing whether or not to use the point on the optical axis of the second measurement light for analysis according to the position of the set analysis region.
  • the anterior segment shape information may be acquired by changing whether or not to use the points on the optical axis of the first measurement light for analysis according to the position of the set analysis region. More specifically, for example, if the positions of the analysis regions overlap in the center of each translucent body, the analysis may be performed using a point on the optical axis of the first measurement light.
  • the analysis may be performed without using the points on the optical axis of the first measurement light.
  • the analysis may be performed without using the points on the optical axis of the first measurement light when the positions of the analysis regions are close to but do not overlap the centers of the transmissive bodies.
  • the ophthalmologic apparatus of the present embodiment may include an anterior segment information acquisition means (for example, the control unit 50).
  • the anterior segment information acquiring means may acquire anterior segment information relating to the anterior segment of the subject's eye.
  • the anterior segment information may include the anterior segment shape information (described above) of the subject's eye.
  • the corneal curvature radius which is one of the parameters in the anterior segment shape information, may be obtained as the anterior segment information.
  • parameters other than the corneal radius of curvature may be obtained.
  • the anterior segment information may include pupil state information regarding the pupil state of the subject's eye.
  • the pupil state may be at least one of a miotic state and a mydriatic state.
  • the information which can grasp the presence or absence of miosis and mydriasis may be used for the pupil state information.
  • values such as pupil diameter may be used.
  • the pupil state information a determination result obtained by determining the presence or absence of miosis or mydriasis based on the value of the pupil diameter may be used.
  • the anterior segment information acquiring means may acquire anterior segment information by receiving anterior segment information acquired by a device different from the ophthalmologic device.
  • the anterior eye segment information may be obtained by an input by the examiner using an operation means (for example, the monitor 16).
  • the anterior segment information may be acquired by analyzing an anterior segment cross-sectional image acquired using a cross-sectional image capturing optical system.
  • the anterior segment information may be acquired by analyzing an anterior segment front image acquired using a front image capturing optical system.
  • the ophthalmologic apparatus of the present embodiment may include specifying means (for example, control unit 50).
  • the specifying means may specify a reflected image included in the anterior segment cross-sectional image acquired using the cross-sectional image capturing optical system.
  • the identifying means may identify the position (coordinates, for example) of the reflected image, or may identify a predetermined range including the position of the reflected image.
  • the identification means may identify the position of the reflected image based on an operation signal input by the examiner's operation of the operation means (for example, the monitor 16). Further, the identifying means may identify the position of the reflected image based on luminance information (for example, at least one of luminance, gradation, gradation, etc.) of the anterior segment cross-sectional image. Further, the specifying means may specify the position of the reflected image based on at least one of the anterior segment information and the anterior segment shape information. In this case, the anterior segment information, the anterior segment shape information, and the position of the reflected image may be associated in advance from experiments or simulations. For example, the position of the reflected image may be specified according to the pupil diameter, corneal shape, lens shape, and the like.
  • the reflected image included in the anterior segment cross-sectional image may be a corneal reflected image generated by reflection (specular reflection) of the second measurement light from the cross-sectional image capturing optical system on the cornea.
  • it may be a slit reflection image generated by projecting slit light as the second measurement light.
  • the reflected image included in the anterior segment cross-sectional image may be a corneal reflected image due to specular reflection of the third measurement light from the front imaging optical system.
  • a corneal reflection image different from the corneal reflection image derived from the second measurement light and the corneal reflection image derived from the third measurement light may be included.
  • the ophthalmologic apparatus of this embodiment may include setting means (for example, the control unit 50).
  • the setting means sets an analysis region that does not include a reflected image generated by reflection (specular reflection) of at least the second measurement light on the cornea of the subject's eye in the anterior segment cross-sectional image acquired using the cross-sectional image capturing optical system. may be set.
  • an analysis region may be set that does not include a reflected image produced by reflection (specular reflection) of the third measurement light on the cornea of the subject's eye.
  • such an analysis region is set to acquire anterior segment shape information including the optical axis of the second measurement light in the cross-sectional imaging optical system (eg, shape information about the cornea and the lens).
  • the setting means may set the analysis region to be analyzed from the target regions in which the anterior segment cross-sectional image can be analyzed.
  • an area excluding the position of the reflected image may be set as the analysis area that does not include the reflected image.
  • an area excluding a predetermined range including the position of the reflected image may be set as the analysis area that does not include the reflected image.
  • the anterior segment shape information based on the anterior segment cross-sectional image is obtained with high accuracy.
  • the setting means sets a non-analysis region (that is, the position of the reflected image or a predetermined range including the position of the reflected image) that is not to be analyzed from the target region of the anterior segment cross-sectional image,
  • the analysis area may be set indirectly.
  • the setting means excludes the position of the reflected image in the anterior segment cross-sectional image (or a predetermined range including the position of the reflected image), and interpolates using the excluded peripheral data to obtain the analysis region may be set. That is, the reflected image may be removed from the anterior segment cross-sectional image by image processing, and the analysis region may be set for the obtained anterior segment cross-sectional image that does not include the reflected image. In this case, all of the aforementioned target regions can be set as analysis regions that do not include reflected images. Of course, part of the target area can also be set as the analysis area.
  • the setting means may set the analysis region based on the anterior segment information acquired by the anterior segment information acquisition means.
  • the analysis region may be set based on the condition of the pupil of the subject's eye (for example, pupil diameter, etc.). Further, for example, the analysis region may be set based on the shape of each translucent body in the anterior segment of the subject's eye (for example, the radius of curvature of the cornea). As a result, the region suitable for analysis of the anterior segment cross-sectional image can be easily grasped.
  • the setting means may set the analysis area by excluding the position of the reflected image specified by the specifying means (or a predetermined range including the position of the reflected image).
  • the ophthalmologic apparatus of the present embodiment may include axial length acquisition means (for example, control unit 50).
  • the axial length obtaining means may also serve as an image processing section, an axial length obtaining section, an arithmetic control section, and the like.
  • the eye axial length acquisition means may acquire the eye refractive power of the subject's eye by controlling acquisition of the eye refractive power using the eye refractive power measurement optical system. More specifically, by controlling the projection of the first measurement light in the eye refractive power measurement optical system and the detection by the photodetector of the fundus reflected light of the first measurement light, the eye refractive power of the subject's eye is measured. may be obtained.
  • the axial length acquiring means may acquire the anterior segment cross-sectional image of the eye to be examined by controlling the acquisition of the anterior segment cross-sectional image using the cross-sectional image capturing optical system. More specifically, by controlling the projection of the second measurement light in the cross-sectional imaging optical system and the detection of the return light (scattered light) of the second measurement light by the photodetector, Partial cross-sectional images may be acquired.
  • the axial length acquisition means acquires the axial length of the eye to be examined based on the refractive power of the eye and a plurality of parameters included in the shape information acquired by the shape information acquisition means by analyzing the cross-sectional image of the anterior segment of the eye.
  • the axial length acquisition means may derive the axial length by ray tracing calculation based on the refractive power of the eye and a plurality of parameters. In the ray tracing calculation, the distance between the point of intersection and the vertex of the cornea when a light ray incident on a predetermined position of the anterior segment from the far point is refracted by the translucent body and intersects the optical axis is derived as the axial length of the eye. be.
  • the eye refractive power at the light-section plane may be used instead of the equivalent spherical power that is generally used when specifying the far point in the field of ophthalmology.
  • the eye refractive power at the light-section plane surface eye refractive power
  • the position of the far point of the light ray passing through the cut plane can be specified more properly.
  • the axial length can be obtained more appropriately.
  • a ray tracing calculation may be performed for each of the plurality of rays, and the axial length of the eye may be obtained as a result of the ray tracing calculation for each ray. For example, an average value (or a weighted average) of the axial lengths obtained by each ray tracing calculation may be obtained as the axial length of the subject's eye.
  • the incident position of the ray with respect to the boundary surface of each transparent body and the angle change at the boundary surface are determined by considering the shape of the transparent body at the cut surface specified from the anterior segment information. may be The ray tracing calculation may also take into account the decentration of the anterior segment translucent body. Eccentricity is identified based on the anterior segment information. As a result of considering the eccentricity of the transmissive body in the cut plane, the axial length can be obtained more appropriately.
  • a ray tracing calculation is performed for each of a plurality of rays including at least the first ray and the second ray to obtain the axial length for each ray, and based on the plurality of axial lengths, the final measurements may be obtained.
  • the first light ray and the second light ray are light rays arranged on the cutting plane with the eye axis interposed therebetween.
  • the axial length acquisition means may adjust the light amount of the second measurement light in the cross-sectional image capturing optical system based on the anterior segment cross-sectional image. More specifically, an anterior segment cross-sectional image (first anterior segment cross-sectional image) of the eye to be inspected is acquired, and if this anterior segment cross-sectional image is determined to be inappropriate for analysis, the amount of light of the second measurement light is reduced. After adjustment, the anterior segment cross-sectional image (second anterior segment cross-sectional image) may be acquired again. Further, in the present embodiment, the axial length acquisition means may adjust the detection conditions of the photodetector in the cross-sectional image capturing optical system based on the anterior segment cross-sectional image.
  • the detection conditions of the photodetector are adjusted to obtain the second anterior segment cross-sectional image.
  • a cross-sectional image may be acquired. This increases the possibility of obtaining appropriate values for the plurality of parameters based on the anterior segment cross-sectional image, and as a result improves the accuracy of the axial length.
  • the axial length obtaining means may determine whether the first anterior segment cross-sectional image is suitable for analysis based on whether the first anterior segment cross-sectional image is obtained satisfactorily. . Further, the axial length obtaining means determines whether the first anterior segment cross-sectional image is suitable for analysis based on whether or not a plurality of parameters based on the first anterior segment cross-sectional image are obtained satisfactorily. may decide. This makes it easier to obtain appropriate values even when measured values for multiple parameters are unavailable or inaccurate.
  • the axial length acquisition means adjusts the light amount of the second measurement light within a predetermined range in which the luminance information of each translucent body detected from the second anterior segment cross-sectional image is not saturated. good.
  • the axial length acquisition means may increase or decrease the set value of the output of the light source, or insert or remove the optical member in the optical path of the second measurement light projected from the light source.
  • the predetermined range may be set in advance based on the detection sensitivity, gain, etc. of the photodetector.
  • the axial length acquisition means adjusts the detection conditions of the photodetector within a predetermined range in which the luminance information of each translucent body detected from the second anterior segment cross-sectional image is not saturated. may In this case, the axial length acquisition means may change at least one of the exposure time, gain, etc. of the photodetector.
  • the ophthalmologic apparatus in this embodiment includes eye refractive power acquisition means for acquiring the eye refractive power of the eye to be inspected, an anterior segment cross-sectional image acquisition means for acquiring an anterior segment cross-sectional image of the eye to be inspected, and an anterior segment cross-sectional image setting means for setting an analysis region that does not include a corneal reflection image in an image; shape information acquisition means for analyzing the analysis region to acquire anterior segment shape information; and an eye axial length acquiring means for acquiring the axial length.
  • the eye refractive power acquiring means acquires the eye refractive power by receiving measurement results using a device different from the ophthalmologic device, calling from an electronic medical record or the like, input by the examiner using the operation means, and the like.
  • the ophthalmologic apparatus includes an eye refractive power measurement optical system
  • the eye refractive power may be obtained as a measurement result using this optical system.
  • the anterior segment cross-sectional image acquisition means may acquire the eye refractive power by receiving an image captured using a device different from the ophthalmologic device, by calling from an electronic medical record or the like.
  • an anterior segment cross-sectional image may be acquired as a result of capturing using this optical system.
  • FIG. 1 is an external view of an ophthalmologic apparatus 10.
  • the ophthalmologic apparatus 10 is a multi-function machine of an objective eye refractive power measuring apparatus (especially an autorefractometer in this embodiment) and a Scheimpflug camera.
  • the ophthalmologic apparatus 10 is a stationary examination apparatus, but is not necessarily limited to this, and may be hand-held.
  • the ophthalmologic apparatus 10 has at least a measurement unit 11 , a base 12 , an alignment drive section 13 , a face support unit 15 , a monitor 16 and an arithmetic control section 50 .
  • the measurement unit 11 includes a measurement system, an imaging system, and the like used for examination of an eye to be examined.
  • the optical system shown in FIG. 2 is arranged.
  • the alignment drive section 13 may be able to move the measurement unit 11 three-dimensionally with respect to the base 12 .
  • the face support unit 15 is used to fix the subject's face in front of the measurement unit 11 .
  • the face support unit 15 is fixed to the base 12 and supports the subject's face.
  • the monitor 16 functions as a touch panel that also serves as an operation unit.
  • the monitor 16 displays the ocular refractive power of the subject's eye E, the anterior segment cross-sectional image, the ocular axial length, and the like on the screen.
  • the arithmetic control unit 50 (also referred to as a processor; hereinafter simply referred to as the control unit 50 ) controls the entire ophthalmologic apparatus 10 . It also processes various inspection results acquired via the measurement unit 11 .
  • FIG. 2 is a schematic diagram showing the optical system of the ophthalmologic apparatus 10.
  • the ophthalmologic apparatus 10 includes a measurement optical system 100, a fixation target presentation optical system 150, a front imaging optical system 200, a cross-sectional imaging optical system (an irradiation optical system 300a and a light receiving optical system 300b, an index projection optical system 400, and It has an alignment target projection optical system, and half mirrors 501, 502, 503 for branching and combining the optical paths of each optical system, an objective lens 505, etc.
  • the light source side is upstream
  • the side of the eye to be examined is the downstream side.
  • the measurement optical system 100 is used to objectively measure the eye refractive power of the eye E to be examined.
  • each value of SPH: spherical power, CYL: cylindrical power, and AXIS: cylinder axis angle may be obtained as a measurement result of the eye refractive power.
  • the measurement optical system 100 has a projection optical system 100a and a light receiving optical system 100b.
  • the projection optical system 100a has at least a measurement light source 111, and projects a spot-shaped measurement light onto the fundus of the eye E to be inspected via the center of the pupil or the corneal vertex of the eye E to be inspected.
  • the measurement light source 111 may be an SLD light source, an LED light source, or other light sources.
  • infrared light is used as the measurement light.
  • near-infrared light with a peak wavelength between 800 nm and 900 nm may be used.
  • near-infrared light with a peak wavelength of 870 nm may be used.
  • a prism 115 is arranged on the common path of the projection optical system 100a and the light receiving optical system 100b. By rotating the prism 115 around the optical axis, the projection light flux on the pupil is rotated eccentrically at high speed. As an example, in this embodiment, the projection light flux is eccentrically rotated in a region of ⁇ 2 mm to ⁇ 4 mm on the pupil. This area is the eye refractive power measurement area in this embodiment.
  • the light receiving optical system 100b has at least a ring lens 124 and an imaging element 125.
  • the light-receiving optical system 100b takes out the reflected light flux of the measurement light flux reflected from the fundus in a ring shape through the periphery of the pupil.
  • the ring lens 124 is arranged at a pupil conjugate position
  • the imaging device 125 is arranged at a fundus conjugate position.
  • the measurement light is eccentrically rotated at high speed on the pupil.
  • Analysis processing is performed on an added image of image data that is sequentially output, and an eye refractive power is derived.
  • at least values of SPH: spherical power, CYL: cylindrical power, and AXIS: cylinder axis angle are acquired as a result of the analysis processing.
  • the measurement optical system 100 may have optical elements such as lenses and diaphragms.
  • the measurement light flux from the measurement light source 111 passes through the hole portion of the hole mirror 113 and the prism 115, is reflected by the half mirrors 502 and 501, respectively, becomes coaxial with the optical axis L1, and passes through the objective lens 505. and reach the fundus.
  • a reflected light flux which is the measurement light flux reflected by the fundus, passes through the optical path through which the measurement light flux has passed, is reflected by the mirror portion of the hole mirror 123 , and reaches the imaging device 125 via the ring lens 124 .
  • a fixation target presenting optical system 150 presents a fixation target to the eye E to be examined.
  • a fixation target is presented on the optical axis of the measurement optical system 100 .
  • the fixation target presenting optical system 150 is used to fixate the eye E to be examined. It is also used to apply fogging and accommodation load to the subject's eye.
  • the fixation target presenting optical system 150 includes at least a light source 151 and a fixation target plate 155 .
  • the fixation target plate 155 may be placed at a fundus conjugate position.
  • a fixation light flux from the light source 151 passes through the half mirror 503 after passing through the fixation target plate 155 and the lens 156 on the optical axis L2. Further, the light passes through the lens 504, passes through the half mirror 502, and is reflected by the half mirror 501, so that the light becomes coaxial with the optical axis L1.
  • the fixation luminous flux further passes through the objective lens 505 and reaches the fundus.
  • the measurement light source 111, the ring lens 124, and the imaging element 125 in the measurement optical system 100, and the light source 151 and the fixation target plate 155 in the fixation target presentation optical system 150 are driven by the drive unit 161 as a drive unit 160. It is integrally movable along the .
  • the focal length within the driving unit 160 in the measurement optical system 100 and the focal length within the driving unit 160 in the fixation target presenting optical system 150 have a predetermined relationship.
  • the presentation distance of the fixation target plate 155 to the eye E that is, the presentation position of the fixation target
  • the imaging device 125 are optically conjugated to the fundus.
  • the hole mirror 113 and the ring lens 124 are pupil conjugate at a constant magnification.
  • the front imaging optical system 200 is used to capture a front image of the anterior segment of the eye E to be examined.
  • the front imaging optical system 200 includes an imaging element 205 and the like.
  • the imaging element 205 may be arranged at a pupil conjugate position.
  • As the front image an observation image of the anterior segment may be acquired. The observed image is used for alignment and the like.
  • the index image (point image) projected onto the cornea from the index projection optical system 400 and the index image (Meyerling image) projected onto the cornea from the alignment index projection optical system 600 are photographed by the front imaging optical system 200. be done.
  • the cross-sectional imaging optical system is used to capture a cross-sectional image of the anterior segment of the eye.
  • the cross-sectional imaging optical system includes an irradiation optical system 300a and a light receiving optical system 300b.
  • the irradiation optical system 300a is coaxial with the projection optical axis (optical axis L1) of the measurement light in the measurement optical system 100, and irradiates the anterior segment with slit light (illumination light).
  • the irradiation optical system 300a has a light source 311, a slit 312, and the like.
  • the light source 311 may be an SLD light source, an LED light source, or other light sources.
  • red visible light or near-infrared light is used as illumination light.
  • red visible light or near-infrared light with peak wavelengths between 650 nm and 800 nm may be utilized.
  • red visible light with a peak wavelength of 730 nm may be used.
  • near-infrared light with a predetermined wavelength as a peak wavelength may also be used.
  • the slit 312 may be placed at a pupil conjugate position.
  • FIG. 3 is a schematic diagram showing the relationship between the visual sensitivity of an eye to be inspected and the wavelength.
  • the eye to be inspected has luminosity in the visible range, which generally peaks around 550 nm, which is green visible light, and gradually decreases as the wavelength increases (closer to the infrared range). In other words, the subject's eye is likely to feel dazzling in green visible light, and less likely to feel dazzling in red visible light. It is said that infrared light is not dazzling.
  • red visible light to near-infrared light which is less likely to be perceived by the eye to be examined, is used as illumination light.
  • the visibility around 650 nm, which is red visible light drops to about 1/10
  • the visibility around 700 nm drops to about 1/200, relative to the visibility around 550 nm, which is green visible light. Therefore, the burden on the subject is greatly reduced. In particular, when targeting young people including children, the burden is reduced and the efficiency of measurement is improved.
  • the passage cross section of the slit light in the anterior segment is referred to as a "cut plane".
  • the cut plane becomes the object plane of the cross-section imaging optical system.
  • the opening of the slit 312 has a horizontal direction (the depth direction of the paper surface) as its longitudinal direction. Therefore, in this embodiment, the horizontal plane (XZ section) including the optical axis L1 is set as the cutting plane.
  • a cut surface is formed at least between the anterior corneal surface and the posterior surface of the lens.
  • the light receiving optical system 300b has a lens system 322, an imaging device 321, and the like.
  • the lens system 322 and the imaging device 321 are arranged in a Scheimpflug relationship with the cutting plane set in the anterior segment. That is, the optical arrangement is such that the extended planes of the cut plane, the principal plane of the lens system 322, and the imaging surface of the imaging element 321 intersect at one line of intersection (one axis). A cross-sectional image of the anterior segment is acquired based on the signal from the imaging device 321 .
  • the imaging element 321 may be configured with a semiconductor substrate made of silicon as a single element.
  • FIG. 4 is a schematic diagram showing the relationship between the light receiving sensitivity of the image sensor 321 and the wavelength.
  • an imaging device using silicon as a single element has sensitivity to wavelengths in the vicinity of 300 nm to 1000 nm, including wavelengths in the ultraviolet, visible, and infrared regions, but has sensitivity in the vicinity of 550 nm to 650 nm, which includes green visible light. It becomes the maximum, and gradually decreases as it approaches the infrared region.
  • the sensitivity of 650 nm or more, which includes red visible light to near-infrared light, used in the irradiation optical system 300a is sufficient for obtaining a cross-sectional image of the anterior segment.
  • some imaging devices have the highest sensitivity in the infrared region, but they are expensive. While it is desired that the device be widely used in many facilities such as hospitals and schools, the high cost of the device may hinder the widespread use of the device. If an imaging element made of silicon is used, the cost of the device can be reduced.
  • the illumination light beam from the light source 311 passes through the slit 312 on the optical axis L3 and becomes a slit light beam. Coaxial with L2. Further, the light passes through the lens 504, passes through the half mirror 502, and is reflected by the half mirror 501, so that the light becomes coaxial with the optical axis L1. The illumination luminous flux further passes through the objective lens 505 and reaches the anterior segment of the eye. Return light from the cut surface formed in the anterior segment reaches the imaging device 321 via the lens 322 .
  • a target projection optical system 400 is used to measure the corneal shape.
  • the target projection optical system 400 projects a target for measuring the shape of the cornea from the front facing the subject's eye to the anterior segment of the eye.
  • a target projection optical system 400 includes a plurality of point light sources 401 .
  • the point light source 401 projects an infinity index by irradiating the cornea with parallel light.
  • the point light source 401 emits infrared light. However, it may be visible light.
  • the point light sources 401 are arranged vertically and horizontally symmetrically about the optical axis L1. For example, in this embodiment, two point light sources are provided on each side. This projects four point image indices onto the cornea. Note that the shape of the index is not limited to this, and a linear index or the like may be included. Also, the number of indices is not limited to this, and may be composed of three or more point image indices.
  • the circumferential area onto which these four point images are projected is the corneal shape measurement area by the index projection optical system 400 and the front imaging optical system 200 .
  • each point image is projected onto a ⁇ 3 mm circumferential region of the corneal model eye.
  • the alignment target projection optical system is used to align (align) the measurement unit 11 with the eye E to be examined.
  • the alignment light source 601 and the index projection optical system 400 form an alignment index projection optical system.
  • the working distance is adjusted by moving the measurement unit 11 in the front-rear direction so that the Purkinje image by the alignment light source 601 and the Purkinje image by the index projection optical system 400 are photographed at a predetermined ratio.
  • the alignment light source 601 projects a finite distance index by irradiating the cornea with diffused light.
  • the alignment light source 601 emits infrared light. However, it may be visible light.
  • the alignment light source 601 is arranged in a ring shape around the optical axis L1. Thereby, in this embodiment, a ring index (so-called Mayer ring) is projected onto the cornea.
  • both the fixation target presenting optical system 150 and the target projecting optical system 300a are irradiated with visible light.
  • a half mirror 503 makes the optical axis L2 of the fixation target presenting optical system 150 and the optical axis L3 of the target projecting optical system 300a coaxial.
  • the fixation target presenting optical system 150 on the transmission side of the half mirror 503 and the target projection optical system 300a on the reflection side of the half mirror 503, the respective optical paths are shared.
  • the half mirror 503 is of a flat type, and astigmatism tends to occur on the transmission side of the half mirror 503 .
  • the optotype projection optical system 300a requires a certain imaging performance in order to obtain a clear cross-sectional image 70 by forming a cross section in the anterior segment. For this reason, it is preferable that the target projection optical system 300a be arranged on the reflection side, which is less affected by astigmatism.
  • a lens 504 a is arranged on the optical axis of the fixation target presenting optical system 150 .
  • the lens 504 a functions as a total length shortening lens for shortening the overall length of the fixation target presenting optical system 150 .
  • the lens 504a also serves to reduce the diameter of the lens 156 located upstream of the lens 504a.
  • FIG. 5 is a schematic diagram in which the fixation target presenting optical system 150 is simplified.
  • the upper diagram of FIG. 5 shows the case where the lens 504a is not arranged.
  • the lower diagram of FIG. 5 shows a case where the lens 504a is arranged.
  • the optical path from the subject's eye E to the fixation target plate 155 is a straight line, and some optical members are omitted.
  • Fundus imaging rays from the center and periphery of the fixation target plate 155 are represented by solid and dotted lines, respectively.
  • the fixation target presenting optical system 150 may be a target-side telecentric optical system, and the lens 504a may be arranged at a pupil conjugate position. At this time, light rays from the center and peripheral portions of the fixation target plate 155 pass through the center of the lens 504a, so that the overall focal length (composite focal length) of the fixation target presenting optical system 150 changes. do not do. Therefore, the relationship between the focal lengths of the fixation target presenting optical system 150 and the measuring optical system 100 in the drive unit 160 is maintained.
  • the lens 156 can be designed with a small diameter. Further, the total length of the fixation target presenting optical system 150 can be shortened while maintaining the predetermined working distance of the subject's eye E and the synthetic focal length of the fixation target presenting optical system 150 . As a result, the size of the ophthalmologic apparatus 10 can be reduced.
  • a lens 504b is arranged on the optical axis of the target projection optical system 300a.
  • the lens 504b has a role of reducing the diameter of the objective lens 505 located downstream of the lens 504b.
  • FIG. 6 is a simplified schematic diagram of the optotype projection optical system 300a.
  • the upper diagram of FIG. 6 shows the case where the lens 504b is not arranged.
  • the lower diagram of FIG. 6 shows a case where the lens 504b is arranged.
  • the optical path from the subject's eye E to the slit 312 is a straight line, and some optical members are omitted.
  • Pupil imaging rays from the center and periphery of the slit 312 are represented by solid and dotted lines, respectively.
  • the objective lens 155 can be designed with a small diameter. It should be noted that the rays from the central and peripheral portions of the slit 312 are refracted in a region farther from the center of the objective lens 505, and the greater the aberration may occur. Therefore, an objective lens 155 having an appropriate diameter may be used so as to reduce the size of the ophthalmologic apparatus 10 and suppress the occurrence of aberrations.
  • a lens 504 that shares the above-described lenses 504a and 504b having different roles is arranged in the fixation target presenting optical system 150 and the target projecting optical system 300a.
  • the lens 504 is arranged downstream of the half mirror 503 where the optical axis L2 of the fixation target presenting optical system 150 and the optical axis L3 of the target projecting optical system 300a are combined. As a result, the inside of the optical system can be made more space-saving.
  • ⁇ Control action> The control operation of the ophthalmologic apparatus 10 will be described with reference to the flowchart shown in FIG.
  • the ophthalmologic apparatus 10 sequentially performs corneal curvature measurement, eye refractive power measurement, and photographing of an anterior segment cross-sectional image, and the axial length is obtained based on the results of the measurements and photographing. be.
  • control unit 50 adjusts the subject's eye E and the ophthalmologic apparatus 10 to a predetermined positional relationship based at least on the observed image of the anterior segment acquired via the front imaging optical system 200 . More specifically, alignment in the XY directions is performed so that the optical axis L1 coincides with the corneal vertex of the eye E to be examined. Alignment in the Z direction is also performed so that the distance between the subject's eye E and the ophthalmologic apparatus 10 is a predetermined working distance. At this time, an alignment index may be projected onto the cornea and the alignment may be adjusted based on the alignment index detected in the observed image.
  • the control unit 50 projects a point image index from the index projection optical system 400 and captures a corneal Purkinje image of the point image index using the front imaging optical system 200 .
  • the control unit 50 also acquires corneal shape information based on the corneal Purkinje image.
  • the corneal shape information is derived based on the image height of the corneal Purkinje image.
  • at least each value of the corneal curvature, the astigmatic power, and the astigmatic axis angle is acquired as the corneal shape information.
  • ⁇ Eye refractive power measurement (S3)> the ocular refractive power of the subject's eye E is measured. Since infrared light is projected onto the subject's eye E as measurement light, the pupil diameter of the subject's eye E becomes a predetermined size in which miosis (for example, ⁇ 2 mm or less) is suppressed. As an example, it is any diameter included in the measurement area of the subject's eye E (area of ⁇ 2 mm to ⁇ 4 mm on the pupil). For example, in eye refractive power measurement, preliminary measurement may be performed first, and main measurement may be performed later.
  • the ocular refractive power of the subject's eye E is measured with the fixation target placed at a predetermined presentation distance.
  • the fixation target plate 155 may be arranged at an initial position that is optically sufficiently far away from the subject's eye E and that corresponds to the far point of the 0D eye.
  • a ring image captured by the imaging device 125 based on the measurement light irradiated in this state is image-analyzed by the control unit 50 .
  • the refractive power value in each meridian direction is obtained.
  • At least the spherical power in the preliminary measurement is obtained by subjecting the refractive power in each meridional direction to a predetermined process.
  • control unit 50 moves the fixation target plate 155 to the fog start position where the subject's eye E is in focus, according to the pre-measured spherical power of the subject's eye.
  • the control unit 50 adds fog to the subject's eye E by moving the fixation target from the fog start position. This cancels the adjustment of the eye E to be examined.
  • the main measurement is performed with fog added to the subject's eye E.
  • the SPH of the eye E to be examined spherical power
  • CYL cylindrical power
  • AXIS astigmatism axis angle objective value
  • a cross-sectional image (Scheimpflug image) of the anterior segment of the subject's eye E is captured.
  • the control unit 50 captures a cross-sectional image of the anterior segment of the eye.
  • the operation of capturing a cross-sectional image may be performed using the completion of the main measurement of the eye refractive power as a trigger. That is, immediately after the completion of the main measurement, illumination light is emitted from the illumination optical system 300a, and the scattered light scattered by the cornea and lens is imaged on the imaging device 321 to form an image of the cross section of the anterior segment. Get an image. This reduces misalignment between the measurement of the eye refractive power and the imaging of the cross-sectional image.
  • FIG. 8 is an example of a cross-sectional image 70 of the anterior segment.
  • Artifacts may appear in the cross-sectional image 70 together with the cornea, iris, lens, and the like.
  • the slit light (illumination light) emitted from the irradiation optical system 300a forms a cut plane in the anterior segment of the eye, but part of it may be reflected (specularly reflected) by the cornea.
  • the image pickup device 321 of the light receiving optical system 300 b captures the corneal reflected light of the slit light together with the return light from the cut surface of the slit light, and the image of the corneal reflected light is reflected in the cross-sectional image 70 as an artifact 75 .
  • the artifact 75 exists, it becomes difficult to obtain the anterior segment shape information with high accuracy.
  • the control unit 50 acquires anterior segment shape information regarding the shape of the anterior segment.
  • the anterior segment shape information includes the radius of curvature of the anterior corneal surface (Ra), the radius of curvature of the posterior corneal surface (Rp), the corneal thickness (CT), the depth of the anterior chamber (ACD), the radius of curvature of the anterior lens surface (ra), A plurality of parameter information may be included that are measurements such as the radius of curvature of the posterior lens surface (rp), lens thickness (LT), and the like.
  • the corneal shape information obtained in step S2 can also be used as the anterior segment shape information.
  • the control unit 50 performs image processing on the cross-sectional image 70 to detect each translucent body (for example, the cornea, aqueous humor, lens, etc.) and acquire anterior segment shape information.
  • luminance information of the cross-sectional image 70 may be used to detect pixel positions corresponding to tissue boundaries (corneal anterior and posterior surfaces, lens anterior and posterior surfaces, irises, etc.), and information such as curvature radii may be obtained.
  • the distance between the pixel positions corresponding to the boundary of the tissue may be obtained, and information such as the thickness and depth of the tissue may be obtained.
  • control unit 50 sets an analysis region that does not include the artifact 75 during image processing of the cross-sectional image 70 .
  • the artifact 75 may lead to erroneous detection of the boundary of each tissue, or a decrease in detection accuracy of the boundary of each tissue.
  • the effect on detection is significant. Therefore, the pixel position of the artifact 75 is specified, the artifact 75 is excluded from the analysis area, and image processing is performed.
  • FIG. 9 is a diagram for explaining the analysis area of the cross-sectional image 70.
  • the control unit 50 may identify the pixel position of the artifact 75 using the brightness information of the cross-sectional image 70 .
  • the corneal reflected light of the slit light is light that does not pass through the cornea or the lens and is not attenuated.
  • the return light from the cut surface of the slit light is light that has been attenuated by passing through the cornea and the lens, and is part of the light scattered by the cornea and the lens. Therefore, the reflected light from the cornea and the returned light (scattered light) have different luminances appearing in the cross-sectional image 70 as images.
  • the control unit 50 may identify the pixel position of the artifact 75 by detecting whether the luminance value exceeds a preset threshold for each pixel position of the cross-sectional image 70 .
  • the control unit 50 excludes at least the pixel positions of the artifacts 75 from the analysis target area Q in the cross-sectional image 70 (that is, the target area Q including all pixel positions).
  • a range having a predetermined number of pixels in the vertical direction and the horizontal direction with reference to the pixel position of the artifact 75 is set as the non-analysis region Q1 (the solid line portion in FIG. 9) to be excluded from the target region Q.
  • an analysis region Q2 (dotted line portion in FIG. 9), which is an analysis region Q2 to be subjected to image processing of the cross-sectional image 70 and is obtained by excluding the non-analysis region Q1 from the target region Q, is set.
  • the control unit 50 may detect pixel positions corresponding to tissue boundaries based on the luminance information of the analysis region Q2, and specify at least three pixel positions on each boundary. Note that when the tissue boundary detected in the analysis region Q2 includes pixel positions on the optical axis L1, at least three pixel positions must include the intersection of the tissue boundary and the optical axis L1. May be specified.
  • the control unit 50 can obtain information such as a radius of curvature by obtaining a circle passing through at least three specified points, and the center point and radius of this circle. In addition, it is possible to obtain information such as the thickness and depth of the tissue by obtaining the distance of the pixel position corresponding to the boundary of the tissue.
  • the control unit 50 may change the designated point on the cross-sectional image 70 .
  • the degree of similarity between the cross-sectional image 70 and the structure of the anterior segment predicted by image processing of the cross-sectional image 70 may be used. If the designated point is in a region with a low degree of similarity, the point may be deleted and reselected from a region with a high degree of similarity.
  • control unit 50 may delete predetermined points so that at least three pixel positions remain. That is, in the cross-sectional image 70, if a point that does not follow the curved surface of the cornea or lens is designated, it may be deleted as appropriate.
  • the control unit 50 calculates the axial length based on the refractive power of the eye E to be examined and a plurality of parameter information in the anterior segment shape information of the eye E to be examined.
  • FIG. 10 is a schematic diagram for explaining the method of deriving the axial length of the eye.
  • the axial length may be derived based on the ray tracing calculation on the cut plane of the anterior segment.
  • the control unit 50 performs ray tracing calculation based on the position of the far point FP, the refractive index of each translucent body, and the parameter information in the anterior segment shape information.
  • the control unit 50 traces a ray (e.g., ray Lx in FIG. 10) incident from the far point FP toward the eye E to be examined, refracts the ray by each translucent body of the eye E to be examined, and aligns the ray with the optical axis. Find the position of the crossing point. Details of the ray tracing calculation will be described later. For example, the position of the fundus oculi Ef is obtained by such ray tracing calculation.
  • the control unit 50 derives the distance between the corneal vertex C and the fundus Ef as the axial length AL.
  • the axial length AL is displayed on the monitor 16 .
  • the axial length AL is displayed together with at least one of the corneal shape information and the eye refractive power (SPH, CYL, AXIS) of the eye E to be examined.
  • the measurement result this time may be displayed with the past measurement result.
  • the measurement results may be displayed by a trend graph in which the horizontal axis is the age (measurement date) and the vertical axis is the eye axial length AL.
  • the display modes of the measurement results are not limited to these.
  • the on-plane eye refractive power which is the eye refractive power on the cutting plane, is obtained, and the position of the far point FP is set based on the on-plane refractive power.
  • the refractive power P on an arbitrary surface is expressed by the following formula.
  • ⁇ is an angle with respect to the horizontal plane, and the horizontal direction is 0°.
  • the control unit 50 traces the ray from the far point FP set in this way. For example, a ray (for example, ray Lx in FIG. 10) directed from the far point FP to a certain position (for example, a position of ⁇ 6 mm at the position of the pupil of the subject's eye (about 3 mm behind the cornea)) is guided. It should be noted that setting the fixed position at the position of the pupil of the subject's eye to ⁇ 6 mm is merely an example, and can be changed as appropriate.
  • This light ray is first refracted at the anterior surface of the cornea.
  • the intersection point of the ray with the anterior corneal surface is calculated based on the radius of curvature Ra of the anterior corneal surface, the position of the far point FP, and the ray angle at the far point FP. Furthermore, the incident angle of the light ray at the intersection is calculated.
  • a light ray that reaches the anterior surface of the cornea changes direction at a fixed angle of refraction with respect to the angle of incidence according to Snell's law. In this way, the rays at each transparent body interface are traced sequentially.
  • the anterior segment shape information (Ra, Rp, CT, ACD, ra, rp, LT) acquired based on the corneal shape information and the cross-sectional image 70 (Scheimpflug image) is It is used as appropriate to give the intersection points.
  • the intersection point that is, the position of the fundus oculi Ef
  • the axis of the eye here, the visual axis
  • AL The distance from the intersection to the corneal vertex C (the origin here) is used as the axial length AL.
  • At least the radius of curvature Ra of the anterior surface of the cornea is Values based on the corneal Purkinje image of the image index are used, and for the remaining values, values based on the cross-sectional image 70 (Scheimpflug image) are used. This is because the measurement accuracy of the corneal anterior surface shape based on the corneal Purkinje image is generally higher than that based on the Scheimpflug image.
  • at least each value of the corneal curvature, the astigmatism power, and the astigmatism axis angle is acquired as the corneal shape information. From these values, the corneal curvature at the cut plane (curvature of the anterior corneal surface) can be determined using a technique similar to that used to determine the refractive power for the cut plane. The reciprocal of the obtained value may be used as Ra.
  • the axial length AL of the subject's eye E can be obtained by tracing the light rays directed to such a fixed position.
  • the method of ray tracing is not limited to the above method.
  • a point to be imaged from the far point FP may be obtained by paraxial calculation.
  • a point to be imaged from the far point FP may be obtained in consideration of a plurality of rays incident on the subject's eye E at different positions.
  • ray tracing for paraxial rays and rays directed to fixed positions different from the paraxial rays may be combined.
  • the final measured value (calculated value) of the axial length may be the average of the axial lengths of each ray-traced (weighted average). can also be used).
  • the axial length AL may be obtained by tracing the light rays directed to the measurement area ( ⁇ 2 mm to ⁇ 4 mm on the pupil) by the measurement optical system 100 .
  • ray tracing may be performed for each of a plurality of rays directed to a region of ⁇ 2 mm to ⁇ 4 mm on the pupil, and the average value of the axial length obtained by each ray tracing may be obtained as a calculation result. Since ray tracing is performed under more appropriate conditions, the axial length can be obtained more accurately.
  • a predetermined offset value may be added to the axial length value obtained in this embodiment.
  • the offset value corrects the error between the calculated value and the measured value.
  • ray tracing may be performed by tracing a ray emitted from the far point FP and passing through the circumferential region on which the point image index for corneal topography measurement is projected. As a result, the conditions for ray tracing become more appropriate, and the axial length can be obtained more accurately.
  • the ophthalmologic apparatus of this embodiment includes a fixation optical path of fixation light in the fixation target presenting optical system and a measurement optical path (projection light) of measurement light (illumination light) in the cross-sectional image capturing optical system. and an optical path coupling member for coupling the optical path.
  • the fixation target can be appropriately presented to the subject's eye, the cross-sectional image of the anterior segment of the eye can be satisfactorily captured, and the axial length of the eye can be accurately obtained. Since the fixation light is converged on the fundus and the illumination light is condensed on the anterior segment of the eye, each optical system is made common, resulting in a complicated configuration. can be When both the fixation light and the illumination light are visible light, the optical path coupling member can be configured more easily.
  • the ophthalmologic apparatus of this embodiment functions as a total length shortening lens for shortening the total length of the fixation target presenting optical system in the common optical path of the fixation optical path and the measurement optical path, and a cross-sectional image capturing optical system.
  • a common lens is arranged to function as a field lens for changing the traveling direction of measurement light (illumination light) in the system.
  • the optical system for presenting a fixation target includes a lens with a shortened total length. It can be designed without enlarging the lens. Therefore, the configuration of the optical system is space-saving, and the ophthalmologic apparatus is miniaturized.
  • the ophthalmologic apparatus of this embodiment uses a planar member as an optical path coupling member.
  • a planar member astigmatism is likely to occur on the transmission side, and astigmatism is less likely to occur on the reflection side. For this reason, the imaging performance of the light arranged on the transmission side is lower than the imaging performance of the light arranged on the reflection side.
  • the fixation optical path on the transmission side priority is given to the imaging performance of the illumination light, and a cross-sectional image of the anterior segment can be satisfactorily captured.
  • the imaging performance of the fixation light is lowered, but the performance to the extent that the fixation target can be fixed is ensured, so the effect on visual recognition is kept small.
  • the ophthalmologic apparatus of the present embodiment identifies artifacts included in the anterior segment cross-sectional image, and sets an analysis region excluding the artifacts. As a result, it is possible to accurately acquire the anterior segment shape information using only the region suitable for analysis of the anterior segment cross-sectional image.
  • the ophthalmologic apparatus of the present embodiment determines whether or not to use a point on the optical axis of the measurement light in the eye refractive power measurement optical system for analysis, depending on the position of the analysis region with respect to the anterior segment cross-sectional image. change. For example, if an artifact is detected near the curved surface of each tissue, or if an artifact is detected overlapping the curved surface of each tissue, the accuracy of the anterior segment shape information may decrease. . By appropriately changing the points used for analyzing the anterior segment cross-sectional image, the anterior segment shape information can be obtained with high accuracy.
  • the optical axes of the fixation target presenting optical system 150 and the target projecting optical system 300a have been described as an example of a configuration in which the optical axes of the target projecting optical system 300a are branched or combined by the planar half mirror 503, but the present invention is not limited to this. .
  • a prism type half mirror may be used to split or combine the respective optical axes.
  • the prism type is less likely to produce astigmatism on either the transmission side or the reflection side. Therefore, regardless of which relationship the fixation target presenting optical system 150 and the target projecting optical system 300a are arranged with respect to the half mirror, the imaging performance of the target projecting optical system 300a can be maintained. As a result, a cross-sectional image of the anterior segment can be captured satisfactorily.
  • the configuration in which the shared lens 504 is arranged on the common optical axis of the fixation target presenting optical system 150 and the target projecting optical system 300a has been described as an example, but it is not limited to this.
  • lenses having different roles may be arranged on the optical axis of each optical system. That is, the lens 504a and the lens 504b may be arranged upstream of the half mirror 503 that splits or combines the optical axes of the respective optical systems.
  • the configuration for specifying the pixel position of the artifact 75 using the luminance value threshold in the cross-sectional image 70 of the anterior segment has been described as an example, but the present invention is not limited to this.
  • the pixel position of the artifact 75 may be specified by calculating the degree of similarity based on the brightness values of the cross-sectional image 70 and the template image.
  • the control unit 50 moves the template image to be overlapped with the cross-sectional image 70 pixel by pixel (performs so-called pattern matching) while the similarity based on the difference in brightness value is zero (or , the value closest to zero) may be detected.
  • the storage unit (memory) of the ophthalmologic apparatus 1 may have a template image.
  • a template image for detecting the artifact 75 may be used.
  • the control unit 50 may specify the pixel position of the template image corresponding to the cross-sectional image 70 as the pixel position of the artifact 75 .
  • the control unit 50 may set the non-analysis region Q1 based on the pixel position of the artifact 75 in the cross-sectional image 70 .
  • a template image representing a standard cross-sectional image of an eye modeled after a general eye structure may be used.
  • the control unit 50 identifies the pixel position of the template image corresponding to the cross-sectional image 70.
  • the control unit 50 may set the pixel position where the template image matches in the cross-sectional image 70 as the analysis region Q2 of the cross-sectional image 70 .
  • control unit 50 may specify a pixel position where the template image does not match in the cross-sectional image 70 as the pixel position of the artifact 75, and set the non-analysis region Q1 of the cross-sectional image 70 based on this. That is, the template image may be used for indirect detection of artifacts 75 .
  • the configuration in which the non-analysis region Q1 and the analysis region Q2 are set using luminance information in the cross-sectional image 70 of the anterior segment has been described as an example, but the present invention is not limited to this.
  • the anterior segment information about the anterior segment of the eye E to be examined may be used to set each region.
  • the anterior segment information may be information including anterior segment shape information (corneal shape information, lens shape information, etc.), information on pupillary conditions (for example, miosis or mydriasis), and the like.
  • the control unit 50 may set at least the non-analysis region Q1 in the cross-sectional image 70 based on the radius of curvature of the anterior surface of the cornea, which is one piece of the anterior segment shape information of the eye E to be examined.
  • the control unit 50 acquires the radius of curvature of the anterior surface of the cornea of the subject's eye E, and also acquires the pixel position of the artifact 75 corresponding to the radius of curvature. For example, from the radius of curvature of the anterior surface of the cornea, the approximate pixel position where the artifact 75 appears can be predicted.
  • the storage unit of the ophthalmologic apparatus 1 may have a correspondence table in which pixel positions that change for each radius of curvature are associated in advance. This makes it possible to determine the non-analysis region Q1 without using the luminance information of the cross-sectional image 70.
  • control unit 50 may set at least the analysis region Q2 in the cross-sectional image 70 based on the pupil diameter, which is one piece of pupil state information of the eye E to be examined.
  • the control unit 50 may acquire the pupil diameter PDM (see FIG. 8) by detecting the iris of the subject's eye E, and set an area inside the pupil diameter PDM as the analysis area Q2.
  • the region inside the pupil diameter PDM may be limited to the same region as the eye refractive power measurement region (for example, ⁇ 2 mm to ⁇ 4 mm on the pupil) by the measurement optical system 100 .
  • the non-analysis region Q1 and the analysis region Q2 may be set by combining the luminance information and the anterior segment information.
  • the case where the artifact 75 is reflected in the cross-sectional image 70 of the anterior segment by the slit light emitted from the irradiation optical system 300a has been described as an example, but the present invention is not limited to this.
  • the measurement light emitted from the target projection optical system 400 and the measurement light emitted from the alignment target projection optical system are reflected by the cornea and captured by the imaging element 321, thereby preventing the reflection of artifacts. It can happen.
  • FIG. 12 is an example of a cross-sectional image 70 of the anterior segment.
  • a point-shaped artifact 76 derived from the light source 401, a ring-shaped artifact 77 derived from the alignment light source 601, and the like may occur (the shape of each artifact is not limited to this). do not have). Therefore, the control unit 50 may exclude the artifacts 76 and 77 from the target region Q as the non-analysis region Q1 in the same manner as the artifact 75, thereby performing image processing on the analysis region Q2 that does not include them. .
  • the anterior segment shape information of the subject's eye can be obtained with higher accuracy, and an appropriate axial length can be obtained.
  • the configuration for excluding artifacts from the analysis region of the cross-sectional image 70 has been described as an example, but the present invention is not limited to this.
  • the present invention is not limited to this.
  • a configuration in which an optical member for shielding the reflected light is arranged may be employed.
  • artifacts are suppressed from appearing in the cross-sectional image 70, and the anterior segment shape information based on the cross-sectional image 70 can be appropriately acquired.
  • the refractive index of each translucent body of the subject's eye E is constant has been described as an example, but the present invention is not limited to this.
  • refractive index information regarding the refractive index of the translucent body may be acquired and the refractive index information may be used to derive the axial length AL.
  • the refractive index of the translucent body based on the refractive index information may be further considered.
  • the refractive index information may include the refractive index of the lens. It is known that the refractive index of the lens changes with aging.
  • the storage unit of the ophthalmologic apparatus 10 may have a calculation formula or a lookup table in which the refractive index of the lens is associated with each age. In this case, by inputting the age of the subject, it is possible to acquire the refractive index according to the age.
  • the control unit 50 may perform ray tracing calculation using such a refractive index of the crystalline lens.
  • the anterior segment shape information may be configured to apply an assumed value to a part thereof.
  • the hypothetical value should be obtained by taking into account the standard value based on the eye model, the average value based on statistical data, etc., the past measured values of the eye to be examined, the measured values of effective parameters, and the general ratio of each tissue. may be configured such that at least one of the estimated values, etc., can be selected.
  • the ophthalmologic apparatus of the present embodiment projects the first measurement light onto the fundus of the eye to be inspected, and determines the eye refractive power of the eye to be inspected based on the light reflected by the fundus of the first measurement light.
  • An ocular refractive power measurement optical system for obtaining the second measurement light is projected onto the anterior segment of the eye to be inspected to form a light cutting plane passing through the optical axis of the first optical system in the anterior segment of the eye to be examined.
  • a cross-sectional image capturing optical system for acquiring a cross-sectional image of the anterior segment of the eye to be inspected based on the return light from the light-section plane of the second measurement light, and acquires the axial length of the eye to be inspected.
  • An ophthalmologic apparatus comprising: setting means for setting an analysis region in an anterior segment cross-sectional image that does not include a reflected image generated by reflection of at least the second measurement light on the cornea of an eye to be inspected; and analysis set by the setting means.
  • Shape information acquiring means for analyzing an area to acquire anterior segment shape information relating to the shape of the anterior segment; eye refractive power acquired using an eye refractive power measuring optical system; and shape information acquired by the shape information acquiring means and an axial length acquiring means for acquiring the axial length based on the anterior segment shape information.
  • the ophthalmologic apparatus of the present embodiment projects the third measurement light onto the cornea of the subject's eye, and captures an anterior segment front image including a projected image of the third measurement light projected onto the cornea,
  • a front image capturing optical system for acquiring corneal shape information about the shape of the cornea, and the setting means further captures a reflected image generated by the reflection of the third measurement light on the cornea in the anterior segment cross-sectional image.
  • An analysis area that does not include may be set.
  • the ophthalmologic apparatus of the present embodiment includes specifying means for specifying a reflected image included in the anterior segment cross-sectional image, and the setting means removes the reflected image specified by the specifying means from the anterior segment cross-sectional image, thereby , the analysis area may be set.
  • the ophthalmologic apparatus of the present embodiment includes an anterior segment information obtaining means for obtaining anterior segment information about the anterior segment of the subject's eye, and the setting means sets the analysis region based on the anterior segment information.
  • the anterior segment information acquiring means acquires the corneal curvature radius of the eye to be examined as the anterior segment information, and the setting means sets the analysis region based on the corneal curvature radius. good too.
  • the anterior segment information acquisition means may acquire the pupil diameter of the subject's eye as the anterior segment information, and the setting means may set the analysis region based on the pupil diameter. .
  • the shape information acquisition means changes whether or not to use the point on the optical axis of the first measurement light for analysis according to the position of the analysis area set by the setting means, Anterior segment shape information may be acquired.
  • the reflected image is a slit reflected image generated by projecting slit light as the second measurement light onto the anterior segment of the subject's eye in the cross-sectional imaging optical system. good too.
  • the ophthalmologic apparatus of the present embodiment is an ophthalmologic apparatus that acquires the axial length of an eye to be inspected, and includes eye refractive power acquisition means that acquires the eye refractive power of the eye to be inspected, and a cross-sectional image of the anterior segment of the eye to be inspected.
  • An anterior segment cross-sectional image acquisition unit to be acquired, and an analysis region in the anterior segment cross-sectional image that does not include a reflected image generated by reflection of the measurement light projected onto the eye to be inspected by the cornea of the eye to be inspected is set.
  • shape information acquisition means for analyzing the analysis region set by the setting means and acquiring anterior segment shape information relating to the shape of the anterior segment; eye refractive power; and the anterior eye acquired by the shape information acquisition means and axial length acquisition means for acquiring the axial length based on the part shape information.
  • terminal control software that performs the functions of the above embodiments is supplied to a system or device via a network or various storage media, and a control device (eg, CPU, etc.) of the system or device reads the program. It is also possible to run For example, it has an eye refractive power measuring optical system for acquiring the eye refractive power of the eye to be inspected, and a cross-sectional image capturing optical system for acquiring an anterior segment cross-sectional image of the eye to be inspected, and an eye axis of the eye to be inspected.
  • An ophthalmologic program for use in an ophthalmologic apparatus that acquires the length of the ophthalmologic apparatus, which is executed by a processor of the ophthalmologic apparatus to set a setting step of setting an analysis region that does not include a reflected image in an anterior segment cross-sectional image, and a setting step.
  • ophthalmologic apparatus 50 control unit 100 measurement optical system 150 fixation target presentation optical system 200 front imaging optical system 300a irradiation optical system 300b light receiving optical system 400 index projection optical system

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Abstract

La présente invention concerne un dispositif ophtalmologique comprenant : un système optique de présentation de cible de fixation pour diffuser de la lumière de fixation sur un œil examiné et présenter une cible de fixation utilisée pour embuer l'œil examiné ; un système optique de mesure de puissance de réfraction oculaire pour diffuser une première lumière de mesure sur le fond d'œil de l'œil examiné et acquérir une puissance de réfraction oculaire de l'œil examiné sur la base de la réflexion de la première lumière de mesure réfléchie par le fond d'œil ; et un système optique d'acquisition d'image en coupe transversale pour diffuser une seconde lumière de mesure sur le segment antérieur de l'œil examiné pour former, dans le segment antérieur, un plan de coupe de lumière traversant l'axe optique du système optique de mesure de puissance de réfraction oculaire, et acquérir une image en coupe transversale du segment antérieur de l'œil examiné sur la base de la lumière renvoyée provenant du plan de coupe de lumière de la seconde lumière de mesure. Le dispositif ophtalmologique acquiert la longueur de l'axe oculaire de l'œil examiné sur la base de la puissance de réfraction oculaire et de l'image en coupe transversale du segment antérieur. La longueur de l'axe oculaire de l'œil examiné est acquise avec une grande précision du fait qu'elle comprend un élément de couplage de passage optique qui couple un passage de lumière de fixation pour la lumière de fixation dans le système optique de présentation de cible de fixation à un passage de lumière de mesure de la seconde lumière de mesure dans le système optique d'acquisition d'image en coupe transversale.
PCT/JP2022/012460 2021-03-31 2022-03-17 Dispositif ophtalmologique WO2022209991A1 (fr)

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JP2021061511A JP2022157345A (ja) 2021-03-31 2021-03-31 眼科装置
JP2021061512A JP2022157346A (ja) 2021-03-31 2021-03-31 眼科装置及び眼科プログラム
JP2021-061512 2021-03-31

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Citations (1)

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Publication number Priority date Publication date Assignee Title
JP2002200045A (ja) * 2000-10-24 2002-07-16 Topcon Corp 眼科装置

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002200045A (ja) * 2000-10-24 2002-07-16 Topcon Corp 眼科装置

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