Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
  • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
  • A61B3/102—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for optical coherence tomography [OCT]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
  • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
  • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
  • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
  • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
  • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
  • A61B3/1241—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes specially adapted for observation of ocular blood flow, e.g. by fluorescein angiography
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T5/00—Image enhancement or restoration
  • G06T5/50—Image enhancement or restoration using two or more images, e.g. averaging or subtraction
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T5/00—Image enhancement or restoration
  • G06T5/90—Dynamic range modification of images or parts thereof
  • G06T5/94—Dynamic range modification of images or parts thereof based on local image properties, e.g. for local contrast enhancement
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T2207/00—Indexing scheme for image analysis or image enhancement
  • G06T2207/10—Image acquisition modality
  • G06T2207/10072—Tomographic images
  • G06T2207/10101—Optical tomography; Optical coherence tomography [OCT]
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T2207/00—Indexing scheme for image analysis or image enhancement
  • G06T2207/10—Image acquisition modality
  • G06T2207/10116—X-ray image
  • G06T2207/10121—Fluoroscopy
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T2207/00—Indexing scheme for image analysis or image enhancement
  • G06T2207/20—Special algorithmic details
  • G06T2207/20212—Image combination
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T2207/00—Indexing scheme for image analysis or image enhancement
  • G06T2207/30—Subject of image; Context of image processing
  • G06T2207/30004—Biomedical image processing
  • G06T2207/30041—Eye; Retina; Ophthalmic
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T2207/00—Indexing scheme for image analysis or image enhancement
  • G06T2207/30—Subject of image; Context of image processing
  • G06T2207/30004—Biomedical image processing
  • G06T2207/30101—Blood vessel; Artery; Vein; Vascular

Definitions

• This disclosure relates to an image processing method, an image processing device, and a program.
• U.S. Patent No. 8,356,901 discloses a technique for analyzing vortex veins from fundus images.
• Japanese Patent Application Laid-Open No. 2015-131 discloses a technique for quantifying choroidal blood vessels from measurement data obtained by an optical coherence tomography (Optical Coherence Tomography).
• a first aspect of the present disclosure is a method for manufacturing a semiconductor device comprising: An image processing method performed by a processor, comprising: Obtaining a fundus image in which choroidal blood vessels are visualized; extracting choroidal arteries running radially from a predetermined position in the fundus image by image processing the fundus image acquired in the acquiring step; generating a fundus image in which the choroidal arteries extracted in the extracting step are enhanced;
• the image processing method includes:
• a second aspect of the present disclosure is an acquisition unit for acquiring a fundus image in which choroidal blood vessels are visualized; an extraction unit that performs image processing on the fundus image acquired by the acquisition unit to extract choroidal arteries running radially from a predetermined position in the fundus image; a generating unit that generates a fundus image in which the choroidal artery extracted by the extracting unit is emphasized;
• the image processing device includes:
• a third aspect of the present disclosure is Obtaining a fundus image in which choroidal blood vessels are visualized; extracting choroidal arteries running radially from a predetermined position in the fundus image by image processing the fundus image acquired in the acquiring step; generating a fundus image in which the choroidal arteries extracted in the extracting step are enhanced; It is a program that causes a computer to execute the above.
• FIG. 1 is a schematic configuration diagram of an ophthalmologic system according to an embodiment.
• 1 is a schematic configuration diagram of an ophthalmologic apparatus according to an embodiment.
• FIG. 2 is a schematic configuration diagram of a server. 4 is an explanatory diagram of functions realized by an image processing program in a CPU of the server;
• FIG. 10 is a flowchart showing an example of a flow of image processing by the server.
• 13 is a flowchart showing an example of the flow of a fluorescent fundus angiography analysis process.
• FIG. 2 is a diagram showing an example of a fundus image of choroidal blood vessels including choroidal arteries.
• 1 is an example of fundus images showing fundus images before and after contrast enhancement in time series.
• FIG. 13 is a diagram showing an example of an image obtained by polar coordinate conversion of a fundus image.
• FIG. 13 is a conceptual diagram showing an example of setting an area on a fundus image.
• FIG. 13 is a diagram showing an example of an image that has been inversely converted from an image in a polar coordinate system to an image in a rectangular coordinate system.
• FIG. 2 illustrates an example of a display screen.
• 11 is a flowchart showing an example of the flow of an OCT analysis process.
• FIG. 2 is a conceptual diagram of OCT volume data.
• FIG. 13 is a conceptual diagram showing a process up to the extraction of choroidal blood vessels.
• 13 is a flowchart showing an example of the flow of processing for extracting the center position of choroidal blood vessels.
• FIG. 13 is a conceptual diagram showing how the centerline of the choroidal blood vessel is derived.
• FIG. 1 is a conceptual diagram of an image obtained by synthesizing a plurality of en-face images.
• 10 is a flowchart showing an example of a process flow for detecting a second feature amount of a choroidal blood vessel.
• FIG. 13 is a diagram showing the relationship of an analysis region to an image of choroidal blood vessels.
• FIG. 1 is a conceptual diagram relating to setting a plurality of analysis regions.
• FIG. 1 is a conceptual diagram of an analysis region for choroidal blood vessels.
• FIG. 1 is a conceptual diagram showing the state of choroidal blood vessels in the choroid in a plurality of analysis regions.
• FIG. 13 is a conceptual diagram showing an example of an analysis region for a choroid region.
• FIG. 2 illustrates an example of a display screen.
• FIG. 2 illustrates an example of a display screen.
• FIG. 2 illustrates an example of a display screen.
• FIG. 13 is an explanatory diagram relating to providing an image of the choroidal vessels and a centerline separately.
• FIG. 1 shows a schematic configuration of an ophthalmic system 100.
• the ophthalmic system 100 includes an ophthalmic device 110, a server device (hereinafter referred to as “server”) 140, and a display device (hereinafter referred to as "viewer”) 150.
• the ophthalmic device 110 acquires fundus images.
• the server 140 stores, in association with a patient ID, multiple fundus images obtained by photographing the funduses of multiple patients using the ophthalmic device 110, and axial lengths measured by an axial length measuring device (not shown).
• the viewer 150 displays the fundus images and analysis results acquired by the server 140.
• Server 140 is an example of an "image processing device" of the present disclosure.
• the ophthalmic device 110, the server 140, and the viewer 150 are connected to each other via a network 130.
• the network 130 may be any network such as a LAN, a WAN, the Internet, or a wide area Ethernet network.
• a LAN may be used for the network 130.
• the viewer 150 is a client in a client-server system, and multiple units are connected via a network. Multiple servers 140 may also be connected via a network to ensure system redundancy.
• the ophthalmic device 110 has an image processing function and the image viewing function of the viewer 150, fundus images can be acquired, processed, and viewed while the ophthalmic device 110 is in a stand-alone state.
• the server 140 has the image viewing function of the viewer 150, fundus images can be acquired, processed, and viewed with the configuration of the ophthalmic device 110 and the server 140.
• ophthalmic devices examination devices for visual field measurement, intraocular pressure measurement, etc.
• a diagnostic support device that performs image analysis using AI (Artificial Intelligence) may be connected to the ophthalmic device 110, the server 140, and the viewer 150 via the network 130.
• AI Artificial Intelligence
• SLO Scanning Laser Ophthalmoscope
• OCT Optical Coherence Tomography
• the horizontal direction is the "X direction”
• the vertical direction relative to the horizontal plane is the "Y direction”
• the direction connecting the center of the pupil of the anterior segment of the subject's eye 12 and the center of the eyeball is the "Z direction”. Therefore, the X direction, Y direction, and Z direction are perpendicular to each other.
• the ophthalmic device 110 includes an imaging device 14 and a control device 16.
• the imaging device 14 is equipped with an SLO unit 18 and an OCT unit 20, and acquires a fundus image of the subject's eye 12.
• the two-dimensional fundus image acquired by the SLO unit 18 will be referred to as an SLO image.
• a tomographic image or an en-face image of the retina created based on the OCT data acquired by the OCT unit 20 will be referred to as an OCT image.
• the control device 16 includes a computer having a CPU (Central Processing Unit) 16A, a RAM (Random Access Memory) 16B, a ROM (Read-Only Memory) 16C, and an input/output (I/O) port 16D.
• CPU Central Processing Unit
• RAM Random Access Memory
• ROM Read-Only Memory
• I/O input/output
• the control device 16 is equipped with an input/display device 16E connected to the CPU 16A via an I/O port 16D.
• the input/display device 16E has a graphic user interface that displays an image of the subject's eye 12 and accepts various instructions from the user.
• An example of the graphic user interface is a touch panel display.
• the control device 16 also includes an image processor 17 connected to the I/O port 16D.
• the image processor 17 generates an image of the subject's eye 12 based on the data obtained by the photographing device 14.
• the control device 16 is connected to the network 130 via a communication interface (I/F) 16F.
• the control device 16 of the ophthalmic device 110 is equipped with an input/display device 16E, but the present disclosure is not limited to this.
• the control device 16 of the ophthalmic device 110 may not be equipped with the input/display device 16E, but may be equipped with a separate input/display device that is physically independent from the ophthalmic device 110.
• the display device has an image processing processor unit that operates under the control of the display control unit 208 (see FIG. 4) of the CPU 16A of the control device 16.
• the image processing processor unit may display an SLO image, etc., based on an image signal that is instructed to be output by the display control unit 208.
• the imaging device 14 operates under the control of the CPU 16A of the control device 16.
• the imaging device 14 includes an SLO unit 18, an imaging optical system 19, and an OCT unit 20.
• the imaging optical system 19 includes an optical scanner 22, and a wide-angle optical system 30.
• the optical scanner 22 performs two-dimensional scanning in the X and Y directions with the light emitted from the SLO unit 18.
• the optical scanner 22 may be any optical element capable of deflecting a light beam, such as a polygon mirror or a galvanometer mirror. It may also be a combination of these.
• the wide-angle optical system 30 combines the light from the SLO unit 18 and the light from the OCT unit 20.
• the wide-angle optical system 30 may be a reflective optical system using a concave mirror such as an elliptical mirror, a refractive optical system using a wide-angle lens, or a catadioptric system combining concave mirrors and lenses.
• a wide-angle optical system using an elliptical mirror or a wide-angle lens it is possible to photograph the retina not only in the center of the fundus but also in the peripheral part of the fundus.
• the wide-angle optical system 30 allows observation of the fundus in a wide field of view (FOV) 12A.
• the FOV 12A indicates the range that can be photographed by the photographing device 14.
• the FOV 12A can be expressed as a field of view.
• the field of view can be defined by an internal irradiation angle and an external irradiation angle.
• the external irradiation angle is the irradiation angle of the light beam irradiated from the ophthalmic device 110 to the subject's eye 12, defined based on the pupil 27.
• the internal irradiation angle is the irradiation angle of the light beam irradiated to the fundus, defined based on the center O of the eyeball.
• the external irradiation angle and the internal irradiation angle are in a corresponding relationship.
• the internal irradiation angle corresponds to approximately 160 degrees.
• the internal irradiation angle is 200 degrees.
• UWF-SLO fundus image an SLO fundus image captured at an internal illumination angle of 160 degrees or more is referred to as a UWF-SLO fundus image.
• UWF is an abbreviation for Ultra Wide Field.
• the wide-angle optical system 30, which sets the fundus field of view (FOV) to an ultra-wide angle, can capture an image of the area from the posterior pole of the fundus of the subject eye 12 beyond the equator, and structures present in the peripheral area of the fundus can be captured.
• FOV fundus field of view
• the ophthalmic device 110 can capture an image of the area 12A with an internal irradiation angle of 200°, with the eyeball center O of the subject's eye 12 as the reference position.
• the internal irradiation angle of 200° is equivalent to an external irradiation angle of 110°, with the pupil of the subject's eye 12 as the reference.
• the wide-angle optical system 30 irradiates laser light from the pupil with an angle of view of an external irradiation angle of 110°, and captures an image of the fundus area with an internal irradiation angle of 200°.
• the SLO system is realized by the control device 16, SLO unit 18, and imaging optical system 19 shown in FIG. 2.
• the SLO system is equipped with a wide-angle optical system 30, which enables fundus imaging with a wide FOV 12A.
• the SLO unit 18 includes a light source 40 of B light (blue light), a light source 42 of G light (green light), a light source 44 of R light (red light), and a light source 46 of IR light (infrared light (e.g., near-infrared light)), and optical systems 48, 50, 52, 54, and 56 that reflect or transmit the light from the light sources 40, 42, 44, and 46 and guide them to one optical path.
• the optical systems 48 and 56 are mirrors, and the optical systems 50, 52, and 54 are beam splitters.
• the B light is reflected by the optical system 48, transmits through the optical system 50, and is reflected by the optical system 54, the G light is reflected by the optical systems 50 and 54, the R light is transmitted through the optical systems 52 and 54, and the IR light is reflected by the optical systems 52 and 56, and each is guided to one optical path.
• the SLO unit 18 is configured to be able to switch between a light source that emits laser light of different wavelengths or a combination of light sources that emit light, such as a mode that emits R light and G light and a mode that emits infrared light.
• a light source 40 of B light a light source 40 of B light
• a light source 42 of G light a light source 42 of G light
• a light source 44 of R light a light source 46 of IR light
• the SLO unit 18 may further include a light source of white light, and may emit light in various modes, such as a mode that emits G light, R light, and B light, or a mode that emits only white light.
• the light incident on the imaging optical system 19 from the SLO unit 18 is scanned in the X and Y directions by the optical scanner 22.
• the scanning light passes through the wide-angle optical system 30 and the pupil 27 and is irradiated onto the fundus.
• the light reflected by the fundus passes through the wide-angle optical system 30 and the optical scanner 22 and is incident on the SLO unit 18.
• the SLO unit 18 includes a beam splitter 64 that reflects B light and transmits all light except B light from the posterior segment (fundus) of the subject's eye 12, and a beam splitter 58 that reflects G light and transmits all light except G light from the light that has passed through the beam splitter 64.
• the SLO unit 18 includes a beam splitter 60 that reflects R light and transmits all light except R light from the light that has passed through the beam splitter 58.
• the SLO unit 18 includes a beam splitter 62 that reflects IR light from the light that has passed through the beam splitter 60.
• the SLO unit 18 includes a B light detection element 70 that detects B light reflected by the beam splitter 64, a G light detection element 72 that detects G light reflected by the beam splitter 58, an R light detection element 74 that detects R light reflected by the beam splitter 60, and an IR light detection element 76 that detects IR light reflected by the beam splitter 62.
• the light (reflected by the fundus) incident on the SLO unit 18 via the wide-angle optical system 30 and the optical scanner 22 is reflected by the beam splitter 64 and received by the B light detection element 70 in the case of B light, and is reflected by the beam splitter 58 and received by the G light detection element 72 in the case of G light.
• the incident light passes through the beam splitter 58 in the case of R light, is reflected by the beam splitter 60, and is received by the R light detection element 74.
• the incident light passes through the beam splitters 58 and 60 in the case of IR light, is reflected by the beam splitter 62, and is received by the IR light detection element 76.
• the image processor 17, which operates under the control of the CPU 16A, generates a UWF-SLO image using signals detected by the B light detection element 70, the G light detection element 72, the R light detection element 74, and the IR light detection element 76.
• the UWF-SLO image generated using the signal detected by the B light detection element 70 is called a B-UWF-SLO image (B color fundus image).
• the UWF-SLO image generated using the signal detected by the G light detection element 72 is called a G-UWF-SLO image (G color fundus image).
• the UWF-SLO image generated using the signal detected by the R light detection element 74 is called an R-UWF-SLO image (R color fundus image).
• the UWF-SLO image generated using the signal detected by the IR light detection element 76 is called an IR-UWF-SLO image (IR fundus image).
• the UWF-SLO image includes the R color fundus image, G color fundus image, B color fundus image, and even the IR fundus image. It also includes a fluorescent UWF-SLO image captured using fluorescence.
• the control device 16 also controls the light sources 40, 42, 44 to emit light simultaneously.
• the fundus of the subject's eye 12 is photographed simultaneously with the B light, the G light, and the R light, thereby obtaining a G-color fundus image, an R-color fundus image, and a B-color fundus image in which positions correspond to each other.
• An RGB color fundus image is obtained from the G-color fundus image, the R-color fundus image, and the B-color fundus image.
• the control device 16 controls the light sources 42, 44 to emit light simultaneously, and the fundus of the subject's eye 12 is photographed simultaneously with the G light and the R light, thereby obtaining a G-color fundus image and an R-color fundus image in which positions correspond to each other.
• An RG color fundus image is obtained from the G-color fundus image and the R-color fundus image.
• a full color fundus image may also be generated using the G-color fundus image, the R-color fundus image, and the B-color fund
• the wide-angle optical system 30 makes the field of view (FOV) of the fundus an ultra-wide angle, making it possible to capture an image of the area from the posterior pole of the fundus of the subject eye 12 beyond the equator.
• FOV field of view
• the image data of the SLO image is sent from the ophthalmic device 110 to the server 140 via the communication interface 16F and stored in the storage device 254 ( Figure 3).
• the OCT system is realized by the control device 16, the OCT unit 20, and the imaging optical system 19.
• the OCT system includes a wide-angle optical system 30, and thus enables OCT imaging of the peripheral part of the fundus, similar to the above-mentioned imaging of the SLO fundus image.
• the wide-angle optical system 30, which sets the fundus field of view (FOV) at an ultra-wide angle, allows OCT imaging of the area extending from the posterior pole of the fundus of the subject eye 12 beyond the equator.
• OCT data of structures present in the peripheral part of the fundus, such as the choroidal artery can be acquired, and tomographic images of choroidal blood vessels, such as the choroidal artery, and 3D structures of choroidal blood vessels, such as the choroidal artery, can be obtained by image processing the OCT data.
• the OCT unit 20 includes a light source 20A, a sensor (detection element) 20B, a first optical coupler 20C, a reference optical system 20D, a collimating lens 20E, and a second optical coupler 20F.
• the light emitted from the light source 20A is branched by the first optical coupler 20C.
• One of the branched lights is collimated by the collimating lens 20E as measurement light and then enters the imaging optical system 19.
• the measurement light passes through the wide-angle optical system 30 and the pupil 27 and is irradiated onto the fundus.
• the measurement light reflected by the fundus is also passed through the wide-angle optical system 30 and enters the OCT unit 20, and enters the second optical coupler 20F via the collimating lens 20E and the first optical coupler 20C.
• the other light emitted from the light source 20A and branched by the first optical coupler 20C is incident on the reference optical system 20D as reference light, and passes through the reference optical system 20D and enters the second optical coupler 20F.
• the interference light is received by the sensor 20B.
• the image processor 17, which operates under the control of the image processing unit 206 (see FIG. 4), generates OCT data detected by the sensor 20B. It is also possible for the image processor 17 to generate OCT images such as tomographic images and en-face images based on the OCT data.
• the ophthalmic device 110 can scan the area 12A with an internal irradiation angle of 200°. In other words, by controlling the optical scanner 22, OCT imaging of a predetermined range is performed. The ophthalmic device 110 can generate OCT data by this OCT imaging.
• the ophthalmologic device 110 can therefore generate OCT images, such as tomographic images (B-scan images) of the fundus, OCT volume data, and en-face images (frontal images generated based on the OCT volume data) that are cross sections of the OCT volume data.
• OCT images include OCT images of the center of the fundus (the posterior pole of the eyeball where the macula, optic disc, etc. are present).
• the OCT data (or image data of the OCT image) is sent from the ophthalmic device 110 to the server 140 via the communication interface 16F and stored in the storage device 254 described in FIG. 3.
• the light source 20A is exemplified as a wavelength-swept type SS-OCT (Swept-Source OCT), but various types of OCT systems, such as SD-OCT (Spectral-Domain OCT) and TD-OCT (Time-Domain OCT), may also be used.
• SS-OCT Session-Coupled OCT
• SD-OCT Spectral-Domain OCT
• TD-OCT Time-Domain OCT
• the server 140 includes a computer main body 252.
• the computer main body 252 has a CPU 262, a RAM 266, a ROM 264, and an input/output (I/O) port 268.
• the input/output (I/O) port 268 is connected to a storage device 254, a display 256, a mouse 255M, a keyboard 255K, and a communication interface (I/F) 258.
• the storage device 254 is, for example, composed of a non-volatile memory.
• the input/output (I/O) port 268 is connected to the network 130 via the communication interface (I/F) 258. Therefore, the server 140 can communicate with the ophthalmic device 110 and the viewer 150.
• the image processing program is stored in the ROM 264 or the storage device 254.
• ROM 264 or storage device 254 is an example of a "memory” in this disclosure.
• CPU 262 is an example of a “processor” in this disclosure.
• the image processing program is an example of a "program” in this disclosure.
• the server 140 stores each data received from the ophthalmic device 110 in the storage device 254.
• the image processing program executed by the CPU 262 has an imaging control function, an image processing function, and a display control function.
• the CPU 262 functions as the imaging control unit 204, the image processing unit 206, and the display control unit 208.
• the image processing unit 206 is an example of an "acquisition unit,” a “detection unit,” a “extraction unit,” a “generation unit,” and an “estimation unit” of the present disclosure.
• the image processing (image processing method) shown in FIG. 5 is realized by the CPU 262 of the server 140 executing an image processing program.
• the image processing program is executed when an instruction to start analysis is received, for example, when an instruction to start analysis is received by an operator operating the keyboard 255K of the management server 140, or when an instruction to start analysis is received by the management server 140 from the viewer 150.
• the image processing program may be executed when the management server 140 receives a captured fundus image from the ophthalmologic device 110.
• step S10 the imaging control unit 204 executes an initial process for the analysis process described below.
• the initial process also includes a process of acquiring information indicating the type of analysis process.
• the information indicating the type of analysis process is information indicating either fluorescein angiography analysis or OCT analysis.
• step S10 may also include a process in which the imaging control unit 204 instructs the ophthalmic device 110 to capture an SLO image by the SLO unit 18 and an OCT image by the OCT unit 20 to capture a fundus image.
• step S20 the image processing unit 206 determines whether the information indicating the type of analysis process indicates fluorescein angiography analysis, and if the determination is positive, the process proceeds to step S30, and if the determination is negative, the process proceeds to step S40.
• step S30 the image processing unit 206 executes a fluorescein angiography analysis process, and in step S50, the display control unit 208 outputs the analysis data of the analysis results, and ends this processing routine.
• step S40 the image processing unit 206 executes an OCT analysis process
• step S50 the display control unit 208 outputs the analysis data of the analysis results, and ends this processing routine.
• the image processing unit 206 may execute the process of step S40 after step S30, or step S30 after step S40, and in these cases, in step S50, the display control unit may output the analysis data of the analysis results of both the fluorescein angiography analysis and the OCT analysis process, and end this processing routine.
• Fluorescein fundus angiography analysis is a process that uses a contrast agent such as indocyanine green to analyze the state of the choroidal blood vessels, including the choroidal arteries.
• the image processor 206 acquires a fundus image. Specifically, an early fundus image after administration of the contrast agent is acquired from the storage device 254. That is, among fundus images captured in a time series, a fundus image (e.g., an SLO image) captured within a predetermined time range from when a predetermined time has elapsed since administration of the contrast agent until a separately predetermined time has elapsed is acquired as the early fundus image.
• the predetermined time range may be a time range obtained experimentally as the initial time when the contrast agent flows through the choroidal blood vessels, or a preset time range in which the contrast agent is estimated to flow through the choroidal blood vessels.
• a plurality of images captured in a time series may be classified into early images in the first half and late images in the second half, and an early fundus image may be selected from the classified early images.
• FIG. 7 shows an example of a fundus image of choroidal blood vessels including choroidal arteries, which is an early fluorescent UWF-SLO image captured using fluorescence.
• FIG. 8 shows an example of a fundus image showing fundus images before and after contrast enhancement in time series.
• the choroidal blood vessels are not visible in fundus image Gt0 taken before contrast medium is administered (before contrast enhancement), but in the state where the contrast medium begins to flow through the choroidal blood vessels (early enhancement), most of the contrast medium is flowing through the choroidal arteries, and fluorescence appears mainly in the choroidal arteries in fundus image Gt1.
• fundus image Gt2 taken in the state where the contrast medium fills the choroidal blood vessels (late enhancement)
• fluorescence appears in almost all blood vessels in the choroid, including arteries and veins.
• the image processing unit 206 performs brightness adjustment.
• the brightness adjustment is a process for enhancing the choroidal blood vessels (e.g., choroidal arteries) that appear in the fluorescent UWF-SLO image.
• the process for enhancing the choroidal blood vessels is a process for increasing the ratio between the brightness of the background image and the brightness of the blood vessel image from the ratio before the brightness adjustment, and includes, for example, normalizing the brightness of the difference between the maximum and minimum brightness values to a predetermined brightness range or adjusting it as contrast. Other examples include adjustments such as erasing the distribution of the minimum brightness values as noise, assigning a bias brightness value to the brightness value, and assigning a magnification factor to the brightness value by a predetermined coefficient.
• the process of step S104 corresponds to adjusting the brightness value so that the dynamic range of the choroidal blood vessel image in the fundus image is increased.
• the image processing unit 206 performs a first coordinate transformation.
• the first coordinate transformation is a polar coordinate transformation that transforms coordinates in a Cartesian coordinate system into coordinates in a polar coordinate system.
• the origin in the polar coordinate transformation may be set to a predetermined position such as the center of the fundus image, a position indicated by an operator, a position determined from fundus structures such as the midpoint between the macula and the optic disc, or the position at which the brightness value is maximum on the fundus image.
• step S108 the image processing unit 206 performs a filter process on the fundus image that has been transformed into polar coordinates as the first coordinate transformation.
• a filter process an image filter that emphasizes an image with continuous brightness in a predetermined direction can be applied, and in this embodiment, Gabor filter processing is applied.
• the choroidal artery runs radially from a specific position toward the periphery. Therefore, the choroidal artery is considered to include a linear image with continuous brightness in a specific direction toward the periphery from a specific position. Therefore, the fundus image is converted to polar coordinates, and an image with continuous brightness in a specific direction is extracted by filter processing. This makes it possible to highlight the choroidal artery.
• FIG. 9A is an example of an image obtained by polar coordinate conversion and filtering of a fundus image captured by the ophthalmic device 110. As shown in FIG. 9A, blood vessels running in a specific direction corresponding to the choroidal artery are emphasized.
• the image processing unit 206 performs a second coordinate transformation.
• the second coordinate transformation is an orthogonal coordinate transformation that transforms the coordinates of the polar coordinate system into coordinates of the Cartesian coordinate system.
• an image in which the blood vessels running in a predetermined direction corresponding to the choroidal artery are emphasized is inversely transformed from the polar coordinate system to an image of the Cartesian coordinate system.
• FIG. 10 shows a fundus image Gt1A as an example of an image that has been converted from an image in a polar coordinate system to an image in a Cartesian coordinate system.
• the image running in a specific direction corresponding to the choroidal artery is emphasized compared to the image shown in FIG. 7.
• the choroidal artery is clearly formed as an image in the fundus image taken early after the administration of the contrast agent.
• the image processing unit 206 detects a first feature of the choroidal blood vessels.
• the first feature of the choroidal blood vessels is information indicating the degree to which the image of the choroidal artery appears in the fundus image early after the administration of the contrast agent.
• an image of the choroidal artery is detected on a fundus image that has been inversely transformed into an image in a Cartesian coordinate system.
• the image of the choroidal artery can be detected by measuring pixels that exceed a predetermined brightness value.
• the ratio of the pixels that make up the detected image of the choroidal artery to the pixels of the entire fundus image is set as the first feature. This first feature makes it possible to quantify the appearance of the choroidal artery that appears in the fundus image early after the administration of the contrast agent.
• step S114 the image processing unit 206 stores the fundus image and data including the first feature amount described above. Specifically, the image data representing the fundus image inversely converted in step S110 and the data representing the first feature amount detected in step S112 are stored in the RAM 266 or the storage device 254, and this processing routine is terminated.
• a captured fundus image is subjected to polar coordinate transformation, filtering, and Cartesian coordinate transformation, but the above-mentioned processes may be performed by setting a portion of the captured fundus image as the image to be processed.
• a portion of the captured fundus image For example, an image included in an area surrounded by curves and straight lines in the shape of a circle, ellipse, or polygon of a predetermined size or a size specified by the operator on the captured fundus image may be extracted as the image to be processed.
• the fundus image may also include predetermined structures present on the fundus, such as the macula and optic disc.
• the stored data (step S114) is output as analysis data by the display control unit 208.
• the analysis data is included in a display screen for displaying an image (2D image) relating to the choroidal blood vessels including the choroidal arteries.
• the display screen is generated by the display control unit 208 of the server 140 based on a user's instruction, and is output as an image signal to the viewer 150.
• the viewer 150 displays the display screen on the display based on the image signal.
• FIG. 11 shows a display screen 500A. As shown in FIG. 11, the display screen 500A has an information area 502 and an image display area 504A.
• the information area 502 has a patient ID display field 512, a patient name display field 514, an age display field 516, a visual acuity display field 518, a right eye/left eye display field 520, and an axial length display field 522.
• the viewer 150 displays the respective information based on the information received from the server 140.
• the image display area 504A is an area that mainly displays the image of the subject's eye, etc.
• the image display area 504A is provided with a display field for displaying the fundus image Gt1 in the state (early stage) in which the contrast agent described above has just started to flow through the choroidal blood vessels, and the fundus image Gt1A in which the choroidal artery is clearly formed as an image.
• the image display area 504A can be provided with a field that displays the patient's treatment history and functions as a notes column in which the operator, the ophthalmologist, can optionally input the results of his/her observations and diagnosis.
• the display screen 500A shows that a fundus image Gt1 at an early stage of contrast as a UWF-SLO image and a fundus image Gt1A in which the choroidal artery has been clearly image-processed are included as images showing the analysis results.
• choroidal arteries are extracted based on an image showing choroidal blood vessels, and an image is generated in which the choroidal arteries are highlighted, making it possible to visualize the choroidal arteries in the choroid photographed by fluorescein angiography.
• a first characteristic value of the choroidal blood vessels is detected, and this first characteristic value makes it possible to quantify the state of the choroidal arteries that appear in fundus images taken early after administration of a contrast agent.
• the first coordinate transformation in step S106 and the second coordinate transformation in step S110 may be omitted.
• FIG. 9B is a conceptual diagram showing how to set a region for each predetermined central angle on a fundus image captured by the ophthalmologic device 110 with a predetermined position as the center.
• the image processing unit 206 sets a region for each predetermined central angle on the fundus image with a predetermined position as the center, and performs a filter process for emphasizing an image with continuous brightness in a predetermined direction for each region.
• the filter process is performed for each of a plurality of predetermined directions from a predetermined center position of the fundus image to the periphery in the target region.
• an image with continuous brightness in a direction from a predetermined center position of the fundus image to the periphery in the target region can be extracted.
• By performing the filter process on all the set regions it is possible to obtain a fundus image in which the choroidal arteries spreading radially from the predetermined position as the center are emphasized without performing polar coordinate conversion.
• fluorescent fundus angiography analysis processing is performed on a fluorescent fundus image using a contrast agent.
• the technology disclosed herein is not limited to performing fluorescent fundus angiography analysis processing on a fluorescent fundus image using a contrast agent.
• fluorescent fundus angiography analysis processing may be performed on an image in which blood vessels are visualized without using a contrast agent, such as an OCTA image captured by OCT angiography.
• the OCT analysis process is a process for analyzing the state of the choroidal blood vessels, including the choroidal arteries, using OCT images.
• step S202 the image processing unit 206 acquires OCT volume data including the choroid corresponding to the fundus image from the storage device 254.
• step S204 the image processing unit 206 performs preprocessing such as blurring to remove noise components, and then in step S206, performs extraction processing of the choroidal blood vessels.
• preprocessing such as blurring to remove noise components
• step S206 performs extraction processing of the choroidal blood vessels.
• Gaussian blurring which eliminates the effects of speckle noise, can be used.
• the OCT volume data 400 is OCT volume data 400 of a rectangular region of a predetermined area, for example, 6 mm x 6 mm, obtained by OCT imaging of the subject's eye using the ophthalmic device 110. A plurality of surfaces of different depths are set in the OCT volume data 400. From the OCT volume data 400, an area in which choroidal blood vessels are predicted to exist is extracted.
• This extraction process makes it possible to extract a surface (bottom surface 400E) of an area deeper than the retinal pigment epithelium cell layer (hereinafter referred to as the RPE layer) (an area farther from the RPE layer as viewed from the center of the eyeball) from a surface a predetermined number of pixels below the RPE layer, for example, 10 pixels below the RPE layer, as the choroidal area.
• the RPE layer retinal pigment epithelium cell layer
• the image processing unit 206 removes noise components (pre-processing) and generates a plurality of en-face images corresponding to each of the set plurality of planes.
• Each of the generated en-face images corresponding to each plane is stored in the RAM 266 by the image processing unit 206.
• the image processing unit 206 generates and stores en-face images.
• the en-face images may be generated from the pixel values of pixels present on the corresponding plane, or a group of pixels in the shallow direction and a group of pixels in the deep direction including the corresponding plane may be extracted from the OCT volume data 400, and the pixel values may be calculated as the average or median brightness values of these pixel groups.
• Image processing such as noise removal may be used when calculating the pixel values.
• the plane 10 pixels below the RPE layer may be, for example, a plane 10 pixels below Bruch's membrane that exists directly below the RPE layer. Note that in order to specify the position 10 pixels below, it may be 10 pixels below in the direction of the A-scan when the OCT volume data was generated.
• the number of pixels defining the plane is not limited to 10 pixels, and any number of pixels may be set. Also, instead of the number of pixels, it may be defined in terms of a length such as millimeters or micrometers.
• the image processing unit 206 extracts choroidal blood vessels from the OCT volume data 400D by performing a line extraction process on the pre-processed OCT volume data 400D. Specifically, the image processing unit 206 performs image processing using, for example, an eigenvalue filter or a Gabor filter, and extracts linear blood vessel regions from the OCT volume data 400D.
• blood vessel regions are low-luminance pixels (blackish pixels), and regions of continuous low-luminance pixels remain as blood vessel portions.
• step S208 the image processing unit 206 performs field synthesis to synthesize the extracted images of the multiple choroid results, derives an image of an area larger than the area obtained by one OCT imaging as a visualized image, and stores it in the RAM 266. Specifically, the above-mentioned processing is performed for each of the different fields of view, i.e., multiple different areas, of the area of interest obtained by OCT imaging, and the obtained images are synthesized.
• FIG. 14 shows a conceptual diagram of the process up to the extraction of choroidal blood vessels.
• the choroidal blood vessels are visualized larger than the area obtained by one OCT imaging (rectangular area of a specified area).
• multiple (three) areas with at least a portion of the area overlapping are applied.
• Each of the OCT volume data 400-1, 400-2, 400-3 obtained by OCT imaging for each of the multiple (three) areas is obtained from the storage device 254, and after preprocessing (step S204), the choroidal blood vessels are extracted (step S206).
• the choroidal blood vessel images MG1, MG2, MG3 are synthesized to obtain a choroidal blood vessel image MG-A.
• step S208 may be skipped and step S210 may be executed after step S206.
• the image processing unit 206 executes processing for extracting the center position of the choroidal blood vessel.
• the processing for extracting the center position of the choroidal blood vessel is processing for deriving a center line passing through the center of the choroidal blood vessel.
• the center line of the blood vessel is a representative line indicating the direction in which the blood vessel runs. Note that it is sufficient to know the running direction of the blood vessel, and the blood vessel center line may be a line passing through a position slightly shifted from the center of the choroidal blood vessel.
• the center position extraction processing is also called a skeletonization processing or image thinning processing, and refers to a processing for converting an image into a line drawing.
• the image processing unit 206 acquires an image for extracting the central position.
• a two-dimensional image including an image of the choroidal blood vessels is applied as the image for extracting the central position.
• one en-face image may be extracted from the en-face images generated from the OCT volume data 400, or a two-dimensional image generated by image processing multiple en-face images may be applied.
• one en-face image included in the choroidal blood vessel image MG-A is acquired as an image MG-a for extracting the central position.
• step S224 the image processing unit 206 executes a center position extraction process to derive a two-dimensional center line using the image acquired in step S222.
• a line segment indicating the two-dimensional center line is derived for the acquired two-dimensional image (for example, one en-face image).
• the two-dimensional center position extraction process it is possible to apply a process in which an image indicating the area of the choroidal blood vessels is repeatedly expanded and contracted until a line segment is obtained, and the finally obtained line segment (for example, a group of pixels in which one pixel continues in the blood vessel direction) is used as the two-dimensional center line SK. For example, as shown in FIG.
• a representative line along which the choroidal blood vessels run (shown as a dotted line in FIG. 16) is derived as the center line SK of the choroidal blood vessels.
• the image processing unit 206 estimates the depth position (Z coordinate value) from the two-dimensional center line SK derived in step S224, and executes a three-dimensional center position extraction process. Specifically, the image processing unit 206 assigns a Z coordinate value in the depth direction to the center line SK expressed in two dimensions to derive it as a three-dimensional center line SK.
• the choroidal blood vessels including the two-dimensional center line SK are located at a depth corresponding to the extraction position of the en-face image.
• the cross section at the three-dimensional center line SK is a cross section that is evenly located on the retina side and the sclera side.
• the extraction position of the en-face image is assigned as an estimated value of the Z coordinate value, and the three-dimensional center line SK is derived.
• the Z coordinate value estimation process may apply morphology processing to data created by extracting the choroidal blood vessels in the depth direction (Z direction) in any XY plane along the center line, that is, data showing the cross-sectional shape of the choroidal blood vessels.
• the Z coordinate value estimation process may also be performed by applying a graph shortest path search process.
• the graph shortest path search process is a process in which choroidal blood vessels are extracted from an arbitrary XY plane along the centerline only at branching points where the extracted centerline branches into multiple centerlines and at the end points of the centerline, and the Z coordinate value of the centerline is estimated by connecting the estimated Z coordinate values by the shortest distance.
• step S228, the image processing unit 206 stores the data indicating the three-dimensional center line derived in step S226 in the RAM 266 or the storage device 254, and ends the process.
• FIG. 16 a conceptual image in which the three-dimensional center line SK derived as described above is superimposed on the choroidal vessel image MG-A is shown as choroidal vessel image MG-Ax.
• the above describes a case where one en-face image is extracted from the en-face images generated from the OCT volume data 400 and a three-dimensional centerline is derived (Z coordinate value is estimated).
• the technology disclosed herein is not limited to extracting and using one en-face image.
• an image generated by synthesizing multiple en-face images may be applied as a single en-face image.
• FIG. 17 shows a conceptual diagram of applying an image obtained by synthesizing multiple en-face images as a single en-face image.
• FIG. 17 shows a conceptual image MGv in which the brightness of multiple en-face images generated from OCT volume data 400 is averaged. Also shown is a single en-face image MGs extracted from the multiple en-face images. A composite image MGc generated by synthesizing multiple en-face images is shown. A graph image MGg showing the relationship between depth and the area occupied by choroidal blood vessels in multiple en-face images is shown.
• the extracted en-face image MGs has missing portions of the choroidal blood vessels. Therefore, the accuracy of the obtained center line SK may be reduced.
• the choroidal blood vessels run in a meandering manner in the depth direction (Z direction). For example, if the choroidal blood vessels run in the +Z direction with respect to the Z direction (running upward, running toward the center of the eyeball), only a portion of the blood vessels is extracted on the en-face image at a specific depth position. And, the choroidal blood vessels are extracted from the en-face image at a position shallower than the specific depth position.
• the composite image MGc may be an en-face image in which the area of the choroidal blood vessel exceeds a predetermined value (for example, a predetermined number of en-face images from the maximum area).
• a predetermined value for example, a predetermined number of en-face images from the maximum area.
• a center position extraction process is performed on each of a plurality of en-face images acquired at positions with different depth directions.
• the three-dimensional center line SK may be derived by combining information on the center line and the Z coordinate value extracted from each en-face image.
• the circularity/ellipticity of the blood vessel cross section may be obtained using the en-face image at each depth position.
• the circularity/ellipticity is calculated from the depth information of the en-face image and the area occupied by the blood vessel on the en-face image; if the area changes in proportion to the change in depth, the shape is circular; if the change in area is greater or smaller than the change in depth, the shape is elliptical.
• step S212 the image processing unit 206 executes a process of detecting a second feature of the choroidal blood vessels.
• the process of detecting the second feature of the choroidal blood vessels is a process of detecting information indicating features related to the shape of the choroidal blood vessels.
• the cross-sectional area and blood vessel diameter of the choroidal blood vessels are detected as an example of the second feature of the choroidal blood vessels.
• a fundus image on which the central position extraction process has not been performed may be used. In that case, step S212 may be executed after step S206 or after step S208.
• step S232 shown in FIG. 18 the image processing unit 206 acquires an image of the choroidal blood vessels whose central positions have been extracted (see image MG-Ax shown in FIG. 16).
• step S234 the image processing unit 206 sets multiple analysis regions for the acquired image of the choroidal blood vessels.
• the analysis region is applied to the region between the first region showing the first cross section at a position that is a first predetermined distance away from a predetermined position that is determined in advance for the choroid region, and the second region showing the second cross section at a position that is a second predetermined distance away from the predetermined position that is different from the first predetermined distance.
• each of the first cross section and the second cross section can be a cross section whose bottom contour is a curve centered on the predetermined position.
• a concentric circle region (a cylindrical region including the depth direction) in which the choroid region is divided in the depth direction of the choroid by the contour of a concentric circle centered on a predetermined position O is used as the contour, and the analysis region is set.
• Figure 19 shows a diagram of an analysis region with a contour of multiple concentric circles centered on a predetermined position O on a plan view of the choroid region.
• Figure 20 shows a perspective view of analysis regions AN1, AN2, and AN3 in which a flat choroid region is divided by a cylindrical contour with a bottom surface of multiple concentric circles centered on the predetermined position O.
• the predetermined position O when setting the analysis region may be set manually, such as by an operator setting a position where he or she designates an area of interest while checking an image of the choroidal blood vessels. It is also possible, for example, to set the analysis region so that it perpendicularly crosses the blood vessels through which the dilation of the choroidal blood vessels runs. In addition, the center of a structure in the fundus or a predetermined position, such as the center of the dilation, may be set.
• the analysis regions are set as analysis region AN1, which is obtained by dividing the choroid region with a circle having a radius of R1, R2 (>R1) centered at a predetermined position O, analysis region AN2, which has a circle having a radius of R2, R3 (>R2), and analysis region AN3, which has a circle having a radius of R3, R4 (>R3).
• analysis region AN1, AN2, and AN3 may be set so that adjacent analysis regions partially overlap, or may be set to be spaced apart at a predetermined interval.
• the analysis region is not limited to a concentric region.
• it may be an ellipse centered on a predetermined position, an oval centered on a predetermined position, or a circular arc centered on a predetermined position.
• the analysis region is set so as to be superimposed on the choroidal blood vessels on the image.
• it is not limited to setting the analysis region in a cylindrical shape.
• it may be a region separated into a plate shape by a curve, such as a part of a concentric sphere.
• the image processing unit 206 derives the second feature amount for each set analysis region.
• the second feature amount of the choroidal blood vessels is detected by deriving the cross-sectional area and blood vessel diameter of the choroidal blood vessels.
• the image processing unit 206 derives the average blood vessel diameter and the average cross-sectional area of the choroidal blood vessels using the volume and blood vessel length of the choroidal blood vessels.
• FIG. 21 shows a conceptual diagram of the analysis region AN.
• the analysis region AN includes a first vascular region BL1 having a first center line SK1 and a second vascular region BL2 having a second center line SK2.
• the number of pixels in the first vascular region BL1 is calculated and set as the volume V1 of the first vascular region BL1.
• the number of pixels of the first center line SK1 is also calculated and set as the vascular length L1 of the first vascular region BL1.
• the average blood vessel diameter ra within the analysis region AN can be made to correspond to the radius rb of a circle that has a common area with the derived average cross-sectional area Sa.
• the average blood vessel diameter ra within the analysis region AN may be calculated using the above-mentioned circularity/ellipticity.
• the average cross-sectional area Sa of the vascular region in the analysis region AN and the average vascular diameter ra, which corresponds to a circular cross section, are derived for each analysis region as second feature amounts within the analysis region AN.
• the average cross-sectional area Sa and the average vascular diameter ra derived as the second feature amount in the analysis region AN are examples of physical quantities related to the shape of the choroidal vessels of the present disclosure.
• Examples of the second feature amount include the average vessel length and skeleton density (the number of pixels of the center line relative to the number of pixels of a unit area or the entire image in the image).
• step S238 the image processing unit 206 stores data indicating the average cross-sectional area Sa and average vascular diameter ra, which are the second feature quantities of the analysis region derived in step S236, in the RAM 266 or the storage device 254, and ends the process.
• data indicating the volume V1 and vascular length L1 of the first vascular region BL1 and the volume V2 and vascular length L2 of the second vascular region BL2 may be stored as the second feature quantities in the RAM 266 or the storage device 254.
• position information for the first vascular region BL1 and the second vascular region BL2 relative to the predetermined position O may be stored in the RAM 266 or the storage device 254.
• the operator can observe the state of the choroidal blood vessels in the choroid (e.g., shape distribution, etc.).
• the technology of the present disclosure is not limited to this.
• the choroid region up to a predetermined radius Rr centered on the above-mentioned predetermined position O may be set as the analysis region.
• the stored data (step S214) is output as analysis data by the display control unit 208.
• the analysis data is included in a display screen for displaying the analysis results from the OCT analysis.
• the display screen is generated by the display control unit 208 of the server 140 based on a user's instruction, and is output as an image signal to the viewer 150.
• the viewer 150 displays the display screen on the display based on the image signal.
• FIG. 24 shows display screen 500B.
• display screen 500B has an information area 502 similar to display screen 500A, and an image display area 504B.
• the image display area 504B is an area that displays the analysis results of the OCT analysis process described above.
• the image display area 504B can include a diagram of the analysis area ( Figure 19) that has multiple concentric circles centered at a predetermined position O as its outline on a plan view of the choroidal area described above.
• a cross-sectional view at any position of a choroidal vessel image (for example, image MG-Ax shown in FIG. 16) that is the analysis result can be applied as a diagram of the analysis region.
• the display screen 500C of the first modified example has an information area 502 similar to that of the display screen 500A, and image display areas 504Ca, 504Cx, 504Cy, and 504Cz.
• the image display area 504Ca is an area for displaying an image MG-Ax (FIG. 16) of choroidal blood vessels as an analysis result of the OCT analysis process described above.
• the image display area 504Ca includes a movable frame surface Wa for providing a cross-sectional view of the choroidal blood vessels in the XY plane at any Z coordinate value.
• the image display area 504Cx is an area for displaying the image MG-Ax of the choroidal blood vessels in the XY plane at any Z coordinate value in conjunction with the movement of the frame surface Wa.
• the image display area 504Ca includes a movable frame surface Wb for providing a cross-sectional view of the choroidal blood vessels in the XZ plane at any Y coordinate value.
• the image display area 504Cy is an area for displaying the image MG-Ax of the choroidal blood vessels in the XZ plane at any Y coordinate value in conjunction with the movement of the frame surface Wb. It also includes a movable frame surface Wc for providing a cross-sectional view of the choroidal blood vessels in the YZ plane at any X coordinate value.
• the image display area 504Cz is an area that displays the image MG-Ax of the choroidal blood vessels as a cross-sectional view in the YZ plane at an arbitrary X coordinate value in conjunction with the movement of the frame surface Wc.
• a cross-sectional view at any position on the image of the choroidal blood vessels can be visualized and provided, making it possible for the operator to check the image of the choroidal blood vessels at any position on the choroid.
• the second modified display screen 500D has an information area 502 similar to that of the display screen 500A, and an image display area 504D.
• the image display area 504D is an area that displays the image MG-Ax (FIG. 16) of the choroidal blood vessels as the analysis result of the OCT analysis process described above.
• the image processing unit 206 receives a command for an arbitrary position P in the image MG-Ax of the choroidal blood vessels, information about the cross section of the choroidal blood vessels at the position P is displayed based on the analysis area AN.
• the second modified example can provide information about the cross-section of the blood vessels at any position while providing an image of the choroidal blood vessels, making it possible for the operator to confirm information about the cross-section of the choroidal blood vessels at a specified position, even if that position is arbitrary.
• the display form of the choroidal vessel image MG-Ax (FIG. 16) resulting from the choroidal vessel analysis can be changed and applied (not shown).
• the choroidal vessel image is provided in a display form in which the color is changed for each layer according to the position in the depth direction.
• the choroidal vessel image is also provided in a display form in which it is enlarged or reduced in at least one of the specified XYZ axes. In this way, by making the display form of the choroidal vessel image changeable, it can be applied to provide areas that the operator wishes to focus on or not focus on according to request.
• images showing the state of the choroidal blood vessels are provided, making it possible to visualize the choroidal blood vessels in various forms in the choroid photographed by OCT.
• image processing is performed by the server 140, but the present disclosure is not limited to this, and image processing may be performed by the ophthalmic device 110, the viewer 150, or an additional image processing device further provided on the network 130.
• each component may exist in one or more instances, provided no contradiction arises.
• image processing is realized by a software configuration using a computer, but the present disclosure is not limited to this, and at least a part of the processing may be realized by a hardware configuration.
• processor refers to a processor in a broad sense, and includes general-purpose processors (e.g., CPU: Central Processing Unit, etc.) and dedicated processors (e.g., GPU: Graphics Processing Unit, ASIC: Application Specific Integrated Circuit, FPGA: Field Programmable Gate Array, programmable logic device, etc.). Therefore, image processing may be performed only by a hardware configuration, or a part of the image processing may be performed by a software configuration and the remaining processing may be performed by a hardware configuration.
• processor operations may not only be performed by a single processor, but may also be performed by multiple processors working together, or may be performed by multiple processors located in physically separate locations working together.
• a program that describes the above-mentioned processes using code that can be processed by a computer may be stored on a storage medium such as an optical disk and distributed.

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