JP7154259B2 - ophthalmic equipment - Google Patents

Description

The present invention relates to ophthalmic equipment.

The ophthalmologic apparatus includes an ophthalmologic imaging apparatus for obtaining an image of an eye to be examined and an ophthalmic measurement apparatus for measuring characteristics of the eye to be examined.

Examples of ophthalmologic imaging equipment include optical coherence tomography to obtain tomographic images using optical coherence tomography (OCT), fundus cameras that take photographs of the fundus, and images of the fundus by laser scanning using a confocal optical system. There is a scanning laser ophthalmoscope (SLO) that obtains .

Examples of ophthalmologic measurement devices include eye refraction testing devices (refractometers, keratometers) that measure the refractive characteristics of the eye to be examined, tonometers, specular microscopes that obtain corneal characteristics (corneal thickness, cell distribution, etc.), There is a wavefront analyzer that uses a Hartmann-Shack sensor to obtain aberration information of an eye to be examined.

Many ophthalmologic apparatuses are provided with a configuration for presenting a fixation target to the subject's eye (or fellow eye). A fixation target has a function of guiding the line of sight in order to acquire data on a desired region of the subject's eye and a function of fixing the subject's eye during data acquisition.

Japanese Patent Application Laid-Open No. 2014-200680

In the conventional ophthalmologic apparatus, photographing and the like are performed while the subject is made to gaze at a stationary fixation target. On the other hand, some imaging takes several seconds or more, and the subject is required to fixate on the fixation target all the time while imaging is being performed. However, continuing to fixate on a stationary fixation target is unnatural and may cause fatigue and stress to the subject. This problem can be particularly pronounced for children, the elderly, and those with low vision.

SUMMARY OF THE INVENTION It is an object of the present invention to provide an ophthalmologic apparatus capable of photographing and measuring a subject's eye in its natural state.

An ophthalmologic apparatus according to an embodiment includes a data acquisition section, an alignment section, a fixation system, a setting section, and a control section. The data acquisition unit includes an optical system for acquiring data of the subject's eye. The alignment section is used for alignment of the optical system with respect to the subject's eye. The fixation system presents a fixation target to the eye to be examined. The setting unit sets the movement pattern of the fixation target. The control unit controls the fixation system for arranging the fixation target at the initial position based on the movement pattern, then controls the alignment unit for alignment, and after controlling the alignment unit, controls the target. Control of the data acquisition unit for acquiring optometric data and control of the fixation system for moving the fixation target in a direction perpendicular to the optical axis of the optical system of the data acquisition unit according to the movement pattern are performed in parallel. to run.

According to the ophthalmologic apparatus according to the embodiment, it is possible to photograph and measure the subject's eye in its natural state.

1 is a schematic diagram showing an example of the configuration of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic apparatus according to an embodiment; FIG. 4 is a flow chart showing an example of the operation of the ophthalmologic apparatus according to the embodiment; 4 is a flow chart showing an example of the operation of the ophthalmologic apparatus according to the embodiment; 4 is a flow chart showing an example of the operation of the ophthalmologic apparatus according to the embodiment;

Embodiments of the present invention will be described in detail with reference to the drawings. An ophthalmologic apparatus according to one embodiment includes an optical coherence tomography (OCT) and a fundus camera as elements for acquiring data of an eye to be examined. Here, instead of or in addition to the fundus camera, a scanning laser ophthalmoscope (SLO), a slit lamp microscope, an ophthalmic surgical microscope, an anterior eye camera, etc. may be provided. Although swept-source OCT is applied in the following examples, other types of OCT (spectral-domain OCT, time-domain OCT, amphasic OCT, polarization OCT, etc.) may also be applied.

<Constitution>
As shown in FIG. 1 , the ophthalmologic apparatus 1 includes a fundus camera unit 2 , an OCT unit 100 and an arithmetic control unit 200 . The retinal camera unit 2 is provided with an optical system and a mechanism for acquiring a front image of the subject's eye. The OCT unit 100 is provided with a part of an optical system and a mechanism for performing OCT. Another part of the optical system and mechanism for performing OCT is provided in the fundus camera unit 2 . The arithmetic control unit 200 includes one or more processors that perform various arithmetic operations and controls. In addition to these, arbitrary elements such as a member for supporting the subject's face (chin rest, forehead rest, etc.) and a lens unit for switching the target part of OCT (for example, attachment for anterior segment OCT) or unit may be provided in the ophthalmologic apparatus 1 .

In this specification, the "processor" includes, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an ASIC (Application Specific Integrated Circuit), a programmable logic device (e.g., SPLD (Simple Programmable Logic Device (CPLD) Programmable Logic Device), FPGA (Field Programmable Gate Array)) or the like. The processor implements the functions according to the embodiment by, for example, reading and executing a program stored in a storage circuit or storage device.

<Fundus camera unit 2>
The fundus camera unit 2 is provided with an optical system for photographing the fundus Ef of the eye E to be examined. The acquired image of the fundus oculi Ef (referred to as a fundus image, fundus photograph, etc.) is a front image such as an observed image or a photographed image. Observation images are obtained by moving image shooting using near-infrared light. A photographed image is a still image using flash light.

The fundus camera unit 2 includes an illumination optical system 10 and an imaging optical system 30 . The illumination optical system 10 irradiates the eye E to be inspected with illumination light. The imaging optical system 30 detects return light of the illumination light from the eye E to be examined. The measurement light from the OCT unit 100 is guided to the subject's eye E through the optical path in the retinal camera unit 2, and its return light is guided to the OCT unit 100 through the same optical path.

Light (observation illumination light) output from an observation light source 11 of an illumination optical system 10 is reflected by a reflecting mirror 12 having a curved reflecting surface, passes through a condenser lens 13, and passes through a visible light cut filter 14. It becomes near-infrared light. Furthermore, the observation illumination light is once converged near the photographing light source 15 , reflected by the mirror 16 , and passed through the relay lenses 17 and 18 , the diaphragm 19 and the relay lens 20 . Then, the observation illumination light is reflected by the periphery of the perforated mirror 21 (area around the perforation), passes through the dichroic mirror 46, is refracted by the objective lens 22, part). The return light of the observation illumination light from the subject's eye E is refracted by the objective lens 22, passes through the dichroic mirror 46, passes through the hole formed in the central region of the apertured mirror 21, and passes through the dichroic mirror 55. , through a focusing lens 31 and reflected by a mirror 32 . Further, this return light passes through the half mirror 33A, is reflected by the dichroic mirror 33, and is imaged on the light receiving surface of the image sensor 35 by the condenser lens . The image sensor 35 detects returned light at a predetermined frame rate. Note that the focus of the imaging optical system 30 is adjusted so as to match the fundus oculi Ef or the anterior segment of the eye.

The light (imaging illumination light) output from the imaging light source 15 irradiates the fundus oculi Ef through the same path as the observation illumination light. The return light of the imaging illumination light from the subject's eye E is guided to the dichroic mirror 33 through the same path as the return light of the observation illumination light, passes through the dichroic mirror 33 , is reflected by the mirror 36 , is reflected by the condenser lens 37 . An image is formed on the light receiving surface of the image sensor 38 .

An LCD (Liquid Crystal Display) 39 displays a fixation target and visual acuity measurement target. A part of the light beam output from the LCD 39 is reflected by the half mirror 33A, reflected by the mirror 32, passes through the focusing lens 31 and the dichroic mirror 55, and passes through the aperture of the apertured mirror 21. The luminous flux that has passed through the aperture of the perforated mirror 21 is transmitted through the dichroic mirror 46, refracted by the objective lens 22, and projected onto the fundus oculi Ef.

By changing the display position of the fixation target on the screen of the LCD 39, the fixation position of the subject's eye E can be changed. Examples of fixation positions include a fixation position for acquiring an image centered on the macula, a fixation position for acquiring an image centered on the optic disc, and a fixation position between the macula and the optic disc. There are a fixation position for acquiring an image centered on the center of the eye fundus and a fixation position for acquiring an image of a site far away from the macula (eye fundus periphery). A GUI (Graphical User Interface) or the like for designating at least one of such typical fixation positions can be provided. Further, a GUI or the like for manually moving the fixation position (the display position of the fixation target) can be provided.

The configuration for presenting a movable fixation target to the subject's eye E is not limited to a display device such as an LCD. For example, a movable fixation target can be generated by selectively lighting multiple light sources in a light source array (such as a light emitting diode (LED) array). Also, one or more movable light sources can generate a movable fixation target.

The alignment optical system 50 generates an alignment index used for alignment of the optical system with respect to the eye E to be examined. Alignment light output from the LED 51 passes through the apertures 52 and 53 and the relay lens 54 , is reflected by the dichroic mirror 55 , and passes through the aperture of the apertured mirror 21 . The light passing through the hole of the perforated mirror 21 is transmitted through the dichroic mirror 46 and projected onto the subject's eye E by the objective lens 22 . The corneal reflected light of the alignment light is guided to the image sensor 35 through the same path as the return light of the observation illumination light. Manual alignment or automatic alignment can be performed based on the received light image (alignment index image).

The focus optical system 60 generates a split index used for focus adjustment of the eye E to be examined. The focus optical system 60 is moved along the optical path (illumination optical path) of the illumination optical system 10 in conjunction with the movement of the imaging focusing lens 31 along the optical path (illumination optical path) of the imaging optical system 30 . The reflecting bar 67 can be inserted into and removed from the illumination optical path. When performing focus adjustment, the reflecting surface of the reflecting bar 67 is arranged at an angle in the illumination optical path. Focus light output from the LED 61 passes through a relay lens 62, is split into two light beams by a split index plate 63, passes through a two-hole diaphragm 64, is reflected by a mirror 65, and is reflected by a condenser lens 66 onto a reflecting rod 67. is once imaged on the reflective surface of , and then reflected. Further, the focused light passes through the relay lens 20, is reflected by the perforated mirror 21, passes through the dichroic mirror 46, is refracted by the objective lens 22, and is projected onto the fundus oculi Ef. The fundus reflected light of the focus light is guided to the image sensor 35 through the same path as the corneal reflected light of the alignment light. Manual alignment or automatic alignment can be performed based on the received light image (split index image).

Diopter correction lenses 70 and 71 are selectively insertable in the imaging optical path between apertured mirror 21 and dichroic mirror 55 . The dioptric correction lens 70 is a plus lens (convex lens) for correcting high hyperopia. The dioptric correction lens 71 is a minus lens (concave lens) for correcting strong myopia.

The dichroic mirror 46 synthesizes the fundus imaging optical path and the OCT optical path. The dichroic mirror 46 reflects light in the wavelength band used for OCT and transmits light for fundus imaging. The OCT optical path is provided with a collimator lens unit 40, an optical path length changing section 41, an optical scanner 42, an OCT focusing lens 43, a mirror 44, and a relay lens 45 in this order from the OCT unit 100 side.

The optical path length changing unit 41 is movable in the direction of the arrow shown in FIG. 1, and changes the length of the optical path for OCT. This change in optical path length is used for optical path length correction according to the axial length of the eye, adjustment of the state of interference, and the like. The optical path length changing section 41 includes a corner cube and a mechanism for moving it.

The optical scanner 42 is arranged at a position optically conjugate with the pupil of the eye E to be examined. The optical scanner 42 deflects the measurement light LS passing through the OCT optical path. The optical scanner 42 is, for example, a galvanometer scanner capable of two-dimensional scanning.

The OCT focusing lens 43 is moved along the optical path of the measurement light LS in order to focus the optical system for OCT. Movement of the imaging focusing lens 31, movement of the focusing optical system 60, and movement of the OCT focusing lens 43 can be controlled in a coordinated manner.

<OCT unit 100>
As illustrated in FIG. 2, the OCT unit 100 is provided with an optical system for performing swept-source OCT. This optical system divides light from a wavelength tunable light source (wavelength swept light source) into measurement light and reference light, and causes interference between the return light of the measurement light from the subject's eye E and the reference light that has passed through the reference optical path. and an interference optical system for generating interference light and detecting the interference light. A detection result (detection signal) obtained by the interference optical system is a signal indicating the spectrum of the interference light, and is sent to the arithmetic control unit 200 .

The light source unit 101 includes, for example, a near-infrared tunable laser that changes the wavelength of emitted light at high speed. The light L0 output from the light source unit 101 is guided to the polarization controller 103 by the optical fiber 102, and the polarization state is adjusted. Further, the light L0 is guided by the optical fiber 104 to the fiber coupler 105 and split into the measurement light LS and the reference light LR.

The reference light LR is guided to the collimator 111 by the optical fiber 110 and converted into a parallel beam, and guided to the corner cube 114 via the optical path length correction member 112 and the dispersion compensation member 113 . The optical path length correction member 112 acts to match the optical path length of the reference light LR and the optical path length of the measurement light LS. The dispersion compensation member 113 acts to match the dispersion characteristics between the reference light LR and the measurement light LS. The corner cube 114 is movable in the incident direction of the reference light LR, thereby changing the optical path length of the reference light LR.

The reference light LR that has passed through the corner cube 114 passes through the dispersion compensating member 113 and the optical path length correcting member 112 , is converted by the collimator 116 from a parallel beam to a converged beam, and enters the optical fiber 117 . The reference light LR incident on the optical fiber 117 is guided to the polarization controller 118 to have its polarization state adjusted, guided to the attenuator 120 via the optical fiber 119 to have its light amount adjusted, and guided to the fiber coupler 122 via the optical fiber 121 . be killed.

On the other hand, the measurement light LS generated by the fiber coupler 105 is guided by the optical fiber 127 and converted into a parallel light beam by the collimator lens unit 40, and the optical path length changing unit 41, the optical scanner 42, the OCT focusing lens 43, and the mirror 44. and the relay lens 45 , reflected by the dichroic mirror 46 , refracted by the objective lens 22 , and incident on the eye E to be examined. The measurement light LS is scattered and reflected at various depth positions of the eye E to be examined. The return light of the measurement light LS from the subject's eye E travels in the opposite direction along the same path as the forward path, is guided to the fiber coupler 105 , and reaches the fiber coupler 122 via the optical fiber 128 .

The fiber coupler 122 combines (interferences) the measurement light LS that has entered via the optical fiber 128 and the reference light LR that has entered via the optical fiber 121 to generate interference light. The fiber coupler 122 generates a pair of interference lights LC by splitting the interference lights at a predetermined splitting ratio (for example, 1:1). A pair of interference lights LC are guided to detector 125 through optical fibers 123 and 124, respectively.

Detector 125 is, for example, a balanced photodiode. A balanced photodiode has a pair of photodetectors that respectively detect a pair of interference lights LC, and outputs the difference between the detection results of these. The detector 125 sends this output (detection signal) to a DAQ (Data Acquisition System) 130 .

A clock KC is supplied from the light source unit 101 to the DAQ 130 . The clock KC is generated in the light source unit 101 in synchronization with the output timing of each wavelength swept within a predetermined wavelength range by the wavelength tunable light source. The light source unit 101, for example, optically delays one of the two branched lights obtained by branching the light L0 of each output wavelength, and then outputs the clock KC based on the result of detecting these combined lights. Generate. The DAQ 130 samples the detection signal input from the detector 125 based on the clock KC. DAQ 130 sends the sampling result of the detection signal from detector 125 to arithmetic control unit 200 .

In this example, an optical path length changing unit 41 for changing the length of the optical path (measurement optical path, measurement arm) of the measurement light LS and an optical path length changing unit 41 for changing the length of the optical path (reference optical path, reference arm) of the reference light LR Although both of the corner cubes 114 are provided, only one of the optical path length changing portion 41 and the corner cubes 114 may be provided. It is also possible to change the difference between the measurement optical path length and the reference optical path length by using optical members other than these.

<Control system>
A configuration example of the control system of the ophthalmologic apparatus 1 is shown in FIG. Control section 210 , image forming section 220 and data processing section 230 are provided in arithmetic control unit 200 .

<Control unit 210>
The control unit 210 executes various controls. Control unit 210 includes main control unit 211 and storage unit 212 .

<Main control unit 211>
The main controller 211 includes a processor and controls each part of the ophthalmologic apparatus 1 (including the elements shown in FIGS. 1 to 3). Note that the photographing focusing lens 31 is moved by a photographing focusing driving section (not shown), and the OCT focusing lens is moved by an OCT focusing driving section. Also, the reference drive unit 114A moves the corner cube 114. As shown in FIG.

The moving mechanism 150 moves, for example, at least the retinal camera unit 2 three-dimensionally. In a typical example, the moving mechanism 150 includes an x stage that can move in the x direction (horizontal direction), an x moving mechanism that moves the x stage, a y stage that can move in the y direction (vertical direction), and a y stage. It includes a y-moving mechanism for moving the stage, a z-stage movable in the z-direction (depth direction), and a z-moving mechanism for moving the z-stage. Each moving mechanism includes an actuator such as a pulse motor, and is controlled by the main controller 211 .

A main control unit 211 controls the LCD 39 . For example, the main controller 211 displays a fixation target at a preset position on the screen of the LCD 39 . Further, the main control unit 211 can gradually change the display position of the fixation target displayed on the LCD 39 (that is, can move the fixation target). The display position and movement mode of the fixation target are set manually or automatically. Manual setting is performed using, for example, a GUI. Automatic setting is performed by, for example, a movement pattern setting unit 231, which will be described later.

<Storage unit 212>
The storage unit 212 stores various data. The data stored in the storage unit 212 include an OCT image, a fundus image, eye information to be examined, and the like. The eye information to be examined includes subject information such as a patient ID and name, left/right eye identification information, electronic medical record information, and the like.

<Image forming unit 220>
The image forming section 220 forms an image based on the output from the DAQ 130 (sampling result of the detection signal). For example, the image forming unit 220 performs signal processing on the spectral distribution based on the sampling result for each A line, forms a reflection intensity profile for each A line, and images these A line profiles as in the conventional swept source OCT. and arrange them along the scan lines. The signal processing includes noise removal (noise reduction), filtering, FFT (Fast Fourier Transform), and the like.

<Data processing unit 230>
The data processing section 230 performs image processing and analysis processing on the image formed by the image forming section 220 . For example, the data processing unit 230 creates three-dimensional image data (stack data, volume data, etc.) based on raster scan data, renders three-dimensional image data, corrects images, and performs image analysis based on analysis applications. Data processing section 230 includes movement pattern setting section 231 and motion detection section 232 .

<Movement pattern setting unit 231>
The movement pattern setting section 231 sets the movement pattern of the fixation target. The movement pattern represents any one of the path along which the fixation target is moved, information equivalent to it, information deriving it, information corresponding to it, information related to it, and the like.

As a typical example, the movement pattern includes the shape of the movement path of the fixation target, the orientation of the shape, the size, the movement direction, the movement speed, and the like. Examples of shapes include circles, rectangles, spirals, straight lines, random shapes, and the like. The orientation of the shape may be set if the shape has asymmetry. For example, for a circular, rectangular, spiral shape, etc., it is possible to set the movement direction to be clockwise, counterclockwise, or a combination thereof; It is possible to set the approaching direction, a combination thereof, etc.; round trip between the end and the second end), etc. can be set. The movement speed can be selected from options such as low speed, medium speed, and high speed, for example. Moreover, a desired moving speed may be settable, or the moving speed may be adjustable.

When a movement pattern (for example, one or more of shape, direction of shape, size, direction of movement, speed of movement, etc.) is designated using the user interface 240 (GUI or the like), the movement pattern setting unit 231 allows the user to Sets the movement pattern corresponding to the specified content.

It is possible to set movement patterns by referring to medical information such as electronic medical charts. For example, when a movement pattern actually applied in imaging or the like is recorded in an electronic medical record or the like, the movement pattern setting unit 231 reads the movement pattern applied in the past from the electronic medical record of the subject, and reads this movement pattern. can be set as the movement pattern for this shooting. As another example, when correspondence information in which predetermined information (for example, a disease name) is associated with a movement pattern is created in advance, the movement pattern setting unit 231 selects a diagnosis name (disease name) from the subject's electronic medical record. name), and the movement pattern corresponding to this diagnosis name can be obtained from the corresponding information.

Preliminary shots can be taken to determine the movement pattern that will be applied to the shots. For example, the main controller 211 causes the ophthalmologic apparatus 1 to perform OCT of the fundus oculi Ef while controlling the LCD 39 to move the fixation target according to one or more movement patterns. When two or more movement patterns are applied, OCT of the fundus oculi Ef is performed while sequentially applying these movement patterns.

The movement pattern setting unit 231 evaluates data acquired by such preliminary OCT or images based thereon. In a typical example, the movement pattern setting unit 231 can perform one or more of noise evaluation, image quality evaluation, contrast evaluation, sharpness evaluation, granularity evaluation, and the like.

The movement pattern setting unit 231 determines whether or not the result of this evaluation is within the allowable range. For example, the movement pattern setting unit 231 determines whether the value (evaluation value) calculated by the evaluation process exceeds a predetermined threshold. If the evaluation result is within the allowable range, the movement pattern setting unit 231 sets the movement pattern applied in preliminary OCT (the movement pattern applied during data collection) as the movement pattern for main imaging. If the evaluation result does not fall within the allowable range (none of the one or more movement patterns are suitable), for example, a mode for manually setting movement patterns is entered.

Any two or more of the above movement pattern setting modes (manual setting mode, medical information reference mode, preliminary imaging mode, etc.) can be combined, or any two or more can be executed sequentially.

An example will be described. First, the movement pattern setting unit 231 determines whether or not the medical information reference mode can be executed. For example, the movement pattern setting unit 231 determines whether or not predetermined information (such as movement patterns applied in the past) is recorded in an electronic medical record or the like.

When predetermined information is recorded in an electronic medical chart or the like, a movement pattern is set in the medical information reference mode. It should be noted that a preliminary photographing mode using this movement pattern can be executed in order to confirm whether or not this movement pattern is appropriate.

If the predetermined information is not recorded in the electronic medical chart or the like, the mode shifts to a preliminary imaging mode. If a suitable movement pattern is determined by the preliminary photography mode, this movement pattern is adopted. If the preliminary capture mode does not determine a suitable movement pattern, the manual setting mode is entered.

The combination and order of movement pattern setting modes (manual setting mode, medical information reference mode, preliminary imaging mode, etc.) are not limited to the above examples.

<Motion detector 232>
The movement detection unit 232 detects movement of the eye E to be examined. Any method may be used to detect the movement of the eye E to be examined.

For example, the movement detection unit 232 can obtain the movement of the eye E to be examined (change in position over time) by analyzing the moving image of the eye E to be examined. An example of this moving image is an observation image of the anterior ocular segment or the fundus oculi Ef. The motion detection unit 232 identifies a predetermined region (pupil region, pupil center, iris region, iris center, macular region, optic papilla region, lesion region, laser treatment plaque, etc.) in each frame of the moving image, and detects a plurality of frames. The movement of the subject's eye E can be detected by comparing the positions of the predetermined regions in . This process is also used in conventional auto-alignment and tracking.

In another example, a projection optical system that projects a light beam onto the cornea or fundus Ef of the eye to be examined E and a detection optical system that detects the reflected light beam using an area sensor or the like are provided. The movement detection unit 232 can detect the movement of the subject's eye E based on the temporal change in the detection position of the reflected light flux by the detection optical system. Note that the method of detecting the movement of the subject's eye E is not limited to these.

<User interface 240>
User interface 240 includes display unit 241 and operation unit 242 . Display unit 241 includes display device 3 . The operation unit 242 includes various operation devices and input devices. The user interface 240 may include a device, such as a touch panel, that combines a display function and an operation function. It is also possible to construct embodiments that do not include at least a portion of user interface 240 . For example, the display device may be an external device connected to the ophthalmic equipment.

<motion>
The operation of the ophthalmologic apparatus 1 will be described.

<First operation example>
A first operation example is shown in FIG. This example of operation includes parallel control of OCT scanning and movement of the fixation target.

(S1: Setting movement pattern of fixation target)
First, the movement pattern of the fixation target is set by the movement pattern setting section 231 . This processing is executed in the manner described above.

(S2: Start of presentation of fixation target)
The main control unit 211 starts presentation of the fixation target by controlling the LCD 39 . For example, the main control unit 211 displays the fixation target at the initial position (pixel position on the LCD 39) based on the movement pattern set in step S1. Alternatively, the main control unit 211 displays a fixation target at a preset position for alignment or the like in step S3.

(S3: alignment/focus adjustment)
The main controller 211 controls the alignment optical system 50 to project alignment indices (two alignment bright spots) onto the eye E to be inspected. Conventionally, auto-alignment or manual alignment is performed. Furthermore, the main controller 211 controls the focus optical system 60 to project the split index onto the fundus oculi Ef. Autofocusing or manual focusing is performed as before.

Furthermore, as the optimization of the photographing conditions, it is possible to adjust the optical path length of the measurement light path, adjust the polarization state of the measurement light LS, adjust the light amount of the measurement light LS, adjust the focus of the measurement light path, and the like. After the optimization is completed, the examiner (or the ophthalmologic apparatus 1) can confirm whether or not a problem such as flare is present in the observation image.

(S4: start shooting)
The examiner or the main control unit 211 instructs to start imaging (OCT, fundus imaging, etc.). The examiner can, for example, use the user interface 240 to perform an operation for instructing the start of imaging. In addition, the main control unit 211 receives, for example, the completion of alignment and focus adjustment, the completion of optimization of imaging conditions, or the absence of problems such as flare contamination or the elimination of problems. can be used to generate an instruction to start shooting.

When an instruction to start shooting is given, the main control unit 211 executes the control of step S5A and the control of step S5B at arbitrary timing. For example, the main controller 211 can start steps S5A and S5B at the same time. Alternatively, after starting one of steps S5A and S5B, the main control unit 211 can start the other at a predetermined timing.

(S5A: Start movement of fixation target)
The main control unit 211 starts moving the fixation target according to the movement pattern set in step S1.

(S5B: Start of OCT scan)
The main controller 211 starts scanning the fundus oculi Ef using OCT by controlling the OCT unit 100, the optical scanner 42, and the like. This scan may be, for example, a raster scan (three-dimensional scan), an OCT angiography (OCT angiography), or a scan that takes a relatively long time, such as an OCT blood flow measurement.

(S6A: Completion of fixation target movement)
The main control unit 211 completes the movement of the fixation target at a predetermined timing. The predetermined timing is based on, for example, instructions from the examiner, completion of the OCT scan, and the like.

(S6B: Completion of OCT scan)
The main controller 211 completes the OCT scan at a predetermined timing. The predetermined timing is based on, for example, an instruction from the examiner, completion of movement of the fixation target, or the like.

The main controller 211 can end the movement of the fixation target and the OCT scan at the same time. Alternatively, the main control unit 211 can terminate one of the movement of the fixation target and the OCT scan and then terminate the other at a predetermined timing.

With such control, movement of the fixation target and OCT scanning are performed in parallel. Here, executing two (or three or more) controls in parallel means that at least part of the period during which one control is executed overlaps with at least part of the period during which the other control is executed. means In this example, the main control unit 211 controls both so that at least part of the period during which the fixation target is moved overlaps with at least part of the period during which the OCT scan is performed.

(S7: Formation of OCT image)
The image forming unit 220 forms an image of the fundus oculi Ef based on data collected by parallel control of movement of the fixation target and OCT scanning. Further, the data processing section 230 can process the image formed by the image forming section 220 .

The image formed in step S7 may be, for example, volume data representing a three-dimensional region of the fundus oculi Ef, its rendering image, an angiographic image (angiogram) of the fundus oculi Ef, a blood flow image of the fundus oculi Ef, and the like.

<Second operation example>
A second operation example is shown in FIG. This operation example includes parallel control of OCT scanning, movement of the fixation target, and tracking using the movement mechanism 150 .

(S1-S4)
Steps S1 to S4 are executed, for example, in the same manner as in the first operation example.

When an instruction to start imaging is issued in step S4, the main control unit 211 executes OCT scan control, fixation target movement control, and tracking control using the movement mechanism 150 at arbitrary timings. For example, the main controller 211 can initiate two or three of these three controls simultaneously. Alternatively, the main control unit 211 starts the first control among these three controls, starts the second control at a predetermined timing thereafter, and starts the third control at a predetermined timing thereafter. be able to. In FIG. 5, the OCT scan control and the fixation target movement control are collectively referred to as step S15A, and the tracking control is referred to as step S15B.

(S15A: Movement of fixation target/start of OCT scan)
The main control unit 211 starts movement of the fixation target according to the movement pattern set in step S1 at a predetermined timing, and starts OCT scanning at a predetermined timing. The start of movement of the fixation target is the same as step S5A in the first operation example, and the start of OCT scanning is the same as step S5B.

(S15B: Start of tracking by moving mechanism)
The main control unit 211 starts tracking by the moving mechanism 150 at a predetermined timing. A first processing example of tracking according to the present example includes, for example, acquisition of a moving image of the subject's eye E, detection of the motion of the subject's eye E by the motion detection unit 232, and movement of the movement mechanism 150 according to the detected motion. Including control. The main control unit 211 causes the retinal camera unit 2 to acquire an infrared observation image, and causes the retinal camera unit 2 to follow the movement of the subject's eye E detected substantially in real time by the movement detection unit 232 (in other words, , to cancel the displacement of the subject's eye E). According to the first processing example, the movement of the subject's eye E can be tracked by the optical system substantially in real time.

A second processing example of tracking according to the present example includes, for example, control of the movement mechanism 150 based on the movement pattern set in step S1. The main control unit 211 controls the movement mechanism 150 so that the fundus camera unit 2 follows the movement of the eye E in the line-of-sight direction according to the movement pattern set in step S1. The second processing example assumes that the subject's eye E follows a moving fixation target.

The first processing example and the second processing example may be combined. For example, while executing the second processing example, obtain the displacement between the proper line-of-sight direction and the actual orientation (position) of the eye to be examined E, and execute the first processing example when this displacement exceeds a predetermined threshold. can do.

(S16A: Movement of fixation target/completion of OCT scan)
The main control unit 211 completes the movement of the fixation target at a predetermined timing, as in step S6A of the first operation example. Also, the main control unit 211 completes the OCT scan at a predetermined timing, as in step S6B of the first operation example.

(S16B: Completion of tracking by moving mechanism)
The main control unit 211 completes tracking by the moving mechanism 150 at a predetermined timing. The predetermined timing is based on, for example, an examiner's instruction, completion of movement of the fixation target, completion of OCT scanning, and the like.

With such control, movement of the fixation target, OCT scanning, and tracking by the movement mechanism 150 are executed in parallel. In this example, at least part of the period during which the fixation target is moved, at least part of the period during which the OCT scan is performed, and at least part of the period during which the movement mechanism 150 performs tracking overlap. The main control unit 211 executes three controls so as to do so.

(S7: Formation of OCT image)
The image forming unit 220 forms an image of the fundus oculi Ef based on data collected by parallel control of movement of the fixation target, OCT scanning, and tracking. This process is executed in the same manner as step S7 in the first operation example.

<Third operation example>
A third operation example is shown in FIG. This operation example includes parallel control of OCT scanning, movement of the fixation target, and tracking using the optical scanner 42 .

(S1-S4)
Steps S1 to S4 are executed, for example, in the same manner as in the first operation example.

When an instruction to start imaging is given in step S4, the main control unit 211 executes OCT scan control, fixation target movement control, and tracking control using the optical scanner 42 at arbitrary timings. For example, the main controller 211 can initiate two or three of these three controls simultaneously. Alternatively, the main control unit 211 starts the first control among these three controls, starts the second control at a predetermined timing thereafter, and starts the third control at a predetermined timing thereafter. be able to. In FIG. 6, the OCT scan control and the fixation target movement control are collectively referred to as step S25A, and the tracking control is referred to as step S25B.

(S25A: Movement of fixation target/start of OCT scan)
The main control unit 211 starts moving the fixation target according to the movement pattern set in step S1 at a predetermined timing, and starts an OCT scan at a predetermined timing. The start of movement of the fixation target is the same as step S5A in the first operation example, and the start of OCT scanning is the same as step S5B.

(S25B: Start of tracking by optical scanner)
The main controller 211 starts tracking by the optical scanner 42 at a predetermined timing. A first processing example of tracking according to the present example includes, for example, acquisition of a moving image of the subject's eye E, detection of the motion of the subject's eye E by the motion detection unit 232, and operation of the optical scanner 42 in accordance with the detected motion. Including control. While causing the retinal camera unit 2 to acquire an infrared observation image, the main control unit 211 causes the projection position of the measurement light LS to follow the movement of the subject's eye E detected substantially in real time by the movement detection unit 232 ( In other words, the optical scanner 42 is controlled so as to cancel the displacement of the eye E to be examined. According to the first processing example, the projection position of the measurement light LS can follow the movement of the subject's eye E substantially in real time.

A second processing example of tracking according to the present example includes, for example, control of the optical scanner 42 based on the movement pattern set in step S1. The main control unit 211 controls the optical scanner 42 so that the projection position of the measurement light LS follows the movement of the subject's eye E in the line-of-sight direction according to the movement pattern set in step S1. The second processing example assumes that the subject's eye E follows a moving fixation target.

The first processing example and the second processing example may be combined. For example, while executing the second processing example, obtain the displacement between the proper line-of-sight direction and the actual orientation (position) of the eye to be examined E, and execute the first processing example when this displacement exceeds a predetermined threshold. can do.

(S26A: Movement of fixation target/completion of OCT scan)
The main control unit 211 completes the movement of the fixation target at a predetermined timing, as in step S6A of the first operation example. Also, the main control unit 211 completes the OCT scan at a predetermined timing, as in step S6B of the first operation example.

(S26B: Completion of tracking by optical scanner)
The main controller 211 completes tracking by the optical scanner 42 at a predetermined timing. The predetermined timing is based on, for example, an examiner's instruction, completion of movement of the fixation target, completion of OCT scanning, and the like.

With such control, movement of the fixation target, OCT scanning, and tracking by the optical scanner 42 are executed in parallel. In this example, at least part of the period during which the fixation target is moved, at least part of the period during which the OCT scan is performed, and at least part of the period during which the optical scanner 42 performs tracking overlap. The main control unit 211 executes three controls so as to do so.

(S7: Formation of OCT image)
The image forming unit 220 forms an image of the fundus oculi Ef based on data collected by parallel control of movement of the fixation target, OCT scanning, and tracking. This process is executed in the same manner as step S7 in the first operation example.

〈Action and effect〉
Actions and effects of the ophthalmologic apparatus according to the embodiment will be described.

An ophthalmologic apparatus according to an embodiment includes a data acquisition unit, a fixation system, and a control unit. The data acquisition unit includes an optical system for acquiring data of the subject's eye. In the example above, the data acquisition unit includes an optical system for performing OCT and the imaging unit 220 . The fixation system presents a fixation target to the eye to be examined. In the above example, the fixation system includes the LCD 39 and elements for guiding the light output from the LCD 39 to the eye E to be examined. The control unit concurrently executes control of the data acquisition unit for acquiring data of the subject's eye and control of the fixation system for moving the fixation target. In the above example, the controller includes main controller 211 .

According to such an ophthalmologic apparatus, photographing and measurement can be performed while the fixation target is moved. It is possible to photograph and measure the subject's eye. As a result, for example, fatigue and stress given to the subject can be reduced.

The ophthalmic device of the embodiment may have a tracking function. The tracking function can be implemented using, for example, a moving mechanism that moves the optical system of the data acquisition section. In the above example, the moving mechanism 150 moves the optical system. Further, the control unit controls the data acquisition unit for acquiring data of the subject's eye, controls the fixation system for moving the fixation target, and controls the movement mechanism for moving the optical system. Can run in parallel.

In one example, the ophthalmologic apparatus of the embodiment may include a detection unit that detects movement of the subject's eye. In the above example, the detector includes motion detector 232 . Furthermore, the controller can control the moving mechanism according to the movement of the subject's eye detected by the detector.

In another example, the control unit controls the fixation system to move the fixation target according to a predetermined movement pattern (predetermined pattern), and controls the movement mechanism based on this predetermined pattern. can do.

It is also possible to implement the tracking function using an optical scanner. The optical scanner scans the subject's eye with light from the light source. In the above example, the optical scanner 42 is used for scanning the subject's eye E with light (measurement light LS) from the light source unit 101 .

In one example, the ophthalmologic apparatus of the embodiment may include a detection unit that detects movement of the subject's eye. Furthermore, the control unit controls the optical system according to the movement of the eye detected by the detection unit in the control of the data acquisition unit for acquiring the data of the eye to be inspected. As a result, the scan position is corrected substantially in real time according to the movement of the subject's eye. For example, when the subject's eye is scanned with a preset scan pattern, it is possible to correct a series of scan positions according to this scan pattern in accordance with the movement of the subject's eye.

In another example, the control unit performs control of the fixation system to move the fixation target according to a predetermined pattern, and controls the data acquisition unit to acquire data of the eye to be inspected in accordance with the predetermined pattern. The control of the optical system based on can be executed.

According to the functions described above, it is possible to photograph and measure the subject's eye in its natural state, and to photograph and measure an appropriate position by tracking according to the movement of the subject's eye and/or the movement of the fixation target. becomes possible.

The ophthalmologic apparatus of the embodiment may include a function (setting unit) for setting the movement pattern of the fixation target. In the above example, the setting section includes the movement pattern setting section 231 . Furthermore, the control unit can control the fixation system so as to move the fixation target according to the movement pattern set by the setting unit. Note that the movement pattern set by the setting unit can be used as the predetermined pattern.

Methods for setting the movement pattern of the fixation target include, for example, a method in which the examiner manually sets a method, a method in which medical information such as an electronic medical record is referred to, and a preliminary photographing (preliminary image) for setting the movement pattern. measurements), any combination thereof, and the like.

Preliminary shots (preliminary measurements) are performed before the main shots (main measurements), including parallel control of the data acquisition unit and fixation system (and tracking). In that specific example, the control unit controls the fixation system to move the fixation target according to one or more patterns while causing the data acquisition unit to acquire preliminary data. The setting unit can set the movement pattern based on the acquired preliminary data.

By providing the movement pattern setting function illustrated above, it is possible to use the movement pattern of the fixation target according to the subject and the eye to be examined. That is, when the fixation target moves, the pattern (shape, orientation, size, movement direction, movement speed, etc.) that easily follows the fixation target is considered to differ for each subject and eye to be examined. Therefore, according to an ophthalmologic apparatus capable of setting a movement pattern of a fixation target, a suitable movement pattern for each subject and each eye to be examined (for example, a natural movement that is considered to cause less fatigue and stress on the subject). pattern) can be applied.

The embodiment described above is merely an example of the present invention. A person who intends to implement the present invention can arbitrarily make modifications (omission, substitution, addition, etc.) within the scope of the gist of the present invention.

In the operation examples shown in FIGS. 4 to 6, the movement of the fixation target is started after the start of imaging (measurement), but the timing of starting the movement of the fixation target is not limited to after the start of imaging. For example, the fixation target can be moved while performing preparatory operations such as alignment, focus adjustment, and optimization of imaging conditions. As a result, it is possible to practice how to move the subject's eye according to the movement pattern of the fixation target, and to prompt the subject to become accustomed to the movement pattern.

Before actual photography (actual measurement), it is possible to practice how to move the subject's eye by, for example, moving the fixation target in a predetermined pattern. Furthermore, preliminary imaging (preliminary measurement) can be performed while repeating the movement of the fixation target in a predetermined pattern for a predetermined number of times while performing tracking in response to a predetermined trigger. As a specific example, after starting the tracking and blink detection processing, the fixation target is moved three times along a circular trajectory (clockwise or counterclockwise) in response to detection of a blink of the subject eye. It is possible to image the fundus that makes a substantially circular motion while moving. By evaluating the data obtained by such preliminary photography (preliminary measurement), it is possible to determine whether or not guidance of the line of sight by the fixation target is appropriate. Depending on the result of this determination, it is possible to practice again how to move the subject's eye, change the movement pattern for practice, or start actual photography (actual measurement).

By predicting the movement pattern of the subject's eye, it is possible to set the movement pattern of the fixation target and the tracking pattern. The motion pattern of the subject's eye can be predicted based on data acquired by the motion detection unit 232, for example.

When photographing or measuring in a binocular vision state, a fixation target can be presented to both eyes of the subject. At this time, control can be performed so that the left-eye fixation target and the right-eye fixation target are moved according to the same pattern. Such an operation is realized, for example, by synchronous control between a display device that displays the left-eye fixation target and a display device that displays the right-eye fixation target. According to this function, shooting and measurement can be performed in a natural binocular vision state.

1 ophthalmic device 39 LCD
42 optical scanner 100 OCT unit 101 light source unit 211 main control unit 220 image forming unit 231 movement pattern setting unit 232 motion detection unit

Claims (4)

a data acquisition unit including an optical system for acquiring data of an eye to be examined;
an alignment unit for aligning the optical system with respect to the eye to be inspected;
a fixation system that presents a fixation target to the eye to be examined;
a setting unit that sets the movement pattern of the fixation target;
After executing the control of the fixation system for arranging the fixation target at the initial position based on the movement pattern, the control of the alignment section for performing the alignment is executed, and the control of the alignment section is executed. After that, controlling the data acquisition unit for acquiring the data, and controlling the fixation system for moving the fixation target in a direction perpendicular to the optical axis of the optical system according to the movement pattern. An ophthalmic device comprising: a controller running in parallel; further comprising a focus adjustment unit for performing focus adjustment of the optical system with respect to the eye to be examined;
The control unit performs the control of the alignment unit for performing the alignment and the focus adjustment after executing the control of the fixation target for arranging the fixation target at the initial position. and executing the control of the focus adjustment unit of and after the control of the alignment unit and the control of the focus adjustment unit, the control of the data acquisition unit for acquiring the data, and the movement pattern according to the 2. The ophthalmologic apparatus according to claim 1, wherein control of said fixation system for moving said fixation target in a direction orthogonal to said optical axis of said optical system is executed in parallel. 3. The ophthalmologic apparatus according to claim 1, wherein the setting unit sets the movement pattern by predicting a movement pattern of the subject's eye. The fixation system includes a display device that displays a fixation target , arranged orthogonal to the optical axis of the optical system ,
In the control of the fixation system for placing the fixation target at the initial position, the control unit controls the display device to display the fixation target at the initial pixel position based on the movement pattern. and
In the control of the fixation system for moving the fixation target in the direction orthogonal to the optical axis of the optical system according to the movement pattern, the control unit changes the display position of the fixation target. controlling the display device to
The ophthalmologic apparatus according to any one of claims 1 to 3, characterized in that:

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