JP6505527B2 - Ophthalmic microscope - Google Patents

Description

  The present invention relates to an ophthalmic microscope.

  In the field of ophthalmology various microscopes are used to observe the eye in a magnified manner. Such ophthalmic microscopes include slit lamp microscopes and surgical microscopes. There are also ophthalmic microscopes provided with an imaging device for imaging a patient's eye. Furthermore, there has also been proposed an apparatus capable of analyzing a photographed image of a patient's eye to detect a lesion. In this image analysis, contrast processing, RGB division, etc. are used. In addition, the application of wearable devices to the medical field has been advanced, and for example, a technique for presenting a photographed image or the like using a head-up display or a head-mounted display has been proposed.

International Publication No. 2012/172907 JP, 2013-39148, A Patent No. 5160958 specification JP, 2015-43920, A

  A conventional ophthalmic microscope capable of imaging a patient's eye includes an observation system for guiding return light from the patient's eye to the eyepiece, and an imaging system for guiding return light branched from the observation system to an imaging device. Therefore, light loss due to branching occurs in both the light guided to the eyepiece and the light guided to the imaging device. Also in the case of presenting a photographed image or the like using a head-up display, since a member for combining a luminous flux such as a photographed image with the luminous flux of the observation image is required, light loss similarly occurs.

  In addition, when using a head-up display, the observation image is always presented to the user, and a photographed image or the like is presented to assist the observation operation by it. Therefore, the observation image can not be erased even if it is desired to confirm only the photographed image or the like. Furthermore, in such a configuration, the contrast of the presented image is lowered, so it is difficult to perform surgery or medical treatment while observing a photographed image or the like. Although it is possible to erase the observation image if the shutter mechanism is used, new problems such as complication and enlargement of the apparatus and an increase in weight occur.

  An object of the present invention is to provide an ophthalmic microscope that can realize clear and selective presentation of observation images and photographed images with a simple configuration.

  The ophthalmic microscope of the embodiment includes an illumination system, a light receiving system, an eyepiece system, a processing unit, and a display control unit. The illumination system illuminates the patient's eye with illumination light. The light receiving system guides the return light of the illumination light from the patient's eye to the imaging device. The eyepiece system includes a display unit and an eyepiece lens disposed on the display surface side of the display unit. The processing unit processes an output from the imaging device. The display control unit performs first display control to cause the display unit to display an observation image that is a moving image based on repetitive output from the imaging device, and second display control to cause the display unit to display the processed image generated by the processing unit. And do.

  According to the ophthalmic microscope of the embodiment, selective presentation of a clear observation image and a clear photographed image can be realized with a simple configuration.

It is a schematic diagram showing an example of composition of an ophthalmology microscope concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology microscope concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology microscope concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology microscope concerning an embodiment. It is a flowchart showing an example of the usage form of the ophthalmologic microscope which concerns on embodiment. It is a flowchart showing an example of the usage form of the ophthalmologic microscope which concerns on embodiment.

  Examples of embodiments of the ophthalmic microscope according to the present invention will be described in detail with reference to the drawings. The contents of the documents cited in this specification and any known techniques can be incorporated into the embodiments of the present invention.

  An ophthalmic microscope is used to observe and capture a magnified image of a patient's eye in medical treatment and surgery in the ophthalmic field. The target site for observation and imaging may be any site of the patient's eye, for example, in the anterior segment, it may be the cornea, the corner, the vitreous body, the lens, the ciliary body, etc. It may be retina, choroid or vitreous. Also, the target site may be a peripheral site of the eye, such as eyelid or eye socket.

  While the ophthalmic microscope of the embodiments described below comprises a Greenock-type stereomicroscope, other embodiments may comprise a Galileo-type stereomicroscope. The Greenoud stereomicroscope is characterized in that the left and right optical systems are provided with separate objective lenses, and that the left and right optical axes are non-parallel, so that it is easy to obtain a three-dimensional image, and the freedom of design is high. Have. On the other hand, the Galileo stereo microscope is characterized in that the left and right optical systems are provided with a common objective lens, and that the left and right optical axes are parallel, and it is easy to combine other optical systems and optical elements. Have.

  In addition to the function of observing and capturing an enlarged image of a patient's eye, the ophthalmologic microscope of the embodiment described below has an optical coherence tomography (OCT) function, but in other embodiments, the OCT function is It does not have to be provided. Also, instead of or in addition to the OCT function, any measurement function, imaging function, measurement function, treatment function, etc. that can be used in the ophthalmology field may be provided.

[Constitution]
The configuration of the ophthalmic microscope according to the embodiment is shown in FIGS. 1 to 4. 1 to 3 show the configuration of an optical system. FIG. 1 shows an optical system when observing a posterior segment, and FIG. 2 shows an optical system when observing an anterior segment. FIG. 3 shows an optical system for providing an OCT function. FIG. 4 shows the configuration of the processing system.

  The ophthalmic microscope 1 includes an illumination system 10 (10L, 10R), a light receiving system 20 (20L, 20R), an eyepiece system 30 (30L, 30R), an irradiation system 40, and an OCT system 60. When observing the posterior segment (the retina or the like), a front lens 90 is disposed in front of the patient's eye E. In addition, it is possible to use a contact lens etc. instead of the non-contacting front lens 90 as shown in FIG. In addition, when observing the angle, a contact mirror (triangular mirror or the like) or the like can be used.

(Lighting system 10)
The illumination system 10 illuminates the patient's eye E with illumination light. Although illustration is omitted, the illumination system 10 includes a light source that emits illumination light, a stop that defines an illumination field, a lens system, and the like. The configuration of the illumination system may be similar to that of a conventional ophthalmologic apparatus (for example, an ophthalmologic surgery microscope, a slit lamp microscope, etc.).

The illumination systems 10L and 10R of the present embodiment are configured coaxially with the light reception systems 20L and 20R, respectively. Specifically, in the left light receiving system 20L for acquiring an image presented to the left eye E ₀ L of the observer, a beam splitter 11L formed of a half mirror, for example, is obliquely provided. The beam splitter 11L couples the light path of the left illumination system 10L to the light path of the left light reception system 20L. The illumination light output from the left illumination system 10L is reflected by the beam splitter 10L and illuminates the patient's eye E coaxially with the left light reception system 20L. Similarly, in the right light receiving system 20R for acquiring an image presented to the right eye E ₀ R of the observer, a beam splitter 11R for obliquely coupling the light path of the right illumination system 10R to the light path of the right light receiving system 20R It is done.

  The position of the illumination light with respect to the optical axis of the light receiving system 20L (20R) can be configured to be changeable. This configuration is realized, for example, by providing a means for changing the irradiation position of the illumination light with respect to the beam splitter 11L (11R), as in the conventional microscope for ophthalmologic surgery.

  In this example, the beam splitter 11L (11R) is disposed between the objective lens 21L (21R) and the patient's eye E, but the position where the optical path of the illumination light is coupled to the light receiving system 20L (20R) is It may be any position of the system 20L (20R). Also, the illumination system and the light receiving system may be arranged non-coaxially. This configuration is applied to a slit lamp microscope, an eye surgery microscope, and the like.

(Light receiving system 20)
In the present embodiment, a pair of left and right light receiving systems 20L and 20R are provided. The left light receiving system 20L has a configuration for acquiring an image presented to the left eye E ₀ L of the observer, and the right light receiving system 20R acquires an image presented to the right eye E ₀ R. It has composition. The left light receiving system 20L and the right light receiving system 20R have the same configuration. The left light receiving system 20L (right light receiving system 20R) includes an objective lens 21L (21R), an imaging lens 22L (22R), and an imaging element 23L (23R).

  It is also possible to apply a configuration in which the imaging lens 22L (22R) is not provided. When the imaging lens 22L (22R) is provided as in the present embodiment, the afocal optical path (parallel optical path) may be provided between the objective lens 21L (21R) and the imaging lens 22L (22R). It becomes easy to arrange an optical element such as a filter or to arrange an optical path coupling member to couple optical paths from other optical systems (ie, the degree of freedom and expandability of the optical configuration are improved). ).

  The symbol AL1 indicates the optical axis (objective optical axis) of the objective lens 21L of the left light receiving system 20L, and the symbol AR1 indicates the optical axis (objective optical axis) of the objective lens 21R of the right light receiving system 20R. The light receiving element 23L (23R) is, for example, an area sensor such as a CCD image sensor or a CMOS image sensor.

  The above is the configuration of the light receiving system 20 when observing the back eye part (fundus oculi) of the patient's eye E (FIG. 1). On the other hand, when observing the anterior segment, as shown in FIG. 2, the focus lens 24L (24R) and the wedge prism 25L (25R) are disposed at a position on the patient eye E side with respect to the objective lens 21L (21R). Be done. The focus lens 24L (24R) of this example is a concave lens, and acts to extend the focal length of the objective lens 21L (21R). The wedge prism 25L (25R) deflects the optical path (objective optical axis AL1 (AR1)) of the left light receiving system 20L (right light receiving system 20R) to the outside by a predetermined angle (indicated by symbols AL2 and AR2). As described above, the focus lens 24L and the wedge prism 25L are disposed in the left light receiving system 20L, and the focus lens 24R and the wedge prism 25R are disposed in the right light receiving system 20R, whereby the focal position F1 for rear eye observation is obtained. To the focal position F2 for anterior segment observation.

  It is possible to use a convex lens as the focus lens. In that case, the focus lens is disposed in the optical path at the time of posterior eye observation, and is retracted from the optical path at the time of anterior eye observation. Instead of switching the focal length by inserting / retracting the focus lens, for example, the focal length can be changed continuously or stepwise by providing a focus lens movable in the optical axis direction.

  In the example shown in FIG. 2, although the base direction of the wedge prism 25L (25R) is outside (that is, it is a base-out arrangement), a wedge prism with a base-in arrangement can be used. In that case, the wedge prism is disposed in the optical path at the time of posterior eye observation, and is retracted from the optical path at the time of anterior eye observation. Instead of switching the direction of the light path by insertion / retraction of the wedge prism, it is possible to configure so that the direction of the light path can be changed continuously or stepwise by providing a prism with a variable prism amount (and prism direction). is there.

(Eyepiece 30)
In the present embodiment, a pair of left and right eyepiece systems 30L and 30R are provided. The left eyepiece system 30L has a configuration for presenting the image of the patient's eye E acquired by the left light reception system 20L to the left eye E ₀ L of the observer, and the right eyepiece system 30R is acquired by the right light reception system 20R The present invention has a configuration for presenting the image of the patient eye E thus captured to the right eye E ₀ R. The left eyepiece system 30L and the right eyepiece system 30R have the same configuration. The left eyepiece system 30L (right eyepiece system 30R) includes a display unit 31L (31R) and an eyepiece lens 32L (32R). The display unit 31L (31R) is, for example, a flat panel display such as an LCD.

It is possible to change the distance between the left eyepiece system 30L and the right eyepiece system 30R. Thus, the distance between the left eyepiece system 30L and the right eyepiece system 30R can be adjusted in accordance with the observer's eye width. In addition, it is possible to change the relative orientation of the left eyepiece system 30L and the right eyepiece system 30R. That is, it is possible to change the angle between the optical axis of the left eyepiece system 30L and the optical axis of the right eyepiece system 30R. Thereby, convergence of both eyes E ₀ L and E ₀ R can be induced, and stereoscopic vision by an observer can be supported.

(Irradiation system 40)
The irradiation system 40 irradiates the patient's eye E with light (measurement light) for performing OCT measurement from a direction different from the objective optical axes (AL1 and AR1, and AL2 and AR2) of the light receiving system 20. In other embodiments, the illumination system may be capable of illuminating the patient's eye with other light in addition to the measurement light for OCT. As a specific example, there is light (aim light, therapeutic laser light) for laser treatment.

  The illumination system 40 includes an optical scanner 41, an imaging lens 42, a relay lens 43, and a deflection mirror 44. The light from the OCT unit 60 is guided to the light scanner 41.

  The light (measurement light) from the OCT unit 60 is guided by the optical fiber 51 and emitted from the end face of the fiber. A collimator lens 52 is disposed at a position facing the end face of the fiber. The measurement light converted into a parallel light beam by the collimator lens 52 is guided to the light scanner 41.

  The light scanner 41 is a two-dimensional light scanner, and includes an x scanner 41H that deflects light in the horizontal direction (x direction) and a y scanner 41V that deflects light in the vertical direction (y direction). The x scanner 41 H and the y scanner 41 V may each be any type of optical scanner, and for example, a galvano mirror is used. The light scanner 41 is disposed, for example, at or near the exit pupil position of the collimating lens 52. Furthermore, the light scanner 41 is disposed, for example, at or near the entrance pupil position of the imaging lens 42.

  When two one-dimensional optical scanners are combined to form a two-dimensional optical scanner as in this example, the two one-dimensional optical scanners are spaced apart by a predetermined distance (for example, about 10 mm). A one-dimensional light scanner can be placed at the exit pupil position and / or the entrance pupil position.

  The imaging lens 42 once forms an image of the parallel light beam (measurement light) that has passed through the light scanner 41. Further, in order to re-image the measurement light in the patient's eye E (the observation site such as the fundus, cornea, etc.), the light is relayed by the relay lens 43 and reflected by the deflection mirror 44 toward the patient's eye E.

  The position of the deflection mirror 44 is determined in advance so that the measurement light guided by the irradiation system 40 is irradiated to the patient's eye E from a direction different from the objective optical axes (AL1 and AR1, and AL2 and AR2) of the light receiving system 20. It is done. In this example, the deflecting mirror 44 is disposed at a position between the left light receiving system 20L and the right light receiving system 20R in which the objective optical axes of the two are disposed nonparallel to each other. One of the factors that make such an arrangement possible is an improvement in the degree of freedom in optical configuration due to the arrangement of the relay lens 43. In addition, for example, the distance between the objective lens 21L and the objective lens 21L and the position conjugate with the light scanner (in this example, the x scanner 41H) in the horizontal direction can be designed to be sufficiently small. Can be

  Generally, since the scannable range (scannable angle) by the light scanner 41 is limited, the scannable range can be expanded by applying an imaging lens 42 (or an imaging lens system) having a variable focal length. It is possible. Besides, any configuration for expanding the scannable area can be applied. In addition, as an example of a means for changing the focal length (focus position in OCT measurement), one or more of the collimator lens 52, the imaging lens 42, and the relay lens 43 can be moved along the optical axis There is a configuration that

(OCT unit 60)
The OCT unit 60 includes an interference optical system for performing OCT. An example of the configuration of the OCT unit 60 is shown in FIG. The optical system shown in FIG. 3 is an example of swept source OCT, and splits light from a wavelength sweeping light source (wavelength variable light source) into measurement light and reference light, and returns the measurement light from the patient's eye E Interference light is generated by causing interference with the reference light passing through the reference light path, and the interference light is detected. The detection result (detection signal) of the interference light by the interference optical system is a signal indicating the spectrum of the interference light, and is sent to the control unit 100.

  The light source unit 61 includes a wavelength sweeping type light source capable of scanning (sweeping) the wavelength of emitted light, as in a general swept source type OCT apparatus. The light source unit 61 temporally changes the output wavelength in a near infrared wavelength band which can not be visually recognized by human eyes.

  The light L0 output from the light source unit 61 is guided to the polarization controller 63 by the optical fiber 62 and its polarization state is adjusted, and is guided to the fiber coupler 65 by the optical fiber 64 to be the measurement light LS and the reference light LR. It is divided.

  The reference light LR is guided by the optical fiber 66A to the collimator 67 and converted into a parallel light beam, and is guided to the corner cube 70 via the optical path length correction member 68 and the dispersion compensation member 69. The optical path length correction member 68 acts as a delay means for matching the optical path length (optical distance) of the reference light LR with the optical path length of the measurement light LS. The dispersion compensation member 69 acts as a dispersion compensation means for matching the dispersion characteristics between the reference light LR and the measurement light LS.

  The corner cube 70 turns back the traveling direction of the reference light LR. The corner cube 70 is movable in a direction along the incident light path and the outgoing light path of the reference light LR, whereby the length of the light path of the reference light LR is changed. Note that one of a unit for changing the length of the light path of the measurement light LS and a unit for changing the length of the light path of the reference light LR may be provided.

  The reference light LR that has passed through the corner cube 70 is converted from a parallel light beam into a focused light beam by the collimator 71 via the dispersion compensation member 69 and the optical path length correction member 68 and is incident on the optical fiber 72. The polarization state of the reference light LR is adjusted. Furthermore, the reference light LR is guided to the attenuator 75 by the optical fiber 74, and the light amount is adjusted under the control of the control unit 100. The reference light LR whose light amount is adjusted is guided to the fiber coupler 77 by the optical fiber 76.

  On the other hand, the measurement light LS generated by the fiber coupler 65 is guided by the optical fiber 51 and emitted from the end face of the fiber, and is collimated by the collimator lens 52. The measurement light LS, which is converted into a collimated light beam, is irradiated to the patient's eye E via the light scanner 41, the imaging lens 42, the relay lens 43, and the deflection mirror 44. The measurement light LS is reflected and scattered at various depth positions of the patient's eye E. The return light of the measurement light LS from the patient's eye E includes reflected light and backscattered light, travels in the same direction as the forward path in the reverse direction, is guided to the fiber coupler 65, and passes through the optical fiber 66B to the fiber coupler 77 To reach.

  The fiber coupler 77 combines (interferences) the measurement light LS incident through the optical fiber 66B and the reference light LR incident through the optical fiber 76 to generate interference light. The fiber coupler 77 splits this interference light at a predetermined branching ratio (for example, 1: 1) to generate a pair of interference lights LC. The pair of interference lights LC emitted from the fiber coupler 77 are guided to the detector 79 by the optical fibers 78A and 78B, respectively.

  The detector 79 is, for example, a balanced photo diode that includes a pair of photodetectors that respectively detect a pair of interference lights LC, and outputs a difference between detection results of these. The detector 79 sends the detection result (detection signal) to the control unit 100.

  Although swept source OCT is applied in this example, it is possible to apply other types of OCT, such as spectral domain OCT.

(Control unit 100)
The control unit 100 controls each part of the ophthalmic microscope 1 (see FIG. 4). Examples of control of the illumination system 10 are as follows: lighting of the light source, turning off, adjustment of the light amount; adjustment of the aperture; adjustment of the slit width if slit illumination is possible. As control of the imaging device 23, there are exposure adjustment, gain adjustment, imaging rate adjustment, and the like.

  The control unit 100 causes the display unit 31 to display various types of information. For example, the control unit 100 causes the display unit 31L to display an image (or an image or data obtained by processing the image) acquired by the imaging device 23L, and an image acquired by the imaging device 23R (or each of them To display on the display unit 31R.

  The control of the light scanner 41 is, for example, to sequentially deflect the measurement light LS so that the measurement light LS is irradiated to a plurality of positions corresponding to a preset OCT scan pattern.

  The control targets included in the OCT unit 60 include a light source unit 61, a polarization controller 63, a corner cube 70, a polarization controller 73, an attenuator 75, a detector 79, and the like.

  Furthermore, the control unit 100 controls various mechanisms. As such a mechanism, a stereo angle changing unit 20A, a focusing unit 24A, an optical path deflecting unit 25A, an interval changing unit 30A, and a direction changing unit 30B are provided.

  The stereo angle changing unit 20A relatively rotationally moves the left light receiving system 20L and the right light receiving system 20R. That is, the stereo angle changing unit 20A relatively moves the left light receiving system 20L and the right light receiving system 20R so as to change the angle formed by the objective optical axes (for example, AL1 and AR1). This relative movement is, for example, to move the left light receiving system 20L and the right light receiving system 20R in opposite rotational directions by the same angle. In this movement mode, the directions of bisectors of the angles formed by the objective optical axes (for example, AL1 and AR1) are constant. On the other hand, it is also possible to perform the relative movement so that the direction of the bisector changes.

  The focusing unit 24A inserts and retracts the left and right focus lenses 24L and 24R with respect to the optical path. The focusing unit 24A may be configured to simultaneously insert / retract the left and right focus lenses 24L and 24R. In another example, the focusing unit 24A may be configured to change the focal position by moving the left and right focus lenses 24L and 24R (simultaneously) in the optical axis direction, or alternatively, the left and right focus lenses 24L and 24L may be configured. It may be configured to change the focal length by (simultaneously) changing the refractive power of 24R.

  The optical path deflecting unit 25A inserts and retracts the left and right wedge prisms 25L and 25R with respect to the optical path. The optical path deflection unit 25A may be configured to simultaneously insert and retract the left and right wedge prisms 25L and 25R. In another example, the optical path deflecting unit 25A changes the direction of the optical paths of the left and right light receiving systems 20L and 20R by (simultaneously) changing the prism amount (and the prism direction) of the left and right wedge prisms 25L and 25R. It may be configured.

  The space changer 30A changes the space between the left and right eyepiece systems 30L and 30R. The space changer 30A may be configured to relatively move the left and right eyepiece systems 30L and 30R without changing the relative orientation of the optical axes of each other.

  The direction changing unit 30B changes the relative direction of the left and right eyepiece systems 30L and 30R. The direction changing unit 30B relatively moves the left eyepiece system 30L and the right eyepiece system 30R so as to change the angle formed by the optical axes of each other. This relative movement is, for example, to move the left eyepiece system 30L and the right eyepiece system 30R in the opposite rotational direction by the same angle. In this movement mode, the directions of bisectors of the angles formed by the optical axes are constant. On the other hand, it is also possible to perform the relative movement so that the direction of the bisector changes.

  The control unit 100 includes a processor. In the present specification, the “processor” is, for example, a central processing unit (CPU), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), a programmable logic device (for example, a simple programmable logic device (SPLD), a CPLD (complex). It means a circuit such as a programmable logic device (FPGA), a field programmable gate array (FPGA) or the like. The control unit 100 realizes the function according to the embodiment by, for example, reading and executing a program stored in a storage circuit or a storage device.

  The control unit 100 may include a storage device in which an image acquired by the ophthalmologic microscope 1 and information (image, electronic medical record information, etc.) generated by another device are stored. Further, the control unit 100 can obtain an image stored in an external storage device by controlling the communication unit 400.

(Data processing unit 200)
The data processing unit 200 executes various data processing. The data processing includes processing for forming an image, processing for processing an image, and the like. In addition, the data processing unit 200 may be able to execute a process of analyzing an image, an inspection result, and a measurement result, and a process related to information on a subject (such as electronic medical record information). The data processing unit 200 includes a processor. The data processing unit 200 includes a magnification changing unit 210, an image processing unit 220, and an OCT image forming unit 230.

(Modification change unit 210)
The magnification change unit 210 magnifies the image acquired by the imaging device 23. This process is a so-called digital zoom process, and includes a process of cutting out a part of the image acquired by the imaging device 23 and a process of creating an enlarged image of the part. The cropping range of the image is set by the observer or by the control unit 100. The magnification changing unit 210 performs the same process on the image (left image) acquired by the imaging device 23L of the left light reception system 20L and the image (right image) acquired by the imaging device 23R of the right light reception system 20R. Apply. Thereby, an image with the same magnification is presented to the left eye E ₀ L and the right eye E ₀ R of the observer. Thus, the magnification changing unit 210 functions to change the display magnification of the image presented to the observer by processing the output from the imaging device 23 (23L, 23R).

  In addition to such a digital zoom function, it is possible to provide a so-called optical zoom function. The optical zoom function is realized by providing variable magnification lenses (variable magnification lens systems) in the left and right light receiving systems 20L and 20R. As a specific example, there is a configuration in which a variable magnification lens is (selectively) inserted into and retracted from the optical path, and a configuration in which the variable magnification lens is moved in the optical axis direction. Control regarding the optical zoom function is performed by the control unit 100.

(Image processing unit 220)
The image processing unit 220 processes the signals output from the imaging elements 23L and 23R. That is, the image processing unit 220 processes the image of the patient's eye E obtained by the imaging elements 23L and 23R.

  The process performed by the image processing unit 220 is arbitrary. The image processing unit 220 can execute arbitrary image processing and arbitrary analysis processing. For example, the image processing unit 220 can execute image correction (contrast correction, color correction, sharpening and the like), feature detection (feature extraction), pattern matching and the like. Further, the image processing unit 220 can perform RGB division of a color image, and synthesis processing of single color images (R image, G image, and B image) obtained by this.

  The processor included in the image processing unit 220 executes, for example, the above-described processing by executing application software stored in advance in the ophthalmic microscope 1 or application software available via a network.

  An image generated by the image processing unit 220 based on the output from the imaging elements 23L and 23R is called a "processed image". As an example of a processing image, an image (a contrast-enhanced image, a color-corrected image, a sharpened image, etc.) subjected to image correction, an image obtained by emphasizing or extracting a region detected by feature detection, a composite of single-color images And a red free image (a composite image of a G image and a B image) obtained by

  The light receiving system 20 of the present embodiment includes a left light receiving system 20L and a right light receiving system 20R. The left image acquired by the imaging device 23L (left imaging device) of the left light reception system 20L and the right image acquired by the imaging device 23R (right imaging device) of the right light reception system 20R are separately transmitted to the image processing unit 220. It is input. The image processing unit 220 processes the left image and the right image separately. At this time, the image processing unit 220 performs the same process or different processes on the left image and the right image. When the left image and the right image are moving images, each of the left imaging device 23L and the right imaging device 23R repetitively outputs a signal (video signal). The repetitive output (at least a part thereof) from each of the left imaging device 23L and the right imaging device 23R is sequentially input to the image processing unit 220 via the control unit 100. Signals sequentially input to the image processing unit 220 correspond to frames of a moving image. The image processing unit 220 can perform processing on each frame. Alternatively, the image processing unit 220 can process one or more representative frames. For example, the image processing unit 220 can apply thinning processing to frames constituting a moving image, and can perform processing on each frame obtained thereby. In addition, the image processing unit 220 can select one or more frames from the frames making up the moving image, and perform processing on each of the selected frames.

(OCT image forming unit 230)
The OCT image forming unit 230 forms an image of the patient's eye E based on the detection result of the interference light LC obtained by the detector 79 of the OCT unit 60. The control unit 100 sends detection signals sequentially output from the detector 79 to the OCT image forming unit 230. The OCT image forming unit 230 performs, for example, Fourier transform or the like on the spectral distribution based on the detection result obtained by the detector 79 for each series of wavelength scans (for each A line) to obtain a reflection intensity profile at each A line. Form Furthermore, the OCT image forming unit 230 forms image data by imaging each A-line profile. Thus, a B-scan image (cross-sectional image) and volume data (three-dimensional image data) are obtained.

  The data processing unit 200 may have a function of analyzing an image (OCT image) formed by the OCT image forming unit 230. As this analysis function, there are reticular film thickness analysis and comparative analysis with normal eyes. Such analysis functions are implemented using known application software. In addition, the data processing unit 200 may have a function of analyzing an image acquired by the light receiving system 20. In addition, the data processing unit 200 may have an analysis function in which analysis of an image acquired by the light receiving system 20 and analysis of an OCT image are combined.

(User interface 300)
The user interface (UI) 300 has a function for exchanging information between the observer or the like and the ophthalmic microscope 1. The user interface 300 includes a display device and an operation device (input device). The display device may include the display unit 31 and may include other display devices. The operating device includes various hardware keys and / or software keys. It is possible to integrally configure at least a portion of the operation device and at least a portion of the display device. The touch panel display is one example.

(Communication unit 400)
The communication unit 400 performs processing of transmitting information to another device and processing of receiving information transmitted from the other device. The communication unit 400 may include a communication device compliant with a predetermined network (LAN, Internet, etc.). For example, the communication unit 400 acquires information from an electronic medical record database or a medical image database via a LAN provided in a medical institution. In addition, when an external monitor is provided, the communication unit 400 transmits an image (an image acquired by the light receiving system 20, an OCT image, etc.) acquired by the ophthalmic microscope 1 to the external monitor in substantially real time. can do.

[Use form]
The usage form of the ophthalmic microscope of the present embodiment will be described. An example of the usage of the ophthalmic microscope is shown in FIG.

(S1: Start observation of the patient's eye)
When the user performs a predetermined operation, the control unit 100 controls the left and right illumination systems 10L and 10R to start irradiating the patient's eye E with illumination light, and is acquired by the left imaging element 23L at a predetermined rate An image (left observation image) is displayed on the left display portion 31L at a predetermined frame rate, and an image (right observation image) acquired at a predetermined rate by the right imaging device 23R is displayed on the right display portion 31R at a predetermined frame rate . At this time, the display control of the left observation image and the display control of the right observation image are synchronized. The user can perform binocular observation (stereoscopic observation) of the patient's eye E in real time via the left and right eyepiece systems 30L and 30R.

  The user operates the left and right light receiving systems 20L and 20R so as to obtain a desired observation field. At this time, adjustment of the observation magnification (magnification of the observation image displayed on the display units 31L and 31R) is also performed. The observation magnification is changed by the digital zoom (magnification changing unit 210).

(S2: Shoot the patient's eye)
The user aligns the observation field with a desired site of the patient's eye E, and performs an operation of instructing imaging at a desired timing. This operation is a predetermined operation using the user interface 300. The left and right captured images acquired by the left imaging device 23L and the right imaging device 23R in response to the imaging instruction operation are sent to the image processing unit 220 via the control unit 100.

(S3: Process a photographed image)
The image processing unit 220 performs one or more preset processes on each of the left and right captured images acquired in step S2. Thereby, the left processed image and the right processed image are generated.

(S4: store the processed image)
The control unit 100 stores the left processed image and the right processed image generated in step S3. These images are stored, for example, in the above-described storage device provided in the control unit 100.

(S5: The user instructs presentation of the processed image)
At this stage, left and right observation images (moving images) are presented. The user performs an operation of instructing presentation of a processed image at a desired timing. This operation is a predetermined operation using the user interface 300.

(S6: Stop presenting the observation image and present the processed image)
In response to the operation performed in step S5, the control unit 100 reads the left processed image and the right processed image stored in step S4 from the storage device. Furthermore, the control unit 100 causes the left processed image to be displayed instead of the left observation image displayed on the left display unit 31L, and the right processed image displayed instead of the right observation image displayed on the right display unit 31R. Display. Thereby, the left processed image and the right processed image are presented to the user.

  The control unit 100 can cause the left display unit 31L and the right display unit 31R to display a list of information (information that can be presented by a user's instruction) stored in the storage device (a list may be displayed on other display devices May be displayed). This list is displayed, for example, outside the observation image. This information includes at least a processed image. Furthermore, this information may include OCT images acquired up to this stage, OCT images acquired in the past, analytical data (layer thickness distribution etc.) based on OCT images, electronic medical record information of the patient, etc. . The user can specify desired information from this list using the user interface 300. The control unit 100 reads out the designated information from the storage device and causes the left display unit 31L and the right display unit 31R to display the information. According to this configuration, desired information can be presented at desired timing.

(S7: The user instructs to resume observation)
When the confirmation of the processed image is completed, the user performs an operation of instructing presentation of an observation image, that is, an operation of instructing resumption of observation. This operation is a predetermined operation using the user interface 300.

(S8: The presentation of the processed image is ended, and the presentation of the observation image is resumed)
In response to the operation performed in step S7, control unit 100 causes the left observation image to be displayed instead of the left processed image displayed on left display unit 31L, and the right processing displayed on right display unit 31R. The right observation image is displayed instead of the image. Thereby, real-time observation of the patient's eye E can be resumed.

(Other usage forms)
In the mode of use shown in FIG. 5, the observation image and the processing image are displayed mutually exclusively. That is, the observation image and the processing image are switched and displayed. On the other hand, it is also possible to display the observation image and the processing image in parallel. An example of such a usage pattern is shown in FIG. Steps S11 to S15 are performed in the same manner as steps S1 to S5 in FIG. 5, respectively.

(S16: Present the processed image with the observation image)
In response to the operation performed in step S15, the control unit 100 reads the left processed image and the right processed image stored in step S14 from the storage device. Further, the control unit 100 causes the left processed image to be displayed together with the left observation image displayed on the left display unit 31L, and causes the right processed image to be displayed together with the right observation image displayed on the right display unit 31R.

  At this time, the processed image can be displayed superimposed on the observation image. This process is performed, for example, using a layer function. That is, the observation image is displayed on the first layer, and the processed image is displayed on the second layer. The opacity (alpha value) is arbitrarily set, for example, adjustable by the user.

  Alternatively, the observation image and the processing image can be displayed in different areas. In this case, the display size of the observation image and the display size of the processed image may be changeable. For example, enlarge the size of the observation image (and reduce the size of the processing image) when you want to focus on the observation image, and enlarge the size of the processing image (and reduce the size of the observation image) when you want to focus on the processing image Can.

(S17: The user instructs the end of the presentation of the processed image)
When the confirmation of the processing image is completed, the user performs an operation of instructing the end of presentation of the processing image, that is, an operation of instructing resumption of observation. This operation is a predetermined operation using the user interface 300.

(S18: Resume observation of the patient's eye)
In response to the operation performed in step S17, control unit 100 ends the display of the left processed image displayed on left display unit 31L, and displays the right processed image displayed on right display unit 31R. End. Thereby, real-time observation of the patient's eye E can be resumed.

[Operation / effect]
The operation and effects of the ophthalmic microscope of the present embodiment will be described.

  The ophthalmic microscope of the present embodiment includes an illumination system (10L, 10R), a light receiving system (20L, 20R), an eyepiece system (30L, 30R), a processing unit (image processing unit 220), and a display control unit (image processing unit 220). And a control unit 100).

  The illumination system illuminates the patient's eye with illumination light. The light receiving system guides the return light of the illumination light emitted to the patient's eye to the imaging device (23L, 23R). Here, the imaging device may be an external device connected to an ophthalmic microscope. The eyepiece system includes a display unit (31L, 31R) and an eyepiece lens (32L, 32R) disposed on the display surface side of the display unit. The processing unit processes an output from the imaging device. The display control unit performs control (first display control) to cause the display unit to display an observation image which is a moving image based on repetitive output from the imaging device, and an image (processed image) generated by the processing unit to the display unit. The control to be displayed (second display control) is executed. The processed image may be an image obtained by processing an image (captured image) captured by the imaging device, or the captured image itself.

  In an embodiment, the light receiving system (20L, 20R) may be configured to guide the return light of the illumination light from the patient's eye to each of the left imaging device (23L) and the right imaging device (23R). Also, the eyepiece system may include a left eyepiece system (31L) and a right eyepiece system (30R). The left eyepiece system includes a left display portion (31L) and a left eyepiece lens (32L) disposed on the display surface side of the left display portion. The right eyepiece system includes a right display portion (31R) and a right eyepiece lens (32R) disposed on the display surface side of the right display portion. The display control unit (control unit 100) controls the left display unit (31L) to display a left observation image which is a moving image based on repetitive output from the left image pickup device (23L) in the first display control; Control for displaying a right observation image, which is a moving image based on repetitive output from the imaging device (23R), on the right display unit (31R) is performed synchronously. Furthermore, in the second display control, the display control unit controls the left display unit (31L) to display the left processed image generated by the processing unit (data processing unit 220) based on the output from the left imaging element (23L). And control for causing the right display unit (31R) to display the right processed image generated by the processing unit based on the output from the right imaging device (23R).

  Here, “execute synchronously” means that two control timings are associated with each other. For example, the display timings of the left and right observation images (or left and right processed images) are controlled such that the left observation image (or left processed image) and the right observation image (or right processed image) are displayed substantially simultaneously. Ru.

  Furthermore, the light receiving system may include a left light receiving system (20L) and a right light receiving system (20R). The left light receiving system includes a left objective lens (21L), and guides the return light of the illumination light from the patient's eye to the left imaging element (23L) through the left objective lens. The right light receiving system includes a right objective lens (21L), and guides return light of illumination light from the patient's eye to the right imaging element (23R) through the right objective lens. Furthermore, the optical axis of the left objective lens (21L) and the optical axis of the right objective lens (21R) are disposed nonparallel to each other.

  In an embodiment, a processed image consisting of moving images can be presented to the user. To that end, the display control unit (control unit 100) causes the display unit (31L, 31R) to display a moving image generated by the processing unit (image processing unit 220) based on repetitive output from the imaging elements (23L, 23R). The second display control can be performed to cause display.

  In an embodiment, the observation image and the processed image can be displayed separately. For that purpose, the ophthalmic microscope includes an operation unit (user interface 300). The display control unit (control unit 100) is configured to be able to switch and execute the first display control and the second display control in response to an operation using the operation unit. The flowchart shown in FIG. 5 shows an example of the usage pattern realized by such a configuration.

  In an embodiment, the observation image and the processed image can be displayed in parallel. For example, the observation image and the processing image can be displayed side by side or overlapping. Therefore, the display control unit (control unit 100) is configured to be able to execute the first display control and the second display control in parallel.

  As an example of such parallel display, it is possible to configure so that the display of the processed image can be turned on / off according to an instruction from the user while constantly displaying the observation image. For that purpose, the ophthalmic microscope includes an operation unit (user interface 300). The display control unit (control unit 100) continuously executes the first display control. Furthermore, the display control unit operates to start the second display control when the first operation is performed using the operation unit, and to end the second display control when the second operation is performed. . The flowchart shown in FIG. 6 shows an example of a usage pattern realized by such a configuration.

  In embodiments, patient eye data obtained by OCT can be presented to the user via the eyepiece system. For example, it is possible to present an OCT image or analysis data of a patient's eye. In addition, settings and conditions regarding OCT can be presented to the user via the eyepiece system. For example, information representing the range of an OCT scan can be superimposed on an observation image or a captured image and presented.

  As described above, the ophthalmologic microscope according to the present embodiment is configured to acquire the observation image and the photographed image using the same imaging device, and as in the conventional ophthalmologic microscope, the observation system and the imaging system Since there is no member for branching the image, there is no light loss due to the branching, and the contrast of the presented image is not deteriorated. Also, the observation image and the photographed image (processed image) can be switched and presented, or they can be presented together. The control for that purpose is only display control for the eyepiece system, and does not cause problems such as complication of the device, increase in size, and increase in weight. As described above, according to the present embodiment, it is possible to realize clear and selective presentation of observation images and photographed images with a simple configuration.

  The above embodiments are merely illustrative for practicing the present invention. A person who intends to practice the present invention can make any modification, omission, addition, substitution, etc. within the scope of the present invention.

1 Ophthalmic microscope 10L, 10R illumination system 20L, 20R light reception system 23L, 23R image pickup device 30L, 30R eyepiece system 31L, 31R display unit 32L, 32R eyepiece lens 100 control unit 220 image processing unit

Claims (8)

An illumination system for illuminating the patient's eye with illumination light;
A light receiving system for guiding return light of the illumination light from the patient's eye to an imaging device;
An eyepiece system including a display unit, and an eyepiece lens disposed on the display surface side of the display unit;
A processing unit that processes an output from the imaging device;
First display control for causing the display unit to display an observation image, which is a moving image based on repetitive output from the imaging element, and second display control, for causing the display unit to display a processed image generated by the processing unit And a display control unit for performing the operation. The light receiving system guides return light of the illumination light from the patient's eye to each of a left imaging device and a right imaging device.
The eyepiece system is
A left eyepiece system including a left display unit and a left eyepiece lens disposed on the display surface side of the left display unit;
A right eyepiece system including a right display unit and a right eyepiece lens disposed on the display surface side of the right display unit;
The display control unit
In the first display control, control for displaying a left observation image, which is a moving image based on repetitive output from the left imaging element, on the left display unit, and moving image based on repetitive output from the right imaging element Execute synchronously with the control to display a certain right observation image on the right display unit,
In the second display control, the control unit causes the left display unit to display the left processed image generated by the processing unit based on the output from the left imaging device, and the processing unit based on the output from the right imaging device. The ophthalmic microscope according to claim 1, wherein the control for synchronously displaying the generated right processed image on the right display unit is performed. The light receiving system is
A left light receiving system including a left objective lens and guiding return light of the illumination light from the patient's eye to the left imaging element through the left objective lens;
A right light receiving system that includes a right objective lens and guides return light of the illumination light from the patient's eye to the right imaging element via the right objective lens;
The ophthalmic microscope according to claim 2, wherein an optical axis of the left objective lens and an optical axis of the right objective lens are disposed non-parallel to each other. The display control unit causes the display unit to display a moving image generated by the processing unit based on the repetitive output from the imaging device in the second display control. The ophthalmic microscope according to any one of 3. It further comprises an operation unit,
The display control unit switches and executes the first display control and the second display control in response to an operation using the operation unit. The ophthalmic microscope according to Item. The ophthalmologic microscope according to any one of claims 1 to 4, wherein the display control unit can execute the first display control and the second display control in parallel. It further comprises an operation unit,
The display control unit continuously executes the first display control,
The second display control is started when the first operation is performed using the operation unit, and the second display control is ended when the second operation is performed. The ophthalmic microscope according to 6. An OCT system that divides light from an OCT light source into measurement light and reference light and detects interference light between return light of the measurement light from the patient's eye and the reference light;
An OCT data generation unit for processing the detection result of the interference light to generate data;
The said display control part performs 3rd display control which displays the data produced | generated by the said OCT data generation part on the said display part. The said display control part is described in any one of the Claims 1-7 characterized by the above-mentioned. Ophthalmic microscope.