JP7567290B2 - Ophthalmic image processing device and ophthalmic image processing program - Google Patents

Description

The present disclosure relates to an ophthalmic image processing device, an ophthalmic image processing program, and an ophthalmic system.

An ophthalmic imaging device capable of photographing the angle of the subject's eye is known (Patent Document 1). Observing the angle is useful in diagnosing and treating glaucoma.

International Publication No. 2015/180923

Glaucoma is treated by selective laser trabeculoplasty (SLT), micro invasive glaucoma surgery (MIGS), etc. When observing the corneal angle, the examiner must remember the treatment area, and then perform surgery on each treatment area, leaving room for improvement.

In view of the above-mentioned conventional techniques, the technical objective of the present disclosure is to provide an ophthalmic image processing device, an ophthalmic image processing program, and an ophthalmic system that can efficiently treat angles.

In order to solve the above problems, the present disclosure is characterized by having the following configuration:

An ophthalmic image processing device according to a first aspect of the present disclosure is an ophthalmic image processing device that processes an image of the angle of a test eye, and is characterized in that it comprises: a treatment method selection means for selecting a treatment method for the angle of the test eye from at least selective laser trabeculoplasty or minimally invasive glaucoma surgery; a first acquisition means for acquiring a first image of the angle of the test eye; a setting means for setting a superposition position at which an index indicating a treatment site in the first image of the angle of the test eye is superimposed on the first image of the angle of the test eye in accordance with the treatment method selected by the treatment method selection means; a second acquisition means for acquiring a second image of the angle of the test eye in which the index is superimposed on the first image of the angle of the test eye based on the superposition position; and an output means for outputting the second image of the angle of the test eye.

An ophthalmic image processing program according to a second aspect of the present disclosure is an ophthalmic image processing program used in an ophthalmic image processing device that processes an image of the angle of a test eye, characterized in that, when executed by a processor of the ophthalmic image processing device, the ophthalmic image processing device executes the following: a treatment method selection step of selecting a treatment method for the angle of the test eye from at least selective laser trabeculoplasty or minimally invasive glaucoma surgery ; a first acquisition step of acquiring a first angle image of the test eye; a setting step of setting a superposition position at which an index indicating a treatment site in the first angle image is superimposed on the first angle image in accordance with the treatment method selected in the treatment method selection step; a second acquisition step of acquiring a second angle image in which the index is superimposed on the first angle image based on the superposition position; and an output step of outputting the second angle image.

1 is an example of an optometry system. FIG. 2 is an external view of the goniophotography device. FIG. 2 is a diagram showing the configuration of a control system and an optical system of the goniophotography apparatus. FIG. FIG. 13 is a diagram showing a panoramic image obtained by combining reflected images. 4 is an example of a screen on a display unit. FIG. 13 is an enlarged view of a portion of the panoramic image. 1 is an example of a control system and an optical system of an optical coherence tomography.

<Example>
An example of this embodiment will be described.

Figure 1 shows an example of an optometry system. The optometry system 1 of this embodiment may include at least an ophthalmic imaging device A and a therapeutic observation device B.

When treating the angle of the subject's eye, an ophthalmic imaging device A is used first. The ophthalmic imaging device A may be an ophthalmic imaging device that captures a reflected image of the angle of the subject's eye as an ophthalmic image. An index indicating the treatment area of the angle can be superimposed on the ophthalmic image captured by the ophthalmic imaging device A (details will be described later). Such an ophthalmic image including an index can be output in various forms, such as being displayed on a monitor, saved in memory, printed using a printer, or transmitted to a treatment observation device B.

Next, the treatment observation device B is used. The treatment observation device B may be a laser treatment device (e.g., a slit lamp, etc.) equipped with an observation system for observing the examinee's eye and irradiating the examinee's eye with laser light. The treatment observation device B uses an image of the iridocorneal angle including an index, thereby efficiently observing and treating the iridocorneal angle.

In the optometry system 1 of this embodiment, the ophthalmic imaging device A also functions as a function for superimposing the index on the iridocorneal angle image (in other words, the function as an ophthalmic image processing device), but this function may also be performed by the therapeutic observation device B. Furthermore, the optometry system 1 of this embodiment may include a computer or the like used as an ophthalmic image processing device, separate from the ophthalmic imaging device A or the therapeutic observation device B.

The following is a detailed explanation of the ophthalmic imaging device A, taking the iridophotography device 100 as an example. The iridophotography device 100 partially images the iridophotography area of the subject's eye, and can generate a full-circumference image of the iridophotography area by combining multiple reflected images captured at different positions.

Figure 2 is an external view of the iridophotography device 100. The left-right direction of the iridophotography device 100 is represented as the X direction, the up-down direction as the Y direction, and the front-back direction as the Z direction.

The goniophotography device 100 includes a base 3, a movable table 4, an alignment mechanism 5, a face support unit 6, an operation unit 7, a display unit 8, an optical unit 10 (described below), a control unit 170 (described below), etc.

The base 3 supports the moving table 4, the face support unit 6, etc. The moving table 4 is placed on the base 3.

The alignment mechanism 5 moves the movable stage 4 relative to the base 3 in at least one of the X, Y, and Z directions. As a result, the optical unit 10 is moved in the X, Y, and Z directions relative to the subject's eye E, and the positional relationship between the subject's eye E and the optical unit 10 is adjusted. For example, the alignment mechanism 5 may be a slide mechanism having a motor, gears, guide rails, etc.

The operation unit 7 inputs a signal for moving the optical unit 10. For example, by tilting the operation unit 7, a signal for moving the moving stage 4 in the YZ direction is input. For example, by rotating a knob (not shown) of the operation unit 7, a signal for moving the moving stage 4 in the Y direction is input.

The display unit 8 displays information about the subject's eye E, an image of the angle of the subject's eye E, etc., on a screen. The display unit 8 also functions as a touch panel that serves as the operation unit 7. By operating the display unit 8, it is possible to input signals for performing various settings, signals for instructing the start and end of imaging, signals for moving the optical unit 10, etc.

Figure 3 shows the configuration of the control system and optical system of the goniophotography device 100.

<Control Unit>
The control unit 170 is a processing device (processor) having electronic circuits that perform control processing and arithmetic processing of each unit. The control unit 170 includes a general CPU (Central Processing Unit), RAM, ROM, etc. For example, the CPU controls each component in the iridophotography device 100. For example, the RAM temporarily stores various information. For example, the ROM stores various programs for controlling the operation of the iridophotography device 100. For convenience, the control unit 170 is assumed to perform image processing of various images obtained by the iridophotography device 100. In other words, the control unit 170 also functions as an image processing unit.

The control unit 170 is electrically connected to the operation unit 7, the display unit 8, the light source and image sensor of the optical system, the memory unit 171, etc. The memory unit 171 may be a non-transient storage medium that can retain the stored contents even if the power supply is cut off. For example, the memory unit 171 may be a hard disk drive, a flash ROM, a USB memory, etc.

<Optical unit>
The optical unit 10 has an imaging optical axis L2 inclined with respect to the fixation optical axis L1. When the alignment is proper, the imaging optical axis L2 is disposed along the angle division line of the corneal angle. The optical unit 10 receives reflected light from the corneal angle region along the imaging optical axis L2, thereby capturing a reflected image of the corneal angle.

The optical unit 10 has a photographing optical system 100a. The photographing optical system 100a is an optical system for photographing a reflected image of an angle. For example, the reflected image photographed by the photographing optical system 100a is processed by the control unit 170, and as a result, a full-circumference image is formed.

The imaging optical system 100a has at least an objective reflecting unit 140, a switching unit 130, and an image sensor 160. The iridophotography device 100 may further have a light source 110 and a focus adjustment unit 150.

The light source 110 is a light source for illuminating the irradiated angle. In this embodiment, the light source 110 emits visible light. In the following description, it is assumed that the light source 110 is capable of emitting at least multiple colors of light with different wavelength ranges (e.g., white light) in order to obtain a color image of the irradiated angle.

The illumination light from the light source 110 is reflected by the beam splitter 120 and directed toward the switching unit 130. At this time, the reflected light of the illumination light is guided to the switching unit 130 along the fixation optical axis L1. The beam splitter 120 separates the projection path and the reception path of the illumination light in the imaging optical system 100a. A half mirror, a mirror with a hole, or the like may be used as the beam splitter 120.

The switching unit 130 is a unit that displaces the capture position of the reflected image around the entire circumference of the angle. By providing the switching unit 130, it is possible to capture reflected images of the angle at multiple capture positions around the entire circumference of the angle. In this embodiment, the switching unit 130 has mirrors 131 and 132 and a driving source (not shown) such as a motor. The switching unit 130 is driven based on a control signal from the control unit 170, and as a result, the imaging optical axis L2 is rotated around the fixation optical axis L1.

The two mirrors 131 and 132 shown in FIG. 3 are arranged in parallel, and the center of the optical path of the illumination light is shifted by a predetermined distance relative to the fixation optical axis L1. The mirrors 131 and 132 are rotated around the fixation optical axis L1 by a drive source (not shown), thereby displacing the position of the illumination light path from the switching unit 130 to the objective reflecting unit 140.

Here, the objective reflecting unit 140 has a reflecting surface that bends the illumination light toward the fixation optical axis L1. The optical axis of the illumination light reflected by the reflecting surface is bent so as to be largely inclined with respect to the fixation optical axis L1, and is guided to the outside of the device. At this time, the optical axis guided to the outside of the device is used as the imaging optical axis L2.

In this embodiment, the objective reflecting unit 140 has a plurality of reflecting surfaces arranged around the fixation optical axis L1. In this embodiment, a prism having a regular polygonal base is used as a specific example of the objective reflecting unit 140. More specifically, a prism having a regular hexagonal base and 16 side surfaces is used. In this embodiment, the reflecting surfaces facing the fixation optical axis L1 are arranged in the directions of 0°, 22.5°, 45°, 67.5°, 90°... (omitted)... 337.5° as viewed from the subject's eye E. Each angle is an angle based on the fixation optical axis L1. For convenience of explanation, 0° is defined as a horizontal plane (more specifically, the right side of the horizontal plane as viewed from the goniophotography device 100).

The control unit 170 can select one of the 16 reflecting surfaces as the surface to which the switching unit 130 will direct the illumination light, thereby directing the illumination light to the shooting positions corresponding to each reflecting surface around the entire circumference of the angle.

The reflected light from the angle region passes back through the objective reflector 140 and the switch 130 and is guided to the beam splitter 120. The illumination light that passes through the beam splitter 120 to the image sensor 160 passes through the focus lens 151 and is received by the image sensor 160. As a result, a reflected image of the angle (see FIG. 4) is captured.

The focus lens 151 is part of the focus adjustment unit in the iridophotography device 100. The iridophotography device 100 is provided with a drive unit 152 that moves the focus lens 151 along the optical axis. The drive unit 152 may include, for example, a linear actuator. The position of the focus lens 151 is adjusted according to the desired tissue in the iridophotography device 100, and an image of the iridophotography device 100 that includes the desired tissue is captured based on the light reception signal from the image sensor 160. In this embodiment, the focus adjustment is performed by moving the focus lens 151, but this is not necessarily limited to this. For example, the focus adjustment may be performed by moving the image sensor 160 in the optical axis direction.

In this embodiment, the iridocorneal image may be a multi-focus image (depth synthesis image). For example, a multi-focus image is an image in which a wide range is in focus. For more information, see JP2019-42304A.

<Control operation>
The control operation of the goniophotography device 100 will now be described.

<Acquisition of an angle image>
The examiner instructs the subject to place his/her face on the face support unit 6. The control unit 170 may detect, by a detector (not shown), that the subject's face has been placed on the chin rest, and automatically start alignment adjustment between the subject's eye E and the optical unit 10.

The examiner also operates the display unit 8 to start photographing the angle of the subject's eye E. In response to a signal from the display unit 8, the control unit 170 photographs a specified photographing position of the angle and obtains a reflected image.

Figures 4 and 5 are examples of angle images of the subject's eye E. Figure 4 shows a reflection image 50 taken at a predetermined shooting position. Figure 5 shows a full-circumference image 60 that is a composite of reflection images 50 taken at different shooting positions. For example, 16 shooting positions for the angle are preset around the entire circumference of the angle. The control unit 170 changes the shooting position of the angle in sequence to capture a reflection image 50 at each position.

The control unit 170 also processes the reflected image 50 at each location to detect the trabecular meshwork. The trabecular meshwork is located between the iris and the cornea. The cornea reflects visible light more easily than the iris, and as a result, there is a large change in brightness near the trabecular meshwork. For example, the control unit 170 may use brightness information of the reflected image 50 to identify the pixel position of the trabecular meshwork.

Furthermore, the control unit 170 generates a full-circumference image 60 of the angle by combining the reflection images 50 at each location. For example, the control unit 170 generates the full-circumference image 60 by arranging the reflection images 50 at each location in a circular ring shape and connecting the trabecular meshwork contained in each. For example, the full-circumference image 60 may be displayed on the display unit 8 and stored in the memory unit 171.

The examiner observes the reflected image 50 and the circumferential image 60 of the angle to diagnose glaucoma in the subject's eye E. If the examiner determines that treatment for glaucoma is necessary, the examiner determines the method of treating the angle. The treatment area differs depending on the method of treating the angle. For example, when performing selective laser trabeculoplasty (SLT), the pigmented area of the trabecular meshwork is the treatment area. For example, when performing minimally invasive glaucoma surgery (MIGS), the treatment area includes the trabecular meshwork, ciliary body, etc.

<Setting the treatment method and displaying the first index>
6 is an example of a screen of the display unit 8. For example, in the initial state of the display unit 8, the omnidirectional image 60 is displayed so that the left-right and up-down directions of the subject's eye E coincide with the left-right and up-down directions of the omnidirectional image 60. That is, the omnidirectional image 60 is displayed as an erect image.

When the examiner has decided on the treatment method for the subject's eye E, he or she operates the display unit 8 to select the switch 81 for setting the treatment method. In response to the signal from the switch 81, the control unit 170 causes a first index 91 to be displayed on the 360 image 60. The first index 91 indicates an area that corresponds to the treatment method and that can be selected as a treatment area, as described below.

For example, the examiner selects SLT as the treatment method and operates the switch 81. For example, the control unit 170 superimposes the first index 91 on the circumferential image 60 along the trabecular meshwork being treated by SLT. As an example, the first index 91 is superimposed on the circumferential image 60 over half or the entire circumference of the trabecular meshwork. More specifically, the pixel position of the trabecular meshwork included in the circumferential image 60 is identified based on the pixel position of the trabecular meshwork in the above-mentioned reflection image 50. In addition, the first index 91 is superimposed on the pixel position of the trabecular meshwork identified in the circumferential image 60.

The first indices 91 may be arranged in a preset number (e.g., the number of laser shots of a typical SLT). The first indices 91 may also be arranged at equal intervals so as not to overlap each other.

<Designation of treatment area and display of second index>
7 is an enlarged view of a part of the circumferential image 60 (the dotted line part shown in FIG. 6 ). When the first indices 91 are superimposed on the circumferential image 60, the examiner operates the display unit 8 to select an arbitrary first indices 91. This designates a superimposition position P at which the second indices 92 indicating the treatment site of the iridocorneal angle are superimposed on the circumferential image 60. The control unit 170 sets the pixel position at which the first indices 91 are displayed on the circumferential image 60 as the superimposition position P of the second indices 92. The control unit 170 also causes the second indices 92 to be superimposed on the superimposition position P set on the circumferential image 60.

In this embodiment, when the examiner selects the first index 91, the control unit 170 switches the first index 91 to the second index 92. The first index 91 and the second index 92 may have different display forms so that they can be distinguished from each other. For example, they may differ in at least one of color, shape, size, transmittance, etc. Of course, the first index 91 and the second index 92 are not limited to being displayed in a switchable manner, and the second index 92 may be displayed superimposed on the first index 91.

<Setting the orientation of the panoramic image>
When the examiner designates a desired treatment site of the iridocorneal angle (when the examiner switches the desired first index 91 to the second index 92), the examiner operates the display unit 8 to select the switch 82 for setting the orientation of the circumferential image 60. The control unit 170 changes the orientation of the circumferential image 60 in response to a signal from the switch 82.

The switch 82 may include an inversion switch 82a for changing whether the omnidirectional image 60 is an upright image or an inverted image (a mirror image or an inverted image of the upright image) that is an inverted image of the upright image. When the examiner operates the inversion switch 82a, the control unit 170 switches between upright display and inverted display of the omnidirectional image 60 in response to a signal from the inversion switch 82a. At this time, the first index 91 and the second index 92 superimposed on the omnidirectional image 60 are both changed to match the upright display and inverted display of the omnidirectional image 60.

The switch 82 may also include a rotation switch 82b for rotating the omnidirectional image 60. When the examiner operates the rotation switch 82b, the control unit 170 rotates the omnidirectional image 60 in a predetermined direction by a predetermined angle in response to a signal from the rotation switch 82b. As an example, the omnidirectional image 60 is rotated counterclockwise by 90 degrees. At this time, the first index 91 and the second index 92 superimposed on the omnidirectional image 60 are both changed in accordance with the rotation of the omnidirectional image 60.

By selecting at least one of the inversion switch 82a and the rotation switch 82b, the examiner can specify the orientation of the circumferential image 60 that is easy to confirm when treating the subject's eye E. For example, the examiner can specify the orientation of the circumferential image 60 taking into consideration the subject's standing position (head side, right side, left side, etc.), the observation direction of the angle of the subject's eye, etc.

<Output of omnidirectional images>
When the examiner selects the orientation of the omnidirectional image 60, he or she operates the display unit 8 to select the switch 83 for outputting the omnidirectional image 60. The control unit 170 outputs the omnidirectional image 60 in response to a signal from the switch 83.

In this embodiment, the control unit 170 transmits the omnidirectional image 60 to a printer (not shown) or the like. At this time, the first index 91 may be deleted from the omnidirectional image 60, and the omnidirectional image 60 may be transmitted in a state in which only the second index 92 is superimposed on the omnidirectional image 60. Of course, the omnidirectional image 60 may be transmitted in a state in which both the first index 91 and the second index 92 are superimposed on the omnidirectional image 60. When the control unit of the printer (not shown) receives the omnidirectional image 60, it prints it.

<Treatment of the Corner Angle>
The examiner uses a laser treatment device as the treatment observation device B to treat the angle of the subject's eye E. The laser treatment device may include an observation optical system for observing the subject's eye E, an illumination optical system for projecting illumination light onto the subject's eye E, an irradiation optical system for irradiating the subject's eye E with laser light, and the like.

The examiner operates the operation unit of the laser treatment device to observe the angle. For example, the control unit of the laser treatment device projects illumination light onto the subject's eye E to obtain an observation image. The examiner also operates the operation unit of the laser treatment device to aim the laser light at the treatment area. At this time, the examiner can easily grasp the start position and irradiation range of the laser light by checking the printed 360 image. When the examiner operates the laser light irradiation switch, the control unit irradiates the laser light to the desired treatment area.

As described above, for example, the ophthalmologic image processing device in this embodiment sets a superimposition position for superimposing an index indicating the treatment area on a first iridocorneal image of the subject's eye, obtains a second iridocorneal image in which the index is superimposed on the first iridocorneal image, and outputs the second iridocorneal image. By using such a second iridocorneal image, the examiner can efficiently proceed with the treatment of the iridocorneal angle. For example, the examiner can perform treatment while knowing in advance the treatment area of the iridocorneal angle.

In addition, for example, the ophthalmologic image processing device in this embodiment acquires the treatment method for the angle and sets the superimposition position of the index according to the treatment method. Therefore, the index is superimposed on an appropriate area according to SLT or MIGS. The examiner can easily understand the area to be treated by checking the second angle image.

In addition, for example, the ophthalmologic image processing device in this embodiment has an operation unit for specifying the superimposition position of the index, and the superimposition position of the index is set to the position specified by the examiner operating the operation unit. The examiner can specify any desired position as the superimposition position, and can easily grasp the area to be treated using the second angle image obtained in this way.

In addition, for example, the ophthalmologic image processing device in this embodiment applies at least one of rotation and inversion processing to the second iridocorneal angle image in response to a switching instruction to switch the orientation of the second iridocorneal angle image, and outputs the image. The orientation of the second iridocorneal angle image can be changed to any orientation according to the position in which the examiner stands when treating the subject's eye, the observation direction in which the examiner observes the subject's eye, etc., making treatment and observation easier.

<Example of transformation>
In this embodiment, the first index 91 and the second index 92 are superimposed on the circumferential image 60 of the iridocorneal angle and output, but the present invention is not limited to this. In this embodiment, the first index 91 and the second index 92 may be similarly superimposed on the reflected image 50 of the iridocorneal angle and output.

In this embodiment, the first index 91 and the second index 92 are superimposed on the circumferential image 60 of the angle in a preset display form and output, but the present invention is not limited to this. In this embodiment, the display form of at least one of the first index 91 and the second index 92 may be changeable.

In this case, the display unit 8 may be provided with a switch for changing the display form of the indices. The examiner may be able to freely change the display form of the first indices 91 and the second indices 92 by operating such a switch. For example, the display form of these indices may include at least one of the line width, color, shape, size, transmittance, etc.

For example, in this manner, the ophthalmologic image processing device in this embodiment can change the shape of the index superimposed on the first iridocorneal angle image. Therefore, for example, the examiner can appropriately change the color or shape of the index to one that is easy for the examiner to identify. Also, for example, the examiner can appropriately change the transmittance of the index so that the examiner can grasp areas that are hidden by the superimposed index.

In this embodiment, the first index 91 is superimposed on the circumferential image 60 of the angle, but the present invention is not limited to this. In this embodiment, it is not necessary to superimpose an area that can be selected as a treatment area, and it is sufficient that at least the treatment area (second index 92) is superimposed on the circumferential image 60.

In this case, the examiner may specify any pixel position in the 360 as the superimposition position P of the second index 92. For example, the second index 92 may be superimposed based on the superimposition position P specified by the examiner's operation of the operation unit 7. As an example, a symbol (figure, letter, number, etc.) may be superimposed as the second index 92 on the superimposition position P specified by the examiner. Also, for example, the second index 92 may be superimposed based on the superimposition position P that changes in conjunction with the operation of the operation unit 7 by the examiner. As an example, a drawing may be superimposed as the second index 92 on the superimposition position P specified by the examiner. In other words, it may be possible to freely draw lines and circles on the 360 image.

In this embodiment, a laser treatment device is used as the treatment observation device B, but this is not limited to this. In this embodiment, a surgical microscope for observing the treatment area of the examinee's eye may also be used as the treatment observation device B. Also, in this embodiment, a wearable device (e.g., a head-mounted display, smart glasses, etc.) may also be used as the treatment observation device B.

In this embodiment, the circumferential image 60 captured by the iridoscopic device 100 and with the treatment area (second index 92) superimposed thereon is printed, but this is not limiting. In this embodiment, the circumferential image 60 captured by the iridoscopic device 100 and with the treatment area superimposed thereon may be transmitted to the laser treatment device. In this case, the laser treatment device may be equipped with a display unit, and may display the circumferential image 60 on the display unit. In this case, the laser treatment device may associate the circumferential image 60 with the observation image, and may superimpose the treatment area specified in the circumferential image 60 on the observation image.

For example, the control unit of the laser treatment device identifies which region of the circumferential image 60 the observation image of the iridocorneal angle corresponds to by comparing the observation image with the circumferential image 60. As an example, the magnification of the observation image and the circumferential image 60 may be matched, and image processing such as template matching and feature point extraction may be performed.

The control unit also associates pixel positions of the observation image with pixel positions of the area identified in the circumferential image 60. This determines the superimposition position at which to superimpose the third index, which is equivalent to the second index 92 included in the circumferential image 60 and indicates the treatment area of the angle, on the observation image. Note that the relationship between the number of pixels of the observation image and the circumferential image 60 is known from the design perspective. The control unit superimposes and displays the third index at the superimposition position set on the observation image.

For example, while checking such an observation image, the examiner may manually align the laser treatment device with respect to the subject's eye E so that the aim of the laser light is aligned with the treatment area (third index). Alternatively, the control unit of the laser treatment device may automatically align the laser treatment device with respect to the subject's eye E based on the amount of deviation between the irradiation axis of the laser light and the treatment area (third index).

In this embodiment, the ophthalmic imaging device A is an iridophotography device 100, but is not limited to this. In this embodiment, an optical coherence tomography device can also be used as the ophthalmic imaging device A.

This will be explained using as an example an optical coherence tomography device that combines the functions of a polarization sensitive OCT (PS-OCT) as an ophthalmic imaging device A and the functions of an ophthalmic image processing device B. The optical coherence tomography device can scan the anterior segment of the subject's eye E with measurement light and obtain OCT data of the anterior segment. For example, the scanning range of the measurement light extends to the angle of the eye (or the area around the angle including the angle), and cross-sectional information, polarization property data, etc. can be obtained as OCT data.

Figure 8 shows an example of the control system and optical system of the optical coherence tomography device 200. The control unit 270 is a processor having electronic circuits that perform control processing and arithmetic processing of each unit, and is composed of a CPU, RAM, ROM, etc. The control unit 270 is electrically connected to the light source 210, coupler 230, detector 220, reference optical system 240, scanning unit 250, memory unit 271, etc. The control unit 270 also functions as an image processing unit.

The OCT optical system 200a may be a PS-SD-OCT that has the functionality of a spectral domain OCT (SD-OCT) in addition to the functionality of a PS-OCT. The OCT optical system 200a may also be a PS-SS-OCT that has the functionality of a swept-wavelength OCT (SS-OCT) in addition to the functionality of a PS-OCT.

In this embodiment, the OCT optical system 200a is a PS-SD-OCT optical system. The OCT optical system 200a may include a light source 210, a detector 220, a coupler 230, a reference optical system 240, a scanning unit 250, an objective lens 260, and the like.

The light from the light source 210 is split into measurement light and reference light by the coupler 230. The measurement light is scanned over the anterior segment in response to the operation of the scanning unit 250. Note that by positioning the scanning unit 250 at or near the focal point of the objective lens 260, the measurement light is irradiated approximately telecentrically with respect to the fixation optical axis L1 and reaches the anterior segment. An interference signal between the return light of the measurement light irradiated to the anterior segment and the reference light is detected and output by the detector 220.

The control unit 270 acquires OCT data of the anterior segment, with the depth direction being the direction along the ocular axis of the subject's eye E, based on the interference signal output from the detector 220. Note that, here, the scanning range of the measurement light for the subject's eye E includes the angle of the eye. In other words, by scanning the angle of the eye with the measurement light, OCT data of the angle of the eye can be acquired.

The OCT optical system 200a may split the return light of the light irradiated to the angle into a first polarized component of light and a second polarized component of light having different polarizations. The control unit 270 may acquire polarization characteristic data based on the light of each polarized component. For example, the polarization characteristic data may be an analysis result regarding the polarization characteristics, and may include at least one of information regarding the birefringence of the angle region (birefringence information), information regarding the polarization uniformity (DOPU) of the angle region, information regarding the polarization axis rotation (Axis-Orientation) of the angle region, etc.

By processing the polarization characteristic data of the angle, the control unit 270 can detect features that cannot be detected by intensity OCT data. As an example, pigment, trabecular meshwork, Schlemm's canal, etc. are detected in the angle. Therefore, for example, similar to the angle imaging device 100, by showing an area (first index 91) on the trabecular meshwork that can be selected as a treatment area in the polarization characteristic data, the treatment area (second index 92) can be easily selected.

In this embodiment, the first index 91 is superimposed on the circumferential image 60 of the iridocorneal angle or the polarization characteristic data in a preset arrangement, but the present invention is not limited to this. In this embodiment, the first index 91 may be arranged based on the results of detecting areas that can be selected as treatment areas.

This will be described using an example in which the optical coherence tomography device 200 is used. For example, the control unit 270 may detect pigmented areas in the trabecular meshwork based on the polarization characteristic data. Since depolarization (polarization scrambling) occurs in pigmented areas, the pigmented areas can be characteristically detected based on depolarization.

As an example, the control unit 270 may determine the amplitude change rate for each position in the spectral waveform in the wavelength range corresponding to the pigmented area and in the wavelength ranges before and after that, and when an amplitude change rate exceeding a threshold is confirmed, it may be estimated that a pigmented area is present at the position corresponding to that spectral waveform. Alternatively, the area in which the pigmented area is detected may be divided into multiple small areas, and the variance of the spectral waveform (for example, the variance of the evaluation value of the spectral waveform) may be determined for each divided area, and the pigmented area may be detected based on the variance. In other words, it is considered that the more pigmented there is, the greater the variation in the spectral waveform. The variance may be compared using envelopes or for each wavelength.

The control unit 270 may superimpose the first index 91 on the pigmented area included in the polarization characteristic data. In other words, the control unit 270 may superimpose the first index 91 on the pigmented area that can be selected as a treatment area.

When the first index 91 is superimposed on the polarization characteristic data, the examiner can select any first index 91 to specify the superimposition position P at which the second index 92 is to be superimposed. The control unit 270 sets the pixel position at which the first index 91 is displayed in the polarization characteristic data as the superimposition position of the second index 92, and superimposes the second index 92.

Of course, the second index 92 may be superimposed on the pigmented area included in the polarization characteristics data without superimposing the first index 91. In other words, the superimposing position P of the second index 92 may be set on the pigmented area. The control unit 270 causes the second index 92 to be superimposed on the superimposing position P set in the polarization characteristics data.

For example, in this manner, the ophthalmologic image processing device in this embodiment detects the treatment area in the iridocorneal angle image, and sets the superimposition position of the index based on the detection result. This allows the index to be superimposed at an appropriate position as the treatment area. For example, the examiner's manual selection of the treatment area and the control unit's automatic selection of the treatment area are guided, improving the operability of the device.

The ophthalmologic image processing device in this embodiment detects the treatment area based on the pigment information included in the iridocorneal angle image and sets the superimposition position of the index. For example, the pigmented area included in the iridocorneal angle image is detected as the treatment area and the superimposition position of the index is set. For example, in SLT, the iridocorneal angle is treated by irradiating the pigmented area present in the trabecular meshwork of the iridocorneal angle with laser light. The area to be treated can be easily selected by detecting the pigmented area of the iridocorneal angle from the pigment information included in the iridocorneal angle image.

In the present embodiment, the case where the examiner performs SLT on the subject's eye has been described as an example, but the present invention is not limited to this. Of course, the examiner may perform MIGS on the subject's eye. In this case, the control unit 170 may superimpose the first index 91 on the part of the trabecular meshwork treated by MIGS where the collecting duct exists (e.g., the part on the nose side). For example, the part where the collecting duct exists may be associated with the circumferential image 60 in advance. As an example, by associating the part where the collecting duct exists with the shooting position of the reflected image 50, the position is identified in the circumferential image 60 synthesized with the reflected image 50. By selecting any first index 91, the examiner can superimpose the second index 92 indicating the treatment part of the angle on the circumferential image 60.

The first index 91 and the second index 92 are not limited to those that allow any point to be specified, but may be those that allow any area to be specified. For example, they may be displayed superimposed as band-shaped indices that are divided into a predetermined angle (for example, every 90 degrees) with respect to the trabecular meshwork.

Note that the present disclosure is not limited to the device described in this embodiment. For example, terminal control software (program) that performs the functions of the above embodiment can be supplied to a system or device via a network or various storage media, and the control device (e.g., CPU, etc.) of the system or device can read and execute the program.

8 Display unit 10 Optical unit 50 Reflected image 60 Full-circumference image 100 Isogonial imaging device 170 Control unit

Claims (3)

An ophthalmologic image processing device that processes an image of an angle of a subject's eye,
a treatment method selection means for selecting a treatment method for the angle of the subject's eye from at least selective laser trabeculoplasty or minimally invasive glaucoma surgery;
a first acquisition means for acquiring a first iridocorneal image of the subject's eye;
a setting means for setting a superimposition position at which an index indicating a treatment site in the first iridocorneal image is superimposed on the first iridocorneal image in accordance with the treatment technique selected by the treatment technique selection means ;
a second acquisition means for acquiring a second iridocorneal image in which the index is superimposed on the first iridocorneal image based on the superimposition position;
an output means for outputting the second iridocorneal image;
An ophthalmologic image processing device comprising: 2. The ophthalmologic image processing apparatus according to claim 1,
a detection means for detecting the treatment area in the first iridocorneal image;
The ophthalmologic image processing apparatus according to claim 1, wherein the setting means sets the superimposition position of the index based on a detection result of the detection means. An ophthalmic image processing program for use in an ophthalmic image processing device for processing an image of an angle of a subject's eye, comprising:
When executed by a processor of the ophthalmologic image processing device,
a treatment method selection step of selecting a treatment method for the angle of the subject's eye from at least selective laser trabeculoplasty or minimally invasive glaucoma surgery;
a first acquisition step of acquiring a first iridocorneal image of the subject's eye;
a setting step of setting a superimposition position at which an index indicating a treatment site in the first iridocorneal image is superimposed on the first iridocorneal image in accordance with the treatment technique selected in the treatment technique selection step;
a second acquisition step of acquiring a second iridocorneal image in which the index is superimposed on the first iridocorneal image based on the superimposition position;
an output step of outputting the second iridocorneal image;
An ophthalmologic image processing program causing the ophthalmologic image processing device to execute the above-mentioned.