JP6186453B2 - Ophthalmic analysis device and ophthalmic imaging device - Google Patents

Description

  The present invention relates to an ophthalmologic analyzer and an ophthalmologic photographing apparatus that analyze information about ophthalmology acquired using optical coherence tomography (hereinafter referred to as OCT).

  In recent years, OCT that forms an image representing the surface form or internal form of an object to be measured using a light beam from a laser light source or the like has attracted attention. Since OCT has no invasiveness to the human body like X-ray CT (Computed Tomography), it is expected to be applied particularly in the medical field and the biological field. For example, in the field of ophthalmology, an apparatus for forming an image of the fundus oculi or cornea has been put into practical use.

  In recent studies, attention has been focused on the relationship between information on a predetermined site such as a fundus or cornea acquired using OCT and a disease. For example, for glaucoma, it is known that thinning of the retinal nerve fiber layer around the optic nerve proceeds before subjective symptoms appear in the patient. According to the latest research, it has been clarified that when subjective symptoms appear, thinning of about 70% occurs in a local region where visual field defects appear, and about 30% as a whole. In addition, it is known that visual field defects due to geographic atrophy (GA) appearing in age-related macular degeneration are caused by retinal pigment epithelium (RPE) disorders. In addition, research on the relationship between functional data such as fundus blood flow dynamics and specific diseases is also underway. As described above, the site where an abnormality occurs is generally different depending on the type and progression of the disease. In addition, the importance of continuous observation for grasping the degree of disease progression and the course after treatment is increasing.

  Such a technique for continuous observation (follow-up observation, preoperative and postoperative observation, etc.) is disclosed in Patent Document 1, for example. Patent Document 1 discloses a trend analysis technique for designating an area focused by an examiner on a tomographic image acquired using OCT and performing follow-up observation on the area.

JP 2014-83268 A

  In the conventional technology, even though the type of disease and the degree of progression differ from patient to patient, since a predetermined parameter is uniformly obtained and continuously observed, local minor changes in the fundus and cornea May not be captured. Further, in the conventional technique, it is common to designate a site of interest each time in each examination, but this is troublesome and a designation error may occur.

  The present invention has been made to solve such a problem, and its purpose is to provide a technology capable of capturing a local minute change in the eye to be examined regardless of the disease type, stage or disease state. There is to do.

The ophthalmic analysis apparatus according to the embodiment includes a receiving unit that receives patient identification information for identifying a patient, and storage means in which interest position information indicating the position of a region of interest is associated with each of the plurality of patient identification information and stored in advance. From the acquisition unit that acquires the position of interest information associated with the patient identification information received by the reception unit, and the patient corresponding to the patient identification information based on the position of interest information acquired by the acquisition unit A specifying unit that specifies a partial region in an image acquired for the eye to be examined; and an analysis unit that analyzes the partial region specified by the specifying unit. The specifying unit specifies a region wider than the region in the image corresponding to the region of interest indicated by the position-of-interest information as the partial region. The ophthalmic analysis apparatus according to the embodiment includes an update unit for updating the position of interest information stored in the storage unit based on the new partial area specified by the specifying unit, and a template indicating an inspection range of visual field inspection A display control unit that displays an image on a display unit and displays the region in the template image corresponding to the partial region specified by the specifying unit on the display unit in an identifiable manner; And an operation unit for setting a new partial area by changing the area. The analysis unit analyzes the new partial region set by the operation unit.

  According to the present invention, it is possible to capture a local minute change of the eye to be examined regardless of the disease type, stage or disease state.

It is a schematic diagram showing an example of composition of an ophthalmology photographing instrument concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology photographing instrument concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology photographing instrument concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology photographing instrument concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology photographing instrument concerning an embodiment. It is a schematic diagram showing an example of composition of an ophthalmology photographing instrument concerning an embodiment. It is a flowchart showing an example of operation | movement of the ophthalmologic imaging device which concerns on embodiment. It is operation | movement explanatory drawing of the ophthalmologic imaging device which concerns on embodiment. It is operation | movement explanatory drawing of the ophthalmologic imaging device which concerns on embodiment. It is operation | movement explanatory drawing of the ophthalmologic imaging device which concerns on embodiment.

  An example of an embodiment of the present invention will be described in detail with reference to the drawings. The ophthalmologic photographing apparatus according to the present invention forms an image (including at least one of a two-dimensional tomographic image and a three-dimensional image) of an eye to be examined (fundus, anterior eye portion, etc.) using OCT. The ophthalmic analysis apparatus according to the present invention receives an input of an image of the eye to be examined acquired using OCT, and performs an analysis process on the image of the eye to be examined. In this specification, images acquired using OCT may be collectively referred to as OCT images. A measurement operation for acquiring an OCT image may be referred to as OCT measurement. In addition, it is possible to use the description content of the literature described in this specification as the content of the following embodiment.

  In the following embodiment, a configuration to which Fourier domain type OCT is applied will be described in detail. In particular, the ophthalmologic imaging apparatus according to the embodiment can acquire both an OCT image and a fundus image of the eye to be examined using a spectral domain OCT technique. The configuration according to the present invention can also be applied to an ophthalmologic photographing apparatus using a method other than the spectral domain, for example, a swept source OCT technique. In this embodiment, an apparatus combining an OCT apparatus and a fundus camera will be described. However, this embodiment may be applied to an ophthalmologic photographing apparatus other than a fundus camera, such as an SLO (Scanning Laser Ophthalmoscope), a slit lamp, an ophthalmic surgical microscope, and the like. It is also possible to combine an OCT apparatus having the configuration according to the above. In addition, the configuration according to this embodiment can be incorporated into a single OCT apparatus.

  Moreover, although the following embodiment demonstrates the case where the image of the macular part in a fundus is acquired as an image of a to-be-examined eye, it is applied also when acquiring the image of parts other than a fundus (for example, anterior eye part). be able to.

[Constitution]
As shown in FIGS. 1 and 2, the ophthalmologic photographing apparatus 1 includes a fundus camera unit 2, an OCT unit 100, and an arithmetic control unit 200. The retinal camera unit 2 has almost the same optical system as a conventional retinal camera. The OCT unit 100 is provided with an optical system for acquiring an OCT image of the fundus. The arithmetic control unit 200 includes a computer that executes various arithmetic processes and control processes. The arithmetic control unit 200 has a function as an “ophthalmologic analyzer”. Further, the function of the “ophthalmologic analyzer” may be realized by the arithmetic control unit 200 and an operation unit 240B described later.

[Fundus camera unit]
The fundus camera unit 2 shown in FIG. 1 is provided with an optical system for obtaining a two-dimensional image (fundus image) representing the surface form of the fundus oculi Ef of the eye E to be examined. The fundus image includes an observation image and a captured image. The observation image is, for example, a monochrome moving image formed at a predetermined frame rate using near infrared light. The captured image may be, for example, a color image obtained by flashing visible light, or a monochrome still image using near infrared light or visible light as illumination light. The fundus camera unit 2 may be configured to be able to acquire images other than these, such as a fluorescein fluorescent image, an indocyanine green fluorescent image, a spontaneous fluorescent image, and the like.

  The retinal camera unit 2 is provided with a chin rest and a forehead support for supporting the subject's face. Further, the fundus camera unit 2 is provided with an illumination optical system 10 and a photographing optical system 30. The illumination optical system 10 irradiates the fundus oculi Ef with illumination light. The photographing optical system 30 guides the fundus reflection light of the illumination light to an imaging device (CCD image sensor (sometimes simply referred to as a CCD) 35, 38). The imaging optical system 30 guides the signal light from the OCT unit 100 to the fundus oculi Ef and guides the signal light passing through the fundus oculi Ef to the OCT unit 100.

  The observation light source 11 of the illumination optical system 10 is constituted by a halogen lamp, for example. The light (observation illumination light) output from the observation light source 11 is reflected by the reflection mirror 12 having a curved reflection surface, passes through the condensing lens 13, passes through the visible cut filter 14, and is converted into near infrared light. Become. Further, the observation illumination light is once converged in the vicinity of the photographing light source 15, reflected by the mirror 16, and passes through the relay lenses 17 and 18, the diaphragm 19 and the relay lens 20. Then, the observation illumination light is reflected at the peripheral portion (region around the hole portion) of the aperture mirror 21, passes through the dichroic mirror 46, and is refracted by the objective lens 22 to illuminate the fundus oculi Ef. An LED (Light Emitting Diode) can also be used as the observation light source.

  The fundus reflection light of the observation illumination light is refracted by the objective lens 22, passes through the dichroic mirror 46, passes through the hole formed in the central region of the perforated mirror 21, passes through the dichroic mirror 55, and is a focusing lens. It is reflected by the mirror 32 via 31. Further, the fundus reflection light passes through the half mirror 33A, is reflected by the dichroic mirror 33, and forms an image on the light receiving surface of the CCD image sensor 35 by the condenser lens. The CCD image sensor 35 detects fundus reflected light at a predetermined frame rate, for example. On the display device 3, an image (observation image) based on fundus reflection light detected by the CCD image sensor 35 is displayed. When the photographing optical system is focused on the anterior segment, an observation image of the anterior segment of the eye E is displayed.

  The imaging light source 15 is constituted by, for example, a xenon lamp. The light (imaging illumination light) output from the imaging light source 15 is applied to the fundus oculi Ef through the same path as the observation illumination light. The fundus reflection light of the imaging illumination light is guided to the dichroic mirror 33 through the same path as that of the observation illumination light, passes through the dichroic mirror 33, is reflected by the mirror 36, and is reflected by the condenser lens 37 of the CCD image sensor 38. An image is formed on the light receiving surface. On the display device 3, an image (captured image) based on fundus reflection light detected by the CCD image sensor 38 is displayed. Note that the display device 3 that displays the observation image and the display device 3 that displays the captured image may be the same or different. In addition, when similar imaging is performed by illuminating the eye E with infrared light, an infrared captured image is displayed. It is also possible to use an LED as a photographing light source.

  An LCD (Liquid Crystal Display) 39 displays a fixation target and an eyesight measurement index. The fixation target is an index for fixing the eye E to be examined, and is used at the time of fundus photographing or OCT measurement.

  A part of the light output from the LCD 39 is reflected by the half mirror 33A, reflected by the mirror 32, passes through the focusing lens 31 and the dichroic mirror 55, passes through the hole of the perforated mirror 21, and reaches the dichroic. The light passes through the mirror 46, is refracted by the objective lens 22, and is projected onto the fundus oculi Ef.

  By changing the display position of the fixation target on the screen of the LCD 39, the fixation position of the eye E can be changed. As the fixation position of the eye E, for example, a position for acquiring an image centered on the macular portion of the fundus oculi Ef, or a position for acquiring an image centered on the optic disc as in the case of a conventional fundus camera And a position for acquiring an image centered on the fundus center between the macula and the optic disc. It is also possible to arbitrarily change the display position of the fixation target.

  Further, the fundus camera unit 2 is provided with an alignment optical system 50 and a focus optical system 60 as in a conventional fundus camera. The alignment optical system 50 generates an index (alignment index) for performing alignment (alignment) of the apparatus optical system with respect to the eye E. The focus optical system 60 generates an index (split index) for focusing on the fundus oculi Ef.

  The light (alignment light) output from the LED 51 of the alignment optical system 50 is reflected by the dichroic mirror 55 via the apertures 52 and 53 and the relay lens 54, passes through the hole of the aperture mirror 21, and reaches the dichroic mirror 46. And is projected onto the cornea of the eye E by the objective lens 22.

  The cornea-reflected light of the alignment light passes through the objective lens 22, the dichroic mirror 46, and the hole, part of which passes through the dichroic mirror 55, passes through the focusing lens 31, and is reflected by the mirror 32. The light passes through 33A, is reflected by the dichroic mirror 33, and is projected onto the light receiving surface of the CCD image sensor 35 by the condenser lens. The light reception image (alignment index) by the CCD image sensor 35 is displayed on the display device 3 together with the observation image. The user performs alignment by performing the same operation as that of a conventional fundus camera. Further, the arithmetic control unit 200 may perform alignment by analyzing the position of the alignment index and moving the optical system (auto-alignment function).

  When performing the focus adjustment, the reflecting surface of the reflecting rod 67 is obliquely provided on the optical path of the illumination optical system 10. The light (focus light) output from the LED 61 of the focus optical system 60 passes through the relay lens 62, is separated into two light beams by the split indicator plate 63, passes through the two-hole aperture 64, and is reflected by the mirror 65, The light is focused on the reflecting surface of the reflecting bar 67 by the condenser lens 66 and reflected. Further, the focus light passes through the relay lens 20, is reflected by the perforated mirror 21, passes through the dichroic mirror 46, is refracted by the objective lens 22, and is projected onto the fundus oculi Ef.

  The fundus reflection light of the focus light is detected by the CCD image sensor 35 through the same path as the cornea reflection light of the alignment light. A light reception image (split index) by the CCD image sensor 35 is displayed on the display device 3 together with the observation image. The arithmetic control unit 200 analyzes the position of the split index and moves the focusing lens 31 and the focus optical system 60 to perform focusing as in the conventional case (autofocus function). Alternatively, focusing may be performed manually while visually checking the split indicator.

  The dichroic mirror 46 branches the optical path for OCT measurement from the optical path for fundus photography. The dichroic mirror 46 reflects light in a wavelength band used for OCT measurement and transmits light for fundus photographing. In this optical path for OCT measurement, a collimator lens unit 40, an optical path length changing unit 41, a galvano scanner 42, a focusing lens 43, a mirror 44, and a relay lens 45 are provided in this order from the OCT unit 100 side. It has been.

  The optical path length changing unit 41 is movable in the direction of the arrow shown in FIG. 1 and changes the optical path length of the optical path for OCT measurement. This change in the optical path length is used for correcting the optical path length according to the axial length of the eye E or adjusting the interference state. The optical path length changing unit 41 includes, for example, a corner cube and a mechanism for moving the corner cube.

  The galvano scanner 42 changes the traveling direction of light (signal light LS) passing through the optical path for OCT measurement. Thereby, the fundus oculi Ef can be scanned with the signal light LS. The galvano scanner 42 includes, for example, a galvano mirror that scans the signal light LS in the x direction, a galvano mirror that scans in the y direction, and a mechanism that drives these independently. Thereby, the signal light LS can be scanned in an arbitrary direction on the xy plane.

[OCT unit]
An example of the configuration of the OCT unit 100 will be described with reference to FIG. The OCT unit 100 is provided with an optical system for acquiring an OCT image of the fundus oculi Ef. This optical system has the same configuration as a conventional spectral domain type OCT apparatus. That is, this optical system divides low-coherence light into reference light and signal light, and generates interference light by causing interference between the signal light passing through the fundus oculi Ef and the reference light passing through the reference optical path. It is configured to detect spectral components. This detection result (detection signal) is sent to the arithmetic control unit 200.

  In the case of a swept source type OCT apparatus, a wavelength swept light source is provided instead of a light source that outputs a low coherence light source, and an optical member that spectrally decomposes interference light is not provided. In general, for the configuration of the OCT unit 100, a known technique according to the type of optical coherence tomography can be arbitrarily applied.

  The light source unit 101 outputs a broadband low-coherence light L0. The low coherence light L0 includes, for example, a near-infrared wavelength band (about 800 nm to 900 nm) and has a temporal coherence length of about several tens of micrometers. Note that near-infrared light having a wavelength band that cannot be visually recognized by the human eye, for example, a center wavelength of about 1040 to 1060 nm, may be used as the low-coherence light L0.

  The light source unit 101 includes a light output device such as a super luminescent diode (SLD), an LED, or an SOA (Semiconductor Optical Amplifier).

  The low-coherence light L0 output from the light source unit 101 is guided to the fiber coupler 103 by the optical fiber 102 and split into the signal light LS and the reference light LR.

  The reference light LR is guided by the optical fiber 104 and reaches the optical attenuator (attenuator) 105. The optical attenuator 105 automatically adjusts the amount of the reference light LR guided to the optical fiber 104 under the control of the arithmetic control unit 200 using a known technique. The reference light LR whose light amount has been adjusted by the optical attenuator 105 is guided by the optical fiber 104 and reaches the polarization adjuster (polarization controller) 106. The polarization adjuster 106 is, for example, a device that adjusts the polarization state of the reference light LR guided in the optical fiber 104 by applying a stress from the outside to the optical fiber 104 in a loop shape. The configuration of the polarization adjuster 106 is not limited to this, and any known technique can be used. The reference light LR whose polarization state is adjusted by the polarization adjuster 106 reaches the fiber coupler 109.

  The signal light LS generated by the fiber coupler 103 is guided by the optical fiber 107 and converted into a parallel light beam by the collimator lens unit 40. Further, the signal light LS reaches the dichroic mirror 46 via the optical path length changing unit 41, the galvano scanner 42, the focusing lens 43, the mirror 44, and the relay lens 45. The signal light LS is reflected by the dichroic mirror 46, is refracted by the objective lens 22, and is applied to the fundus oculi Ef. The signal light LS is scattered (including reflection) at various depth positions of the fundus oculi Ef. The backscattered light of the signal light LS from the fundus oculi Ef travels in the same direction as the forward path in the reverse direction, is guided to the fiber coupler 103, and reaches the fiber coupler 109 via the optical fiber 108.

  The fiber coupler 109 causes the backscattered light of the signal light LS to interfere with the reference light LR that has passed through the fiber coupler 103. The interference light LC generated thereby is guided by the optical fiber 110 and emitted from the emission end 111. Further, the interference light LC is converted into a parallel light beam by the collimator lens 112, dispersed (spectral decomposition) by the diffraction grating 113, condensed by the condenser lens 114, and projected onto the light receiving surface of the CCD image sensor 115. Although the diffraction grating 113 shown in FIG. 2 is a transmission type, other types of spectroscopic elements such as a reflection type diffraction grating may be used.

  The CCD image sensor 115 is a line sensor, for example, and detects each spectral component of the split interference light LC and converts it into electric charges. The CCD image sensor 115 accumulates this electric charge, generates a detection signal, and sends it to the arithmetic control unit 200.

  In this embodiment, a Michelson type interferometer is employed, but any type of interferometer such as a Mach-Zehnder type can be appropriately employed. Further, in place of the CCD image sensor, another form of image sensor such as a CMOS (Complementary Metal Oxide Semiconductor) image sensor can be used.

[Calculation control unit]
The configuration of the arithmetic control unit 200 will be described. The arithmetic control unit 200 analyzes the detection signal input from the CCD image sensor 115 and forms an OCT image of the fundus oculi Ef. The arithmetic processing for this is the same as that of a conventional spectral domain type OCT apparatus.

  The arithmetic control unit 200 controls each part of the fundus camera unit 2, the display device 3, and the OCT unit 100. For example, the arithmetic control unit 200 displays an OCT image of the fundus oculi Ef on the display device 3.

  As the control of the fundus camera unit 2, the arithmetic control unit 200 controls the operation of the observation light source 11, the imaging light source 15 and the LEDs 51 and 61, the operation control of the LCD 39, the movement control of the focusing lenses 31 and 43, and the reflector 67. Movement control, movement control of the focus optical system 60, movement control of the optical path length changing unit 41, operation control of the galvano scanner 42, and the like are performed.

  As control of the OCT unit 100, the arithmetic control unit 200 performs operation control of the light source unit 101, operation control of the optical attenuator 105, operation control of the polarization adjuster 106, operation control of the CCD image sensor 115, and the like.

  The arithmetic and control unit 200 includes, for example, a microprocessor, a RAM (Random Access Memory), a ROM (Read Only Memory), a hard disk drive, a communication interface, and the like, as in a conventional computer. A computer program for controlling the ophthalmologic photographing apparatus 1 is stored in a storage device such as a hard disk drive. The arithmetic control unit 200 may include various circuit boards, for example, a circuit board for forming an OCT image. The arithmetic control unit 200 may include an operation device (input device) such as a keyboard and a mouse, and a display device such as an LCD.

  The fundus camera unit 2, the display device 3, the OCT unit 100, and the calculation control unit 200 may be configured integrally (that is, in a single housing) or separated into two or more housings. It may be.

[Control system]
The configuration of the control system of the ophthalmologic photographing apparatus 1 will be described with reference to FIGS.

(Control part)
The control system of the ophthalmologic photographing apparatus 1 is configured around the control unit 210. The control unit 210 includes, for example, the aforementioned microprocessor, RAM, ROM, hard disk drive, communication interface, and the like. The control unit 210 is provided with a main control unit 211 and a storage unit 212.

(Main control unit)
The main control unit 211 performs the various controls described above. In particular, the main control unit 211 includes a focusing drive unit 31A of the retinal camera unit 2, an optical path length changing unit 41, a galvano scanner 42 and an OCT focusing driving unit 43A, a light source unit 101 of the OCT unit 100, an optical attenuator 105, and The polarization controller 106 is controlled. In addition, the main control unit 211 executes various display controls described later.

  The focusing drive unit 31A moves the focusing lens 31 in the optical axis direction. Thereby, the focus position of the photographic optical system 30 is changed. The main control unit 211 can also move an optical system provided in the fundus camera unit 2 in a three-dimensional manner by controlling an optical system drive unit (not shown). This control is used in alignment and tracking. Tracking is to move the apparatus optical system in accordance with the eye movement of the eye E. When tracking is performed, alignment and focusing are performed in advance. Tracking is a function of maintaining a suitable positional relationship in which the alignment and focus are achieved by causing the position of the apparatus optical system to follow the eye movement.

  The OCT focusing drive unit 43A moves the focusing lens 43 in the optical axis direction of the signal optical path. Thereby, the focus position of the signal light LS is changed. The focusing position of the signal light LS corresponds to the depth position (z position) of the beam waist of the signal light LS.

  Further, the main control unit 211 performs processing for writing data into the storage unit 212 and processing for reading data from the storage unit 212.

(Memory part)
The storage unit 212 stores various data. Examples of the data stored in the storage unit 212 include OCT image image data, fundus image data, and examined eye information. The eye information includes information about the subject such as patient identification information (patient ID) and name for identifying a patient, information about the eye such as left / right eye identification information, and attention for each patient. Interest position information indicating the position of the region of interest to be included is included.

  In this embodiment, the storage unit 212 stores information as shown in FIG. 5 in advance, for example. In this information, for each of a plurality of patient IDs (PID1, PID2,...), Target eye information (right eye or left eye), interest position information (ROI1, ROI2,...), Parameters Type information (P1, P2,...) Is associated. The patient ID is identification information corresponding to a patient. In the information illustrated in FIG. 5, target eye information “right eye”, interest position information “ROI1”, and parameter type information “P1” are associated with the patient ID “PID1”. Furthermore, target eye information “left eye”, position of interest information “ROI2”, and parameter type information “P2” are associated with the same patient ID “PID1”. Further, target eye information “right eye”, interest position information “ROI3”, and parameter type information “P3” are associated with another patient ID “PID2”. Similarly, with respect to patient IDs other than these, target eye information, interest position information, and parameter identification information are associated with each other.

  Note that “both eyes” can be designated as the target eye information, and the position information and / or the parameter type information common to the right eye and the left eye can be associated with the patient ID. For example, this configuration can be applied to a disease that progresses (substantially) in both the left and right eyes. Further, it is also possible to configure so that only the interest position information and the parameter type information are associated with the patient ID without associating the target eye information with the patient ID. This configuration is used, for example, when applied to a disease that progresses in (substantially) the same way for both the left and right eyes as described above, or when the patient's examination is performed only on one eye. The storage unit 212 stores various programs and data for operating the ophthalmologic photographing apparatus 1.

(Image forming part)
The image forming unit 220 forms tomographic image data of the fundus oculi Ef based on the detection signal from the CCD image sensor 115. This process includes processes such as noise removal (noise reduction), filtering, and FFT, as in the conventional spectral domain type optical coherence tomography. In the case of another type of OCT apparatus, the image forming unit 220 executes a known process corresponding to the type.

  The image forming unit 220 includes, for example, the circuit board described above. In this specification, “image data” and “image” based thereon may be identified. Moreover, the part of the fundus oculi Ef and the image thereof may be identified with each other.

(Data processing part)
The data processing unit 230 performs various types of image processing and analysis processing on the image formed by the image forming unit 220. For example, the data processing unit 230 executes various correction processes such as image brightness correction and dispersion correction. Further, the data processing unit 230 performs various types of image processing and analysis processing on the image (fundus image, anterior eye image, etc.) obtained by the fundus camera unit 2.

  The data processing unit 230 performs known image processing such as interpolation processing for interpolating pixels between tomographic images to form image data of a three-dimensional image of the fundus oculi Ef. Note that the image data of a three-dimensional image means image data in which pixel positions are defined by a three-dimensional coordinate system. As image data of a three-dimensional image, there is image data composed of voxels arranged three-dimensionally. This image data is called volume data or voxel data. When displaying an image based on volume data, the data processing unit 230 performs rendering processing (volume rendering, MIP (Maximum Intensity Projection), etc.) on the volume data, and views the image from a specific gaze direction. Image data of a pseudo three-dimensional image is formed. This pseudo three-dimensional image is displayed on a display device such as the display unit 240A.

  It is also possible to form stack data of a plurality of tomographic images as image data of a three-dimensional image. The stack data is image data obtained by three-dimensionally arranging a plurality of tomographic images obtained along a plurality of scanning lines based on the positional relationship of the scanning lines. That is, stack data is image data obtained by expressing a plurality of tomographic images originally defined by individual two-dimensional coordinate systems by one three-dimensional coordinate system (that is, by embedding them in one three-dimensional space). is there.

  The data processing unit 230 can perform alignment between the fundus image and the OCT image. When the fundus image and the OCT image are acquired in parallel, since both optical systems are coaxial, the optical axis of the imaging optical system 30 is used to (substantially) simultaneously acquire the fundus image and the OCT image. Can be aligned with reference to. Regardless of the acquisition timing of the fundus image and the OCT image, the OCT image and the fundus image are aligned by aligning the fundus image with the image obtained by projecting the OCT image onto the xy plane. It is also possible to do. This alignment method is applicable even when the fundus image acquisition optical system and the OCT measurement optical system are not coaxial. Even if both optical systems are not coaxial, if the relative positional relationship between both optical systems is known, the same alignment as in the coaxial case is executed with reference to this relative positional relationship. It is possible.

  In this embodiment, the data processing unit 230 includes an acquisition unit 231, a specification unit 232, an analysis unit 233, and an update unit 234.

  The control unit 210 receives a patient ID specified by the user using the operation unit 240B. In addition, the control unit 210 may perform a patient authentication process, and thereby accept a patient ID corresponding to the patient when the patient is authenticated. The authentication process may be started when the patient inputs a predetermined personal identification number to the operation unit 240B, or may be started by reading out information recorded on an authentication card lent in advance. The control unit 210 is an example of a “accepting unit” according to this embodiment.

  As described above, the storage unit 212 stores interest position information associated with each of a plurality of patient IDs in advance. The interest position information is information indicating the position of the region of interest. In this embodiment, as shown in FIG. 5, the storage unit 212 stores in advance interest position information and parameter type information associated with each of a plurality of patient IDs. The parameter type information is information indicating the type of parameter to be calculated, and can be changed later. For example, a doctor or the like observes a part of the eye to be examined based on the position-of-interest information, and designates a parameter type determined to be necessary for the follow-up observation of the part using the operation unit 240B. Upon receiving this designation, the control unit 210 registers the parameter type information in association with the patient ID of the patient. When a doctor or the like designates addition, deletion, or change of a parameter using the operation unit 240B in subsequent follow-up observation, the control unit 210 can update the parameter type information based on the designation.

  In general, the type of parameter to be applied differs depending on the type of disease or the type of region of interest. For example, for a glaucoma patient, a parameter representing the shape of the optic nerve head may be obtained, or the form of the retinal nerve fiber layer may be obtained. In addition, retinal pigment epithelium morphology may be obtained for patients with age-related macular degeneration. Therefore, it is possible to mount the following functions in the apparatus according to the embodiment: a function for storing in advance information associated with a disease type and / or region of interest type and a parameter type; disease type and / or interest A function of accepting an input of a region type; a function of specifying a parameter type associated with input information from the above information; a function of associating the specified parameter type and the input region of interest type with a patient ID. In addition, as described above, the region of interest type may be determined according to the disease type. In that case, a function of previously storing information associated with one or more region types of interest with respect to the disease type and a function of identifying the region of interest type associated with the input disease type from the information are further provided. Is possible. Even when the configuration for automatically setting the parameter type (and the region of interest type) is applied as described above, a function is provided for the user to change the automatically set content afterwards. It's okay.

  The storage unit 212 is an example of a “storage unit” that stores information as illustrated in FIG. 5 in advance. The storage means may be provided outside the ophthalmologic photographing apparatus 1. For example, it is possible to apply a configuration in which the ophthalmologic photographing apparatus 1 is communicably connected to a server apparatus having a storage unit function via a network such as an in-hospital LAN (Local Area Network). Here, the ophthalmologic imaging apparatus 1 and the server apparatus may be connected via a WAN (Wide Area Network) such as the Internet. Further, the ophthalmologic photographing apparatus 1 and the server apparatus may be connected via a network in which a LAN and a WAN are combined.

(Acquisition Department)
The acquisition unit 231 acquires the position-of-interest information associated with the patient ID from the storage unit 212. Further, the acquisition unit 231 acquires parameter type information associated with the patient ID from the storage unit 212 together with the position of interest information.

(Specific part)
The specifying unit 232 specifies a partial region in the OCT image acquired for the patient's eye to be examined corresponding to the patient ID based on the position-of-interest information acquired by the acquiring unit 231. The partial region is a region corresponding to the region of interest in the OCT image. The partial region may not be a region that matches the region of interest. For example, the specifying unit 232 can specify the partial region in the OCT image so as to include a region corresponding to the region of interest indicated by the position-of-interest information. As an example of a method of specifying a partial region by the specifying unit 232, there are a case where it is performed automatically and a case where it is performed manually.

  As an example in the case of performing automatically, the specifying unit 232 can specify a region wider than the region in the OCT image corresponding to the region of interest as a partial region. For example, the specifying unit 232 specifies a region in the OCT image corresponding to the region of interest using the position of interest information, and specifies a region wider than the specified region as a partial region. Alternatively, the specifying unit 232 divides the OCT image into a plurality of regions, uses the position-of-interest information, specifies a region that overlaps the region of interest, and collects one or more specified regions. It may be configured to set a partial area. Further, the specifying unit 232 may specify a region in the OCT image corresponding to the region of interest using the position-of-interest information, and set a region obtained by enlarging the specified region by a predetermined distance as a partial region. Is possible. The range (distance and direction) to be expanded in this process is, for example, a factor that affects the expansion of a lesion (region of interest) such as a disease type, disease state, stage, or event (medicine, treatment, etc.) and / or its Set according to possible factors. Alternatively, the specifying unit 232 uses the position-of-interest information to specify a specific point in the OCT image, and expands by a predetermined distance so that a region of a predetermined shape includes the region of interest based on the specific point. An area may be specified. For example, the specifying unit 232 acquires evaluation information such as the shape and thickness distribution of a predetermined tissue by analyzing an OCT image and a fundus image, and based on this evaluation information, a range corresponding to a lesioned part is obtained. Identify and compare this specific range with the region of interest indicated by the position of interest information, and set the partial region so that this region of interest and at least the region included in the specific range and not included in the region of interest are included It is also possible to perform.

  In this way, by specifying a region wider than the region in the OCT image corresponding to the region of interest as a partial region, particularly in continuous observation of irreversible progression (glaucoma, age-related macular degeneration, etc.) This eliminates the trouble of specifying the region of interest each time. In addition, there is an advantage that the spread of the lesioned part can be easily recognized. Even when such an automatic setting process is applied, a manual adjustment as described below can be additionally performed.

  When manually specifying the partial area, the specifying unit 232 receives the designation from the user and specifies the partial area. For example, the specifying unit 232 receives operation information based on a user's operation on the operation unit 240B, and specifies a partial region based on the operation information. Specifically, first, the control unit 210 causes the display unit 240A to display an OCT image acquired for the eye to be examined. The user designates a desired range in the OCT image displayed on the display unit 240A using the operation unit 240B. Based on the range in the OCT image designated by the user, the identifying unit 232 identifies the partial region. At this time, the partial area may be an image area corresponding to a range designated by the user or an image area wider than the designated range. When the latter is applied, the specifying unit 232 executes a process similar to the automatic process described above, for example.

  The specifying unit 232 can also specify a partial region without receiving designation from the user. Depending on whether or not the setting target of the region of interest is a reference image acquired in the past for the eye to be examined, the specifying unit 232 performs different processing to specify the partial region. Note that the specifying unit 232 may be configured to be compatible with both cases, or may be configured to be compatible with only one of the cases. When both cases can be dealt with, the processing mode is switched according to the setting mode of the region of interest. In the case where only one case can be handled, information in a form that can be processed by the specifying unit 232 is input to the specifying unit 232.

  When the region of interest is set with respect to the reference image, the position-of-interest information may include position information indicating the position of the region in the reference image. In this example, the specifying unit 232 includes a displacement calculating unit 232A as illustrated in FIG. The displacement calculation unit 232A calculates the displacement between the reference image and the OCT image acquired for the eye to be examined. For example, the displacement calculating unit 232A specifies a feature point for each of the reference image and the OCT image, and calculates a displacement between the specified feature point by calculating a displacement between the specified feature points. Examples of feature points include fovea, optic papilla (center, contour, etc.), blood vessels (characteristic blood vessels, bifurcations, etc.), and laser treatment traces. The specifying unit 232 specifies the partial region based on the displacement calculated by the displacement calculating unit 232A and the position information. As a specific example of this processing, the specifying unit 232 performs alignment (image matching) between the reference image and the OCT image so that the displacement calculated by the displacement calculating unit 232A is canceled, so that An image region in the OCT image corresponding to the region of interest is specified, and this is set as a partial region. Alternatively, the specifying unit 232 specifies an image region in the OCT image corresponding to the region of interest in the reference image, and moves the coordinate value range corresponding to the specified image region so that the displacement is canceled. Thus, the partial area can be specified. Further, the specifying unit 232 may specify a region in the OCT image corresponding to the region of interest in the reference image using the position information. In this case, the specifying unit 232 specifies a partial region in the OCT image from the displacement calculated by the displacement calculating unit 232A.

  When the region of interest is not set with respect to the reference image, the position-of-interest information may include position information indicating the position of the part of the eye to be examined. For example, the position information can include information indicating the relative position (one or more combinations of the displacement direction and the displacement amount) of the part with respect to the feature point in the eye to be examined. Examples of feature points include the fovea, the optic disc, blood vessels, and laser treatment traces as described above. In this case, the specifying unit 232 is not provided with the displacement calculating unit 232A. The specifying unit 232 specifies a partial region by specifying a region in the OCT image corresponding to the position of the part indicated by the position information. For example, the specifying unit 232 specifies the position (coordinate value) of the feature point by analyzing the OCT image. The identifying unit 232 identifies, as a partial region, a position (region) that is shifted by the amount of displacement in the displacement direction indicated by the position information from the position of the identified feature point. Another example will be described. The positional information includes, as the relative position, the displacement (displacement direction and amount) of the representative point (center of gravity, center, etc.) of the part relative to the feature point, and the range (shape, size, Information (range information) indicating a direction or the like). In this case, the identifying unit 232 identifies the position (coordinate value) of the feature point by analyzing the OCT image, obtains a position (coordinate value) that is separated from the coordinate value by the displacement indicated by the position information, and Position. And the specific | specification part 232 specifies the target partial area | region based on the position of this representative point, and the said range information.

(Analysis Department)
The analysis unit 233 analyzes the partial region specified by the specification unit 232. For example, the analysis unit 233 calculates parameters for the partial region specified by the specification unit 232 based on the parameter type information corresponding to the patient (the eye to be examined) acquired by the acquisition unit 231. An example of the parameter is a value representing the size of the partial area. Examples of the size of the partial region include the width, area, volume, thickness, and mass (estimated value) of the partial region. Examples of the size value include a value distribution in the partial area and a value at a representative point (center, center of gravity position, etc.) in the partial area.

  In this embodiment, in order to observe the relationship between the inspection position (measurement point) by the perimeter and the fundus morphology of the eye to be examined, the control unit 210 displays a template image indicating the inspection range of the visual field inspection by the perimeter. It is displayed on the display unit 240A. The template image is an image representing a plurality of grids. Each grid corresponds to the inspection position of the visual field inspection. The shape of the grid may be a rectangle or a shape other than a rectangle. As an example of a method of dividing a plurality of grids, a method of dividing a region radially from the analysis center with a feature point in a partial region as an analysis center, or a method of dividing a region by one or more concentric circles centering on the analysis center And a method of dividing an area into a grid. The feature points in the partial area include, for example, the fovea, the center of the optic disc, the branch of the blood vessel, and the laser treatment trace. Thereby, the measurement point of the perimeter and the grid position can be matched, and the relationship between the measurement point of the perimeter and the form of the fundus of the eye to be examined can be observed.

  Further, the control unit 210 causes the display unit 240A to display an area in the template image corresponding to the partial area specified by the specifying unit 232 so as to be identifiable. For example, the control unit 210 displays a grid corresponding to the partial region among a plurality of grids in the template image in a predetermined manner. As an example of displaying in a predetermined mode, there are an example in which a grid is filled with a predetermined color or a grid is drawn in a predetermined pattern. The partial area specified by the specifying unit 232 is displayed in units of grids in the template image. Thereby, the control unit 210 can display the partial region specified by the specifying unit 232 and the other region in the template image in different modes. A sector can be configured by combining one or more grids corresponding to partial areas.

  The user sets a new partial region by changing the region in the template image displayed in an identifiable manner using the operation unit 240B. The analysis unit 233 analyzes the new partial area set by the operation unit 240B. The analysis unit 233 can analyze a partial region in units of sectors configured by combining one or more grids.

  Further, the position-of-interest information may be information indicating the positions of two or more regions of interest. That is, there may be a plurality of regions of interest in the OCT image acquired for the eye to be examined. In this case, the specifying unit 232 specifies two or more partial regions corresponding to two or more regions of interest. The analysis unit 233 acquires two or more analysis results corresponding to the two or more partial regions. Specifically, the specifying unit 232 specifies two or more regions of interest by specifying a partial region in the OCT image corresponding to the region of interest for each of the two or more regions of interest included in the position of interest information. Two or more corresponding partial areas are specified. The analysis unit 233 acquires the analysis result corresponding to each of the two or more partial regions by performing the above analysis for each partial region.

  The control unit 210 can display two or more areas corresponding to the two or more partial areas in an identifiable manner in the template image. Specifically, the control unit 210 displays a grid corresponding to one partial area and a grid corresponding to another partial area in one template image in different modes. Accordingly, in one template image, two or more partial areas are displayed in different modes and in units of grids. Each partial region is configured as a sector including a combination of one or more grids, for example.

  Furthermore, the control unit 210 may display the above two or more analysis results in association with the above two or more areas displayed in an identifiable manner. For example, the control unit 210 can display the analysis result of one partial region in association with the grid in the template image corresponding to the one partial region on the display unit 240A. The control unit 210 displays the grid corresponding to the one partial region in the first color while displaying the analysis result of the one partial region in the first color. In addition, the control unit 210 displays the analysis result of another partial region other than the one partial region in a second color different from the first color, and displays a grid corresponding to the other partial region in the template image. Display in two colors. This makes it possible to easily grasp the relationship between the position in the template image and the analysis result for each partial region.

(Update section)
The update unit 234 operates when a new partial region (partial region different from that applied in the past) is set in the current examination. As a case where a new partial area is set, there are a case where the specifying unit 232 specifies an area wider than the partial area applied in the past, or a case where the user sets using a template image or the like. The update unit 234 updates the position-of-interest information stored in the storage unit 212 based on the new partial area set by the specifying unit 232. As a result, even when the position and size of the partial region change, continuous observation is facilitated, and a local minute change can be captured.

  The data processing unit 230 that functions as described above includes, for example, the aforementioned microprocessor, RAM, ROM, hard disk drive, circuit board, and the like. In a storage device such as a hard disk drive, a computer program for causing the microprocessor to execute the above functions is stored in advance.

(User interface)
The user interface 240 includes a display unit 240A and an operation unit 240B. The display unit 240A includes the display device of the arithmetic control unit 200 and the display device 3 described above. The operation unit 240B includes the operation device of the arithmetic control unit 200 described above. The operation unit 240B may include various buttons and keys provided on the housing of the ophthalmologic photographing apparatus 1 or outside. For example, when the fundus camera unit 2 has a housing similar to that of a conventional fundus camera, the operation unit 240B may include a joystick, an operation panel, or the like provided on the housing. The display unit 240 </ b> A may include various display devices such as a touch panel monitor provided in the housing of the fundus camera unit 2.

  The display unit 240A and the operation unit 240B do not need to be configured as individual devices. For example, a device in which a display function and an operation function are integrated, such as a touch panel monitor, can be used. In that case, the operation unit 240B includes the touch panel display and a computer program. The operation content for the operation unit 240B is input to the control unit 210 as an electrical signal. Further, operations and information input may be performed using a graphical user interface (GUI) displayed on the display unit 240A and the operation unit 240B.

  The display unit 240A is an example of a “display unit” according to this embodiment. The control unit 210 is an example of a “display control unit” according to this embodiment. The operation unit 240B is an example of an “operation unit” according to this embodiment.

[Scanning signal light and OCT images]
Here, the scanning of the signal light LS and the OCT image will be described.

  Examples of the scanning mode of the signal light LS by the ophthalmologic photographing apparatus 1 include a horizontal scan, a vertical scan, a cross scan, a radial scan, a circular scan, a concentric scan, and a spiral (vortex) scan. These scanning modes are selectively used as appropriate in consideration of the observation site of the fundus, the analysis target (form of a sieve plate, etc.), the time required for scanning, the precision of scanning, and the like.

  The horizontal scan scans the signal light LS in the horizontal direction (x direction). The horizontal scan also includes an aspect in which the signal light LS is scanned along a plurality of horizontal scanning lines arranged in the vertical direction (y direction). In this aspect, it is possible to arbitrarily set the scanning line interval. Further, the above-described three-dimensional image can be formed by sufficiently narrowing the interval between adjacent scanning lines (three-dimensional scanning). The same applies to the vertical scan.

  In the cross scan, the signal light LS is scanned along a cross-shaped trajectory composed of two linear trajectories (straight trajectories) orthogonal to each other. In the radiation scan, the signal light LS is scanned along a radial trajectory composed of a plurality of linear trajectories arranged at a predetermined angle. The cross scan is an example of a radiation scan.

  In the circle scan, the signal light LS is scanned along a circular locus. In the concentric scan, the signal light LS is scanned along a plurality of circular trajectories arranged concentrically around a predetermined center position. A circle scan is an example of a concentric scan. In the spiral scan, the signal light LS is scanned along a spiral (spiral) locus while the radius of rotation is gradually reduced (or increased).

  Since the galvano scanner 42 is configured to scan the signal light LS in directions orthogonal to each other, it can independently scan the signal light LS in the x direction and the y direction, respectively. Further, by simultaneously controlling the directions of the two galvanometer mirrors included in the galvano scanner 42, the signal light LS can be scanned along an arbitrary locus on the xy plane. Thereby, various scanning modes as described above can be realized.

  By scanning the signal light LS in the above-described manner, a tomographic image on a plane stretched by the direction along the scanning line (scanning trajectory) and the fundus depth direction (z direction) can be acquired. In addition, the above-described three-dimensional image can be acquired particularly when the scanning line interval is narrow.

  A region on the fundus oculi Ef to be scanned with the signal light LS as described above, that is, a region on the fundus oculi Ef to be subjected to OCT measurement is referred to as a scanning region. The scanning area in the three-dimensional scan is a rectangular area in which a plurality of horizontal scans are arranged. The scanning area in the concentric scan is a disk-shaped area surrounded by the locus of the circular scan with the maximum diameter. In addition, the scanning area in the radial scan is a disk-shaped (or polygonal) area connecting both end positions of each scan line.

[Operation example]
An operation example of the ophthalmologic photographing apparatus 1 according to this embodiment will be described. Hereinafter, a case will be described in which three-dimensional image data is created based on two or more tomographic images acquired using OCT and a partial region is specified based on the three-dimensional image data.

FIG. 7 shows a flowchart of an example of the operation of the ophthalmologic photographing apparatus 1. It is assumed that alignment and focusing have been completed and a fixation target is presented to the eye E.
8 to 10 are diagrams for explaining the operation of the ophthalmologic photographing apparatus 1. FIG. 8 illustrates an example of an image (window) displayed on the display unit 240A when the user specifies a partial region. FIG. 9 shows an example of an image showing a sector setting state. FIG. 10 illustrates an example of an image displayed on the display unit 240A when trend analysis is performed.

(S1)
First, the main control unit 211 (control unit 210) receives a patient ID associated with a patient to be observed. For example, the control unit 210 receives the patient ID designated by the user using the operation unit 240B as described above.

(S2)
Next, the acquisition unit 231 acquires the interest position information and parameter type information associated with the patient ID from the storage unit 212 based on the patient ID received in S1.

(S3)
The main control unit 211 causes the LCD 39 to display a fixation target for acquiring an image centered on the fovea. As a result, the eye to be examined can be fixed at a fixation position for acquiring the image. In this state, the main control unit 211 controls the light source unit 101, the galvano scanner 42, and the like to scan the region including the macular portion of the fundus oculi Ef with the signal light LS. The image forming unit 220 forms a plurality of tomographic images corresponding to the scanning mode. The data processing unit 230 executes known image processing such as interpolation processing for interpolating pixels between tomographic images formed by the image forming unit 220 to form image data of a three-dimensional image of the fundus oculi Ef.

(S4)
Next, the specifying unit 232 specifies a partial region in the tomographic image based on the position-of-interest information acquired in S2 from the three-dimensional image data formed in S3.

  The data processing unit 230 (identification unit 232) can create a front image (C scan image, projection image, shadowgram, etc.) from the three-dimensional image data. The specifying unit 232 may specify a region including a region where a desired layer is missing from the created front image as a new partial region.

  The data processing unit 230 can specify a desired layer region from the three-dimensional image data. In this case, the data processing unit 230 creates a flattened image by modifying the three-dimensional image data so that the boundary of the specified layer region is flat (so that the same z coordinate value is obtained). Further, the specifying unit 232 specifies an abnormal part of a desired tissue based on the created flattened image, and specifies a data area including the abnormal part as a new partial area. As an example of the abnormal part, there is a part whose form is changed as compared with a normal state. Examples of the part where the form has changed include a part where a predetermined layer region is missing, and a part where the predetermined layer region is deformed. For example, in the case of glaucoma, it is known that the optic nerve fiber layer is lost. Therefore, the data processing unit 230 creates a flattened image so that the boundary of the layer region of the inner boundary membrane (ILM) becomes flat, and the specifying unit 232 uses the optic nerve fiber layer (NFL) of the created flattened image. By analyzing whether or not there is a defect site, a data region including the defect site can be specified as a new partial region. The specifying unit 232 may specify a new partial region by detecting a missing region of a desired layer from layer thickness distribution information (Thickness Data) acquired by another device.

  Alternatively, the specifying unit 232 may specify a new partial area in response to designation from the user. For example, it is assumed that analysis software is stored in the storage unit 212 in advance. In response to the software activation trigger, the main control unit 211 activates the analysis software. Thereby, for example, a screen as shown in FIG. 8 is displayed on the display unit 240A.

  A window 300 shown in FIG. 8 includes five image display units 301 to 305. These image display units 301 to 305 are a cross-sectional image display unit, two vertical cross-sectional image display units, a front image display unit, and a processed image display unit, respectively. The cross-sectional image display unit 301, the vertical cross-sectional image display units 302 and 303, and the processed image display unit 305 display images based on three-dimensional image data acquired using OCT. A front image is displayed on the front image display unit 304. The front image is, for example, an image created based on three-dimensional image data or a fundus image. The images displayed on these image display units 301 to 305 are not limited to these.

  The cross-sectional image display unit 301 displays an image (C cross-sectional image, C scan image) of an xy cross-section (also referred to as a C cross-section) orthogonal to the z direction.

  The longitudinal section image display units 302 and 303 display images (B section images and B scan images) of sections (also referred to as B sections) along the z direction, respectively. The vertical cross-sectional image display units 302 and 303 display B cross-sectional images corresponding to the arrangement relationship with the horizontal cross-sectional image display unit 301, respectively. For example, in the C cross-sectional image 411 displayed on the cross-sectional image display unit 301, when the horizontal direction of the window 300 is the x direction and the vertical direction is the y direction, the vertical cross section located on the left side of the cross-sectional image display unit 301 The image display unit 302 displays the B cross-sectional image of the yz cross section, and the vertical cross section image display unit 303 positioned below the cross sectional image display unit 301 displays the B cross sectional image of the xz cross section.

  The data processing unit 230 creates a flattened image by flattening the B cross-sectional image so that the boundary of the desired layer region becomes flat, and uses this as a new B cross-sectional image. The vertical cross-sectional image display unit 302 displays a new B cross-sectional image 412 obtained by performing the flattening process on the B cross-sectional image of the yz cross section. The vertical cross-sectional image display unit 303 displays a new B cross-sectional image 413 obtained by performing the flattening process on the B cross-sectional image of the xz cross section.

  A front image 404 is displayed on the front image display unit 304. The front image includes a near-infrared moving image, its frame (still image), a color image, and the like.

  The processed image display unit 305 displays an image (processed image) obtained by performing predetermined processing on the three-dimensional image data. An example of the processed image is a feature-enhanced image in which a desired feature portion is emphasized. An example of a feature-enhanced image is a shadowgram. The shadowgram is formed by integrating data included in a predetermined range in the z direction out of the three-dimensional image data in the z direction. This process is executed by the data processing unit 230.

  Further, the window 300 is provided with a patient information display unit 311, a data selection unit 312, and a data storage destination display unit 313. The patient information display unit 311 displays information about the patient such as the patient ID and the patient name. When the data selection unit 312 is clicked, a window for selecting the 3D image data to be observed is popped up. In this window, a list of information regarding 3D image data included in a folder set in advance as a storage destination of 3D image data is displayed. The user selects desired three-dimensional image data based on this list. The data storage destination display unit 313 displays information on the folder in which the selected 3D image data is stored.

  Further, the main control unit 211 detects a B cross-sectional position image (a linear image 502 indicated by a broken line) indicating the cross-sectional position of the B cross-sectional image 412 and a B cross-sectional position image (a linear image indicated by a broken line) indicating the cross-sectional position of the B cross-sectional image 413 501) is superimposed on the C cross-sectional image 411 and displayed. Further, the main control unit 211 displays the C cross-sectional position images (linear images 511 and 512 indicated by broken lines) indicating the cross-sectional position of the C cross-sectional image 411 so as to overlap the B cross-sectional images 412 and 413, respectively. The straight line image 501 extends to the B cross-sectional image 412 and shows the cross-sectional position of the B cross-sectional image 413 in the B cross-sectional image 412. Similarly, the straight line image 502 extends to the B cross-sectional image 413 and shows the cross-sectional position of the B cross-sectional image 412 in the B cross-sectional image 413.

  Further, the main control unit 211 causes the front image display unit 304 to display a front image 404 based on the front image data imported in advance. Further, the main control unit 211 includes a rectangular image 521 indicating the range of the three-dimensional scan, a cross-sectional position image (straight line image) 522 indicating the cross-sectional position of the B cross-sectional image 412, and a cross-sectional position indicating the cross-sectional position of the B cross-sectional image 413. An image (straight line image) 523 is displayed so as to overlap the front image 404.

  The user can switch display / non-display of the linear images 501, 502, 511, 512, 521, 522, and 523 by a predetermined operation.

  In the new B cross-sectional image 412, a desired layer that has been drawn as a curved image in the B cross-sectional image before the flattening process is drawn as a straight line image 541. Furthermore, the other part of the new B cross-sectional image 412 is depicted with a deformation corresponding to the deformation from the curved image to the linear image 541. For example, the straight line image 541 is displayed in a display mode different from other parts.

  Similarly, in the new B cross-sectional image 413, a desired layer drawn as a curved image in the B cross-sectional image before the flattening process is drawn as a linear image 542. Furthermore, the other part of the new B cross-sectional image 413 is depicted with a deformation corresponding to the deformation from the curved image to the linear image 542. For example, the straight line image 542 is displayed in a display mode different from other parts.

  In this way, the user can observe a B cross-sectional image obtained by flattening a desired part of the eye E. According to this B cross-sectional image, the positional relationship between the part and another part can be easily grasped.

  In S4 of FIG. 7, the specifying unit 232 performs partial processing based on the position designated by the user using the operation unit 240B with respect to the C cross-sectional image 411 displayed on the cross-sectional image display unit 301 of FIG. The area AR can be specified. In addition, the specifying unit 232 uses the operation unit 240B to specify the flattened image displayed on the longitudinal cross-sectional image display units 302 and 303 and the feature-enhanced image displayed on the processed image display unit 305. The partial area may be specified based on the position. In addition, the specifying unit 232 may specify a new partial region from the layer thickness distribution information (Thickness Data) that is missing from the desired layer.

(S5)
The data processing unit 230 sets one or more sectors by collecting grids including the area specified in S4. For example, as shown in FIG. 9, five sectors are set for the optic nerve fiber layer (NFL). FIG. 9 shows a sector setting example when the 6 mm × 6 mm region including the macula is divided into a 10 × 10 grid centered on the fovea position pp0 for the eye to be examined (right eye). Each grid corresponds to the inspection position of the visual field inspection. In FIG. 9, the grids in the same sector are schematically represented so that the patterns of the grids are the same.

  Depending on the region of interest, the grid division method may be different. For example, for another layer other than the optic nerve fiber layer (NFL) (for example, GCC (= NFL + GCL + IPL)), less than 5 or 6 or more sectors are set by a grid divided by another division method. In addition, the sector set as shown in FIG. 9 may be superimposed on the fundus image.

  The data processing unit 230 can also set a region having a high correlation with an arbitrary layer set in advance as a partial region. For example, the highly correlated area is set as a partial area according to the running state of the nerve. The data processing unit 230 can set such a highly correlated area as a sector as shown in FIG.

(S6)
Next, the analysis unit 233 analyzes the partial region identified in S4. Specifically, the analysis unit 233 sets the parameter for the partial region in the sector unit set in S5 based on the parameter type information corresponding to the eye to be examined acquired by the acquisition unit 231 together with the position of interest information in S2. calculate. Examples of parameters include the width, area, and thickness of the partial region. The parameter calculated in S5 is stored in the storage unit 212 in association with the calculation time information.

(S7)
Subsequently, the main control unit 211 causes the display unit 240A to display the parameters calculated in S6 in time series. Trend analysis can be performed by analyzing parameters calculated at different timings for the same sector according to a time series.

  For example, as illustrated in FIG. 10, the main control unit 211 displays a window 600 on the display unit 240A. FIG. 10 shows a display example of an image for trend analysis for the eye to be examined (left eye). The window 600 is provided with a sector display area 601 and a trend graph display area 602. The sector display area 601 displays the sector setting state set in S5. The user can designate a desired sector using the operation unit 240B in units of sectors displayed in the sector display area 601. In the trend graph display area 602, an image in which the parameters calculated in S6 are graphed in time series for the sector specified in the sector display area 601 is displayed. FIG. 10 shows an example in which a sector 604 is designated in the sector display area 601 and an image in which parameters corresponding to the sector 604 are graphed in time series in the trend graph display area 602 is displayed. FIG. 10 shows an example in which an image for trend analysis for the left eye is displayed, but an image for trend analysis as shown in FIG. 10 may be simultaneously displayed for each of both eyes.

  The main control unit 211 may display the parameter calculated in S6 on the display unit 240A in association with an event such as a medication date, a treatment date, or an examination date. Further, the main control unit 211 may display a future parameter change prediction curve in the trend graph display area 602 in accordance with the past parameter change. The data processing unit 230 may obtain an approximate curve with respect to past parameters, and may use the approximate curve as a change prediction curve.

  In FIG. 7, the case where the partial area is specified based on the three-dimensional image data has been described. However, the partial area is specified based on the A scan image, the B scan image, the C scan image, the volume data, or the fundus image. You may do it.

[effect]
The effects of the arithmetic control unit 200 according to this embodiment and the ophthalmologic photographing apparatus 1 to which the arithmetic control unit 200 is applied will be described. The ophthalmologic analysis apparatus can be realized as a part of the ophthalmologic photographing apparatus 1 like the arithmetic control unit 200 of the above embodiment, for example. It is also possible to apply an ophthalmologic analyzer that does not have functions for OCT measurement and fundus imaging.

  The arithmetic control unit 200 (ophthalmic analysis apparatus) includes a control unit 210 (accepting unit), an acquiring unit 231, a specifying unit 232, and an analyzing unit 233. The controller 210 receives patient identification information for identifying a patient. The acquisition unit 231 stores the patient identification information received by the control unit 210 from the storage unit 212 (storage unit) in which the position-of-interest information indicating the position of the region of interest is associated with each of the plurality of pieces of patient identification information. Acquire related position information of interest. The specifying unit 232 specifies a partial region in the OCT image acquired for the patient's eye to be examined corresponding to the patient identification information based on the position-of-interest information acquired by the acquiring unit 231. The analysis unit 233 analyzes the partial region specified by the specification unit 232.

  According to such an arithmetic control unit 200, it is possible to continuously observe a region to be noted for each patient, so that a local minute change in the eye to be examined can be performed regardless of the disease type, stage, or disease state. It becomes possible to capture.

  Further, the position-of-interest information includes position information indicating the position of a region in the reference image acquired in the past for the eye to be examined, and the specifying unit 232 calculates the displacement between the reference image and the OCT image. The partial region may be specified based on the displacement calculated by the displacement calculating unit 232A and the position information. Thereby, when the region of interest is set with respect to the reference image acquired in the past for the eye to be examined, the specifying unit 232 determines the partial region based on the displacement calculated by the displacement calculating unit and the position information. It becomes possible to specify with high accuracy. Therefore, it is possible to accurately grasp the change in the analysis result by the analysis unit 233.

  Further, the position-of-interest information includes position information indicating the position of the part of the eye to be examined, and the specifying unit 232 specifies the region in the OCT image corresponding to the position of the part indicated by the position information. Identify partial areas. Thereby, even if the region of interest is not set for a reference image acquired in the past for the eye to be examined, the specifying unit 232 can specify the partial region with high accuracy. Therefore, it is possible to accurately grasp the change in the analysis result by the analysis unit 233.

  The specifying unit 232 may specify a partial region so as to include a region in the OCT image corresponding to the region of interest indicated by the position-of-interest information. Further, the specifying unit 232 may specify a region wider than the region in the OCT image corresponding to the region of interest as the partial region. Thereby, for example, when a region that is missing in a predetermined part is being observed as a region of interest, the user can easily recognize the extent of the missing region.

  The arithmetic control unit 200 may include an update unit that updates the position-of-interest information stored in the storage unit 212 based on the new partial area specified by the specifying unit 232. As a result, even when the position and size of the partial region change, continuous observation is facilitated, and a local minute change can be captured.

  The arithmetic control unit 200 displays a template image indicating the inspection range of the visual field inspection on the display unit 240A, and the display unit can identify the region in the template image corresponding to the partial region specified by the specifying unit 232 It may include a control unit 210 (display control unit) to be displayed on 240A and an operation unit 240B for setting a new partial region by changing the region displayed in an identifiable manner. The analysis unit 233 analyzes the new partial area set by the operation unit 240B.

  The interest position information indicates the positions of two or more regions of interest, the specifying unit 232 specifies two or more partial regions corresponding to the two or more regions of interest, and the analyzing unit 233 includes two or more partial regions. Two or more corresponding analysis results may be acquired, and the control unit 210 may display two or more areas corresponding to two or more partial areas so that they can be identified in the template image.

  In addition, the control unit 210 may display two or more analysis results and two or more areas in association with each other.

  The ophthalmologic photographing apparatus 1 may include a control unit 210 (accepting unit), an acquiring unit 231, an image forming unit 220, a specifying unit 232, and an analyzing unit 233. The controller 210 receives patient identification information for identifying a patient. The acquisition unit 231 stores the patient identification information received by the control unit 210 from the storage unit 212 (storage unit) in which the position-of-interest information indicating the position of the region of interest is associated with each of the plurality of pieces of patient identification information. Acquire related position information of interest. The image forming unit 220 forms an OCT image by executing OCT on the patient's eye to be examined corresponding to the patient identification information based on the position-of-interest information acquired by the acquiring unit 231. The specifying unit 232 specifies a partial region in the OCT image formed by the image forming unit 220 based on the position-of-interest information acquired by the acquiring unit 231. The analysis unit 233 analyzes the partial region specified by the specification unit 232.

  According to such an ophthalmologic photographing apparatus 1, since it is possible to continuously observe a region to be noted for each patient, a local minute change of the eye to be examined regardless of the disease type, stage or disease state. Can be captured.

[Modification]
In the above-described embodiment, by analyzing a partial region that is associated in advance for each patient and specified based on the position-of-interest information, it is possible to continuously observe parameters for the region designated for each patient. However, the embodiment is not limited to this. In the modification of the embodiment, first, an OCT image acquired for a patient's eye to be examined is analyzed. Thereafter, a part of the analysis result is specified based on the position-of-interest information associated in advance for each patient.

  The configuration of each part of the ophthalmologic photographing apparatus according to this modification is the same as that of the ophthalmic photographing apparatus according to the embodiment. Hereinafter, an ophthalmologic photographing apparatus according to this modification will be described focusing on differences from the embodiment.

  The difference between the arithmetic control unit applied to the ophthalmologic photographing apparatus according to this modification and the arithmetic control unit 200 applied to the ophthalmic photographing apparatus 1 according to the embodiment is that the analysis unit 233 is received by the control unit 210. Based on the point of analyzing the image acquired for the patient's eye to be examined corresponding to the patient ID, and the specifying unit 232 specifies a part of the analysis result by the analyzing unit 233 based on the interest position information acquired by the acquiring unit 231. It is point to do.

  That is, the arithmetic control unit according to this modification includes a control unit 210 (accepting unit), an acquiring unit 231, an analyzing unit 233, and a specifying unit 232. Control unit 210 receives a patient ID for identifying the patient. The acquisition unit 231 associates each of the plurality of patient identification information with the patient ID received by the control unit 210 from the storage unit 212 (storage unit) in which the position of interest information indicating the position of the region of interest is associated and stored in advance. Obtained interest position information. The analysis unit 233 analyzes the OCT image acquired for the patient's eye to be examined corresponding to the patient ID. The identifying unit 232 identifies a part of the analysis result obtained by the analyzing unit 233 based on the position-of-interest information acquired by the acquiring unit 231. Thus, by extracting the analysis result for the region designated for each patient from the entire analysis result of the OCT image acquired for the patient's eye, the patient's stage and Regardless of the pathological condition, it is possible to capture local minute changes in the morphology of the fundus, cornea and the like.

  The configuration and operation of the arithmetic control unit according to this modification are the same as the configuration and operation of the arithmetic control unit according to the embodiment except for the above points.

  The ophthalmologic imaging apparatus according to the present modification includes a control unit 210 (accepting unit), an acquisition unit 231, an image forming unit 220, an analysis unit 233, and a specifying unit 232. Control unit 210 receives a patient ID for identifying the patient. The acquisition unit is associated with the patient ID received by the control unit 210 from the storage unit 212 (storage means) in which interest position information indicating the position of the region of interest is associated with each of the plurality of patient IDs and stored in advance. Get interest location information. The image forming unit 220 forms an OCT image by performing OCT on the patient's eye to be examined corresponding to the patient ID based on the position-of-interest information acquired by the acquiring unit 231. The analysis unit 233 analyzes the OCT image formed by the image forming unit 220. The identifying unit 232 identifies a part of the analysis result obtained by the analyzing unit 233 based on the position-of-interest information acquired by the acquiring unit 231.

  The configuration and operation of the ophthalmologic photographing apparatus according to this modification are the same as the configuration and operation of the ophthalmic photographing apparatus 1 according to the embodiment except for the above points.

[Others]
In the above embodiment or its modification, the case where OCT is performed on the fundus has been described, but the present invention is not limited to this. For example, the present invention can also be applied to the case where OCT is performed on the anterior segment in order to analyze a predetermined part of the anterior segment.

  A computer program for realizing the above-described embodiment or its modification can be stored in any recording medium readable by a computer. Examples of the recording medium include a semiconductor memory, an optical disk, a magneto-optical disk (CD-ROM / DVD-RAM / DVD-ROM / MO, etc.), a magnetic storage medium (hard disk / floppy (registered trademark) disk / ZIP, etc.), and the like. Can be used. It is also possible to transmit / receive this program through a network such as the Internet or a LAN.

  The configuration described above is merely an example for favorably implementing the present invention. Therefore, arbitrary modifications (omitted, replacement, addition, etc.) within the scope of the present invention can be made as appropriate.

DESCRIPTION OF SYMBOLS 1 Ophthalmology imaging device 2 Fundus camera unit 10 Illumination optical system 30 Imaging optical system 42 Galvano scanner 100 OCT unit 101 Light source unit 115 CCD image sensor 200 Arithmetic control unit 210 Control part 211 Main control part 212 Storage part 220 Image formation part 230 Data processing Unit 231 acquisition unit 232 identification unit 232A displacement calculation unit 233 analysis unit 234 update unit 240A display unit 240B operation unit E eye ELS fundus LS signal light LR reference light LC interference light

Claims (6)

A reception unit for receiving patient identification information for identifying a patient;
The interest position information associated with the patient identification information received by the accepting unit is acquired from storage means in which interest position information indicating the position of the region of interest is associated with each of the plurality of patient identification information in advance and stored. An acquisition unit;
Based on the position-of-interest information acquired by the acquisition unit, a specifying unit that specifies a partial region in the image acquired for the patient's eye to be examined corresponding to the patient identification information;
An analysis unit for analyzing the partial region identified by the identification unit;
Including
The specifying unit specifies a region wider than the region in the image corresponding to the region of interest indicated by the position of interest information as the partial region,
An update unit for updating the position-of-interest information stored in the storage unit based on the new partial area specified by the specifying unit ;
A display control unit that displays a template image indicating an inspection range of visual field inspection on the display unit, and causes the display unit to display a region in the template image corresponding to the partial region specified by the specifying unit. When,
An operation unit for setting a new partial region by changing the region displayed in an identifiable manner;
Including
The ophthalmic analysis apparatus characterized in that the analysis unit analyzes the new partial region set by the operation unit . A reception unit for receiving patient identification information for identifying a patient;
The interest position information associated with the patient identification information received by the accepting unit is acquired from storage means in which interest position information indicating the position of the region of interest is associated with each of the plurality of patient identification information in advance and stored. An acquisition unit;
Based on the position-of-interest information acquired by the acquisition unit, a specifying unit that specifies a partial region in the image acquired for the patient's eye to be examined corresponding to the patient identification information;
An analysis unit for analyzing the partial region identified by the identification unit;
A display control unit that displays a template image indicating an inspection range of visual field inspection on the display unit, and causes the display unit to display a region in the template image corresponding to the partial region specified by the specifying unit. When,
An operation unit for setting a new partial region by changing the region displayed in an identifiable manner;
Including
The analysis unit, ophthalmology analyzer you characterized by analyzing said new partial area set by the operation unit. The position-of-interest information indicates positions of two or more regions of interest;
The specifying unit specifies two or more partial regions corresponding to the two or more regions of interest;
The analysis unit acquires two or more analysis results corresponding to the two or more partial regions,
The ophthalmic analysis apparatus according to claim 1 , wherein the display control unit displays two or more regions corresponding to the two or more partial regions so as to be identifiable in the template image . The ophthalmic analysis apparatus according to claim 3, wherein the display control unit further displays the two or more analysis results in association with the two or more regions . A reception unit for receiving patient identification information for identifying a patient;
The interest position information associated with the patient identification information received by the accepting unit is acquired from storage means in which interest position information indicating the position of the region of interest is associated with each of the plurality of patient identification information in advance and stored. An acquisition unit;
An image forming unit that forms an image by performing optical coherence tomography on a patient's eye corresponding to the patient identification information based on the position-of-interest information acquired by the acquisition unit;
A specifying unit for specifying a partial region in the image formed by the image forming unit based on the position-of-interest information acquired by the acquiring unit;
An analysis unit for analyzing the partial region identified by the identification unit;
Including
The specifying unit specifies a region wider than the region in the image corresponding to the region of interest indicated by the position of interest information as the partial region,
An update unit for updating the position-of-interest information stored in the storage unit based on the new partial area specified by the specifying unit;
A display control unit that displays a template image indicating an inspection range of visual field inspection on the display unit, and causes the display unit to display a region in the template image corresponding to the partial region specified by the specifying unit. When,
An operation unit for setting a new partial region by changing the region displayed in an identifiable manner;
Including
The analysis unit analyzes the new partial area set by the operation unit.
An ophthalmologic photographing apparatus characterized by that. A reception unit for receiving patient identification information for identifying a patient;
The interest position information associated with the patient identification information received by the accepting unit is acquired from storage means in which interest position information indicating the position of the region of interest is associated with each of the plurality of patient identification information in advance and stored. An acquisition unit;
An image forming unit for forming an image by performing the optical coherence tomography with respect to the eye of the patient corresponding to the previous SL patient identification information,
A specifying unit for specifying a partial region in the image formed by the image forming unit based on the position-of-interest information acquired by the acquiring unit;
An analysis unit for analyzing the partial region identified by the identification unit;
A display control unit that displays a template image indicating an inspection range of visual field inspection on the display unit, and causes the display unit to display a region in the template image corresponding to the partial region specified by the specifying unit. When,
An operation unit for setting a new partial region by changing the region displayed in an identifiable manner;
Including
The ophthalmologic photographing apparatus , wherein the analysis unit analyzes the new partial area set by the operation unit .

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