WO2006022045A1 - 光干渉断層装置 - Google Patents
光干渉断層装置 Download PDFInfo
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- WO2006022045A1 WO2006022045A1 PCT/JP2005/006789 JP2005006789W WO2006022045A1 WO 2006022045 A1 WO2006022045 A1 WO 2006022045A1 JP 2005006789 W JP2005006789 W JP 2005006789W WO 2006022045 A1 WO2006022045 A1 WO 2006022045A1
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- layer
- thickness
- line
- layer thickness
- inspection object
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
- A61B3/1225—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes using coherent radiation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/1005—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring distances inside the eye, e.g. thickness of the cornea
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
- G01N21/17—Systems in which incident light is modified in accordance with the properties of the material investigated
- G01N21/47—Scattering, i.e. diffuse reflection
- G01N21/4795—Scattering, i.e. diffuse reflection spatially resolved investigating of object in scattering medium
Definitions
- the present invention relates to a measuring device (for example, optical coherence tomography (0 CT)) that nondestructively measures the thickness of one or more layers constituting the retina, trachea, gastrointestinal tract, etc. About.
- a measuring device for example, optical coherence tomography (0 CT)
- This type of measuring device includes a device that measures the thickness of the nerve fiber layer of the retina (for example, GDxVCC (manufactured by Tyre Zeiss Meditech), HRT (manufactured by Neudelberg))
- An optical coherence tomography apparatus for example, JP-A-10-99337) that measures an image is known.
- an optical coherence tomography apparatus will be described as an example.
- the optical coherence tomography apparatus obtains a tomographic image of an inspection object by irradiating the inspection object such as a retina with light and detecting reflected light reflected from the inspection object.
- the optical coherence tomography apparatus is usually provided with a light source for irradiating light on an inspection object.
- the light from the light source is divided into two by a beam splitter, one of which is applied to the reflecting mirror and the other is applied to the object to be inspected.
- the light incident on the inspection object is absorbed, reflected, and scattered in the inspection object, and the remainder becomes transmitted light and proceeds to the deep layer.
- the inspected object such as the retina is composed of a plurality of layers, and each layer has a different tissue density and tissue arrangement.
- the light reflected from the object to be inspected includes reflected light reflected from each layer (inside the layer and its boundary).
- the intensity of the reflected light reflected by each layer is the intensity unique to each layer, and there is a time difference depending on the depth of each layer.
- the light detector detects the intensity and time difference of the reflected light reflected by each layer. Specifically, the reflected light reflected from the object to be inspected and the light reflected by the reflecting mirror (reference light) are caused to interfere, and the interference wave is made incident on the photodetector.
- the photodetector converts incident interference waves into electrical signals.
- the electrical signal converted by the photodetector is imaged by a computer, and the image is displayed on a display device or the like.
- the intensity of the interference wave detected by the photodetector can also specify the boundary of each layer, and the thickness of each layer can be calculated by specifying the boundary of each layer.
- each layer constituting the inspection object is useful as an index for quantitatively grasping the state of the inspection object.
- the thickness of the retina is useful for diagnosing changes in the retinal thickness due to retinal edema (macular edema), and the thickness of the retinal nerve fiber layer is the degree of progression of glaucoma. It is useful when diagnosing.
- the conventional optical coherence tomography apparatus calculates the thickness of each layer at each scanning position from a two-dimensional tomographic image obtained by scanning light on the surface of the object to be inspected, and calculates the thickness and position of each layer. Equipped with a function to display the relationship as a graph.
- FIG. 26 schematically shows a “position-thickness” graph displayed by a conventional optical coherence tomography apparatus. As shown in FIG. 26, the conventional “position thickness” graph displays the scanning position on the horizontal axis and plots the thickness on the vertical axis.
- the linear scanning method may be effective for grasping the state of the object to be inspected.
- it is effective to measure the thickness of the nerve fiber layer around the optic nerve head by scanning the circumference of the optic nerve head in a ring shape for the above-mentioned diagnosis of glaucoma, “diagnosis of disease state” and determination of the therapeutic effect.
- the “position thickness” graph is displayed in a straight line as shown in FIG. 26 even when the object is scanned in a ring shape. For this reason, it is difficult to intuitively grasp at which part of the test object the layer thickness is thick (or thin).
- Such a problem is not a problem inherent to optical coherence tomography, but is a device that measures the thickness of the nerve fiber layer described above (for example, GDxVCC (Carl Zeiss Meditech), HRT (Heidelberg)) This is a problem.
- the object of the present invention is to graph the “position-layer thickness” relationship obtained by inspecting an object to be inspected. How It is to provide technology that can be easily grasped.
- An optical coherence tomography apparatus to which the present invention is applied irradiates an inspection object composed of one or more layers with light, and causes reflected light reflected by each layer of the inspection object to interfere with reference light. It is equipped with an optical interference tomometer that acquires one-dimensional tomographic information in the depth direction of the inspection object by detecting the intensity of the interference light. Therefore, the light irradiated by the optical coherence tomography is scanned in a line shape on the object to be inspected, or is scanned in a planar shape (for example, a scanning in a linear shape is repeated to scan in a planar shape). Therefore, it is possible to obtain 2D or 3D tomographic information of the inspection object.
- This optical coherence tomography device (1) is based on the setting line set on the inspection object for at least one layer constituting the inspection object based on the two-dimensional or three-dimensional tomographic information of the inspection object.
- the layer thickness at each position is calculated.
- the axis representing the position on the setting line is displayed in a shape similar to the shape of the setting line, and the calculated layer thickness is determined in the normal direction from the axis. It is further equipped with an arithmetic unit (for example, a processor, a computer, etc.) that outputs a graph showing the relationship of “positional layer thickness” plotted on the scale.
- an arithmetic unit for example, a processor, a computer, etc.
- the axis representing the position on the setting line is displayed in a shape similar to the setting line, and the layer thickness
- the axial force is also plotted at a predetermined scale in the normal direction. Since the axis representing the position is represented by a shape similar to the setting line, the operator can intuitively know which part is thick (or thin) from the graph. For example, when the setting line is set in a ring shape, the axis representing the position becomes a ring shape, and the layer thickness is plotted in the normal direction from the axis (for example, radially outward from the center of the ring shape). For this reason, it is possible to intuitively understand at which position of the ring-shaped setting line the layer thickness is thick (or thin).
- an operator operates a pointing device (for example, a mouse). It is also possible to set the setting line. After the setting line is set by the operator, light can be scanned along the setting line, and a “position-layer thickness” graph can be output based on the two-dimensional tomographic information obtained thereby. (That is, the setting line and the scanning line are the same).
- the three-dimensional slice information may be acquired by scanning light in a planar shape in advance, and then a setting line may be set in the scanned region of the light (for example, the operator uses a mouse Etc.) Set the line to the desired shape.
- the optical coherence tomography apparatus may further include means (for example, a display) for displaying a “positional thickness” graph.
- means for photographing the inspection object may further include means for photographing the inspection object.
- the display means preferably displays a photographed image of the inspection object photographed by the photographing means, and displays the “positional thickness” graph superimposed on the displayed photographed image. According to this device, the “positional thickness” graph is superimposed on the photographed image of the inspected object, so it is easier to determine which part of the inspected object is thicker (or thinner). Can grasp.
- a setting line may be further displayed on the captured image of the inspection object displayed on the display means. For example, when a setting line is set in a ring shape, the setting line is displayed on the photographed image, and an axis line (ring) representing the position is displayed so as to be concentric with the setting line.
- a setting line is displayed on the photographed image, and an axis line (ring) representing the position is displayed so as to be concentric with the setting line.
- the optical coherence tomography apparatus preferably includes means (for example, a memory, a database, etc.) for storing the two-dimensional or three-dimensional tomographic information of the inspection object together with the acquired date and time.
- the display means obtains the date and time of acquisition from among the plurality of “position thickness” graphs obtained from the 2D or 3D tomographic information. It is preferable to display at least two graphs having different values. By displaying multiple “position-thickness” graphs with different acquisition dates and times, changes over time of the object to be inspected can be grasped more easily.
- the display means displays a reference value for determining whether or not a force having a normal "positional layer thickness” relationship and a "position-layer thickness” graph.
- "Position-layer thickness” graph And the reference value are displayed together, it is possible to easily determine whether or not the inspection object is normal.
- a reference value for determining whether or not the force is normal for example, the “positional layer thickness average value” obtained by statistically processing the “positional layer thickness” relationship acquired for a plurality of inspection objects or The “normal value of the thickness at the position” can be used.
- the display means can display the reference value in various ways.
- the display means can display a “positional layer thickness” graph and a “positional layer thickness average value” graph or a “positional layer thickness normal value” graph in combination. . Since the reference value is displayed in the same format as the “position-thickness” graph of the inspection object, it is possible to easily determine which part of the inspection object is abnormal.
- an arithmetic device (processor)
- the computer calculates the layer thickness at each position on the setting line for each of the plurality of layers constituting the object to be inspected.
- the optical interference cutoff device further includes means for selecting one or a plurality of layers from the calculated layers, and the display means displays the “position-layer thickness” graph for the selected layers. Prefer to display ,.
- the boundary between the layers cannot be clearly determined from the two-dimensional tomographic image of the inspection object obtained by the optical coherence tomography. is there .
- an examiner such as a doctor
- the optical coherence tomography apparatus includes a second display means (for example, a display) for displaying a two-dimensional tomographic image of a cross section along the set line based on the two-dimensional or three-dimensional tomographic information of the inspection object, (2) A means for designating an arbitrary point in the image displayed on the display means (for example, a mouse) and a means for setting a virtual line connecting the designated points (for example, an arithmetic device such as a processor) are further provided. It is preferable.
- a second display means for example, a display
- a means for designating an arbitrary point in the image displayed on the display means for example, a mouse
- a means for setting a virtual line connecting the designated points for example, an arithmetic device such as a processor
- the doctor or the like operates the designation means while looking at the two-dimensional tomographic image displayed on the second display means, and Specify multiple points that you think.
- the setting means sets an imaginary line (boundary line), and thereby, the boundary line of each layer can be set.
- an arithmetic device (processor, computer, etc.) is further set by the setting means. It is preferable to calculate the distance force between adjacent virtual lines among a plurality of virtual lines. As a result, the thickness of each layer can be calculated even when the boundary between the layers cannot be clearly determined.
- the present invention also configures the inspection object based on the two-dimensional tomographic information of the inspection object acquired by the optical coherence tomography by scanning the surface of the inspection object in a line shape.
- a new program is provided to display the relationship between the thickness of at least one layer and the position on the scan line on the display device.
- This program allows a computer to: (1) a layer thickness calculation means for calculating a layer thickness at each position on the scanning line from the acquired two-dimensional tomographic information for at least one layer constituting the object to be inspected; (2) A display device that displays an axis representing a position on the scanning line in a shape similar to the shape of the scanning line, and displays a graph in which the calculated layer thickness is plotted at a predetermined scale in the normal direction to the axial force. It functions as a control means.
- the present invention relates to an inspection object based on the two-dimensional tomographic information of the inspection object acquired by the optical coherence tomography by scanning the surface of the inspection object in a line. It provides a new method for displaying on the display device the relationship between the layer thickness of at least one layer and the position on the scan line.
- a step of calculating a layer thickness at each position on the scanning line from the two-dimensional tomographic information, and an axis representing the position on the scanning line is used as the shape of the scanning line.
- displaying on the display device a graph in which the calculated layer thickness is plotted with a predetermined scale in the normal direction to the axial force.
- the present invention is not limited to the optical coherence tomography apparatus.
- the present invention can be applied to a device that measures the thickness of a nerve fiber layer.
- FIG. 1 is a block diagram showing the overall configuration of an optical coherence tomography apparatus according to an embodiment of the present invention.
- FIG. 2 is a diagram schematically showing the configuration of OCT.
- FIG. 3 is a diagram showing the state of light transmitted through each part of the OCT.
- FIG. 4 is a flowchart showing an example of an inspection procedure using an optical coherence tomography apparatus.
- ⁇ 5] Flow chart showing an example of the procedure for displaying the “position-layer thickness” graph by optical coherence tomography.
- FIG. 7 is a diagram showing an example of inspection (scanning) performed using the optical coherence tomography apparatus.
- ⁇ 8 A diagram that schematically shows an example of the “position thickness” graph displayed on the monitor of the optical coherence tomography system.
- FIG. 9 is a diagram schematically showing a state in which a fundus photograph is superimposed on the “position thickness” graph shown in FIG.
- FIG. 11 is a diagram showing a graph obtained by performing a smoothing process on the “positional thickness” graph shown in FIG. ⁇ 12]
- the “Position-layer thickness” graph shown in FIG. 8 shows both “Position-normal upper limit value” and “Position-normal lower limit value”.
- FIG. 14 is a diagram for explaining an examination example in which light is scanned in a planar shape on the eye to be examined.
- FIG. 15 is a diagram showing an example of setting lines set in the area when the inspection shown in FIG. 14 is performed.
- FIG. 16 is a “positional layer pressure” graph of a cross section along the setting line shown in FIG.
- FIG. 17 is a diagram obtained by converting the “positional thickness” graph shown in FIG. 16 into a “positional thickness” graph according to the present invention.
- FIG. 18 is a diagram for explaining an inspection example in which light is also scanned radially with optic nerve head power.
- FIG. 19 is a diagram for explaining a procedure for easily obtaining a “position-layer thickness” graph around the optic disc from the two-dimensional tomogram obtained from FIG. 18.
- FIG. 20 is a flowchart for explaining the procedure for identifying the boundary line of each layer when the boundary of each layer of the two-dimensional tomographic image is unknown.
- FIG.21 Diagram for explaining the procedure for specifying the boundary line of each layer when the boundary of each layer of the 2D tomographic image is unknown (when multiple points on the boundary line are specified).
- FIG.22 Diagram for explaining the procedure for identifying the boundary line of each layer when the boundary of each layer of the two-dimensional tomogram is unknown (state in which the boundary line is set by connecting the specified points on the boundary line) ) o
- FIG. 23 is a diagram showing a fundus photograph of an eye to be examined and six scanning lines set radially on the eye to be examined.
- FIG. 24 is a graph in which the layer thickness of each part in the scanning region is mapped from the tomographic information obtained for the six scanning lines shown in FIG.
- FIG. 25 is a diagram in which the mapped graph of FIG. 24 and a fundus photograph are superimposed and displayed.
- FIG. 26 is an example of a “position thickness” graph displayed on a conventional optical coherence tomography apparatus.
- the optical coherence tomography apparatus 10 is an apparatus for inspecting the fundus (retina) of a living eye, and is used in ophthalmic medical sites such as ophthalmology, ophthalmology hospitals, ophthalmology clinics in general hospitals.
- the optical coherence tomography device 10 controls the optical device 12 for inspecting the eye A to be examined, the optical device 12, and the inspection data obtained by the optical device 12.
- a computer 14 is provided for analysis and processing.
- the optical device 12 includes a fundus monitor optical system for monitoring the eye A (fundus) and a measurement optical system 24 (hereinafter referred to as OCT) for obtaining a tomographic image of the eye A.
- a fundus monitor optical system for monitoring the eye A (fundus)
- OCT measurement optical system 24
- the fundus monitor optical system includes a monitor CCD 32, an illumination light source 34, a half mirror 30, a clock mirror 26 (visible light reflection Z infrared light transmission), an objective lens 28, and the like.
- the monitor CCD 32 is a CCD that images the fundus of the eye A to be examined.
- the illumination light source 34 is a visible light source that illuminates the eye A to be examined.
- the light (visible light) emitted from the illumination light source 34 is reflected by the half mirror 30 and the dichroic mirror 26, and illuminates the eye A through the objective lens 28.
- the light (visible light) reflected by the eye A is reflected by the dichroic mirror 26 through the objective lens 28 and detected by the CCD 32 for monitoring.
- the image of the eye A to be examined obtained by the monitor CCD 32 is sent to the computer 14 and displayed on the monitor 18.
- the measurement optical system 24 irradiates the fundus (retinal) of the eye A with infrared light and detects the reflected light (infrared light) to acquire a tomographic image of the eye A (fundus). . That is, light (infrared light) that also emits the measurement optical system 24 is transmitted through the dichroic mirror 26 and enters the eye A through the objective lens 28. The light (infrared light) incident on eye A is the retina of eye A (for details, see Absorbs, reflects, and scatters in each layer). Of the light that is absorbed, reflected, and scattered, the light (infrared light) reflected in the direction of the measurement optical system 24 passes through the dichroic mirror 26 and is detected by the measurement optical system 24.
- the measurement optical system 24 includes a low-coherence light source 33, a photodetector 34, an optical fiber coupling device 36, a probe 38, a reflecting mirror 42, and the like.
- a low coherence light source 33 for example, a super luminescent diode light source can be used.
- Light emitted from the low-coherence light source 33 [near-infrared light (for example, 850 nm diode light)] is guided to the optical fiber coupling device 36 by the optical fiber 30.
- the optical fiber coupling device 36 functions as a beam splitter. For this reason, the light guided to the optical fiber connecting device 36 is divided into two. One of the divided lights is guided to the optical fiber 31 and the other is guided to the optical fiber 46.
- the light guided to the optical fiber 31 is applied to the eye A through the probe 38.
- the probe 38 is movable with respect to the eye A in the X-axis and Y-axis directions (up / down / left / right directions).
- the irradiation position of the light to the eye A can be scanned in the X-axis and Y-axis directions (changed in the vertical and horizontal directions).
- the light reflected from the eye A is guided to the optical fiber coupling device 36 by the optical fiber 31 again.
- the light guided to the optical fiber 46 is applied to the reflecting mirror 42 through the lens 40.
- the reflecting mirror 42 can be moved back and forth in the direction of the arrow in the figure.
- the distance (optical path length) between the reflecting mirror 42 and the optical fiber connecting device 36 changes.
- the light reflected by the reflecting mirror 42 is again guided to the optical fiber connecting device 36 by the optical fiber 46.
- the light guided by the optical fiber 31 and the light guided by the optical fiber 46 become interference waves in the optical fiber coupling device 36.
- This interference wave is guided to the optical detector 34 by the optical fiber 45.
- the photodetector 34 detects the intensity of the interference wave guided by the optical fiber 45.
- the light intensity detected by the photodetector 34 is sent to the computer 14.
- the light emitted from the low-coherence light source 33 is guided by the optical fiber 30 to the beam splitter 37 (that is, the optical fiber coupling device 36).
- the light guided to the beam splitter 37 is divided into two parts, one of which is directed toward the eye A (measurement light in the figure).
- the other is directed to the reflecting mirror 42 (reference light in the figure).
- the measurement light irradiated to the eye A is reflected by each layer of the retina (for example, nerve fiber layer, inner reticulate layer, outer reticulated layer, pigment epithelial layer, etc.) and becomes a reflected wave in which these lights overlap ( Reflected measurement light in the figure).
- the reference light applied to the reflecting mirror 42 is reflected by the reflecting mirror 42 and becomes reflected reference light.
- the reflected measurement light and the reflected reference light become one interference wave by the beam splitter 37, pass through the optical fiber 45, and are detected by the photodetector 34.
- the distance between the reflecting mirror 42 and the beam splitter 37 (the optical path length of the reflected reference light) is changed by changing the position of the reflecting mirror 42.
- the optical path length of the reflected light reflected by each layer of eye A varies depending on the position (depth) of eye A to be examined. Therefore, when the optical path length of the reflected reference light is changed by changing the position of the reflecting mirror 42, the interference wave detected by the photodetector 45 also changes. This is because it changes where the light interference phenomenon is reflected in the depth direction of the retina. Therefore, by changing the position of the reflector 42 (by scanning), it is possible to obtain a reflection intensity distribution (tomographic information) in the depth direction (Z-axis direction) of the retina.
- the measurement optical system 24 can obtain 2D and Z or 3D tomographic information of the retina of the eye A to be examined.
- the optical device 12 described above can be adjusted in position with respect to the eye A (that is, the subject's head fixed to the chin rest (not shown)). That is, as shown in FIG. 1, the optical device 12 is moved up and down, left and right, and back and forth (X-axis, Y-axis, and Z-axis directions) with respect to the eye A by the drive mechanism 22. By moving the optical device 12 by the drive mechanism 22, the optical device 12 can be focused on the retina of the eye A to be examined.
- the drive mechanism 22 is controlled by the computer 14.
- an input unit 16 a monitor 18, a data storage unit 20, and the like are connected to the computer 14.
- the input unit 16 includes a pointing device such as a mouse and a keyboard.
- the examiner can operate the input unit 16 to specify which part of the eye A to be scanned with light.
- the monitor 18 displays an image acquired by the monitor CCD 32, a retinal tomographic image obtained by imaging the retinal tomographic information acquired by the measurement optical system 24, and the like.
- the data storage unit 20 stores retinal tomographic information acquired by the measurement optical system 24.
- the examiner operates the input unit 16 to input the ID of the subject (S10).
- the examiner adjusts the position of the optical device 12 and the eye A (S12).
- the monitor 18 displays an image of the eye A taken by the monitor CCD 32 and an index light for alignment.
- the examiner operates the joystick (not shown) while viewing the image of the eye A to be displayed on the monitor 18 to adjust the position of the optical device 12 so that the index light is displayed at the desired position of the eye A to be examined.
- the optical device 12 is adjusted so that the fundus of the subject eye A is clearly displayed.
- the inspector operates the input unit 16 to set the position where the irradiation light is irradiated and the scanning method thereof (S14). For example, when the irradiation light is scanned linearly, the fact that scanning is performed linearly is input, and then the start point and end point of the scanning line are set on the eye A to be examined displayed on the monitor 18. Further, when the irradiation light is scanned in a circular shape (ring shape), the fact that scanning is performed in a circular shape is input, and then the center and starting point of the scanning line are set on the eye A to be examined displayed on the monitor 18.
- a circular shape ring shape
- step S16 the computer 14 starts irradiating irradiation light by the measurement optical system 24 (S16).
- irradiation of irradiation light is started, tomographic information in the Z-axis direction of the eye A is measured by scanning the reflecting mirror 42 (S18). The measured tomographic information is sequentially stored in the memory in the computer 14.
- the computer 14 determines whether or not the scanning of the irradiation light has ended (that is, whether or not the irradiation light has been scanned to the scanning end position) (S20). If the irradiation light scanning has not been completed (NO in step S20), the probe 38 is moved to change the irradiation position (S22), and the processing from step S16 is repeated.
- the computer 14 takes a fundus picture of the eye A (S23). Specifically, the image data acquired by the monitor CCD 32 is stored in the memory in the computer 14.
- step S24 the optical coherence tomographic information obtained by repeating step S18 (two-dimensional tomographic information) ) And the fundus photograph taken in step S23 is stored in the data storage unit 20 in association with the ID of the subject (S24).
- the examiner inputs the ID of the subject (patient) to be graphed from the input unit 16 (S26).
- the inspector operates the input unit 16 to select optical coherence tomographic information to be graphed (S28).
- the data storage unit 20 stores a plurality of pieces of optical coherence tomographic information relating to the same subject. For example, multiple optical interference information such as optical coherence tomographic information with different inspection dates and times, optical coherence tomographic information with different scanning parts (for example, optic nerve head or macular region) and scanning methods (for example, linear or circular), etc. Fault information is stored.
- optical coherence tomographic information to be graphed is selected from them.
- step S30 the computer 14 calculates the layer thickness of each layer at each scanning position (irradiated light irradiation position) based on the selected optical coherence tomographic information.
- the procedure for calculating the layer thickness of each layer will be described in detail with reference to FIG. Figure 6 schematically shows optical interference information (intensity distribution of interference waves in the Z-axis direction) at the scanning positions PI and P2.
- the position where the light intensity changes in a peak can be specified as the boundary between layers.
- a differential value of light intensity is calculated, and when the differential value becomes larger than a preset set value (positive value), the position is defined as a boundary between layers. Can be determined.
- the thickness of each layer can be calculated by calculating the difference (Tl, T2, etc. in the figure).
- the examiner can easily determine which layer the calculated layer thickness is.
- the first calculated layer thickness can be determined as the retinal nerve fiber layer.
- the layer thickness of each layer is calculated by using a product installed on a commercially available optical coherence tomography device.
- a product installed on a commercially available optical coherence tomography device.
- Can be used for example, a known optical coherence tomography apparatus (manufactured by Carl 'Zeiss' Meditech) is equipped with a function (program) that outputs the thickness of each layer as a number based on the measured optical coherence tomography information. By using this program, the thickness of each layer can be obtained.
- an inspector can manually specify the boundary surface of each layer and calculate the layer thickness of each layer based on the specification.
- the computer 14 visualizes the measured optical coherence tomographic information and displays the tomographic image on the monitor 18. The inspector operates the mouse or the like to move the pointer in the monitor 18 and specify the boundary of each layer in the displayed tomogram.
- the computer 14 calculates the number of pixels of each layer from the position coordinates of the specified boundary of each layer, and converts the calculated number of pixels into the actual layer thickness.
- the calculation of the layer thickness of each layer described above is not necessarily performed by the computer 14 of the optical coherence tomography apparatus 10.
- the computer 14 force can output a tomographic image (image) to another computer, and the thickness of each layer can be calculated by another computer.
- the processing after step S32 described below can be performed by another computer.
- the computer 14 creates display data, and outputs the created display data to the monitor 18 (S32).
- the “position thickness” graph is displayed on the monitor 18 (S34).
- various commercially available software can be used. For example, use a graphing software that inputs a 2D numerical data group [2D data of (position, layer thickness) for each scanning step] and converts the input 2D numerical data group into a graph. Can do. Alternatively, you can create your own graphing software using software creation software (for example, Microsoft (registered trademark) visual studio). Such a graph It is preferable that the conversion software or the original creation software has a function for overlapping and displaying separately captured images. This is because, as shown in FIG. 9, fundus photographs taken separately on the “position-thickness” graph can be displayed in an overlapping manner (FIG. 9 will be described in detail later).
- each layer around the optic disc is useful for diagnosing glaucoma and determining the therapeutic effect.
- the circumference of the optic disc is scanned in a circle.
- the “position-layer thickness” graph is acquired.
- FIG. 8 schematically shows a graph displayed on the monitor 18.
- the line that schematically displays the fundus of the optic disc is displayed as a two-dot chain line, and the scanning line is displayed as a dotted line.
- the layer thickness is displayed only at some points on the scanning line.
- the axis representing the position of the scanning line is displayed as a circle concentric with the scanning line.
- auxiliary lines extending radially from the center of the circle are drawn at appropriate scanning angles (eg, 30 °, 60 °, etc.).
- two circles concentric with the axis are drawn on the outside of the axis.
- the inner circle represents a layer thickness of 100 / z m
- the outer circle represents a layer thickness of 200 / z m.
- the layer thickness at each scanning position is plotted outward (in the normal direction) from the axis, and adjacent points are connected by a straight line.
- the axis line and the scanning line are drawn in concentric circles (that is, similar shapes), so the layer thickness is at any position on the scanning line. It can be intuitively grasped whether it is thick (or thin) (in the example of Fig. 8, the layers are thin at 0 °, 180 °, 330 °).
- a graph in which only the layer thickness of the retinal nerve fiber layer is plotted can be graphed for each layer constituting the force retina.
- the layer thickness of multiple layers (i layer, (i + 1) layer, (i + 2) layer) at a time can be It can also be displayed. In this case, it is desirable to be able to distinguish the type of layer by color or the like.
- the layer to be displayed on the monitor 18 may be selected by operating the input unit 16. This is because the layer whose layer thickness varies depending on the disease. For example, the thickness of the nerve fiber layer changes in glaucoma, and the thickness of the outer granular layer changes in retinitis pigmentosa.
- the examiner (doctor) can select the layer to be displayed on the monitor 18 according to the symptom of the subject and diagnose the subject's disease.
- the layer thickness is calculated only for the corresponding layer in step S30 in FIG. May be.
- the layer thickness of each layer may be displayed in a ratio with a normal value. That is, the layer thickness
- the layer thickness obtained by examination, the normal upper limit value (for example, + 10% of the average value of normal eyes) and the normal lower limit value (for example, the average value of normal eyes) 10%) may be displayed together. According to such a configuration, it can be determined at a glance whether or not the layer thickness obtained by the measurement belongs to the normal range. Also, as shown in Fig. 12, when the normal upper limit value and normal lower limit value at each position on the scanning line are displayed, it is easy to determine which part of the measured layer thickness is normal and which part is abnormal. Can be judged.
- each graph described above may be printed (output) by a printer or the like provided separately.
- the scanning line set for the eye to be examined can have an arbitrary shape, for example, an arc, a synthetic circle, or the like. Furthermore, you can draw by omitting the scale of each graph described above.
- a “positional layer thickness” graph may be superimposed on the fundus image captured by the monitor CCD 32 and displayed.
- the positional relationship between the scanning line and the fundus image can be understood at a glance, and the scanning line and the axis line are concentric. It is possible to grasp intuitively whether the thickness is appropriate.
- examination history for the same patient may be displayed.
- the data storage unit 20 of the optical coherence tomography apparatus 10 displays the test results (for example, “position-layer thickness” graph, retinal tomographic information, etc.) of each patient (for example, for each patient ID number). It memorizes with the inspection date. Then, by operating the input unit 16 and specifying a patient (for example, by inputting a patient ID), the computer 14 reads the specified test result of the patient from the data storage unit 20. The computer 14 then displays the patient's examination history on the monitor 18. In the example shown in FIG. 10, the inspection result of date A (position thicker) and the inspection result of date B (date A is past than date B) (position thicker) are displayed. From the patient's examination history displayed on the monitor 18, it is possible to easily determine the therapeutic effect between date A and date B, and whether or not the lesion is aggravated or improved.
- the test results for example, “position-layer thickness” graph, retinal tomographic information, etc.
- the eye to be examined is irradiated with light in a ring shape, and the tomographic information on the scanning line is acquired by the measurement optical system 24.
- the inspection by the optical coherence tomography apparatus 10 is not limited to such a method.
- the scanning surface scanning region
- the tomographic information (three-dimensional tomographic information) in the scanning region is acquired by the measurement optical system 24, as shown in FIG.
- the scanning direction of the irradiation light may be repeated from the right side of the figure to the left side as shown by the solid line in FIG. 14, or the left side force of the figure as shown by the dotted line in the figure.
- the scanning may be repeated, or the scanning may be repeated alternately, such as scanning from the left side of the figure to the right side after scanning with the right side of the figure. o)
- a separate line may be set in the scanning region, and the relationship between the position on the set line and the layer thickness may be acquired.
- the relationship between the position on the setting line and the layer thickness can be displayed with the position as the horizontal axis and the layer thickness as the vertical axis as shown in Fig. 16 (conventional method), or in Fig. 17
- the axis representing the position should have a shape similar to the setting line (ie, a ring), and the axial force should also be plotted in the normal direction.
- the axis representing the position is displayed in a ring shape around the optic disc, and the layer thickness is plotted in the direction of the normal axis of the axial force, and the smoothing process is applied to the straight line connecting the plotted points. Apply. Even in this way, the general tendency of the layer thickness around the optic disc can be grasped. Note that the scanning of light on the six scanning lines shown in FIG. 18 may be performed in either direction.
- the computer 14 automatically calculates the layer thickness of each layer based on the optical coherence tomographic information obtained by the measurement optical system 24.
- the examiner operates the input unit 16 to identify the boundary of each layer, and The computer 14 may calculate the layer thickness of each layer based on the determined boundary.
- FIG. 20 shows a procedure in which the inspector specifies the boundary of each layer and calculates the thickness of each layer based on the specified boundary.
- the computer 14 first visualizes the optical coherence tomographic information measured by the measurement optical system 24, and displays the optical coherence tomographic image on the monitor 18 (S36).
- the examiner operates the input unit 16 (mouse or the like) to designate a point that is considered to be a boundary in the optical coherence tomographic image displayed on the monitor 18 (S38).
- Examiner has anatomical knowledge If the boundary of each layer is unclear (for example, it can be determined whether the boundary of each layer is only discontinuous), specify the boundary of each layer by entering the part where the boundary can be determined. This is because it can be done.
- the computer 14 connects the designated plurality of points with a straight line (S40), and then performs a smoothing process on the straight line to obtain a curved line (S40). S42). Thereby, each designated point is connected and a temporary boundary line is set.
- FIG. 21 shows a state in which a plurality of points designated in the optical coherence tomographic image are connected by straight lines
- FIG. 22 shows a state in which smoothing processing is performed on the straight lines connecting the plurality of points.
- the inspector operates the input unit 16 to input whether or not to confirm the boundary set by the above-described procedure (S44).
- step S44 If the inspector does not finalize the set boundary line (NO in step S44), the process returns to step S38 and the processing from step S38 is repeated. For this reason, the inspector will specify more points so that an appropriate boundary line is set.
- the set boundary line is confirmed (YES in step S44)
- the set boundary line is confirmed as the final boundary line (S46), and then whether or not all necessary boundary lines have been set. Judgment is made (S48). If all necessary boundary lines have been set (if NO in step S48), return to step S38 and repeat the process from step S38. This will set the boundaries on all necessary layer boundaries.
- the computer 14 calculates the layer thickness of each layer also for the set boundary force (S50).
- the computer 14 calculates the number of pixels of each layer from the position coordinates of the boundary line of each adjacent layer, and converts the calculated number of pixels into the actual layer thickness.
- the computer 14 displays a “position-layer thickness” graph on the motor 18 (S52).
- the inspector can calculate the thickness of each layer by designating multiple boundaries of each layer. Can do. Unlike the above-described embodiment, the inspector may operate the input unit 16 to directly draw the boundary line of each layer.
- each layer constituting the retina (retinal nerve fiber layer, photoreceptor outer segment layer, photoreceptor inner nodal layer, outer granule layer, outer reticulated layer, inner granule layer , Inner plexiform layer, ganglion cell layer) can also be graphed.
- the boundary between layers constituting the retina may be unclear. Even in such a case, the inspector can manually determine (specify) the boundary line of each layer in the optical coherence tomographic image, and the thickness of each layer can be obtained from the determined boundary line interval. .
- the thickness of each layer in the scanning plane is displayed two-dimensionally from the thickness of each layer at each position on each scanning line obtained. can do. For example, as shown in FIG. 23, scanning is performed on a plurality of scanning lines set radially with respect to the retina of the subject eye, or parallel to the retina of the subject eye as shown in FIG. Scanning multiple scanning lines to obtain 3D tomographic information of the eye to be inspected, and as shown in Fig. 24, the obtained 3D tomographic information force also displays the layer thickness of each part in different colors (Hereafter, such a display is called mapping). As shown in Fig. 25, the mapped graph and fundus photo may be superimposed and displayed.
- each layer of the retina can be mapped by the above-described method, it can be used for diagnosis of a disease in which only a specific layer of the retina is strongly damaged except for the retinal nerve fiber layer.
- the thickness of the choroid, choroidal capillary plate, etc. located on the sclera side of the retina, which is connected only by the retina, the mapping of each layer of the cornea, and the posterior vitreous body Mapping indicating the range of detachment or retinal detachment is also possible. It is also possible to select a plurality of layers from each layer constituting the network film and map the total thickness of these layers.
- the optical coherence tomography apparatus 10 described above is for obtaining a tomographic image of the retina.
- the technique of the present invention irradiates light on the surface of the digestive tract, and the digestive tract.
- the present invention can be applied to an endoscope apparatus for grasping the edema state and the like. Furthermore, it can be used to distinguish between a tumor part and a normal part in a surgical operation.
- the technique of the present invention is not limited to an optical coherence tomography device, but a device that measures the thickness of the nerve fiber layer of the retina by measuring the phase change of the polarized light that has passed through the eye to be examined (for example, GDxV CC (Curl Zeiss' Meditech) and devices that measure the three-dimensional structure of the retina by scanning the retina with laser light and measuring the reflected light of the retina (for example, HRT (manufactured by Heidelberg)) Can be applied.
- GDxV CC Curl Zeiss' Meditech
- HRT manufactured by Heidelberg
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