WO2019056042A1 - Imagerie ophtalmique à double caméra - Google Patents

Imagerie ophtalmique à double caméra Download PDF

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Publication number
WO2019056042A1
WO2019056042A1 PCT/AU2018/000178 AU2018000178W WO2019056042A1 WO 2019056042 A1 WO2019056042 A1 WO 2019056042A1 AU 2018000178 W AU2018000178 W AU 2018000178W WO 2019056042 A1 WO2019056042 A1 WO 2019056042A1
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WO
WIPO (PCT)
Prior art keywords
image
camera
eye
light
images
Prior art date
Application number
PCT/AU2018/000178
Other languages
English (en)
Inventor
Robin Mcwilliams
Victor Previn
Original Assignee
Ellex Medical Pty Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from AU2017903807A external-priority patent/AU2017903807A0/en
Application filed by Ellex Medical Pty Ltd filed Critical Ellex Medical Pty Ltd
Publication of WO2019056042A1 publication Critical patent/WO2019056042A1/fr

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Classifications

    • 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
    • A61B3/13—Ophthalmic microscopes
    • A61B3/135—Slit-lamp microscopes
    • 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
    • A61B3/0008—Apparatus for testing the eyes; Instruments for examining the eyes provided with illuminating means
    • 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
    • A61B3/0016—Operational features thereof
    • A61B3/0041—Operational features thereof characterised by display arrangements
    • A61B3/0058—Operational features thereof characterised by display arrangements for multiple images
    • 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
    • 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
    • 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
    • A61B3/14—Arrangements specially adapted for eye photography
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/10—Beam splitting or combining systems

Definitions

  • the present invention relates to ophthalmic imaging. More particularly, the invention is relates to methods, devices, and systems for dual camera ophthalmic imaging.
  • Slit lamp instruments are commonly used for eye examination, in both a clinical research and ophthalmological context. Slit lamp instruments can facilitate examination of various parts of the eye, e.g. the retina, conjunctiva, cornea, iris, aqueous humour, lens, and eyelid.
  • a slit lamp instrument includes two main components: the slit lamp itself, which is a light source that projects light into the eye to serve to illuminate; and a microscope that can be used by an operator to view images of a region of the eye illuminated by the slit lamp.
  • an ocular lens is used in conjunction with a slit lamp instrument to facilitate ophthalmoscopy of the retina, wherein the ocular lens is placed directly onto the eye and alters the field of view.
  • a slit lamp instrument to facilitate ophthalmoscopy of the retina
  • the ocular lens is placed directly onto the eye and alters the field of view.
  • such lenses placed between the slit lamp illumination and the eye can induce back reflections of the slit lamp light on the image viewed by the microscope.
  • any movement of this lens or the patient's eye, or the other slit lamp components can cause the reflections to move around and interfere with the image.
  • reflections are prominent enough to mask key target information, for example the position of a laser treatment.
  • An operator will generally adjust the ocular lens until the reflections are minimized or direct them off the region of interest. Human stereo vision then combines the unobscured detail from both eyes, minimizing the impact of such reflections.
  • a Digital imaging system has a lower dynamic range than the human eye and does not intrinsically have stereo functionality. As a result the imaging sensor may saturate in the areas of reflection, potentially obscuring important information.
  • Ocular dominance sometimes called eye preference or 'eyedness', is the tendency to prefer visual input from one eye to the other.
  • Some degree of ocular dominance is very common, and when using an ocular lens for slit lamp imaging, a user will tend to focus based on their dominant eye. In this case, the image from a central view will typically be slightly out of focus. Accordingly, it can be difficult to capture a completely focused image, particularly where the slit lamp instrument is used by various users who may have different ocular dominance.
  • This invention broadly provides a method of obtaining a plurality of images of a single eye, using a plurality of imaging components or cameras.
  • the invention also broadly provides a device suitable for capturing a plurality of images of a single eye, using one or more light sources and a plurality of imaging components or cameras.
  • a system including one of more light sources and said device is also broadly provided.
  • a method of imaging an eye visualised using an ophthalmic instrument including the steps of:
  • the one or more light sources according to the method of this aspect may be of the ophthalmic instrument and/or of a device operatively connected thereto.
  • the imaging of the eye that is performed according to the method of this aspect may be imaging of a component of the eye selected from the group consisting of the eyelid; the eyelid margins; the tear film; the conjunctiva; the cornea; the aqueous humour; the iris; the lens; the vitreous humour; and the retina.
  • the component of the eye is the retina.
  • the first image and/or the second image correspond to one or more images viewed or viewable by an operator of the ophthalmic instrument.
  • the first image and the second image are captured by the first camera and the second camera simultaneously, or substantially simultaneously.
  • the respective images of the eye captured by the first camera and the second camera are captured using light that has travelled via one or more optical lenses.
  • the lenses are of the ophthalmic instrument and/or of a device operatively connected to the ophthalmic instrument.
  • the respective first and second images captured by the first camera and the second camera will suitably have one or more different characteristics.
  • the different characteristics are in respect of the origin of light used to produce, achieve, or result in the images.
  • the different characteristics are in respect of the path via which light has travelled to produce, achieve, or result in the images.
  • light used to produce, achieve, or result in the first image has travelled via a first optical path.
  • light used to produce, achieve, or result in the second image has travelled via a second optical path.
  • the first and second optical paths are different.
  • the different characteristics are in respect of one or more filters via which light has travelled to produce, achieve, or result in the images.
  • the different characteristics are in respect of one or more lenses via which light has travelled to produce achieve, or result in the images.
  • the different characteristics are in respect of one or more mirrors via which light has travelled to produce, achieve, or result in the images.
  • the different characteristics of the first and second images may be of the visible properties of the images themselves.
  • light used to produce the first image originates from a first light source
  • light used to produce the second image originates from a second light source.
  • light originating from the first light source is of a first wavelength or wavelength range
  • light originating from the second light source is of a second wavelength or wavelength range.
  • the first and the second wavelengths or wavelength ranges are different.
  • the first and second images are produced by light that has travelled via one or more optical lenses along different optical paths.
  • the first and second images have travelled via one or more different optical lenses.
  • the one or more lenses are of the ophthalmic instrument and/or of a device operatively connected thereto.
  • one or both of the respective images captured by the first and second camera has travelled via a beam splitter.
  • the first image has travelled via a first beam splitter, wherein respective beams split by the first beam splitter are (a) captured by the first camera to form the first image; and (b) viewed as an image by a user of the ophthalmic instrument.
  • respective beams viewed as an image by the user are directed via a first eyepiece of a stereomicroscope of the ophthalmic instrument, and viewed through the eyepiece.
  • said image viewed by the user is the same, or substantially the same, as the first image captured by the first camera.
  • the second image has travelled via a second beam splitter, wherein respective beams split by the second beam splitter are (a) captured by the second camera to form the second image; and (b) viewed by a user of the ophthalmic instrument.
  • respective beams viewed as an image by the user are directed via a second eyepiece of a stereomicroscope of the ophthalmic instrument, and viewed through the eyepiece.
  • said image viewed by the user is the same, or substantially the same, as the second image captured by the second camera.
  • first image and the second image have travelled via a filter.
  • one of the first image and the second image have travelled via a filter, and the other has not travelled via a filter.
  • first image and the second image have travelled via respective different filters.
  • the filter allows transmission of light produced by a first light source.
  • the second image has travelled via a filter, preferably the filter allows transmission of light produced by a second light source.
  • the first image and the second image may have been directed via respective lenses with different properties.
  • the first image and the second image have been travelled via respective lenses with different focal depth.
  • one or both of the first and second images have travelled via a magnifying lens.
  • one or both of the first and second images may have been travelled via a magnifying lens that is not an ocular lens, such as a handheld ocular lens.
  • one of the first and second images may have travelled via a magnifying lens, wherein the other of the first and second images has not have travelled via a magnifying lens.
  • the first and second images may have travelled via respective magnifying lenses, wherein said lenses have different magnifying power.
  • the first image and/or the second image have travelled via a dichroic mirror.
  • the first image has travelled via a dichroic mirror, preferably, (a) light originating from a first light source is reflected from the mirror and captured by the first camera to form the first image; and (b) light originating from a second light source is transmitted through the mirror and viewed as an image by a user of the ophthalmic instrument.
  • the eye that is visualised using the ophthalmic instrument has been magnified using a handheld ocular lens or the like.
  • the image captured by the first camera and/or the image captured by the second camera has travelled through the handheld ocular lens.
  • the image captured by the first camera and the image captured by the second camera has travelled through a handheld ocular lens.
  • imaging of the eye according to the method of this aspect includes the step of selecting a suitable, or relatively more suitable, image of the eye visualised using the slit lamp instrument from the first image captured by the first camera and the second image captured by the second camera.
  • imaging of the eye according to the method of this aspect includes the step of obtaining or otherwise producing a suitable image of the eye, by combining at least part of the first image captured with the first camera with at least part of the second image captured by the second camera.
  • the suitable image of the eye may be an image that is not obscured, disrupted, or otherwise compromised, by the presence of an optical artefact.
  • the optical artefact may be a reflection, refraction, or shadow.
  • the optical artefact is caused by or otherwise related to magnification of the eye using an ocular lens.
  • the suitable image of the eye may be an image that is appropriately or adequately focused.
  • an image is selected from the first image captured by the first camera and the second image captured by the second camera, wherein the respective images have been directed through respective optical paths of a stereo microscope, and one of said images is more suitably focused.
  • the image is more suitably focused due to optical dominance of a user.
  • the method may include the step of comparing the first image, or a portion thereof, and/or or the second image, or a portion thereof, to a reference image.
  • the reference image may be indicative or exemplary of a suitable image; or an unsuitable image.
  • the reference image is indicative or exemplary of a suitable image. Comparing the first image; second image; and/or one or more portions thereof to a reference may facilitate characterisation and/or selection of the images or portions as suitable or relatively suitable, or unsuitable or relatively unsuitable.
  • the imaging according to the method of this aspect produces or results in an image of an eye that includes one or more portions or layers produced using light originating from a first light source; and one or more portions or layers imaged using a second light source.
  • the image may include one or more portions or layers imaged using a first wavelength or wavelength range of light; and one or more portions or layers imaged using a second wavelength or wavelength range of light.
  • the imaging produces or results in an image of the eye that is suitable for a clinical purpose, such as a diagnosis of an ophthalmic condition, disease, or disorder.
  • the method may include the further step of diagnosing and/or treating an ophthalmic condition based on or otherwise informed by the imaging of the eye.
  • the ophthalmic condition diagnosed and/or treated according to the method of this aspect is a retinal disorder or retinopathy.
  • the retinal disorder or retinopathy is treated using a regenerative therapy, such as a laser regenerative therapy.
  • the clinical purpose for which the image of the eye is suitable is the identification of a portion or region of the eye that has or has not been previously subject to treatment.
  • the method may include the further step of treating a portion or region of the eye that has or has not been previously subject to treatment. Preferably, said region has not been previously subject to treatment.
  • the method may include the step of imaging the eye using a scanning laser ophthalmoscope.
  • the invention resides in a device for imaging an eye visualised using an ophthalmic instrument and one or more light sources of the device and/or the ophthalmic instrument, the device comprising:
  • one or more switches operably connected to the first camera and/or the second camera for activating and/or deactivating the camera, wherein:
  • the first camera is positionable relative to the ophthalmic instrument to capture a first image of the eye using at least one of the one or more light sources of the device and/or the ophthalmic instrument;
  • the second camera is positionable relative to the ophthalmic instrument to capture a second image of the eye using at least one of the one or more light sources of the device and/or the ophthalmic instrument.
  • the first camera is adapted or adaptable to capture a first image of the eye using a first light source; and the second camera is adapted or adaptable to capture a second image of the eye using a second light source.
  • the light source(s) of the device of this aspect are of the ophthalmic instrument. In an embodiment, the light source(s) are of the device. In an embodiment, at least one light source is of the device, and at least one light source is of the ophthalmic instrument.
  • the first camera and the second camera of the device of this aspect are digital cameras.
  • said cameras are capable of capturing still images.
  • said cameras are capable of capturing video images.
  • the device comprises an imaging trigger connecting the first camera and the second camera for synchronisation of the capture of respective images by the first camera and the second camera.
  • the device comprises one or more beam splitters via which the first image and/or second image pass.
  • the device comprises a first beam splitter for directing respective beams: (a) to the first camera to form the first image; and (b) for viewing of an image of the eye by a user.
  • the device comprises a second beam splitter for directing respective beams: (a) to the second camera to form the second image; and (b) for viewing of an image of the eye by a user.
  • the device comprises one or more dichroic mirrors.
  • the device may comprise a first dichroic mirror for: (a) reflecting light originating from a first light source to the first camera to form the first image; and (b) transmitting light originating from a second light source for viewing as an image of the eye by a user.
  • the device may comprise a second dichroic mirror for: (a) reflecting light originating from a second light source to the second camera to form the second image; and (b) transmitting light originating from a first light source for viewing as an image of the eye by a user.
  • the device of this aspect further comprises one or more filters via which the first image and/or the second image travel.
  • the device comprises a first filter via which the first image travels. Additionally or alternatively, the device may comprise a second filter via which the second image travels.
  • the device of this aspect further comprises one or more lenses via which the first image and/or the second image travel.
  • the one or more lenses are focusing lenses and/or magnifying lenses.
  • the device comprises one or more focusing lenses via which the first image and/or the second image travel.
  • the device may comprise a first focusing lens via which the first image travels; and a second focusing lens via which the second image travels.
  • the first and second lenses have different focal depth.
  • the device comprises one or more magnifying lenses via which the first image and/or the second image travel.
  • the device may comprise a first focusing lens via which the first image travels; and a second focusing lens via which the second images travels.
  • the first and second lenses have different magnifying power.
  • the device of this aspect may further comprise one or more filters, such as safety filters, for filtering light used for viewing as an image by a user.
  • filters such as safety filters
  • the device of this aspect may further comprise a processor for processing data, such as data received from the cameras; the switch; the filters; the lenses; the mirrors; the light sources; and/or the ophthalmic instrument.
  • a processor for processing data such as data received from the cameras; the switch; the filters; the lenses; the mirrors; the light sources; and/or the ophthalmic instrument.
  • the device may further comprise a signaling component for transmitting signals, such as between the camera; the switch; the processor; the lenses; the mirrors; the light sources; and/or the ophthalmic instrument.
  • a signaling component for transmitting signals, such as between the camera; the switch; the processor; the lenses; the mirrors; the light sources; and/or the ophthalmic instrument.
  • the device may further comprise a storage component for storing data, such as imaging data obtained by the cameras of the device.
  • a system comprising an ophthalmic instrument in operable connection with a device of the second aspect.
  • the system of this aspect further comprises an ocular lens, such as a handheld ocular lens, in operable connection with the ophthalmic instrument and/or device.
  • the first and the second cameras of the device are located within a delivery head of the ophthalmic instrument.
  • the device comprises first and/or second beam splitters
  • the beam splitters are located within a delivery head of the ophthalmic instrument.
  • the device comprises one or more filters via which the first image and/or the second image travel
  • the filters are located within a delivery head of the ophthalmic instrument.
  • the lenses are located within a delivery head of the ophthalmic instrument.
  • the device comprises one or more dichroic mirrors
  • the dichroic mirrors are located within a delivery head of the ophthalmic instrument.
  • a fourth aspect of the invention provides a device of the second aspect or a system of the third aspect, for use according to the method of the first aspect.
  • Figure 1 sets forth a perspective view of the ophthalmic laser system described in International application PCT/AU2002/000475.
  • Figure 2 sets forth a schematic top view of an embodiment of a device of the invention positioned relative to an eye.
  • Figure 3 sets forth a schematic top view of an embodiment of a device of the invention positioned relative to an eye.
  • Figure 4 sets forth a schematic top view of an embodiment of a system of the invention.
  • Figure 5 sets forth a schematic top view of an embodiment of a system of the invention.
  • Figure 6 sets forth an exemplary first image (left) and second image
  • Figure 7 sets forth an exemplary first image (left) and second image (right) captured of a retina of an eye as described herein.
  • Figure 8 sets forth exemplary sets (A and B) of first (left) and second (right) images captured of a retina of an eye as described herein.
  • Figure 9 sets forth an exemplary reference image of a retina of an eye as described herein.
  • Figure 10 sets forth an example of aligning a raw camera image obtained as described herein.
  • Figure 1 1 sets forth an example of 'mapping' or 'stitching' a raw camera image as described herein.
  • Figure 12 sets forth an example of aligning multiple raw camera images with a reference image as described herein.
  • Figure 13 sets forth a flow diagram of an automated procedure for processing images as described herein.
  • Figure 14 sets forth a flow diagram depicting detail of steps involved in comparing and processing images using a reference according to the procedure set forth in Figure 12.
  • Devices as described herein are for use with ophthalmic instruments, including slit lamps and variations thereof.
  • a slit lamp instrument is the proprietary ophthalmic laser system described in International application PCT/AU2002/000475, incorporated herein in full by reference, which is shown in Figure 1 .
  • This system (labelled 1 in PCT/AU2002/000475 and Figure 1 reproduced therefrom) comprises: delivery module 2; console module 3; viewing microscope 4; support arm 5; slit lamp tower 6; a patient support 7; control knobs 8-12; lever 13; and joystick 14.
  • Device 100 for imaging an eye is shown.
  • Device 100 can be fitted to any suitable ophthalmic instrument as will be described further herein, including slit lamps and variations thereof, such as the ophthalmic laser system shown in Figure 1 .
  • Device 100 comprises first camera 1 10 and second camera 120 in the form of digital cameras; and switch 130.
  • Switch 130 is operably connected to first camera 1 10 and second camera 120 by respective wired connections 131 .
  • connections 131 may alternatively be wireless connections, as hereinbelow described.
  • Device 100 also includes trigger 132, which operably connects first camera 1 10 and second camera 120, and facilitates synchronisation of the capture of respective images by the cameras.
  • trigger 132 is in the form of a wired connection, however a wireless trigger may also be used.
  • first camera 1 10 and second camera 120 are positioned to image eye 101 . More particularly, first camera 1 10 and second camera 120 are positioned to receive light as shown schematically with dashed lines labelled L-C1 and L-C2, respectively, which originates from a light source (not shown) and is reflected from eye 101 as shown schematically by a dashed line labelled L-E.
  • light L-E from eye 101 passes or travels through or via a first optical path including one or more lenses (not shown), and exits said optical path as light L-C1 .
  • Light L-C1 then enters first camera 1 10 facilitating capture of a first image by first camera 1 10.
  • light L-E from eye 101 passes or travels through or via a second optical path including one or more lenses (not shown), and exits said optical path as light L-C2.
  • Light L-C2 then enters second camera 120 facilitating capture of a second image by second camera 120.
  • Switch 130 can be actuated to activate and/or inactivate first camera 1 10 and second camera 120. More particularly, switch 130 can be actuated to simultaneously activate both first camera 1 10 and second camera 120, which simultaneous actuation is facilitated also by trigger 132. It will be appreciated that said function of switch 130 and trigger 132 allows for simultaneous capture of corresponding first and second images of eye 101 produced from light having travelled from eye 101 through different optical paths.
  • Device 200 for imaging an eye is shown.
  • Device 200 can be fitted to any suitable ophthalmic instrument as described further herein, including slit lamps and variations thereof, such as the ophthalmic laser system depicted in Figure 1 .
  • slit lamps and variations thereof such as the ophthalmic laser system depicted in Figure 1 .
  • device 200 comprises first camera 210 and second camera 220 in the form of digital cameras; and switch 230.
  • Switch 230 is operably connected to first camera 210 and second camera 220 by respective wired connections 231 . It will be appreciated that connections 231 may alternatively be wireless connections.
  • device 200 further includes trigger 232, which operably connects first camera 210 and second camera 220, and facilitates synchronisation of the capture of respective images by the cameras.
  • trigger 232 is in the form of a wired connection, however a wireless trigger may also be used.
  • Device 200 additionally includes: first light source 245; second light source 255; first lens pair for focal and magnification adjustment 261/262; second lens pair that for focal and magnification adjustment 271/272; first filter 265; and second filter 275.
  • First light source 245 and second light source 255 are sources of respective wavelengths or wavelength ranges of light.
  • Typical wavelength ranges of first light source and second light source are: 390-700 nanometers (visible light), including about 400nm, 450nm, 500nm, 550nm, 600nm, and 650nm; 400-500nm (blue light; e.g. for imaging hemoglobin absorption); 500-550nm (green light, e.g. for exciting auto florescence); 600-700nm (red light, e.g. for distinguishing between oxygenated and non-oxygenated hemoglobin; 700-900nm (near infrared, NIR, e.g. for non- visible imaging).
  • first lens pair 261/262 is adapted, typically using an apochromatic lens, to optimize correction across the spectrum of light produced by first light source 245 and minimize aberration in the periphery, and to provide suitable focal depth for imaging of eye 101 by camera 210.
  • second lens pair 271/272 is adapted, typically using an apochromatic lens, to optimize correction across the spectrum of light produced by second light source 255 and minimize aberration in the periphery, and to provide suitable focal depth for imaging of eye 101 by camera 220.
  • light L-S1 of a first wavelength or wavelength range produced by first light source 245 is reflected from eye 101 as light L-E1 .
  • Light L-S2 of a second wavelength or wavelength range produced by second light source 255 is reflected from eye 101 as light L-E2.
  • Light L-C1 then enters first camera 210 facilitating capture of a first image by first camera 210.
  • first lens pair 261/262 adjusts focal depth and magnification for capture of the first image; and first filter 265 filters the reflected light for capture of the first image, such that light L-C1 is suitably focused, magnified, and filtered for capture by camera 210.
  • light reflected from eye 101 including light L-E2, and typically also light L-E1 , passes through or by a second optical path, including second lens pair 271/272; and second filter 275, and exits said optical path as light L-C2.
  • Light L-C2 then enters first camera 220 facilitating capture of a second image by second camera 220.
  • second lens pair 271/272 adjusts focal depth and magnification for capture of the second image; and second filter 275 filters the reflected light for capture of the second image, such that light L-C2 is suitably focused, magnified, and filtered for capture by camera 220.
  • the first wavelength or wavelength range of light produced by first light source 245, and the second wavelength or wavelength range of light produced by second light source 255 may be the same or different. Typically, the first wavelength or wavelength range and the second wavelength or wavelength range are different.
  • Focal plane adjustment of the first lens pair 261/262 and second lens pair 271/272 may be the same or different. Typically, focal plane adjustment by first lens pair and second lens pair is independent, such that focal plane is different for the first image captured by first camera 210 and the second image captured by second camera 220.
  • Magnification adjustment by first magnification lens 262 and second magnification lens 272 may be the same or different. Typically, magnification adjustment by first magnification lens 262 and second magnification lens 272 is different, such that magnification is different for the first image captured by first camera 210 and the second image captured by second camera 220.
  • Filter 265 and filter 275 may filter the same or different wavelengths or wavelength ranges of light. Typically, filter 265 and filter 275 filter different wavelengths or wavelength ranges of light, such that the wavelength or wavelength range is different for the first image captured by first camera 210 and the second image captured by second camera 220.
  • filter 265 allows transmission of all, substantially all, or most of light of a wavelength or wavelength range corresponding to light L-S1 produced by first light source 245.
  • filter 265 prevents or constrains transmission of all, substantially all, or most of light of a wavelength or wavelength range corresponding to light L-S2 produced by second light source 255.
  • filter 275 allows transmission of all, substantially all, or most of light of a wavelength or wavelength range corresponding to light L-S2 produced by second light source 255.
  • filter 275 prevents or constrains transmission of all, substantially all, or most of light of a wavelength or wavelength range corresponding to light L-S1 produced by first light source 245.
  • filters 265 and 275 allows capture of the first image by first camera 210 and the second image by second camera 220 using respective different wavelengths of light.
  • switch 230 can be actuated to activate and/or inactivate first camera 210 and/or second camera 220.
  • switch 230 can be actuated to simultaneously activate both first camera 210 and second camera 220, which simultaneous actuation is facilitated also by trigger 232. It will be appreciated that said function of switch 230 and trigger 232 allows for simultaneous capture of first and second images of eye 101 produced from light having travelled from eye 101 through the first and second different optical paths.
  • system 20 of the invention comprising an embodiment of device 100 in operable connection with an ophthalmic instrument in the form of slit lamp instrument 50 is schematically depicted. Eye 101 of a subject 102 is positioned for imaging using system 20.
  • Slit lamp instrument 50 of system 20 is an ophthalmic laser system as depicted in Figure 1 .
  • slit lamp instrument 50 comprises slit lamp 51 ; stereomicroscope 52; subject support 53; base 54; and platform 55.
  • Slit lamp 51 and microscope 52 are adjacent to base 54.
  • Subject support 53 and base 54 are adjacent to platform 55.
  • Microscope 52 comprises delivery head 520; first eyepiece 5201 ; and second eyepiece 5202.
  • Subject support 53 comprises headrest 530.
  • first camera 1 10 The embodiment of device 100 as depicted in Figure 3 comprises first camera 1 10; second camera 120; switch 130; connections 131 (not shown); and trigger 132 (not shown), as for embodiment of device 100 as depicted in Figure 1 .
  • first camera 1 10 and second camera 120 are ultra-fast high resolution single PCB cameras with local focal optics.
  • This embodiment of device 100 further comprises first beam splitter 160; and second beam splitter 170.
  • First camera 1 10; first beam splitter 160; second camera 120; and second beam splitter 170 are located within delivery head 520 of slit lamp instrument 50.
  • First beam splitter 160 is operably connected with first camera 1 10 and first eyepiece 5201 ; and second beam splitter 170 is operably connected with second camera 120 and second eyepiece 5202.
  • this embodiment of device 100 comprises processor 140; and storage component 150.
  • Processor 140 is connected to first camera 1 10; second camera 120; and switch 130.
  • Storage component 150 is connected to processor 140. Connections between first camera 1 10, and second camera 120; switch 130; processor 140; and storage component 150 of device 100 are present but not shown in Figure 4. However, these may be wired connections, or wireless connections, as desired. Suitable wireless connections, can include Bluetooth, infrared, or Near Field Communication (NFC) connections, although without limitation thereto.
  • NFC Near Field Communication
  • Switch 130; processor 140; and storage component 150 are located within housing 1000.
  • Housing 1000 is typically located underneath respective eyepieces 5201 and 5202, on platform 55.
  • first camera 1 10 and second camera 120 are connected to processor 140 within housing 1000 by respective high speed universal serial bus (USB) connections.
  • USB universal serial bus
  • processor 140 is in the form of a high powered single board computer
  • storage component 150 is in the form of solid state storage.
  • System 20 further comprises ocular lens 300, which can facilitate magnification of the posterior pole of eye 101 , expanding the field of view of the retina.
  • Ocular lens 200 may be any suitable ocular lens such as the Area CentralisTM manufactured by Volk, or the Mainster FocalTM manufactured by Ocular.
  • slit lamp 51 of system 50 directs light (light not shown) onto eye 101 .
  • slit lamp 51 of slit lamp instrument 50 can be adjusted to illuminate a desired portion, part, or component of eye 101 .
  • the illumination of slit lamp 51 can be adjusted to be directed on the retina of eye 101 .
  • Ocular lens 300 and stereomicroscope 52 can be used in conjunction to focus an image of a desired portion of eye 101 illuminated using slit lamp 51 , such as the posterior pole of the retina, for viewing by a user through first eyepiece 5201 and second eyepiece 5202.
  • First beam splitter 160 splits light within the first optical path, and delivers respective beams (a) to first camera 1 10 facilitating capture of the first image; and (b) to first eyepiece 5201 for viewing by a user of stereomicroscope 52.
  • Second beam splitter 170 splits light within the second optical path, and delivers respective beams (a) to second camera 120 facilitating capture of the second image; and (b) to second eyepiece 5202 for viewing by a user of stereomicroscope 52.
  • switch 130 can be actuated to simultaneously activate both first camera 1 10 and second camera 120, via trigger 132, as hereinabove described.
  • Processor 140 processes data such as data received from switch 130 regarding actuation of switch 130; and/or image data received from first camera 1 10 and second camera 120.
  • Storage component 150 stores data received from processor 140, e.g. image data.
  • device 200 can be fitted to ophthalmic instruments, such as a slit lamp instrument, or a modification thereof, to form a system similar as described above in relation to system 50.
  • ophthalmic instruments such as a slit lamp instrument, or a modification thereof
  • device 200 comprises first light source 245; second light source 255; first lens pair 261/262; second lens pair 271/272; first filter 265; and second filter 275.
  • embodiments of device 200 suitable for fitting to an ophthalmic instrument such as a slit lamp instrument, or a modification thereof may further comprise processor 240 (corresponding to processor 140 of device 100); storage component 250 (corresponding to storage component 150 of device 100); first beam splitter 260 (corresponding to first beam splitter 160 of device 100); and/or second beam splitter 270 (corresponding to second beam splitter 170 of device 100).
  • processor 240 corresponding to processor 140 of device 100
  • storage component 250 corresponding to storage component 150 of device 100
  • first beam splitter 260 corresponding to first beam splitter 160 of device 100
  • second beam splitter 270 corresponding to second beam splitter 170 of device 100.
  • Figure 5 schematically depicts system 30, comprising device 200 operatively connected to ophthalmic instrument 60. Eye 101 of a subject 102 is positioned for imaging using system 30.
  • Ophthalmic instrument 60 of system 30 comprises stereomicroscope 62; subject support 63; base 64; and platform 65.
  • Microscope 62 is adjacent to base 64.
  • Subject support 63 and base 64 are adjacent to platform 65.
  • Microscope 62 comprises delivery head 620; first eyepiece 6201 ; and second eyepiece 6202.
  • Subject support 63 comprises headrest 630.
  • the embodiment of device 200 in Figure 5 comprises first camera 210 and second camera 220 in the form of digital cameras; switch 230; processor 240; storage component 250; first beam splitter 260; second beam splitter 270; first light source 245; and second light source 255; first beam splitter 260; and second beam splitter 270.
  • This embodiment of device 200 further comprises first lens pair 261/262; second lens pair 271 /272; first filter 265; and second filter 275, as described above with reference to Figure 3. These components are not shown in Figure 5 but are typically located within delivery head 620 of ophthalmic instrument 60.
  • First light source 245 and second light source 255 of device 200 are located adjacent to base 64 of ophthalmic instrument 60.
  • First camera 210; first beam splitter 260; second camera 220; and second beam splitter 270 of device 200 of system 30 are located within delivery head 620 of ophthalmic instrument 60.
  • First beam splitter 260 is operably connected with first camera 210 and first eyepiece 6201 ; and second beam splitter 270 is operably connected with second camera 220 and second eyepiece 6202.
  • Switch 230; processor 240; and storage component 250 are located within housing 2000 of system 30. Housing 2000 is typically located underneath respective eyepieces 6201 and 6202, on platform 65. As depicted in Figure 5, processor 240 is in the form of a high powered single board computer; and storage component 250 is in the form of solid state storage.
  • First camera 210; second camera 220; switch 230; and storage component 250 are operably connected to processor 240.
  • First light source 245; second light source 255; first beam splitter 260; second beam splitter 270; first lens pair 261/262; second lens pair 271/272; first filter 265; and/or second filter 275 may also be operably connected to processor 240.
  • Connections processor 240 and other components of device 200 are not shown in Figure 5, but may be wired connections, or wireless connections, as desired. Suitable wireless connections, can include Bluetooth, infrared, or Near Field Communication (NFC) connections, although without limitation thereto.
  • NFC Near Field Communication
  • Device 200 and/or system 60 may further comprise one or more dichroic mirrors (not shown); and/or one or more safety filters (not shown).
  • dichroic mirrors and/or safety filters are used where first light source 245 or second light source 255 produces light that is undesirable for viewing by a user of system 60.
  • dichroic mirrors and/or safety filters are located within delivery head 620.
  • first light source 245 or second light source 255 may be viewed by a user of system 60.
  • a dichroic mirror may be used to direct infrared light to first camera 210 or second camera 220, and prevent or constrain infrared light from entering eyepiece 6201 or eyepiece 6202.
  • light produced by first light source 245 or second light source 255 can be prevented or constrained from entering (or exiting) eyepiece 6201 or eyepiece 6202 by placing a suitable safety filter adjacent, near to, in front of, or behind, the eyepiece.
  • system 30 may further comprise a handheld ocular lens similar to that described in relation to system 20, although this is not shown in Figure 5.
  • ophthalmic instrument 60 of system 30 are similar to slit lamp instrument 50 of system 20, as described with reference to Figure 5, ophthalmic instrument 60 does not comprise a slit lamp. Instead, light for visualisation of eye 101 is provided by light sources 245 and 255 of device 200. However, for clarity, in the context of system 30, designation of light sources 245 and 255 as of device 200 is not limiting. For example, one or both of light sources 245 and 255 may instead be considered components of ophthalmic instrument 60.
  • light sources 245 and 255 of device 200 of system 60 direct light (not shown) of respective wavelengths or wavelength ranges onto eye 101 .
  • Light sources 245 and/or 255 are adapted such that the light sources can be adjusted to illuminate a desired portion, part, or component of eye 101 .
  • the illumination of light sources 245 and/or 255 can be adjusted to be directed on the retina of eye 101 .
  • First beam splitter 260 splits light within the first optical path, and delivers respective beams (a) through first lens pair 261/262 (not shown); and first filter 265 (not shown) to first camera 210, facilitating capture of the first image; and (b) to first eyepiece 6201 for viewing by a user of stereomicroscope 62.
  • Second beam splitter 270 splits light within the second optical path, and delivers respective beams (a) through second lens pair 271/272 (not shown); and second filter 275 (not shown) to second camera 220 facilitating capture of the second image; and (b) to second eyepiece 6202 for viewing by a user of stereomicroscope 62.
  • switch 230 can be actuated to simultaneously activate both first camera 210 and second camera 220, via trigger 232 (not shown), as hereinabove described.
  • Processor 240 processes data received from other components of device 200, such as switch 230 regarding actuation of switch 230; and/or processes image data received from first camera 210 and second camera 220.
  • Storage component 250 stores data received from processor 240, e.g. image data.
  • systems and/or devices of the invention can enable capture of a first image and a second image of eye 101 using light that has passed through different optical paths of a stereomicroscope.
  • This capture of a first image and a second image of eye 101 can be particularly advantageous in the context of imaging of an eye visualised using a slit lamp instrument or modification thereof and an ocular lens, as it can eliminate or reduce problems of visual artefacts associated with use of the ocular lens.
  • use of an ocular lens may produce reflections, refractions, or other artefacts, that can obscure or otherwise interfere with the visualisation of an eye using a slit lamp instrument.
  • the same artefact associated with the use of an ocular lens will not be present in respective images obtained through each of the eyepieces.
  • a second image of eye 101 simultaneously captured using a second camera as described herein should not present with the same visual artefact.
  • the capture of light that has passed through different optical paths of a stereomicroscope using systems and/or devices of the invention can additionally or alternatively be particularly advantageous for capturing a focused image of eye 101.
  • focusing on eye 101 is performed using a stereomicroscope as described herein by a user with ocular dominance
  • typically the image captured based on light having passed through one of the optical paths is in focus
  • the image captured based on light having passed through the other of the optical paths may be relatively out of focus or unfocused.
  • at least one of the first image and the second image captured using a system and/or device of the invention is suitably in focus or focused.
  • a suitable image for viewing and/or other downstream application can be selected from, or produced using, the first image and the second image of eye 101.
  • the suitable image may be substantially free of visual artefacts, or substantially free of a particular undesirable visual artefact. Additionally or alternatively, the image may be suitably focused.
  • Figure 6 sets forth capture of an exemplary first image and second image of a retina of an eye using a system of the invention.
  • a laser beam is being directed onto the retina, to guide or aim laser retinal therapy.
  • An optical artefact in the form of a reflection from an ocular lens is visible in the first image, but absent in the second image.
  • the laser beam is visible in the second image due to the absence of the optical artefact, but not in the first image due to the presence of the optical artefact.
  • the second image could be selected as suitably artefact free for viewing or other downstream application e.g. to plan or assess retinal therapy.
  • Figure 7 sets forth capture of another exemplary first image and second image of a retina of an eye using a system of the invention.
  • a laser beam is being directed onto the retina, to guide or aim laser retinal therapy.
  • the first image is out of focus
  • the second image is in focus, due to focusing of the stereomicroscope of the slit lamp instrument of the system by a user with ocular dominance.
  • the second image could be selected as suitably focused for viewing, or other downstream application e.g. to plan or assess retinal therapy.
  • Figures 8(A) and 8(B) set forth further sets of first and second images. As for Figures 6 and 7, the images are of a retina of an eye, and a laser beam is being directed onto the retina. In both Figure 8(A) and Figure 8(B), the second image could be selected as suitable focused.
  • a relatively more suitable image can be selected from the first image and the second image captured using a system of the invention by manual selection and/or automatic selection.
  • Manual selection of a suitable image will typically involve visualisation of the respective images by a user of the system, such as an ophthalmologist, to identify a relatively more suitably image.
  • Automated selection will typically involve using computer software to identify the preferred image.
  • a suitable image may be produced using one or more first images and one or more second images captured using systems of the invention, by combining portions of the first image(s) and the second image(s). For example, a portion of a first image that is substantially artefact free can be combined with a portion of a second image that is substantially artefact free, to produce a single substantially artefact free image. Similarly, a portion of a first image that is adequately focused can be combined with a portion of a second image that is adequately focused, to produce a single adequately focused image.
  • respective different portions of the first image and second image may be focused and unfocussed, e.g., if the ocular lens 300 is not placed directly perpendicular to a light source and/or laser beam.
  • combining portions of the first image and the second image will involve automated processing.
  • This automated processing may involve comparison of the one or more first images and one or more second images to a reference image, as hereinbefore described.
  • An example of comparing the multiple images obtained using a system of the invention to a reference image using appropriate software, to facilitate production of a single image by combining portions of a first image and a second image, is set forth in Figure 12.
  • systems of the invention may have the capacity, e.g. via a processor and/or storage component, in conjunction with suitable software, to perform automated processing as herein described.
  • Automated processing may alternatively be conducted using appropriate computing equipment separate from systems of the invention, by transfer of data obtained using systems of the invention to said equipment. The processing may preferably be performed in real time but post-processing may also be appropriate in some circumstances.
  • a typical procedure for initiating an image formed by one or more first and/or second images obtained using systems of the invention, and subsequent comparison of further images (e.g. during treatment of an eye, such as retinal therapy) to the initialised image is set forth in Figure 13.
  • a user slowly views all parts of, for example, the retina and the process builds a full image of the retina of the eye of a patient by combining multiple separate images.
  • the full size image is compared to the reference image.
  • each new image is stitched to the full size image produced in the initial set up steps. It has been found that it is less processor intensive to stitch new information (from each image captured during treatment) to a corrected image of the patient's eye than to compare each image to a reference image. This is because comparison to the reference image requires rotating, cropping, scaling and filtering (as shown in Figure 14 and explained below) whereas using a corrected patient image does not require these steps, hence requiring less processing. Comparison to a reference image can be done periodically as required, most likely at the beginning and end of a treatment session
  • a suitable source of reference images are obtainable using a Scanning Laser Ophthalmoscopy (SLO) such as the MAIA (Macular Integrity Assessment) device available from CenterVue Inc. of Fremont California.
  • SLO Scanning Laser Ophthalmoscopy
  • Figure 14 provides detail of exemplary processing steps which may be used to register an image from the camera system to a second image, from the same camera system, or another imaging system such as an SLO.
  • the image is pre-processed for feature enhancement and processing performance optimisation.
  • a Frangi vesselness filter is then applied, to emphasise the blood vessel structures in the image and suppress noise followed by feature descriptors for key points in the image are extracted, which are compared against feature descriptors from the second image. When matching features are found, the locations of these feature pairs are processed to calculate the geometric transform between the two images.
  • This transform information can be used to either overlay one image onto the other image (producing a larger composite image), or to allow the location of a significant feature which is visible in one image (such as a laser spot or anatomical abnormality) to be determined on the other image which does not show that feature.
  • Systems and devices as described herein are adapted for use in retinal therapy as exemplified the figures.
  • the systems and devices can be advantageous for use in identifying suitable position of the retina for retinal rejuvenation therapy, although without limitation thereto.
  • the system and device can be advantageous for identifying a position within the retina wherein retinal therapy has previously been conducted.
  • visualisation of an eye 101 using systems and/or devices of the invention may be useful or advantageous in the context of diagnosing, treating, or preventing various other ophthalmic conditions.
  • these conditions may include cataract; conjunctivitis; corneal injury such as corneal ulcer or corneal swelling; Fuchs' dystrophy; keratoconus; macular degeneration; retinal detachment; retinal vessel occlusion; retinitis pigmentosa; Sjogren's syndrome; Toxoplasmosis; uveitis; and Wilson's disease.
  • a guide or reference tool or component for therapy such as an aiming beam (e.g. laser beam) will typically be captured on file and its location recorded using systems and/or devices of the invention.
  • an aiming beam e.g. laser beam
  • This can provide information regarding the location of prior treatment, and can advantageously serve to guide selection of further therapy. For example, it may be desirable to perform further therapy in the same or a different portion or location of the eye as compared to a portion or location that has previously been treated.
  • systems and/or devices as described herein that comprise a first light source and a second light source can have specific advantages.
  • such systems can be used to capture a first image using a first wavelength or wavelength range of light; and a second wavelength or wavelength range of light, simultaneously.
  • the captured images can then be combined similar as hereinabove described including for analytical or diagnostic application, and/or used individually for separate applications.
  • images can be simultaneously captured using a first light source that is visible light, to provide an accurate representation of what a user sees; and a second light source that is infrared, to allow for greater contrast for identifying key diagnostic features.
  • a second light source that is a red light source could be used to provide greater contrast for identifying oxygenated hemoglobin.
  • any suitable combination of light sources can be chosen for a given application.
  • systems and/or devices as described herein that comprise lenses for focal and/or magnification adjustment can have particular advantages.
  • this arrangement can be used to capture images with different focus, such that features in different layers of the eye can be simultaneously imaged. Such images may be combined (doubling focal depth), or used independently. It will be appreciated that similar considerations apply in relation magnification.
  • the terms 'comprises', 'comprising', 'includes', 'including', or similar terms are intended to mean a non-exclusive inclusion, such that a method, system or apparatus that comprises a list of elements does not include those elements solely, but may well include other elements not listed.

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Abstract

L'invention concerne un procédé d'imagerie d'un œil visualisé à l'aide d'un instrument ophtalmique. Le procédé comprend les étapes consistant à éclairer un œil à l'aide d'une ou plusieurs sources lumineuses ; à capturer une première image de l'œil éclairé à l'aide d'une première caméra ; à capturer une deuxième image de l'œil éclairé visualisé à l'aide d'une deuxième caméra ; et à générer une image de l'œil à l'aide de la première image et de la deuxième image. L'invention concerne également des dispositifs et des systèmes associés.
PCT/AU2018/000178 2017-09-19 2018-09-19 Imagerie ophtalmique à double caméra WO2019056042A1 (fr)

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AU2017903807A AU2017903807A0 (en) 2017-09-19 Dual camera slit lamp imaging
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WO2022244582A1 (fr) * 2021-05-19 2022-11-24 株式会社トプコン Microscope ophtalmique

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WO2006000072A1 (fr) * 2004-06-29 2006-01-05 Jorge Mitre Systeme et procede de capture, de stockage et d'affichage d'images stereoscopiques
US20090190093A1 (en) * 2007-12-21 2009-07-30 Cesare Tanassi Dual scheimpflug system for three-dimensional analysis of an eye
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WO2022244582A1 (fr) * 2021-05-19 2022-11-24 株式会社トプコン Microscope ophtalmique

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