JP2014079378A - Corneal endothelial cell photographing apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it possible to analyze an image of corneal endothelial cells with a simple manual operation.SOLUTION: A corneal endothelial cell photographing apparatus comprises an illumination optical system for emitting illumination light toward the cornea of a subject eye and a light-receiving optical system having a photodetector for receiving the reflected light from the cornea containing endothelial cells, and acquires a photographed image in which the endothelial cells of the cornea are taken. The corneal endothelial cell photographing apparatus further includes: instruction acceptance means for accepting a selection instruction from an examiner with respect to at least one of the endothelial cells in the photographed image displayed on a display screen of display means; display control means for superpose-displaying a reference pattern formed in a size corresponding to the endothelial cells on the display screen at a display position corresponding to the endothelial cells selected by the instruction acceptance means; and cell analysis means which acquires the result of an analysis of the endothelial cells of the subject eye on the basis of the display size of the reference pattern, and outputs the acquired analysis result.

Description

  The present invention relates to a corneal endothelial cell imaging apparatus that images corneal endothelial cells of a subject's eye.

  A corneal endothelial cell imaging device that irradiates illumination light toward the cornea of a subject's eye and receives reflected light from endothelial cells of the cornea to capture an endothelial cell image is known (see Patent Document 1).

  This apparatus analyzes the acquired endothelial cell image and outputs analysis results such as the number and density of endothelial cells. With normal eyes, the cells can be clearly photographed and analyzed with high accuracy.

JP 2011-245184 A

  By the way, when an eye that is hard to observe corneal endothelium such as a diseased eye is measured, the number of cells for one image may be very small. The number of cells of the corneal endothelium in automatic analysis is required to be at least 100, but it is not uncommon for the number of detected eyes to be 50 or less in diseased eyes. In such cases, manual analysis is required because automatic analysis cannot be detected. Conventional manual analysis methods include “grid method”, “vertex input method”, “center input method” and the like.

  However, in the conventional method, it takes time and effort to input information on the corneal endothelial cell image necessary for analysis.

  In view of the above problems, an object of the present invention is to provide a corneal endothelial cell imaging apparatus capable of analyzing a corneal endothelial cell image by a simple manual operation.

  In order to solve the above problems, the present invention is characterized by having the following configuration.

(1) An illumination optical system that irradiates illumination light toward the cornea of an eye to be examined, and a light-receiving optical system that includes a photodetector that receives reflected light from the cornea including endothelial cells. A corneal endothelial cell imaging device for acquiring a captured image including the endothelial cells,
An instruction receiving means for receiving a selection instruction from an examiner for at least one of the endothelial cells on the captured image displayed on the display screen of the display means;
Display control means for superimposing and displaying a reference pattern formed in a size corresponding to the endothelial cells on the display screen at a display position corresponding to the endothelial cells selected by the instruction receiving means;
Cell analysis means for obtaining an analysis result related to the endothelial cell of the eye to be examined based on the display size of the reference pattern, and outputting the obtained analysis result;
It is characterized by providing.
(2) The display control means previously displays a plurality of reference patterns having different display sizes,
The instruction receiving means receives a selection instruction for selecting one reference pattern from a plurality of reference patterns displayed in advance,
The corneal endothelial cell imaging device according to (1), wherein the display control means displays a reference pattern having the same size as the selected reference pattern on the captured image.
(3) The corneal endothelial cell imaging apparatus according to (2), wherein the display control means displays in advance a plurality of reference patterns having different display sizes outside the display area of the captured image on the display screen.
(4) The instruction receiving unit receives coordinate position information on the captured image based on a touch position on the touch panel on which the captured image is displayed.
The corneal endothelial cell imaging apparatus according to any one of (1) to (3), wherein the display control means displays a reference pattern at a display position corresponding to the coordinate position information.
(5) The instruction receiving means further receives a change instruction from an examiner that changes at least one of the position, size, and shape of the reference pattern,
The corneal endothelial cell imaging device according to any one of (1) to (4), wherein the display control unit controls display of the reference pattern in accordance with a selection instruction from the instruction receiving unit.
(6) The display control means can superimpose and display a plurality of reference patterns in accordance with a plurality of endothelial cells displayed at different positions on the display screen,
The corneal endothelial cell imaging apparatus according to any one of (1) to (5), wherein the analysis unit obtains an integrated analysis result obtained by integrating analysis results regarding each endothelial cell based on each display size of the plurality of reference patterns.
(7) The corneal endothelial cell imaging device according to any one of (1) to (6), wherein the display control unit displays a frame-like pattern for surrounding the periphery of the endothelial cells on the display screen as a reference pattern.
(8) A corneal endothelial cell analysis program that is executed in a corneal endothelial cell analysis apparatus that analyzes the endothelial cells using a photographed image including endothelial cells of a subject's eye cornea,
By being executed by the processor of the corneal endothelial cell analyzer,
An instruction receiving step for receiving a selection instruction from an examiner for at least one endothelial cell on the captured image displayed on the display screen of the display means;
A display control step of superimposing and displaying a reference pattern formed in a size corresponding to the endothelial cell on the display screen at a display position corresponding to the endothelial cell selected in the instruction receiving step;
A cell analysis step for obtaining an analysis result related to the endothelial cell of the eye to be examined based on the display size of the reference pattern, and outputting the obtained analysis result;
Is executed by the corneal endothelial cell analyzing apparatus.

  According to the present invention, an analysis result can be easily output in a short time by a slight manual operation.

  An embodiment for carrying out an apparatus according to the present invention will be described with reference to the drawings. 1 to 13 are diagrams according to examples of the present embodiment.

<Overview>
The corneal endothelial cell imaging device according to the present embodiment has a function of acquiring a captured image including endothelial cells of the eye cornea to be examined. The apparatus can include, for example, an endothelium imaging system having an illumination optical system 10 and a light receiving optical system 30. The illumination optical system 10 irradiates illumination light toward the cornea of the eye to be examined, and the light receiving optical system 30 includes a photodetector that receives reflected light from the cornea including corneal endothelial cells.

  The instruction receiving unit (for example, the control unit 90) has a function of receiving a selection instruction from the examiner. The instruction receiving unit can receive an operation signal from a user interface such as a touch panel, a mouse, or a keyboard.

  The display unit (for example, the display monitor 95) has a function of displaying a captured image including endothelial cells. The display unit may be a monitor mounted on an apparatus main body provided with an endothelium imaging system, or may be a display monitor externally attached to the apparatus main body. An endothelium image photographed by the endothelium photographing means is displayed on the display screen of the display means. The endothelial image includes endothelial cells.

  The display control unit (for example, the control unit 90) has a function of controlling display on the display unit. The display control unit has a function of outputting a captured image to the display unit.

  The cell analysis unit (for example, the control unit 90) has a function of analyzing endothelial cells included in the captured image.

<Manual analysis using reference patterns>
The operation of each component when performing manual analysis using a reference pattern will be described. The instruction receiving unit receives, for example, a selection instruction from the examiner for at least one endothelial cell that is visible on the captured image displayed on the display screen of the display unit.

  The display control unit superimposes a reference pattern (for example, reference pattern Q11, reference pattern Q, etc.) having a size corresponding to the endothelial cell on the display screen at a display position corresponding to the endothelial cell selected via the instruction receiving unit. This is displayed (see FIGS. 6 and 8 to 13).

  The cell analysis unit acquires an analysis result regarding the endothelial cells superimposed on the reference pattern based on the display size of the reference pattern, and outputs the acquired analysis result.

  Thereby, since the examiner can easily collate the size of the reference pattern with at least one endothelial cell selected on the display screen, it is possible to easily analyze the endothelial cell by manual operation.

  When acquiring the analysis result, the cell analysis unit may calculate an analysis value (for example, at least one of the density, area, and size of the endothelial cells) based on the display size of the reference pattern, for example. The relationship between the display size and the analysis value is set in advance, and the analysis value is calculated by an arithmetic expression, a calculation table, or the like.

<Reference pattern>
The reference pattern may be a frame-like pattern for surrounding the periphery of the endothelial cell on the display screen. Thereby, since the endothelial cell on the display screen is surrounded by the frame-shaped pattern, the examiner can easily collate the size of the reference pattern with the endothelial cell.

  Examples of the frame-like pattern include polygons (preferably hexagons (because they are close to the shape of endothelial cells)), circles, and the like. The frame-like pattern is expressed by, for example, an arbitrary line type, for example, a solid line, a dotted line, or a one-dot chain line. In addition, the inside of the frame may be colored (preferably having a transmittance that allows an endothelial image to be seen), or may be hatched.

  Of course, the present invention is not limited to the frame-shaped pattern, and certain effects can be obtained with other patterns. For example, a pattern in which hatching without a frame is formed or a pattern in which a colored region without a frame is formed may be used.

  For example, the instruction receiving unit may receive a selection instruction from an examiner that changes at least one of the position, size, and shape of the reference pattern, and the display control unit selects from the examiner received by the instruction receiving unit. The display of the reference pattern is controlled according to the instruction (see FIGS. 8 to 10). Thereby, since a reference pattern can be changed by the selection instruction | indication from an examiner, a reference pattern can be easily changed into the pattern corresponding to the cell on a display screen.

  The display control unit may superimpose and display a plurality of reference patterns according to a plurality of endothelial cells displayed at different positions on the display screen, and the cell analysis unit may display each display size of the plurality of reference patterns. Based on the above, an integrated analysis result obtained by integrating the analysis results regarding each endothelial cell may be obtained (see FIG. 12). The integrated analysis result includes, for example, at least one of the maximum value, the minimum value, the average value, the standard deviation, and the coefficient of variation obtained by comparing and calculating the size of the reference pattern Q regarding each endothelial cell and the analysis result. Thereby, since a plurality of endothelial cells can be selected, an integrated analysis result of the analysis results regarding each endothelial cell can be obtained, and the reliability of the analysis result can be increased to obtain a more accurate result.

<Pre-displayed reference pattern>
The reference pattern displayed in advance is displayed together with, for example, a photographed image, and the examiner uses the reference pattern as an index for evaluating the endothelial cells of the eye to be examined.

  For example, the display control unit may previously display a plurality of reference patterns having different display sizes (see reference patterns P1 to P4 in FIG. 6). The instruction receiving unit receives a selection instruction for selecting one reference pattern from among a plurality of reference patterns displayed in advance. The display control unit may superimpose and display a reference pattern having the same size as the selected reference pattern on the captured image. Thus, the examiner can easily select a reference pattern that matches the size of the endothelial cell of the eye to be examined based on the reference pattern that is displayed in advance, so that analysis by manual operation can be performed more smoothly.

  For example, the display control unit may display in advance a plurality of reference patterns having different display sizes outside the display area of the captured image on the display screen. Thereby, the reference pattern superimposed on the captured image for analysis can be easily distinguished from the reference pattern displayed in advance.

<User interface>
For example, the instruction receiving unit may receive coordinate position information on the captured image based on a touch position on the touch panel on which the captured image is displayed, and the display control unit refers to a display position corresponding to the coordinate position information. A pattern may be displayed. A touch instruction simplifies selection instructions for an arbitrary endothelial cell, and a reference pattern can be easily displayed on the selected cell image.

  In this case, the display control unit is not limited to the touch panel, and the display control unit superimposes the cursor on the captured image displayed on the display unit, and shoots based on the coordinate position of the cursor that is moved according to the operation signal from the user interface. Coordinate position information on the image may be received.

<Example>
Examples of the apparatus according to this embodiment will be described below with reference to the drawings. FIG. 1 is an external side configuration diagram of a corneal endothelial cell imaging apparatus according to the present embodiment. In the following description, the X direction is described as the left-right direction, the Y direction as the up-down direction, and the Z direction as the front-back direction.

  The device 100 is a so-called stationary device, and is a base 1, a face support unit 2 attached to the base 1, and a movable base provided so as to be movable on the base 1 by a sliding mechanism not shown. 3 and a photographing unit (device main body) 4 that is provided so as to be movable with respect to the movable table 3 and accommodates a photographing system and an optical system described later.

  The imaging unit 4 is moved in the left-right direction (X direction), the up-down direction (Y direction), and the front-rear direction (Z direction) with respect to the eye E by an XYZ driving unit 6 provided on the moving table 3. The movable table 3 is moved in the XZ direction on the base 1 by operating the joystick 5. Further, when the examiner rotates the rotary knob 5 a, the photographing unit 4 is moved in the Y direction by the Y drive of the XYZ drive unit 6. A start switch 5 b is provided on the top of the joystick 5. The display monitor 95 is provided on the examiner side of the imaging unit 4. In this embodiment, the photographing unit 4 is moved relative to the eye E by a sliding mechanism (not shown) or the XYZ driving unit 6.

  In addition, as a structure which moves the imaging | photography part 4, the structure which moves the imaging | photography part 4 with respect to a right-and-left eye by the drive of the motor of the drive part 6 without providing a mechanical sliding mechanism may be sufficient. Moreover, the structure which has a touch panel as a manual operation member like the joystick 5 may be sufficient as this apparatus.

  FIG. 2 is a schematic configuration diagram illustrating an example of an optical arrangement and a control system configuration when the optical system housed in the photographing unit 4 is viewed from above. FIG. 3 is a view of the first projection optical system and the second projection optical system as viewed from the subject side. The overall configuration of the optical system includes an illumination optical system 10, an imaging optical system (light receiving optical system) 30, a front projection optical system 50, first projection optical systems 60a and 60b, and second projection optical systems 65a to 65d (see FIG. 3). And an internal fixation optical system 70 (70a to 70g), an external fixation optical system 75 (75a to 75f), an anterior ocular segment observation optical system 80, and a Z alignment detection optical system 85.

  The illumination optical system 10 irradiates illumination light from the illumination light source 12 obliquely toward the cornea Ec. The illumination optical system 10 includes an illumination light source (eg, visible LED, flash lamp) 12 that emits visible light for endothelium imaging, a condensing lens 14, a slit plate 16, a dichroic mirror 18 that reflects and transmits infrared light, and light projection. A lens 20. The light emitted from the illumination light source 12 illuminates the slit plate 16 via the condenser lens 14. Then, the slit light that has passed through the slit plate 16 is converged by the light projecting lens 20 via the dichroic mirror 18 and irradiated onto the cornea. Here, the slit plate 16 and the cornea Ec are disposed at a substantially conjugate position with respect to the objective lens 20.

  The imaging optical system 30 obtains an endothelial cell image by receiving reflected light from the cornea Ec containing endothelial cells with an imaging element. The imaging optical system 30 is symmetrical with the illumination optical system 10 with respect to the optical axis L1, and includes an objective lens 32, a visible light reflecting / infrared transmitting dichroic mirror 34, a mask 35, a first imaging lens 36, and a total reflection mirror 38. The second imaging lens 42, a first two-dimensional imaging device dedicated for acquiring an endothelial cell image (for example, a two-dimensional CCD image sensor (Charge coupled device image sensor), a two-dimensional CMOS (Complementary Metal Oxide Semiconductor Image). Sensor), etc.) 44. The mask 35 is disposed at a position substantially conjugate with the cornea Ec with respect to the objective lens 32. The first imaging lens 36 and the second imaging lens 42 form an imaging optical system that forms an endothelial image on the image sensor 44. The imaging element 44 is disposed at a position substantially conjugate with the cornea Ec with respect to the lens system of the imaging optical system 30.

  The cornea-reflected light from the illumination optical system 10 is directed in the direction of the optical axis L3 (oblique direction), converged by the objective lens 32, reflected by the dichroic mirror 34, temporarily imaged by the mask 35, and an endothelial cell image is obtained. Light that becomes noise during acquisition is blocked. Then, the light that has passed through the mask 35 is imaged on the two-dimensional imaging device 44 via the first imaging lens 36, the total reflection mirror 38, and the second imaging lens 42. Thereby, a high-magnification corneal endothelial cell image is acquired. The output of the image sensor 44 is connected to the control unit 90, and the acquired cell image is stored in the memory 92. The cell image is displayed on the monitor 95.

  The front projection optical system 50 projects the alignment index from the front toward the cornea Ec. The front projection optical system 50 includes an infrared light source 51, a light projection lens 53, and a half mirror 55, and projects infrared light for XY alignment detection onto the cornea Ec from the direction of the observation optical axis L1. Infrared light emitted from the light source 51 is converted into a parallel light beam by the light projecting lens 53, then reflected by the half mirror 55, and projected onto the center of the cornea Ec to form an index i10 (see FIG. 4). ).

  The first projection optical systems 60a and 60b project an alignment index at infinity toward the cornea Ec from an oblique direction. The first projection optical systems 60a and 60b are disposed so as to be inclined at a predetermined angle with respect to the optical axis L1. The first projection optical systems 60a and 60b have infrared light sources 61a and 61b and collimator lenses 63a and 63b, respectively, are arranged symmetrically with respect to the optical axis L1, and are infinite with respect to the eye E. An index is projected (see FIG. 2). The first projection optical systems 60a and 60b are disposed on substantially the same meridian as the horizontal direction passing through the optical axis L1 (see FIG. 3).

  The lights emitted from the light sources 61a and 61b are collimated by the collimator lenses 63a and 63b, respectively, and then projected onto the cornea Ec to form the indices i20 and i30 (see FIG. 4).

  The second projection optical systems 65a to 65d project alignment indexes at a finite distance toward the cornea Ec from a plurality of oblique directions. The second projection optical systems 65a to 65d are arranged to be inclined with respect to the optical axis L1. The second projection optical systems 65a to 65d have infrared light sources 66a to 66d, are arranged symmetrically with respect to the optical axis L1, and project a finite index onto the eye E. The second projection optical systems 65a and 65b are disposed above the optical axis L1 and are disposed at the same height with respect to the Y direction. The second projection optical systems 65c and 65d are disposed below the optical axis L1 and are disposed at the same height with respect to the Y direction. The second projection optical systems 65a and 65b and the second projection optical systems 65c and 65d are arranged in a vertically symmetrical relationship with the optical axis L1 in between.

  Here, the light from the light sources 66a and 66b is irradiated obliquely upward toward the upper part of the cornea Ec, and indexes i40 and i50 which are virtual images of the light sources 66a and 66b are formed. In addition, light from the light sources 66c and 66d is irradiated obliquely downward toward the lower portion of the cornea Ec, and indexes i60 and i70 that are virtual images of the light sources 66c and 66d are formed (see FIG. 4).

  According to the index projection optical system as described above, the index i10 is formed at the corneal apex of the eye E (see FIG. 4). In addition, the indices i20 and i30 by the first projection optical systems 60a and 60b are formed symmetrically with respect to the index i10 at the same horizontal position as the index i10. Further, the indices i40 and i50 by the second projection optical systems 65a and 65b are formed symmetrically with respect to the index i10 above the index i10. The indices i60 and i70 by the second projection optical systems 65c and 65d are formed symmetrically with respect to the index i10 below the index i10.

  The internal fixation optical systems 70a to 70i project a fixation target from the inside to the eye E. The internal fixation optical systems 70a to 70i include visible light sources (fixation lamps) 71a to 71i, a light projection lens 73, and a dichroic mirror 74 for visible reflection and infrared transmission. Visible light emitted from the light source 71 is converted into a parallel light beam by the light projection lens 73, reflected by the dichroic mirror 74, and projected onto the fundus of the eye E. An external fixation optical system is disposed in the vicinity of the first projection optical systems 60a and 60b and the second projection optical systems 65a to 65d.

  The internal fixation optical systems 70a to 70i have a plurality of fixation targets arranged at different positions with respect to the direction orthogonal to the optical axis L4, and guide the fixation direction of the eye E in each direction. The internal fixation optical systems 70 a to 70 i are provided inside the photographing unit 4. For example, the visible light source 71a is disposed in the vicinity of the optical axis L4, and is used to obtain an endothelial image of the central part of the cornea by guiding the eye E in the front direction. The plurality of visible light sources 71b to 71i are arranged on the same circumference with the optical axis L4 as the center, and are arranged at predetermined angles as viewed from the subject. In FIG. 2, 45 degrees are arranged at each position of 0 degree, 45 degrees, 90 degrees, 135 degrees, 180 degrees, 225 degrees, 270 degrees, and 315 degrees. The visible light sources 71b to 71i are used to obtain an endothelium image in the vicinity of the central portion of the cornea by guiding the visual line direction of the eye E to the peripheral direction.

  The external fixation optical systems 75a to 75f project fixation targets from the outside. The external fixation optical systems 75 a to 75 f have a plurality of fixation targets arranged at different positions with respect to the XY directions, and cause the fixation direction of the eye to be examined to be swung more than the internal fixation optical system 70. The external fixation optical systems 75a to 75f are provided outside the photographing unit 3 and on the eye E side. For example, the external fixation optical systems 75a to 75f have visible light sources (fixation lamps) 76a to 76f, and are 2 o'clock and 4 o'clock as viewed from the subject on the same circumference around the optical axis L1. It is arranged at each of the hour, 6 o'clock, 8 o'clock, 10 and 12 o'clock positions. The visible light sources 76a to 76f are used to obtain an endothelial image in the peripheral part of the cornea by guiding the visual line direction of the eye E to the peripheral direction. In this case, an outer endothelial cell image is acquired further than the images acquired by the visible light sources 71b to 71g.

  For example, when photographing the lower cornea, the position of the fixation lamp (fixation target) is set upward, and fixation of the eye E is guided upward. When photographing the upper cornea, the position of the fixation lamp (fixation target) is set downward, and fixation of the eye E is guided downward.

  Returning to FIG. The anterior segment observation optical system 80 observes the anterior segment image from the front. The anterior ocular segment observation optical system 80 has an objective lens 82 and a two-dimensional image sensor 84 for acquiring an anterior ocular segment front image, and has a second image sensor 84 different from the first image sensor 44. Then, the anterior segment image and the alignment index are captured by the second image sensor 84. As the two-dimensional image sensor 84, for example, a two-dimensional CCD image sensor or a two-dimensional CMOS is used.

  The anterior segment illuminated by an anterior segment illumination light source (not shown) is imaged by the two-dimensional imaging device 84 via the dichroic mirror 74, the half mirror 55, and the objective lens 82. Similarly, the corneal reflection images by the front projection optical system 50, the first projection optical systems 60a and 60b, and the second projection optical systems 65a to 65d are received by the two-dimensional imaging device 84.

  The output of the image sensor 84 is connected to the control unit 90, and the anterior segment image captured by the image sensor 84 is displayed on the monitor 95 as shown in FIG. Note that the reticle LT displayed electronically on the monitor 95 indicates a reference for XY alignment. Note that the observation optical system 80 also serves as a detection optical system for detecting the alignment state of the imaging unit 4 with respect to the eye E.

  The Z alignment detection optical system 85 detects the alignment state of the imaging unit 4 with respect to the eye E in the Z direction. The Z alignment detection optical system 85 includes a light projecting optical system 85a that projects a detection light beam from an oblique direction toward the cornea Ec, and a light receiving optical system 85b that receives a corneal reflected light beam by the light projecting optical system 85a. . The optical axis L2 of the light projecting optical system 85a and the optical axis L3 of the light receiving optical system 85b are arranged at positions symmetrical with respect to the observation optical axis L1.

  The light projecting optical system 85a includes, for example, an illumination light source 86 that emits infrared light, a condensing lens 87, a pinhole plate 88, and a lens 20. Here, the pinhole plate 88 and the cornea Ec are disposed at a substantially conjugate position with respect to the lens 20. The light receiving optical system 85 b includes, for example, a lens 32 and a one-dimensional light receiving element (line sensor) 89. Here, the one-dimensional light receiving element 89 and the cornea Ec are disposed at a substantially conjugate position with respect to the lens 32.

  The infrared light emitted from the light source 86 illuminates the pinhole plate 88 through the condenser lens 87. Then, the light that has passed through the opening of the pinhole plate 88 is projected onto the cornea Ec through the lens 20. The corneal reflection light is received by the light receiving element 89 via the lens 32 and the dichroic mirror 34.

  The output of the light receiving element 89 is connected to the control unit 90 and used for Z alignment detection with respect to the eye E. Here, the light receiving position of the alignment light flux received on the light receiving element 89 is changed depending on the positional relationship between the imaging unit 4 and the eye E in the Z direction. For example, the control unit 90 detects the position of the corneal reflected light in the detection signal from the light receiving element 89 and detects the alignment state in the Z direction. The alignment detection using the light receiving element 89 is used for precise alignment with the eye E.

  The control unit 90 controls the entire apparatus. The control unit 90 includes a rotary knob 5a, a start switch 5b, an XYZ driving unit 6, two-dimensional imaging devices 44 and 84, light sources, a memory 92 as a storage device, a monitor 95, and an operation unit (operation input unit) 96. Is connected. The monitor 95 of this embodiment is a touch panel that can be input by an examiner, and also serves as at least a part of the operation input unit 96.

  Note that the apparatus of the present embodiment has a first imaging mode (each position imaging mode) in which the examiner sets a fixation position each time an endothelial image is captured, and imaging at a plurality of preset fixation positions. The second shooting mode (hereinafter referred to as the continuous shooting mode) in which the above is continuously performed can be switched. The mode switching is performed, for example, by a predetermined mode switching switch or parameter setting. Of course, the apparatus does not necessarily have to be equipped with two modes. It may be an apparatus equipped with only the second shooting mode.

  For example, the control unit 90 controls the display on the monitor 95. In addition, the control unit 90 detects the alignment state of the imaging unit 4 with respect to the eye E in the XYZ directions based on the light reception result of the alignment index. And the control part 90 outputs the signal which instruct | indicates the movement of the imaging | photography part 4 based on the detection result. Further, the control unit 90 detects the alignment state of the photographing unit 4 in the Z direction with respect to the eye E based on the light reception result of the light receiving element 89.

<Display screen during analysis>
The display on the monitor 95 at the time of analysis will be described. The control unit 90 includes a processor (for example, a CPU) that controls various control processes and a storage medium that stores an analysis program. The processor executes processing described below according to the analysis program.

  FIG. 5 is a schematic diagram showing the basic screen configuration of analysis. The basic screen 200 displays a photographed corneal endothelial cell image (endothelium image) 201 of the eye E, a photographed eye information display unit 202, an analysis result display unit 210, a distribution graph display unit 220, various operation buttons, and the like. .

  A corneal endothelium image 201 is displayed on the left side of the basic screen 200. The photographed eye information display unit 202 on the upper right side displays the photographed eye information of the displayed endothelial image 201 (for example, left and right eyes, fixation lamp lighting position, anterior eye image, etc.). Furthermore, the endothelial cell density, average endothelial area, standard deviation of the endothelial area, coefficient of variation of the endothelial area, maximum area, minimum area, and hexagonal cell appearance of the endothelial image 201 displayed on the analysis result display unit 210 on the right side are displayed. The rate and other analysis results are displayed.

  In the distribution graph display unit 220 on the lower right side of the endothelial image 201, distribution states such as square variations and cell area variations are displayed in a histogram.

  Various operation buttons are displayed at the top of the basic screen 200, and a manual analysis button 241 is displayed as one of them. When the manual analysis button 241 is touched, a manual analysis screen 260 (see FIGS. 6 and 8 to 10) is displayed.

  The display position of each display unit is not limited to this embodiment. Further, the displayed analysis result is not limited to the present embodiment.

  FIG. 6 is a schematic diagram showing a manual analysis screen 260. In the manual analysis screen 260, the endothelial image 201 is displayed on the left side, and the reference pattern selection buttons 203a, 203b, 203c, and 203d on which a plurality of reference patterns P1, P2, P3, and P4 of different sizes are displayed are displayed on the upper right part. Is done. The sizes of the reference patterns P1 to P4 displayed on the reference pattern selection buttons 203a to 203d correspond to the cell density displayed in the vicinity. The larger the displayed cell density, the smaller the reference patterns P1 to P4. Conversely, the smaller the cell density, the larger the displayed pattern. This correspondence relationship is an example and can be set as appropriate. For example, the size of the reference patterns P1 to P4 may correspond to the cell area.

  When any position on the endothelial image 201 is touched after touching any one of the reference pattern selection buttons (hereinafter referred to as selection buttons) 203a to 203d, the reference corresponding to the selected selection buttons 203a to 203d is referred to. Pattern Q is displayed at that position. When the reference pattern Q is displayed on the endothelium image 201, one reference pattern Q being selected (during operation) is displayed with light color (emphasis). Thereby, it is possible to recognize which reference pattern Q is effective for selection (operation) in the reference patterns Q displayed on the endothelial image 201. It should be noted that the selection buttons 203a to 203d being selected are preferably displayed in an emphasized manner so that which selection buttons 203a to 203d are selected.

  A pattern deletion button 205 is displayed at the right center of the manual analysis screen 260. By touching the pattern deletion button 205, the reference pattern Q being selected (operating) on the endothelial image 201 can be deleted. .

  A pattern move button 206, a size change button 207, an OK button 208, and a cancel button 209 are displayed on the lower right portion of the manual analysis screen 260. Check boxes 206a and 207a are displayed on the pattern movement button 206 and the size change button 207, respectively, and one of the check boxes 206a and 207a selected from the buttons 206 and 207 is checked.

  When the check box 206 a of the pattern moving button 206 is checked, the reference pattern Q displayed on the endothelial image 201 can be moved by a drag operation and displayed at an arbitrary position on the endothelial image 201. At this time, the size of the reference pattern Q does not change.

  When the check box 207 a of the size change button 207 is checked, the size of the reference pattern Q can be changed by dragging the vicinity of the inner end of the reference pattern displayed on the endothelial image 201. At this time, the reference pattern Q does not move.

  When the OK button 208 is touched, the manual analysis screen 260 is not displayed. At the same time, an analysis result calculated based on the size of the reference pattern Q displayed on the endothelial image 201 is displayed on the analysis result display unit 210 and the distribution graph display unit 220.

  When the cancel button 209 is touched, the manual analysis screen 260 is not displayed. At this time, even if the reference pattern Q is displayed on the endothelial image 201, it is not reflected in the analysis result display unit 210 and the distribution graph display unit 220.

<Operation>
An operation when manually analyzing the photographed endothelial image 201 of the eye E in the apparatus having the above configuration will be described (see FIG. 7). The examiner images alignment adjustment and a corneal endothelial cell image (endothelium image) 201 based on the operation of the joystick 5.

  The control unit 90 displays on the monitor 95 the corneal endothelial cell image 201 of the eye E acquired by the image sensor 44, the photographed eye information, the analysis result display unit 210, and the like. As shown in FIG. 5, the corneal endothelial cell image 201 of the eye E has a small number of cells that can be identified by the examiner, and automatic analysis cannot be performed. Therefore, the analysis result is not displayed on the analysis result display unit 210 and the distribution graph display unit 220.

  Since the automatic analysis result is not displayed on the endothelial image 201, the analysis result display unit 210, or the like, the examiner determines the necessity of manual analysis and touches the manual analysis button 241. Then, a manual analysis screen 260 as shown in FIG. Note that the monitor 95 (touch panel) is described as performing a touch, drag, or other operation using the stylus 270 (see FIG. 8), but is not limited thereto.

  An endothelium image 201 is displayed on the manual analysis screen 260. The examiner identifies one cell C1 from among the endothelial cells that can be recognized in the endothelial image 201. Then, the selection buttons 203a to 203d on which the reference patterns P1 to P4 close to the size of the specified cell C1 are displayed are touched and selected. At this time, the control unit 90 highlights and displays one of the selected selection buttons 203a to 203d. Here, as an example, it is assumed that the selection button 203a has been selected.

  When the examiner touches an arbitrary position on the endothelial image 201 in a state where the selection button 203a is selected, as shown in FIG. 8, the control unit 90 sets the size of the reference pattern P1 at the touched arbitrary position. A reference pattern Q11 corresponding to this is displayed.

  The examiner touches the pattern movement button 206 and checks the check box 206a. If already checked, there is no need to touch. While touching the reference pattern Q11 displayed on the endothelium image 201, the user drags to the location of the specified cell C1. As shown in FIG. 9, the control unit 90 moves and displays the reference pattern Q11 to the location of the identified cell C1 in accordance with the examiner's drag. Thereby, the cell C1 is selected. In this case, even if the reference pattern Q11 is moved and displayed in the vicinity of the cell C1, a certain effect can be satisfied.

  When the size of the cell C1 is different from the reference pattern Q11, the examiner changes the size of the reference pattern Q11 according to the size of the cell C1. Therefore, first, the examiner touches the size change button 207 and checks the check box 207a. Next, the examiner touches a portion of the reference pattern Q11 to be deformed and performs a drag operation to change the size of the reference pattern Q11 to be equal to that of the cell C1. As shown in FIG. 10, the control unit 90 changes the size of the reference pattern Q11 in accordance with the examiner's drag operation and displays it. In this way, the reference pattern Q11 displayed on the endothelial image 201 can be changed to an arbitrary position and size and displayed.

  The examiner substantially matches the size of the cell C1 with the reference pattern Q11 and touches the OK button 208. Then, the manual analysis screen 260 is not displayed, and as shown in FIG. 11, the control unit 90 displays the endothelial cell density, the average endothelial area, and other analysis results calculated based on the size of the reference pattern Q11. It is displayed on the analysis result display unit 210. Further, a distribution chart or the like is displayed on the distribution graph display unit 220. At this time, the mark 242 may be displayed on the endothelial image 201 or the analysis result display unit 210 so that the displayed analysis result is an analysis result by manual analysis. Thereby, it is possible to identify whether the displayed analysis result is based on automatic analysis or manual analysis.

  The arrangement of the reference pattern Q11 may be one, but if more detailed results are desired, the above operation is repeated and analysis is performed based on the sizes of the plurality of reference patterns Q. When displaying a plurality of reference patterns Q, the examiner touches an arbitrary position on the endothelial image 201 in a state where any of the selection buttons 203a to 203d is selected. Then, each time it is touched, the second and subsequent new reference patterns Q can be displayed. For example, the examiner touches and selects the selection button 203c on which the reference pattern P3 close to the size of the second selected cell C2 is displayed. Next, as shown in FIG. 12, the examiner touches an arbitrary position on the endothelial screen 201 to display a new reference pattern Q31. Then, the examiner adjusts the position and size of the reference pattern Q31 so as to match the cell C2 as described above, and touches the OK button.

  When a plurality of reference patterns Q are displayed on the endothelial image 201, the control unit 90 displays the integrated analysis result calculated based on the sizes of the plurality of reference patterns Q on the analysis display unit 210. In addition, a distribution chart or the like is displayed on the distribution graph display unit 220.

  When the reference pattern Q displayed on the endothelial image 201 is to be deleted, first, the examiner touches and selects the reference pattern Q to be deleted. The control unit 90 changes the display of the touched reference pattern Q and displays it with a light color (emphasis). When the examiner touches the delete button 205 in this state, the control unit 90 erases the display of the selected reference pattern Q.

  The method of deleting the reference pattern Q is not limited to this, and for example, a method of deleting the most recently displayed reference pattern Q using the delete button 205 as a “return” button may be used. Further, for example, a method may be adopted in which the deletion mode 205 is touched to enter the deletion mode and the reference pattern Q to be deleted is touched.

  When the analysis is completed, the examiner touches the print button 248 as necessary to print the analysis result.

  With such a configuration, it is possible to easily manually analyze the endothelial image 201 such as a diseased eye that is difficult to see visually and cannot be detected by automatic analysis.

  Note that the reference patterns P1 to P4 and Q may have any shape. For example, a polygonal shape such as a pentagon or a hexagon may be used, or a circular shape may be used.

  In the above description, the reference pattern Q corresponds to one endothelial cell, but may be a pattern corresponding to a plurality of cells. For example, as shown in FIG. 13, a plurality of reference patterns Q may be displayed in series, or the display of the reference pattern Q may be arbitrarily set.

  When a plurality of reference patterns Q are displayed on the endothelial image 201, when calculating an average value as an analysis result, calculation may be performed using an average value of the sizes of the plurality of reference patterns Q. You may average the analysis result each calculated from the magnitude | size of each reference pattern Q.

  In the above description, the pattern movement button 206 and the size change button 207 are provided. However, the present invention is not limited to this. For example, when the reference pattern Q is moved on the endothelium image 201, the reference pattern Q may be moved by dragging while touching the approximate center of the reference pattern Q. When changing the size of the reference pattern Q, the size of the reference pattern Q may be changed by touching and dragging the vicinity of the frame inside the reference pattern Q. Thus, the examiner can omit the operation of touching the pattern movement button 206 and the size change button 207 to switch the operation. However, for small endothelial cells that are difficult to select by distinguishing between the approximate center of the reference pattern Q and the vicinity of the inner frame, the operability is improved by using the embodiment.

  In the above description, when the OK button 208 is pressed, the manual analysis screen is hidden. However, both the basic screen 200 and the manual analysis screen may be always displayed.

  In the basic screen 200, the reference pattern Q may be displayed on the endothelial image 201. Further, reference pattern selection buttons 203 a to 203 d may be displayed on the basic screen 200 and the reference pattern Q may be adjusted on the endothelial image 201 of the basic screen 200. By separating the basic screen 200 and the manual analysis screen 260 as in this embodiment, the manual analysis screen can be widely displayed on the monitor 95, and the operability is improved.

  In the present embodiment, the reference pattern selection buttons 203a to 203d on which the reference patterns P1 to P4 are displayed are described as four. However, the number is not limited to this, and the number of reference pattern selection buttons may be any number.

  In the above description, the reference pattern selection buttons 203a to 203d are selected to determine the size of the reference pattern Q to be displayed on the endothelial image 201. However, the cells displayed on the endothelial image 201 are displayed. The size of the reference pattern Q to be displayed may be determined from the distance between the two points by touching and selecting the vertices of C1 and C2.

  The present invention can also be expressed as follows. (1) An illumination optical system that irradiates illumination light toward the cornea of the eye to be examined, and a light receiving optical system that includes a photodetector that receives reflected light from the cornea including corneal endothelial cells, and the eye to be examined A corneal endothelial cell imaging device that images corneal endothelial cells, a display unit that displays a captured image of the endothelial cell, a display control unit that controls display of the display unit, and a command signal input to the imaging device The display control means, based on a command signal of the operation means, to arrange a reference pattern corresponding to the size of the endothelial cells at an arbitrary position on the captured image, A corneal endothelial cell imaging apparatus, comprising: an analysis unit that acquires an analysis result related to the endothelial cell of the eye to be examined based on a size of the reference pattern.

It is an external appearance side block diagram of the corneal-endothelial-cells imaging device which concerns on this embodiment. It is a schematic block diagram which shows an example of the optical arrangement | positioning when the optical system accommodated in the imaging | photography part is seen from upper direction, and the structure of a control system. It is a figure when the 1st projection optical system and the 2nd projection optical system are seen from the subject side. FIGS. 4A and 4B are diagrams illustrating an example of an anterior ocular segment observation screen when photographing the inner skin of the cornea, FIG. 4A is a display example when there is misalignment, and FIG. It is an example of a display in a state. It is the schematic which shows the basic screen structure of an analysis. It is the schematic which shows a manual analysis screen. It is a flowchart figure which shows the flow of operation | movement. It is the schematic which shows a manual analysis screen when a reference pattern is displayed on an endothelium image. It is the schematic which shows the manual analysis image after moving the reference pattern on an endothelium image. It is the schematic which shows the manual analysis image when the magnitude | size of the reference pattern on an endothelium image is changed. It is the schematic which shows the basic screen on which the analysis result analyzed based on the magnitude | size of the reference pattern on an endothelium image was displayed. It is the schematic which shows the manual analysis screen when a some reference pattern is displayed on an endothelial image. It is the schematic which shows the example from which a reference pattern differs.

4 Shooting unit (device main unit)
6 driving unit 10 illumination optical system 12 illumination light source 30 imaging optical system 44 imaging element 80 anterior ocular segment observation optical system 85 Z alignment detection optical system 85a light projecting optical system 85b light receiving optical system 90 control unit 95 monitor 200 basic screen 201 corneal endothelium Cell image (endothelial image)
203a to 203d Reference pattern selection button 205 Pattern deletion button 206 Pattern movement button 207 Size change button 241 Manual analysis button 260 Manual analysis screen Q Reference pattern

Claims (8)

An illumination optical system that irradiates illumination light toward the cornea of an eye to be examined; and a light receiving optical system that includes a photodetector that receives reflected light from the cornea including endothelial cells, and the endothelial cells of the cornea A corneal endothelial cell imaging device that acquires a captured image including:
An instruction receiving means for receiving a selection instruction from an examiner for at least one of the endothelial cells on the captured image displayed on the display screen of the display means;
Display control means for superimposing and displaying a reference pattern formed in a size corresponding to the endothelial cells on the display screen at a display position corresponding to the endothelial cells selected by the instruction receiving means;
Cell analysis means for obtaining an analysis result related to the endothelial cell of the eye to be examined based on the display size of the reference pattern, and outputting the obtained analysis result;
A corneal endothelial cell imaging device comprising: The display control means previously displays a plurality of reference patterns having different display sizes,
The instruction receiving means receives a selection instruction for selecting one reference pattern from a plurality of reference patterns displayed in advance.
The corneal endothelial cell imaging apparatus according to claim 1, wherein the display control unit displays a reference pattern having the same size as the selected reference pattern on the captured image.   The corneal endothelial cell imaging apparatus according to claim 2, wherein the display control means displays in advance a plurality of reference patterns having different display sizes outside the display area of the captured image on the display screen. The instruction receiving means receives coordinate position information on the captured image based on a touch position on the touch panel on which the captured image is displayed,
The corneal endothelial cell imaging apparatus according to claim 1, wherein the display control unit displays a reference pattern at a display position corresponding to the coordinate position information. The instruction receiving means further receives a change instruction from an examiner who changes at least one of the position, size, and shape of the reference pattern,
The corneal endothelial cell imaging apparatus according to claim 1, wherein the display control unit controls display of the reference pattern in accordance with a selection instruction from the instruction receiving unit. The display control means can superimpose and display a plurality of reference patterns in accordance with a plurality of endothelial cells displayed at different positions on the display screen,
The corneal endothelial cell imaging apparatus according to claim 1, wherein the analysis unit obtains an integrated analysis result obtained by integrating analysis results regarding each endothelial cell based on each display size of the plurality of reference patterns.   The corneal endothelial cell imaging apparatus according to claim 1, wherein the display control unit displays a frame-like pattern for surrounding the periphery of the endothelial cells on the display screen as a reference pattern. A corneal endothelial cell analysis program that is executed in a corneal endothelial cell analysis device that analyzes the endothelial cells using a photographed image including endothelial cells of a subject's eye cornea,
By being executed by the processor of the corneal endothelial cell analyzer,
An instruction receiving step for receiving a selection instruction from an examiner for at least one endothelial cell on the captured image displayed on the display screen of the display means;
A display control step of superimposing and displaying a reference pattern formed in a size corresponding to the endothelial cell on the display screen at a display position corresponding to the endothelial cell selected in the instruction receiving step;
A cell analysis step for obtaining an analysis result on the endothelial cell of the eye to be examined based on the display size of the reference pattern, and outputting the obtained analysis result;
Is executed by the apparatus for analyzing corneal endothelial cells.

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