JP6469387B2 - Fundus analyzer - Google Patents

Description

  The present invention relates to a fundus analysis apparatus that analyzes a fundus image of an eye to be examined.

  The fundus image is an image acquired using a fundus imaging apparatus or the like. Among such fundus images, the fundus front image depicts the state of blood vessels (fundus blood vessels) located in the fundus such as the retina and choroid. Therefore, the fundus front image provides useful information for diagnosing ophthalmic and circulatory diseases and for evaluating the degree of lifestyle-related diseases.

  For example, a doctor refers to an evaluation parameter calculated by performing a predetermined analysis process on the fundus front image, and performs a diagnosis of a disease, an evaluation of the degree of lifestyle-related diseases, and the like. As an example of such an analysis process, the blood vessel region depicted in the fundus front image is specified, the diameter of the arterial region and the diameter of the vein region are obtained from the specified blood vessel region, and the obtained diameter of the arterial region and the vein region are obtained. There is a process of estimating the arteriovenous diameter ratio from the diameter (for example, Patent Document 1 and Patent Document 2).

Japanese Patent Laid-Open No. 10-071125 Special table 2014-504523 gazette

  In recent years, attention has been focused on observing the shape and distribution of blood vessel regions located at the fundus of the retina, choroid, and the like with true values (actual size values) for the purpose of improving the accuracy of disease diagnosis and the like.

  However, in the conventional analysis process for diagnosing a disease or the like, data defined in the Gullstrand model eye model is used as many parameters in the eyeball optical system. Therefore, although the refractive index, corneal curvature, axial length, etc., which are parameters representative of the eyeball optical system, are parameters specific to the eye to be examined, these are treated as constants in the above analysis processing, It had a great influence on the accuracy of the measured values such as the shape and distribution of the obtained blood vessel region. Therefore, even if the blood vessel region can be extracted with high accuracy, the accuracy of the obtained measurement value is not sufficient. This applies not only to the measurement values related to the diameter of the blood vessel but also to other measurement values.

  The problem to be solved by the present invention is made to solve the above-mentioned problems, and it is possible to obtain a highly accurate evaluation parameter useful for diagnosis of a disease, evaluation of the degree of lifestyle-related disease, and the like. An object of the present invention is to provide a fundus analysis apparatus.

In order to solve the above-described problem, the invention according to claim 1 includes an image acquisition unit that acquires a front image of the fundus of the eye to be examined, a measurement value acquisition unit that acquires a measurement value of the optical characteristics of the eye to be examined, Based on the measurement value acquired by the measurement value acquisition unit, a size information generation unit that generates size information for converting the scale of the front image acquired by the image acquisition unit into an actual size, and the front By analyzing the image, the fundus of the fundus is identified, and an analysis unit for obtaining the diameter of the blood vessel based on the size information generated by the size information generation unit , an image representing the diameter of the arterial region, and the vein region A first display control unit that causes a display means to display a blood vessel diameter comparison image including an image representing a diameter, and the analysis unit identifies a nipple region by analyzing the front image; ,Previous An analysis target region specifying unit that specifies an analysis target region based on the papillary region specified by the nipple region specifying unit, and a blood vessel region specifying that specifies a blood vessel region in the analysis target region specified by the analysis target region specifying unit A diameter of the blood vessel region specified by the blood vessel region specifying unit, a diameter of the blood vessel region determined by the blood vessel diameter calculation unit, the diameter of the arterial region and the diameter of the vein region and the blood vessel area classification unit for classifying into a diameter, Ru fundus analyzing apparatus der including.
The invention according to claim 2 is the fundus analysis apparatus according to claim 1 , wherein the blood vessel diameter comparison image includes a first circular image representing a diameter of the arterial region, the first circular image, and having a common center, and, including a second circular image representative of the diameter of the vein region.
The invention according to claim 3 includes an image acquisition unit that acquires a front image of the fundus of the eye to be examined, a measurement value acquisition unit that acquires a measurement value of optical characteristics of the eye to be examined, and the measurement value acquisition unit. By analyzing the front image and a size information generation unit that generates size information for converting the scale of the front image acquired by the image acquisition unit into an actual dimension based on the acquired measurement value An analysis unit for identifying a blood vessel of the fundus and obtaining the diameter of the blood vessel based on the size information generated by the size information generation unit; and a first diameter distribution display image representing a change in the diameter of the artery region in the axial direction And a second display control unit that displays on the display means a second diameter distribution display image representing a change in the diameter of the vein region in the axial direction , and the analysis unit analyzes the front image to analyze the nipple region The A nipple region specifying unit to be determined, an analysis target region specifying unit for specifying an analysis target region based on the nipple region specified by the nipple region specifying unit, and the analysis target region specified by the analysis target region specifying unit A blood vessel region specifying unit for specifying a blood vessel region in the blood vessel, a blood vessel diameter calculating unit for obtaining a diameter of the blood vessel region specified by the blood vessel region specifying unit, and a diameter of the blood vessel region obtained by the blood vessel diameter calculating unit An ophthalmologic apparatus includes a blood vessel region classification unit that classifies into a diameter of an arterial region and a diameter of the vein region .
The invention according to claim 4 is the fundus analysis apparatus according to claim 3 , wherein each of the first diameter distribution display image and the second diameter distribution display image is on a straight line representing an axis thereof. It includes a line connecting one end side of a plurality of orthogonal line segments each having a length corresponding to a diameter at a plurality of positions, and a line connecting the other end side.
The invention described in Claim 5 is the fundus analyzing apparatus according to any one of claims 1 to 4, comprising a user interface for correcting the nipple area manually, the analysis The target area specifying unit specifies the analysis target area based on the papillary area corrected using the user interface.
The invention according to claim 6 is the fundus analysis apparatus according to any one of claims 1 to 5 , wherein the measurement value is a corneal curvature, a refractive index, and an eye axis of the eye to be examined. The size information generation unit generates the size information by performing magnification correction based on the measurement value, including at least one of the lengths.
The invention described in Claim 7 is the fundus analyzing apparatus according to any one of claims 1 to 6, comprising a storage unit for storing in advance standard value of eye's optical characteristics, the size The information generation unit generates the size information based on the measurement value and the standard value.
The invention according to claim 8 is the fundus analysis apparatus according to any one of claims 1 to 7 , wherein the image acquisition unit captures the front image by photographing the fundus. Includes the acquisition unit.
The invention according to claim 9 is the fundus analysis apparatus according to any one of claims 1 to 8 , wherein the measurement value acquisition unit optically measures the eye to be examined. The measurement part which acquires the said measured value by is included.

  According to the fundus analysis apparatus according to the present invention, it is possible to obtain an evaluation parameter useful for diagnosis of a disease, evaluation of the degree of lifestyle-related disease, and the like with high accuracy.

It is a schematic diagram showing an example of composition of a fundus analysis system concerning an embodiment. It is a schematic diagram showing an example of composition of a fundus analysis system concerning an embodiment. It is a schematic diagram showing an example of composition of a fundus analysis system concerning an embodiment. It is a schematic diagram showing an example of composition of a fundus analysis device concerning an embodiment. It is a schematic diagram showing an example of composition of a fundus analysis device concerning an embodiment. It is a flowchart showing an example of operation | movement of the fundus analyzer which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment. It is operation | movement explanatory drawing of the fundus analysis apparatus which concerns on embodiment.

  An example of an embodiment of a fundus analysis apparatus according to the present invention will be described in detail with reference to the drawings. The fundus analysis apparatus according to the present invention obtains the size related to the blood vessel region depicted in the fundus front image with high accuracy with high accuracy based on the optical characteristics peculiar to the eye to be examined. In the following embodiments, the fundus front image may be a C cross-sectional image in an arbitrary depth direction of the fundus portion as well as an image representing the fundus surface. In addition, it is possible to use suitably the description content of the literature described in this specification as the content of the following embodiment.

[Fundus analysis system]
FIG. 1 is a block diagram showing a configuration example of a fundus analysis system to which the fundus analysis apparatus according to this embodiment is applied. A fundus analysis system 10 according to this embodiment includes a fundus imaging apparatus 20, an ophthalmologic measurement apparatus 30, a database 40, and a fundus analysis apparatus 100. The fundus imaging apparatus 20, the ophthalmologic measurement apparatus 30, the fundus analysis apparatus 100, and the database 40 are communicably connected via a connection line 50 such as a LAN (Local Area Network) cable or a dedicated line. Note that the communication mode of these devices is not limited to wired communication, and may be wireless communication using radio waves or the like. Further, the fundus analysis apparatus 100 may be provided so as to be able to communicate with the fundus imaging apparatus 20, the ophthalmologic measurement apparatus 30, and the database 40 provided at a remote place via a network. Further, the fundus analysis apparatus 100 may realize the function by cloud computing via a network.

  The fundus imaging apparatus 20 is an imaging apparatus used in the ophthalmic field. The fundus imaging apparatus 20 is configured to acquire a fundus front image of the eye to be examined and output the image data to the outside of the apparatus. Such a fundus imaging apparatus 20 includes an imaging unit 21. The imaging unit 21 includes an imaging element such as a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor, and images the fundus of the subject's eye by using the imaging element. Get an image.

  The fundus photographing apparatus 20 includes a fundus camera, a slit lamp microscope (slit lamp), a surgical microscope, a scanning laser ophthalmoscope (hereinafter referred to as SLO), and an optical coherence tomography (hereinafter referred to as OCT). OCT apparatus using the above method. Arbitrary well-known things can be used as a fundus camera, a slit lamp microscope device, a surgical microscope, a scanning laser ophthalmoscope, and an OCT device. An example of a fundus camera is described in Japanese Patent Application Laid-Open No. 2006-26097. As a slit lamp microscope apparatus, for example, there is one described in JP-A-2005-224298. An example of a surgical microscope is described in Japanese Patent Application Laid-Open No. 2009-297073. Examples of SLO include those described in Japanese Patent Application Laid-Open No. 2012-143284. An example of the OCT apparatus is described in Japanese Patent Application Laid-Open No. 2008-246158. According to such an OCT apparatus, it is possible to obtain a C-scan image, a projection image, a shadowgram, or the like as a fundus front image.

  The fundus imaging apparatus 20 is an example of an “image acquisition unit” according to this embodiment. Note that the fundus analysis system 10 may be configured to include one or more fundus imaging apparatuses 20. Further, at least a part of the functions of the fundus imaging apparatus 20 may be included in the fundus analysis apparatus 100. For example, the fundus analysis apparatus 100 may be configured to include the function of the fundus imaging apparatus 20.

  The ophthalmologic measurement device 30 is a device that measures the optical characteristics of the eye to be examined. The ophthalmologic measurement apparatus 30 can measure the optical characteristics of the eye to be examined corresponding to model eye data used for analysis processing (described later) on the fundus front image. The ophthalmologic measurement apparatus 30 is configured to acquire a measurement value of optical characteristics of the eye to be examined and output the measurement data to the outside of the apparatus. Such an ophthalmologic measurement apparatus 30 includes a measurement unit 31. The measurement part 31 acquires the measured value of the optical characteristic of the eyeball by optically measuring the eye to be examined.

  Examples of the ophthalmologic measurement apparatus 30 include a refractive index measurement apparatus, a corneal shape measurement apparatus, and an axial length measurement apparatus. Any known device can be used as the refractive index measuring device, the corneal shape measuring device, and the axial length measuring device. Examples of the refractive index measuring device include a refractometer. An example of a refractive index measuring apparatus is described in Japanese Patent Application Laid-Open No. 2002-253506. According to such a refractive index measuring apparatus, it is possible to acquire the refractive index as a measured value of the optical characteristics of the eye to be examined. Examples of the corneal shape measuring device include a keratometer and a corneal topographer. An example of a corneal shape measuring apparatus is described in Japanese Patent Application Laid-Open No. 2000-308617. According to such a corneal shape measuring apparatus, it is possible to acquire a corneal curvature radius or the like as a measured value of the optical characteristics of the eye to be examined. The corneal shape measuring device may be an anterior ocular segment OCT device. Examples of the axial length measuring device include an ultrasonic measuring device. An example of the axial length measuring device is described in Japanese Patent Laid-Open No. 05-277075. According to such an axial length measuring apparatus, it is possible to acquire the axial length or the like as a measured value of the optical characteristics of the eye to be examined. An OCT apparatus may be used as the axial length measuring apparatus.

  The ophthalmologic measurement apparatus 30 is an example of a “measurement value acquisition unit” according to this embodiment. The fundus analysis system 10 may be configured to include one or more ophthalmologic measurement devices 30. Further, at least a part of the functions of the ophthalmologic measurement apparatus 30 may be included in the fundus analysis apparatus 100. For example, the fundus analysis apparatus 100 may be configured to include the function of the ophthalmologic measurement apparatus 30.

  The database 40 is a filing system that manages image data representing an image in the ophthalmic field, measurement values of optical characteristics of the eye to be examined, and the like. For example, a large-capacity storage device that stores image data and measurement values and the large-capacity storage device And database software for managing measured image data and measurement values. The database 40 receives the image data of the fundus front image of the eye to be examined acquired by the fundus imaging apparatus 20 via the connection line 50, and stores the received image data in association with the patient having the eye to be examined. The database 40 receives the measurement value of the optical characteristic of the eye to be examined acquired by the ophthalmic measurement apparatus 30 via the connection line 50, and stores the received measurement value in association with the patient having the eye to be examined.

  2 and 3 show an outline of the configuration of the database 40 according to this embodiment. The database 40 stores model eye data 41 and eye data 42 to be examined. The model eye data 41 is data (standard value of the eye optical characteristics) obtained by modeling the optical characteristic parameters of the eyeball optical system. Examples of model eyes include a Gullstrand model eye and a Helmholz model eye. Examples of model eye parameters include the curvature of the cornea, the refractive index of the entire eyeball or lens, the axial length, and the like.

  The subject eye data 42 is information in which image data and measurement values acquired for the subject eye of the patient are associated with a patient ID for identifying the patient. The image data is image data of a fundus front image acquired by the fundus imaging apparatus 20. Further, the image data may be image data that can be a basis of the fundus front image. As this image data, there is volume data acquired by OCT measurement or the like. Further, when the fundus imaging apparatus 20 is, for example, fundus 3D angiography, the image data may be image data of a three-dimensional contrast image of the fundus blood vessel. The measured value is a measured value of the optical characteristics of the eye to be inspected acquired by the ophthalmic measuring apparatus 30.

  The database 40 is an example of a “storage unit” according to this embodiment. Note that the fundus analysis system 10 may be configured to include one or more databases 40. In addition, at least a part of the functions of the database 40 may be included in the fundus analysis apparatus 100. For example, the fundus analysis apparatus 100 may be configured to include the function of the database 40.

  The database 40 may include a filing system for other uses such as an electronic medical record, in addition to the filing system described above.

  The fundus analysis apparatus 100 obtains an evaluation parameter (for example, the diameter of the blood vessel) indicating the shape and distribution of the blood vessel drawn on the front surface of the fundus based on the measurement value of the optical characteristic of the eye to be examined stored in the database 40. . This makes it possible to evaluate the shape and distribution of blood vessels in the fundus at an actual size that is the same as or close to the true value, and can contribute to improving the accuracy of disease diagnosis and the evaluation of the degree of lifestyle-related diseases. become.

[Ocular fundus analyzer]
FIG. 4 shows a block diagram of a configuration example of the fundus analysis apparatus 100 according to this embodiment. 4 also shows the fundus imaging apparatus 20, the ophthalmologic measurement apparatus 30, and the database 40 of FIG.

  The fundus analysis apparatus 100 includes a control unit 110, a user interface (UI) 120, and an arithmetic processing unit 130.

(Control part)
The control unit 110 governs overall control of the fundus analysis apparatus 100. The control unit 110 includes a main control unit 111 and a storage unit 112.

(Main control unit)
The main control unit 111 controls each unit of the fundus analysis apparatus 100. For example, the main control unit 111 receives a user operation performed on the user interface 120, and specifies the control content corresponding to the content of the operation. The main control unit 111 controls each unit of the fundus analysis apparatus 100 according to the specified control content. The main control unit 111 may control the fundus imaging apparatus 20, the ophthalmologic measurement apparatus 30, or the database 40 according to the control content.

  For example, the main control unit 111 causes the processing result of the arithmetic processing unit 130 to be output to the user interface 120 (display unit 122). The main control unit 111 reads the fundus front image acquired by the fundus imaging apparatus 20, the measured value of the optical characteristics of the eye acquired by the ophthalmologic measurement apparatus 30, or the image based on the image data stored in the database 40 or the eye to be examined. The measured value of the optical characteristic may be output to the user interface 120 (display unit 122).

  For example, the main control unit 111 controls each unit of the arithmetic processing unit 130 and acquires a processing result by the arithmetic processing unit 130. The main control unit 111 reads the fundus front image acquired by the fundus imaging apparatus 20, the measurement value of the optical characteristic of the eye to be acquired acquired by the ophthalmic measurement apparatus 30, and the image data stored in the database 40 and the optical characteristic of the eye to be inspected. Each unit of the arithmetic processing unit 130 is controlled using at least one of the measured values. The main control unit 111 can control each unit of the arithmetic processing unit 130 according to the control content.

  The main control unit 111 can perform the above-described control by reading a program stored in advance in the storage unit 112 and executing a process corresponding to the read program. Further, the main control unit 111 performs processing for writing data into the storage unit 112 and processing for reading data from the storage unit 112. The main control unit 111 is an example of a “first display control unit” according to this embodiment.

(Memory part)
The storage unit 112 stores various data. Examples of data stored in the storage unit 112 include data read from the database 40 such as image data of a fundus front image acquired by the fundus imaging apparatus 20 (image data, measurement of optical characteristics of the eye to be examined). Value), image data in the middle of analysis processing in the arithmetic processing unit 130, analysis processing results, eye information to be examined, and the like. The eye information includes information about the eye such as information about the patient such as patient ID and name. Further, the storage unit 112 stores various programs and data for operating the fundus analysis apparatus 100.

(User interface)
The user interface 120 includes an operation unit 121 and a display unit 122. The operation unit 121 includes the operation device of the fundus analysis apparatus 100. The operation unit 121 may include various buttons and keys provided on the housing of the fundus analysis apparatus 100 or on the outside. The display unit 122 includes the display device of the fundus analysis apparatus 100 described above. Note that the operation unit 121 and the display unit 122 do not have to be configured as individual devices. For example, a device in which a display function and an operation function are integrated, such as a touch panel monitor, can be used. In that case, the operation unit 121 includes the touch panel display and a computer program. The operation content for the operation unit 121 is input to the control unit 110 as an electrical signal. Further, operations and information input may be performed using the graphical user interface (GUI) displayed on the display unit 122 and the operation unit 121.

(Calculation processing part)
The arithmetic processing unit 130 includes a size information generation unit 131 and an analysis unit 140. The size information generation unit 131 obtains size information in the fundus front image acquired by the fundus imaging device 20 based on the measured value of the optical characteristics of the eye to be examined acquired by the ophthalmic measurement device 30. The size information is a reference value for converting the scale of the acquired fundus front image into an actual size. This reference value includes a value (coefficient) for converting the distance in the fundus front image into the distance in the real space. The distance in the fundus front image includes, for example, the size of one pixel (vertical length, horizontal length), pixel spacing (pixel pitch), and the like. The unit of distance in real space is, for example, micrometers. The analysis unit 140 analyzes the fundus front image to identify the fundus blood vessel (corresponding image region) and obtains the diameter of the blood vessel based on the size information generated by the size information generation unit 131. For example, the analysis unit 140 obtains the diameter of the identified fundus blood vessel with the actual size value based on the size information obtained by the size information generation unit. Hereinafter, a blood vessel may be described as a blood vessel region in an image corresponding to the blood vessel.

(Size information generator)
The size information generation unit 131 generates size information using the measured value of the optical characteristic of the eye to be examined. The size information generation unit 131 generates size information using the model eye data and the measurement value acquired by the ophthalmologic measurement apparatus 30. In the size information generation process, among the parameters included in the model eye data, for the parameters that can be measured by the ophthalmologic measurement device 30, the measurement values acquired by the ophthalmologic measurement device 30 are used. That is, the size information generation unit 131 can generate size information based on the measurement value acquired by the ophthalmic measurement apparatus 30 and the model eye data (standard value) stored in the database 40.

  In this embodiment, the measurement value includes at least one of the corneal curvature (radius of curvature), the refractive index (refractive power), and the axial length of the eye to be examined, and the size information generation unit 131 uses the magnification based on the measurement value. It is possible to generate size information by performing correction. In addition, as the measured value of the refractive index, for example, the measured value “S” of the sphericity of the eye to be examined and the equivalent sphericity “S + C / 2” obtained from the measured value “C” of the astigmatism can be used.

  For example, the size information generating unit 131 calculates the magnification of the eye to be examined by the eyeball optical system, and generates size information indicating the size of one pixel in the fundus front image of the eye to be examined from the obtained magnification.

  As a specific example, first, the size information generating unit 131 calculates the magnification of the eye to be examined by the eyeball optical system based on the measured value of the optical characteristics of the eye to be examined. In this embodiment, an imaging magnification that takes into account both the magnification by the eye to be examined and the magnification by the imaging optical system of the imaging unit 21 of the fundus imaging apparatus 20 is obtained. Here, the imaging optical system of the imaging unit 21 has a general configuration in which an objective lens, an imaging aperture, a variable power lens (focusing lens), and a relay lens are arranged on the optical axis in order from the eye to be examined. Shall.

  First, when the refractive index is a measured value at the apex of the cornea (corneal refractive index), the size information generating unit 131 converts the refractive index into a pupil refractive index (pupil refractive index) as necessary. This calculation can be performed, for example, based on the spectacle wearing distance and the distance from the corneal apex to the entrance pupil, as in the conventional case.

  Next, the size information generation unit 131 calculates the imaging position of the fundus front image by the objective lens. This calculation can be performed, for example, by using Newton's formula based on the pupil refraction degree, the focal length of the objective lens, and the distance from the entrance pupil to the front focal point of the objective lens.

  Next, the size information generation unit 131 calculates the photographing magnification by the variable power lens (focusing lens). This calculation can be performed, for example, by solving a quadratic expression representing the relationship between the calculation result of the imaging position by the objective lens, the focal length of the variable power lens, the distance between principal points, and the object image distance with respect to the photographing magnification. .

  Next, the size information generation unit 131 calculates the exit angle from the objective lens. This calculation can be performed based on, for example, the calculation result of the shooting magnification, the distance from the rear principal point of the objective lens to the shooting aperture, and the focal length of the objective lens. At this time, the emission angle is calculated so that the height of the image on the image detection surface becomes a predetermined value. The predetermined value is, for example, −0.1 mm (a negative sign indicates that an image is formed downward from the optical axis).

  Next, the size information generation unit 131 calculates an incident angle to the objective lens such that the height of the image on the stop surface of the photographing aperture becomes the predetermined value. This calculation can be performed based on, for example, the calculation result of the exit angle from the objective lens and the angular magnification of the entrance pupil and the photographing aperture.

  Next, the size information generation unit 131 calculates the radius of curvature of the posterior surface of the cornea of the eye to be examined. This calculation can be performed, for example, based on the measured value of the corneal curvature (curvature of the anterior surface of the cornea) measured by the ophthalmologic measuring apparatus 30 and the ratio of the curvatures of the anterior and posterior surfaces of the cornea. As the curvature ratio, for example, a value of model eye data can be used. For example, when the curvature (curvature radius) of the rear surface of the cornea is measured using an corneal OCT apparatus or the like, this measured value can be used as the curvature radius of the rear surface of the cornea.

  Next, the size information generation unit 131 calculates the distance between the far point and the object (corneal apex). This calculation can be performed based on, for example, the refractive index at the apex of the cornea and the spectacle wearing distance.

  Next, the size information generation unit 131 calculates the distance from the rear surface of the crystalline lens of the eye to be examined to the retinal surface (fundus). This calculation can be performed, for example, by paraxial ray tracing based on a measured value and a calculated value of the curvature (curvature radius) of the cornea. At this time, for example, the value of model eye data can be used as the optical constant of the eyeball.

  Next, the size information generation unit 131 calculates the axial length of the eye E to be examined. This calculation can be performed based on the calculation result of the paraxial ray tracing and the distance from the front surface of the cornea to the rear surface of the crystalline lens. As this distance, for example, the value of model eye data can be used.

  Next, the size information generation unit 131 calculates an error between the calculation result of the axial length and the measurement result of the axial length, and determines whether this error is included in a predetermined allowable range. As this error, for example, the error of the calculation result with respect to the measurement value, that is, the absolute value of the quotient obtained by dividing the difference between the measurement value and the calculation result by the measurement value is obtained. The allowable range of this error is set in advance as a threshold value for determining which value is used as the optical constant of the eyeball optical system of the eye to be examined.

  When the error of the axial length is within the allowable range, for example, the measured value and calculation result of the curvature of the cornea (curvature radius), the measured value of the refractive index, and the calculated result of the axial length are used as the optical constant of the eye to be examined. To do. In addition, as the radius of curvature of the retina surface (fundus), a value that is half of the calculation result of the axial length is adopted. Further, as the distance from the back surface of the lens to the retina (fundus), a value obtained by subtracting the standard value of the distance from the front surface of the cornea to the back surface of the lens (model eye data value) from the calculation result of the axial length.

  On the other hand, when the error of the axial length is not included in the allowable range, for example, the refractive index of the crystalline lens of the eye to be examined is calculated by performing paraxial reverse ray tracing using the measured values of the vertex refractive index and the axial length. . As the optical constant of the eye to be examined, for example, a measurement value and a calculation result of the curvature of the cornea (curvature radius), a measurement value of the refractive index, and a measurement value of the axial length are employed. Further, as the radius of curvature of the retinal surface (fundus), a value that is half of the measured value of the axial length is adopted. Further, as the distance from the posterior surface of the lens to the retina (fundus), a value obtained by subtracting the standard value of the distance from the anterior cornea to the posterior surface of the lens (model eye data value) from the measured value of the axial length.

  When the optical constant of the eye to be examined is determined, the size information generation unit 131 calculates the image height on the retinal surface (fundus). This calculation can be performed by, for example, ray tracing using the determined optical constant and the calculation result of the incident angle to the objective lens.

  Finally, the size information generation unit 131 is based on the calculation result of the image height on the retina surface, the calculation result of the image height on the detection surface, the relay magnification by the relay lens (effect of the imaging optical system, etc.) Calculate the magnification. This magnification takes into consideration the magnification by the eyeball optical system of the eye to be examined and the magnification by the photographing optical system.

  The size information generation unit 131 calculates the vertical and horizontal lengths (unit: micrometers / pixel) of one pixel in the fundus front image from the calculated magnification as size information. For example, the size information generation unit 131 includes table information in which the vertical and horizontal lengths of one pixel are associated in advance with each of a plurality of magnifications, and by referring to the table information, the size information generation unit 131 can calculate the frontal fundus image from the obtained magnification. The lengths of each pixel in the vertical and horizontal directions can be obtained. Note that, instead of the table information regarding a plurality of discrete magnification values, it is also possible to use graph information in which continuous changes in magnification values are associated with changes in the size of one pixel.

(Analysis Department)
The analyzing unit 140 identifies the fundus blood vessel by analyzing the acquired fundus front image, and obtains the diameter of the blood vessel based on the size information generated by the size information generating unit 131. The analysis unit 140 appropriately performs predetermined image processing on the front fundus image to be analyzed before or during the analysis processing so that it is easy to identify a desired blood vessel region in the acquired fundus front image. It is possible.

  The analysis unit 140 includes a nipple region specifying unit 141, an analysis target region specifying unit 142, a blood vessel region specifying unit 143, a blood vessel diameter calculating unit 144, a blood vessel region classifying unit 145, a statistical value calculating unit 146, and a ratio calculation. Part 147.

(Nipple area specific part)
The nipple area specifying unit 141 analyzes the fundus front image to specify an optic nerve area corresponding to the optic nerve head depicted in the fundus front image (hereinafter simply referred to as “nipple area”). For example, the nipple region specifying unit 141 can specify the nipple region and its outline portion by performing a known luminance threshold process and a known edge enhancement process on the fundus front image.

  Further, for example, the nipple region specifying unit 141 can specify a nipple region by using threshold processing relating to luminance with respect to the fundus front image and shape analysis (pattern matching or the like) of the image region. Specifically, the nipple region specifying unit 141 specifies a nipple region by searching for an image region having a higher (or lower) luminance than that of the surrounding area and having a substantially circular or substantially elliptical shape.

  In addition, for example, the nipple region specifying unit 141 performs a smoothing process on the fundus front image, and based on the difference between the smoothed image acquired thereby and the original fundus front image, the contour of the optic nerve head, etc. It is possible to specify the nipple region by extracting a portion (high-frequency component of the original fundus front image) that is relatively clearly depicted in the fundus front image. As the smoothing process, any technique such as a moving average filter process, a Gaussian filter process, various spatial filter processes, and downsampling can be applied.

(Analysis target area identification part)
The analysis target area specifying unit 142 specifies the analysis target area based on the nipple area specified by the nipple area specifying unit 141. The analysis target region is a region for which an evaluation parameter such as a diameter of a blood vessel connected to the optic nerve head is calculated. The analysis target area specifying unit 142 specifies an annular area around the nipple area specified by the nipple area specifying unit 141 as the analysis target area. By specifying a region far from the optic nerve head as an analysis target region in this way, it is easy to specify a blood vessel region corresponding to a blood vessel connected to the optic nerve head, and these blood vessels can be analyzed without leakage. It becomes possible.

  For example, the analysis target area specifying unit 142 specifies the barycentric position of the nipple area specified by the nipple area specifying unit 141. The analysis target area specifying unit 142 specifies an annular area having a predetermined inner diameter and a predetermined outer diameter as the analysis target area with the specified center of gravity as the center. In this embodiment, an annular region having a predetermined fixed inner diameter and a predetermined fixed outer diameter is an analysis target centering on the position of the center of gravity of the nipple region. The inner diameter and the outer diameter are data determined by measuring a plurality of eyes to be examined. When the analysis target region is specified based on the diameter of the nipple region, the analysis target region depends on the nipple region unique to the eye to be examined, and evaluation parameters may not be compared. On the other hand, according to this embodiment, the analysis target region can be specified without depending on the diameter of the nipple region unique to the eye to be examined, and therefore, evaluation parameters can be compared.

  In addition, although the analysis object area | region specific | specification part 142 specifies the gravity center position of a nipple area | region, it is not limited to this. When the outer edge of the nipple region is circular or when the outer edge of the nipple region is approximated by a circle, the center position of the circle may be specified. When the outer edge of the nipple region is elliptical or when the outer edge of the nipple region is approximated to an ellipse, the center position of the ellipse (intersection position between the major axis and the minor axis) may be specified. Further, when the outer edge of the nipple region is neither circular nor elliptical, an arbitrary position of the region near the center of the nipple region may be specified. Further, any position in the nipple region may be set by the user.

(Vessel region specific part)
The blood vessel region specifying unit 143 specifies a blood vessel region in the analysis target region specified by the analysis target region specifying unit 142. For example, the blood vessel region specifying unit 143 specifies a blood vessel region using threshold processing related to luminance with respect to the fundus front image and shape analysis (pattern matching or the like) of the image region. Specifically, the blood vessel region specifying unit 143 specifies a blood vessel region by searching for a linear image region having higher (or lower) luminance than the surrounding area.

  When the analysis target region is an annular region centered on an arbitrary position (for example, the position of the center of gravity) in the nipple region and having a predetermined inner diameter and a predetermined outer diameter, the blood vessel region specifying unit 143 is as described above. Among the regions corresponding to the blood vessels specified in (1), the inner boundary of the annulus (the inner circle having a predetermined inner diameter) intersects the outer boundary of the annulus (the outer circle having a predetermined outer diameter). ) Is identified as a blood vessel region. In addition, a labeling process can be performed on the identified blood vessel region. The identified blood vessel region includes an image region corresponding to one or more blood vessels. In the labeling process, an image region corresponding to each blood vessel is specified, and an identifier (label) is attached to each image region. The process of specifying an image region corresponding to each blood vessel includes a process of classifying the specified blood vessel region into one or more connected regions. This classification process may include, for example, region growing, edge detection, threshold processing, and the like. As described above, the blood vessel region corresponding to each blood vessel existing in the annular region is specified so as to be identifiable. When there is a blood vessel branch in the annular region, two or more blood vessels related to the branch may be handled as a single blood vessel, or each blood vessel related to the branch may be handled individually.

(Vessel diameter calculator)
The blood vessel diameter calculating unit 144 obtains the diameter of the blood vessel region specified by the blood vessel region specifying unit 143. In this embodiment, the diameter of the blood vessel region is the diameter of the region corresponding to the inner diameter of the blood vessel. For example, the blood vessel diameter calculating unit 144 obtains the center line of the blood vessel region specified by the blood vessel region specifying unit 143, and the position where the obtained center line and a line segment orthogonal to the center line intersect the boundary of the blood vessel region. Is calculated as the width of the blood vessel region. The blood vessel diameter calculation unit 144 can obtain the size of the blood vessel region with the actual size value by multiplying the calculated width of the blood vessel region by the size information generated by the size information generation unit 131.

(Vessel region classification part)
The blood vessel region classifying unit 145 classifies the diameter of the blood vessel region obtained by the blood vessel diameter calculating unit 144 into the diameter of the arterial region and the diameter of the venous region. For example, the blood vessel region width and the color information of the blood vessel region are used for classification of the blood vessel region. The width of the blood vessel region is obtained by the blood vessel diameter calculation unit 144. The color information of the blood vessel region is information including the color of each of the arterial region and the vein region acquired in advance. In this case, the blood vessel region classification unit 145 can classify the diameter of the blood vessel region into the diameter of the arterial region and the diameter of the vein region based on the width of the blood vessel region and the color information of the blood vessel region.

  In addition, when the classification of the blood vessel region is possible only with the color information of the blood vessel region, the blood vessel region classification unit 145 converts the diameter of the blood vessel region into the diameter of the arterial region and the diameter of the vein region based on the color information of the blood vessel region. It is possible to classify. Further, for example, the blood vessel region classifying unit 145 classifies the blood vessel region specified by the blood vessel region specifying unit 143 into a vein region and an arterial region, and the blood vessel diameter calculating unit 144 sets the diameter of the arterial region and the diameter of the vein region. Each may be calculated.

(Statistics calculation part)
The statistical value calculation unit 146 obtains a statistical value of the diameter of the blood vessel region based on the diameter of the blood vessel region obtained by the blood vessel diameter calculation unit 144. Statistical values of the diameter of the blood vessel region include an estimated value of the central retinal artery diameter (hereinafter referred to as CRAE), an estimated value of the central retinal vein diameter (hereinafter referred to as CRVE), and the like.

For example, the statistical value calculation unit 146 applies CRAE to a predetermined number or more of arterial regions by repeatedly applying an integrated equation for integrating two arterial regions into one region as shown in equation (1). Calculate as a representative value. In Expression (1), the diameters of the two arterial regions are denoted as W ₁ and W _2, and the diameter of the integrated region is denoted as W ₃ .

For example, the statistical value calculation unit 146 applies CRVE to a predetermined number or more of vein regions by repeatedly applying an integration formula for integrating two vein regions into one region as shown in Equation (2). Calculate as a representative value. In Expression (2), the diameters of the two arterial regions are denoted as W ₁ and W _2, and the diameter of the integrated region is denoted as W ₃ .

  Further, the statistical value calculation unit 146 calculates CRAE as a representative value by repeatedly applying the integrated expression shown in Expression (1) to two adjacent arterial areas with respect to a predetermined number or more of arterial areas. It is possible. Similarly, the statistical value calculation unit 146 calculates CRVE as a representative value by repeatedly applying the integrated expression shown in Expression (2) to two adjacent vein areas for a predetermined number or more of vein areas. Is possible.

(Ratio calculation part)
The ratio calculation unit 147 calculates a ratio based on the diameter of the arterial region and the diameter of the vein region obtained by the statistical value calculation unit 146. The ratio obtained by the ratio calculation unit 147 includes an arteriovenous ratio (hereinafter referred to as AVR). Since the calculation method of AVR is publicly known, description thereof is omitted.

[Hardware configuration example]
FIG. 5 shows a hardware configuration example of the fundus analysis apparatus 100 according to this embodiment. The fundus analysis apparatus 100 according to this embodiment includes, for example, a general-purpose computer. The fundus analysis apparatus 100 includes a processor 200, a RAM (Random Access Memory) 201, a non-volatile storage device 202, a display 203, a keyboard 204, a mouse 205, and a communication interface (I / F) 206.

  The processor 200 is configured by an arbitrary microprocessor such as a CPU (Central Processing Unit) or an MPU (Micro Processing Unit) that executes various arithmetic processes and control processes.

  The RAM 201 is a volatile storage device, and programs and data being executed by the processor 200 are expanded.

  The nonvolatile storage device 202 includes a storage device (external storage device) such as a hard disk drive (Hard Disk Drive) or a ROM (Read Only Memory). The nonvolatile storage device 202 stores a program in advance. The processor 200 executes the processing according to this embodiment by developing the program on the RAM 201. The nonvolatile storage device 202 (particularly, the hard disk drive) may store image data of the fundus front image received from the database 40 and measured values of optical characteristics of the eye to be examined.

  The display 203 includes an arbitrary display device such as an LCD (Liquid Crystal Display) or a CRT (Cathode Ray Tube) display. The display 203 is a device that realizes a function as the display unit 122.

  The keyboard 204 and the mouse 205 are used as input devices for inputting various types of information based on information such as images and screens displayed on the display 203, and as operation devices for instructing execution of a desired operation. Used. A keyboard 204 and a mouse 205 are devices that realize functions as the operation unit 121.

  The communication interface 206 performs data communication with other apparatuses such as the fundus imaging apparatus 20, the ophthalmologic measurement apparatus 30, and the database 40 via a connection line 50 (communication line) such as a LAN. The communication interface 206 includes a network adapter such as a LAN card. In addition, when it is possible to connect to a WAN (Wide Area Network) such as the Internet, a communication device such as a modem is provided in the communication interface 206.

[Operation example]
An operation example of the fundus analysis system 10 according to this embodiment will be described. In the following, after acquiring a fundus front image by the fundus imaging apparatus 20, acquiring a measurement value of the optical characteristics of the eye to be examined by the ophthalmologic measurement apparatus 30, an evaluation parameter obtained by analyzing the fundus front image is displayed on the display unit. A series of operation examples until display on 122 is shown. A case where CRAE, CRVE, and AVR are calculated as evaluation parameters will be described.

FIG. 6 shows a flowchart of an example of the operation of the fundus analysis system 10. When the fundus analysis apparatus 100 includes the functions of the fundus imaging apparatus 20, the ophthalmologic measurement apparatus 30, and the database 40, the flow illustrated in FIG.
7 to 19 are explanatory diagrams of operations of the fundus analysis apparatus 100. FIG. 7 to 19 are diagrams for explaining the operation of the fundus analysis apparatus 100 in the operation example of the fundus analysis system 10 shown in FIG.

(S1)
First, the fundus imaging apparatus 20 receives an instruction from the user, and the imaging unit 21 acquires a fundus front image of the eye to be examined. The fundus imaging apparatus 20 transmits image data of the captured fundus front image to the database 40.

(S2)
Next, when the database 40 receives the image data of the fundus front image from the fundus imaging apparatus 20 via the connection line 50, the database 40 associates the received fundus with the patient ID corresponding to the patient specified in advance by the user. Save the image data of the front image.

(S3)
Next, the ophthalmologic measurement apparatus 30 receives an instruction from the user and measures the optical characteristics of the eye to be examined by the measurement unit 31. In this embodiment, the ophthalmologic measurement apparatus 30 acquires measured values of the corneal curvature, the refractive index, and the axial length of the eye to be examined. The ophthalmologic measurement apparatus 30 transmits the acquired measurement value of the optical characteristic of the eye to be examined to the database 40.

(S4)
Next, when the database 40 receives the measurement value of the optical characteristic of the eye to be examined from the ophthalmologic measurement device 30 via the connection line 50, the database 40 stores the received measurement value in association with the patient ID.

(S5)
Next, in response to the user performing a predetermined operation, the fundus analysis apparatus 100 (main control unit 111) displays, for example, a patient selection screen 1000 illustrated in FIG. The patient selection screen 1000 includes a patient ID input / display unit 1001, a patient name input / display unit 1002, a phonetic input / display unit 1003, a patient list display unit 1004, and an OK button 1005. .

  The patient list display unit 1004 displays a list of patients whose ophthalmologic images such as fundus images have been taken. This list displays information such as patient ID, patient name, sex, date of birth, date of registration (date of registration of the photographed fundus front image in the database), date of last visit, etc. for each patient. Is done.

(S6)
The user performs a predetermined operation on the operation unit 121 to select a desired patient from the patient list displayed on the patient list display unit 1004. When the user clicks the OK button 1005 using the operation unit 121 (such as the mouse 205) and confirms the selection of the patient specified in S6, the main control unit 111 identifies the patient ID of the selected patient. . The main control unit 111 accesses the database 40, reads image data and eye data to be examined associated with the specified patient ID, and develops them in the storage unit 112.

(S7)
Next, the main control unit 111 causes the display unit 122 to display the image selection screen 2000 shown in FIG. The image selection screen 2000 includes a patient information display unit 2001, an image list display unit 2002, and an OK button 2003.

  The patient information display unit 2001 displays patient information (patient ID, patient name, etc.) of the patient selected in S6. The image list display unit 2002 displays a list of fundus front images registered for the patient. In this list, information such as an image shooting date, a procedure (procedure; shooting procedure (type of shot image)), and an image file name are displayed for each image.

(S8)
The user selects a desired image from the list of the fundus front image displayed on the image list display unit 2002 by performing a predetermined operation on the operation unit 121. When the user clicks the OK button 2005 using the operation unit 121 (such as the mouse 205) and confirms the selection of the image specified in S7, the main control unit 111 stores the image data of the selected image in the storage unit. 112, the fundus front image is displayed on the display unit 122. FIG. 9 shows an example of an image display screen 3000 displaying the fundus front image G.

(S9)
Next, the arithmetic processing unit 130 (analyzing unit 140) adjusts the image by performing predetermined image processing on the image selected in S8 so that the identification of the nipple region and the blood vessel region is facilitated. . For example, the arithmetic processing unit 130 divides the color information of the image into red, green, and blue components, and generates an image in which the contrast is enhanced by the color information of two components of green and blue. FIG. 10A shows an example of an enlarged image (before contrast enhancement) of the vicinity of the nipple region in the fundus front image selected in S8. FIG. 10B shows an example of an image after contrast enhancement with respect to the image shown in FIG. 10A. Compared with the nipple region N1 and blood vessel region B1 depicted in the image shown in FIG. 10A, the contrast of the nipple region N1 ′ and blood vessel region B1 ′ depicted in the image shown in FIG. 10B is emphasized. Thereby, compared with the case where the image shown to FIG. 10A is used, specification of a nipple area | region and a blood vessel area | region becomes easy by using the image shown to FIG. 10B.

  Further, for example, the arithmetic processing unit 130 may shift the luminance of the entire image so that the average luminance of the entire image is within a preset threshold for all the components of red, green, and blue. This facilitates the identification of the nipple region and the blood vessel region even in a dark image or a bright image.

(S10)
Next, the nipple area | region identification part 141 specifies a nipple area | region by analyzing the image which performed image adjustments, such as contrast emphasis in S9 as mentioned above. First, the nipple region specifying unit 141 generates an image as shown in FIG. 11A by performing threshold processing relating to the luminance on the image adjusted in S9. In the image shown in FIG. 11A, the nipple region N2 is depicted.

  Next, the nipple area | region identification part 141 produces | generates an image as shown to FIG. 11B by performing a well-known edge emphasis process with respect to an image as shown to FIG. 11A. In the image shown in FIG. 11B, a contour portion N3 of the nipple region N2 is depicted.

  The main control unit 111 trims the image so that the identified nipple region N2 is displayed at the center of the screen, and causes the display unit 122 to display an image representing the identified nipple contour (FIG. 12). FIG. 12 represents an example of an image displayed by superimposing the contour portion N3 ′ of the nipple region N2 ′ on the fundus front image selected in S8. The main control unit 111 causes the storage unit 112 to store the image data of the image shown in FIG. 12 and the coordinate data indicating the position of the identified nipple region and its contour portion.

(S11)
Next, the size information generation unit 131 generates size information as described above using the measured value of the optical characteristic of the eye to be examined acquired in S3. Thereby, the lengths corresponding to the vertical and horizontal directions of one pixel in the fundus front image selected in S8 are calculated as actual size values.

(S12)
Next, the analysis target area specifying unit 142 specifies the analysis target area based on the nipple area specified in S10. Specifically, the analysis target area specifying unit 142 obtains the barycentric position P of the nipple area specified in S10 as shown in FIG. The analysis target area specifying unit 142 specifies a circle R1 having a radius D1 and a circle R2 having a radius D2 (0 <D1 <D2) centered on the obtained center of gravity position P, and is sandwiched between the specified circle R1 and circle R2. The specified annular area is specified as the analysis target area. D1 is, for example, 1800 micrometers. D2 is 2700 micrometers, for example.

  Further, the analysis target area specifying unit 142 can specify the analysis target area based on the nipple area manually corrected by the user. In this case, the user corrects the contour shape of the nipple region using the operation unit 121 while viewing the region including the nipple region displayed on the display unit 122. The analysis target area specifying unit 142 obtains the center of gravity position P of the nipple area as described above from the contour shape of the nipple area corrected by the user, and thereafter performs the same processing.

(S13)
Next, the blood vessel region specifying unit 143 specifies the blood vessel region in the analysis target region specified in S12. For example, the blood vessel region specifying unit 143 performs well-known threshold processing and well-known edge enhancement processing on the analysis target region in the image adjusted in S9, and binarizes the processed image as shown in FIG. An image as shown is generated. In the image shown in FIG. 14, the blood vessel region in the analysis target region is depicted.

(S14)
Next, the blood vessel region specifying unit 143 obtains the center line of the specified blood vessel region. For example, the blood vessel region specifying unit 143 can obtain a center line of the blood vessel region as shown in FIG. 15 by performing a known thinning process on the specified blood vessel region. In the image shown in FIG. 15, the center line of the identified blood vessel region is depicted.

  Next, the blood vessel region specifying unit 143 specifies a straight line in a direction perpendicular to the center line at a predetermined position on the obtained center line. The distance between two points where the identified straight line intersects the boundary of the blood vessel region corresponding to the blood vessel wall is taken as the diameter at that position. The blood vessel region specifying unit 143 multiplies the diameter by the size information generated in S11 to obtain the diameter with an actual size value. Such diameter measurement and calculation are executed at a plurality of positions along the center line of the blood vessel region, and a plurality of diameter values obtained thereby are averaged to obtain a blood vessel diameter.

(S15)
Next, as described above, the blood vessel region classification unit 145 classifies the diameter of the blood vessel region obtained in S14 into the diameter of the artery region and the diameter of the vein region. The main control unit 111 causes the display unit 122 to display the arterial region and the venous region classified by the blood vessel region classifying unit 145 (FIG. 16). FIG. 16 shows an example of an image displaying arterial regions A1 to A9 and vein regions V1 to V8 classified in S15.

  Note that the blood vessel regions to be classified by the blood vessel region classifying unit 145 are limited to blood vessel regions having a diameter of a predetermined width or more. Thereby, the precision of an evaluation parameter can be improved.

  Further, the user may be able to correct the classification result by the blood vessel region classification unit 145 by performing an operation on the operation unit 121 while viewing the image shown in FIG. For example, the user can use the operation unit 121 to select one of the arterial regions displayed on the display unit 122 and change the arterial region to a vein region. Further, the user can use the operation unit 121 to select one of the vein regions displayed on the display unit 122 and change the vein region to an arterial region. In addition, the user can select either the artery region or the vein region displayed on the display unit 122 using the operation unit 121, and can exclude the selected artery region or vein region from the blood vessel region. .

(S16)
Next, the main control unit 111 causes the storage unit 112 to store image data of the image (FIG. 16) in which the classification of the arterial region and the venous region is determined in S15, and coordinate data indicating the positions of the arterial region and the venous region. .

(S17)
Next, the statistical value calculation unit 146 calculates CRAE and CRVE by a known calculation method from the diameter of the artery region and the diameter of the vein region registered in S16.

  For example, the statistical value calculation unit 146 can calculate CRAE using the diameters of a predetermined number of arterial regions among the plurality of arterial regions shown in FIG. For example, the statistical value calculation unit 146 calculates CRAE using the diameters of the top six arterial regions having the largest diameters among the plurality of arterial regions shown in FIG. Similarly, the statistical value calculation unit 146 calculates CRVE using the diameters of a predetermined number of vein regions among the plurality of vein regions shown in FIG. For example, the statistical value calculation unit 146 calculates CRVE using the diameters of the upper six vein regions with the larger diameters among the plurality of arterial regions shown in FIG.

  Next, the ratio calculation unit 147 calculates an AVR by a known calculation method using the CRAE and CRVE calculated by the statistical value calculation unit 146.

  The main control unit 111 stores the calculated CRAE, CRVE, and AVR in the storage unit 112.

(S18)
The main control unit 111 causes the display unit 122 to display the analysis result of the fundus front image based on various information stored in the storage unit 112 (FIG. 17). FIG. 17 shows an example of an image 4000 displaying the analysis result of the fundus front image. In FIG. 17, on the left side of the image, the patient ID, the corneal information, the centroid position P of the nipple region, the circles R1 and R2 of the boundary of the analysis target region, and the identified arterial region and vein region are depicted. In addition, on the right side of the image 4000, CRAE (AR1, 225 micrometers), CRVE (AR2, 305 micrometers), AVR (AR3), a display indicating the degree of arteriosclerosis based on AVR (AR4), and the specified artery The measurement results (average diameter, maximum diameter, minimum diameter, SD) of the region and vein region are depicted. The warning level is expressed such that the lower the AVR value, the higher the warning level.

  In this embodiment, as shown in FIG. 17, the main control unit 111 causes the display unit 122 to display a blood vessel diameter comparison image including an image representing the diameter of the artery region and an image representing the diameter of the vein region. The blood vessel diameter comparison image is configured to include a first circular image representing the diameter of the arterial region and a second circular image having a center common to the first circular image and representing the diameter of the vein region. For example, for CRAE, a blood vessel diameter comparison image including a circle K2 (first circular image) representing the diameter of the arterial region is displayed inside a circle K1 (second circular image) corresponding to the diameter of the venous blood vessel. For CRVE, a blood vessel diameter comparison image including a circle K4 (first circular image) representing the diameter of the arterial region is displayed inside a circle (second circular image) K3 corresponding to the diameter of the venous blood vessel. Thereby, the user can easily grasp the relationship between CRAE and CRVE.

  This is the end of the operation of the fundus analysis system 10 (end).

  In S18, the main control unit 111 may cause the display unit 122 to display a diameter distribution display image representing the distribution of the diameter of the arterial region and the diameter of the vein region. For example, when the user selects one of the arterial region or the vein region classified by the blood vessel region classifying unit 145, a diameter distribution display image representing the diameter distribution of the selected region is displayed in the vicinity of the image shown in FIG. Let

  In addition, the main control unit 111 displays a first diameter distribution display image (FIG. 18) indicating a change in diameter in the axial direction of the arterial region and a second diameter distribution display image (FIG. 19) indicating a change in diameter in the axial direction of the vein region. ) Can be displayed on the display unit 122. Each of the first diameter distribution display image and the second diameter distribution display image includes a line connecting one end side of a plurality of orthogonal line segments each having a length corresponding to a diameter at a plurality of positions on a straight line representing the axis, and It is comprised including the line which connects the other end side. FIG. 18 shows an example of the first diameter distribution display image. FIG. 19 shows an example of the second diameter distribution display image. The main control unit 111 is an example of a “second display control unit” according to this embodiment. For example, the center line obtained by the blood vessel region specifying unit 143 is linearized, and the end point is a position where a line segment orthogonal to the center line intersects the boundary of the blood vessel region. By connecting one end side of a plurality of line segments orthogonal to the center line and connecting the other end side of the plurality of line segments, the images shown in FIGS. 18 and 19 can be generated.

[effect]
Hereinafter, effects of the fundus analysis apparatus 100 according to the embodiment will be described.

  The fundus analysis apparatus 100 includes an image acquisition unit, a measurement value acquisition unit, a size information generation unit 131, and an analysis unit 140. The image acquisition unit acquires a front image of the fundus of the eye to be examined. The measurement value acquisition unit acquires a measurement value of optical characteristics of the eye to be examined. The size information generation unit 131 generates size information for converting the scale of the front image acquired by the image acquisition unit into an actual dimension based on the measurement value acquired by the measurement value acquisition unit. The analysis unit 140 identifies the fundus blood vessel by analyzing the front image, and obtains the blood vessel diameter based on the size information generated by the size information generation unit 131.

  According to such a configuration, it becomes possible to determine the diameter of the blood vessel with an actual size value that is the same as or close to the true value based on the fundus illumination image, for diagnosis of diseases and evaluation of the degree of lifestyle-related diseases, etc. It becomes possible to obtain useful evaluation parameters with high accuracy.

  The analysis unit 140 may include a nipple region specifying unit 141, an analysis target region specifying unit 142, a blood vessel region specifying unit 143, and a blood vessel diameter calculating unit 144. The nipple area | region identification part 141 specifies a nipple area | region by analyzing a front image. The analysis target area specifying unit 142 specifies the analysis target area based on the nipple area specified by the nipple area specifying unit 141. The blood vessel region specifying unit 143 specifies a blood vessel region in the analysis target region specified by the analysis target region specifying unit 142. The blood vessel diameter calculating unit 144 obtains the diameter of the blood vessel region specified by the blood vessel region specifying unit 143.

  According to such a configuration, after identifying the nipple area corresponding to the optic nerve head, the vascular area corresponding to the blood vessel connected to the optic nerve head can be identified on the basis of the identified nipple area. Evaluation parameters for connected blood vessels can be obtained with high accuracy.

  The analysis unit 140 may include a blood vessel region classification unit 145. The blood vessel region classifying unit 145 classifies the diameter of the blood vessel region obtained by the blood vessel diameter calculating unit 144 into the diameter of the arterial region and the diameter of the venous region.

  According to such a configuration, by referring to the diameter of the blood vessel region, it is possible to improve the accuracy of determining whether the blood vessel region is an arterial region or a vein region.

  The analysis unit 140 may include a ratio calculation unit 147. The ratio calculation unit 147 obtains a ratio based on the diameter of the artery region and the diameter of the vein region.

  According to such a configuration, the ratio based on the diameter of the arterial region and the diameter of the venous region can be obtained based on the diameter of the blood vessel obtained with an actual size value that is the same as or close to the true value. The accuracy of the obtained ratio can be improved.

  In addition, the fundus analysis apparatus 100 displays the main diameter control unit 111 (first display control) that causes the display unit 122 (display unit) to display a blood vessel diameter comparison image including an image representing the diameter of the artery region and an image representing the diameter of the vein region. Part).

  According to such a configuration, it is possible to easily grasp the relationship between the diameter of the artery region and the diameter of the vein region.

  The blood vessel diameter comparison image may include a first circular image representing the diameter of the arterial region and a second circular image having a center common to the first circular image and representing the diameter of the vein region.

  According to such a configuration, it is possible to easily grasp the relationship between the diameter of the artery region and the diameter of the vein region.

  In addition, the fundus analysis apparatus 100 displays a first diameter distribution display image that represents a change in diameter in the axial direction of the arterial region and a second diameter distribution display image that represents a change in diameter in the axial direction of the vein region. Main control part 111 (second display control part) to be displayed on the means) may be included.

  According to such a configuration, it is possible to easily grasp the diameter distribution of the arterial region and the vein region.

  Each of the first diameter distribution display image and the second diameter distribution display image includes a line connecting one end side of a plurality of orthogonal line segments each having a length corresponding to a diameter at a plurality of positions on a straight line representing the axis, and Includes a line connecting the other end.

  According to such a configuration, it is possible to easily grasp the diameter distribution of the arterial region and the vein region.

  The analysis target area specifying unit 142 may specify an annular area around the nipple area as the analysis target area.

  According to such a configuration, the region to be separated from the optic disc to some extent is set as the analysis target, thereby facilitating the specification of the blood vessel region corresponding to the blood vessel connected to the optic disc, and the blood vessels as the analysis target without leakage. It becomes possible to do.

  Further, the analysis target region specifying unit 142 specifies the center of gravity position of the nipple region, specifies an annular region centered on the specified center of gravity and having a predetermined inner diameter and a predetermined outer diameter. Good.

  According to such a configuration, the analysis target region can be specified without depending on the diameter of the papilla region unique to the eye to be examined, so that comparison of evaluation parameters and the like are possible.

  Further, the fundus analysis apparatus 100 includes a user interface 120 for manually correcting the nipple region, and the analysis target region specifying unit 142 specifies the analysis target region based on the nipple region corrected using the user interface 120. May be.

  According to such a configuration, even when the identification of the nipple region is insufficient, it is possible to obtain an evaluation parameter useful for diagnosing a disease or evaluating the degree of lifestyle-related disease with high accuracy.

  The measurement value includes at least one of the corneal curvature, the refractive index, and the axial length of the eye to be examined, and the size information generation unit 131 may generate the size information by performing magnification correction based on the measurement value. Good.

  According to such a configuration, it is possible to generate size information according to the optical identification of the eye to be inspected using the measured values of the optical characteristics of the eye to be inspected that are easy to acquire.

  In addition, the fundus analysis apparatus 100 may include a storage unit 112 that stores a standard value of the eye optical characteristic in advance, and the size information generation unit 131 may generate size information based on the measurement value and the standard value.

  According to such a configuration, it is possible to generate size information according to the optical characteristics of the eye to be examined as much as possible while diverting a part of the standard values of the eye optical characteristics.

  The image acquisition unit may include an imaging unit that acquires a front image by imaging the fundus.

  Further, the measurement value acquisition unit may include a measurement unit that acquires a measurement value by optically measuring the eye to be examined.

[Modification]
A modification of the above embodiment will be described. The following modifications can be combined with any configuration described in the above embodiment.

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

  In the above embodiment, the analysis target area specifying unit may divide the analysis target area into a plurality of sectors (partial areas). In this case, the analysis unit 140 can calculate statistical values such as CRVE, CRAE, and AVR in units of sectors. In other words, the statistical value calculation unit 146 can obtain the statistical value of the diameter of the blood vessel region in each of the plurality of sectors based on the diameter of the blood vessel region obtained by the blood vessel diameter calculation unit 144. Thereby, paying attention to a predetermined sector such as a sector including a region between the optic nerve head and the macula, it becomes possible to diagnose a disease and evaluate the degree of lifestyle-related disease by CRVE, CRAE, AVR and the like.

  The fundus front image according to the above embodiment may be volume data in addition to the C scan image acquired by the OCT apparatus, the fundus image obtained by the SLO, the projection image, and the shadowgram.

  A computer program for realizing the above embodiment can be stored in any recording medium readable by a computer. Examples of the recording medium include a semiconductor memory, an optical disk, a magneto-optical disk (CD-ROM / DVD-RAM / DVD-ROM / MO, etc.), a magnetic storage medium (hard disk / floppy (registered trademark) disk / ZIP, etc.), and the like. Can be used.

  It is also possible to transmit / receive this program through a network such as the Internet or a LAN.

10 fundus analysis system 20 fundus imaging device 21 imaging unit 30 ophthalmological measurement device 31 measurement unit 40 database 50 connection line 100 fundus analysis device 110 control unit 111 main control unit 112 storage unit 120 user interface 121 operation unit 122 display unit 130 arithmetic processing unit 131 Size information generating unit 140 Analyzing unit 141 Nipple region specifying unit 142 Analysis target region specifying unit 143 Blood vessel region specifying unit 144 Blood vessel diameter calculating unit 145 Blood vessel region classifying unit 146 Statistical value calculating unit 147 Ratio calculating unit

Claims (9)

An image acquisition unit for acquiring a front image of the fundus of the eye to be examined;
A measurement value acquisition unit for acquiring a measurement value of the optical characteristics of the eye to be examined;
Based on the measurement value acquired by the measurement value acquisition unit, a size information generation unit that generates size information for converting the scale of the front image acquired by the image acquisition unit into an actual dimension;
An analyzer that identifies the blood vessel of the fundus by analyzing the front image, and obtains the diameter of the blood vessel based on the size information generated by the size information generator;
A first display control unit that causes the display means to display a blood vessel diameter comparison image including an image representing the diameter of the artery region and an image representing the diameter of the vein region;
Including
The analysis unit
A nipple region specifying part for specifying a nipple region by analyzing the front image;
An analysis target region specifying unit that specifies an analysis target region based on the papillary region specified by the nipple region specifying unit;
A blood vessel region specifying unit for specifying a blood vessel region in the analysis target region specified by the analysis target region specifying unit;
A blood vessel diameter calculating unit for obtaining a diameter of the blood vessel region specified by the blood vessel region specifying unit;
A blood vessel region classification unit that classifies the diameter of the blood vessel region obtained by the blood vessel diameter calculation unit into the diameter of the arterial region and the diameter of the vein region;
Fundus analyzer including The blood vessel diameter comparison image includes a first circular image representing the diameter of the arterial region and a second circular image having a common center with the first circular image and representing the diameter of the vein region. The fundus analysis apparatus according to claim 1 . An image acquisition unit for acquiring a front image of the fundus of the eye to be examined;
A measurement value acquisition unit for acquiring a measurement value of the optical characteristics of the eye to be examined;
Based on the measurement value acquired by the measurement value acquisition unit, a size information generation unit that generates size information for converting the scale of the front image acquired by the image acquisition unit into an actual dimension;
An analyzer that identifies the blood vessel of the fundus by analyzing the front image, and obtains the diameter of the blood vessel based on the size information generated by the size information generator;
A second display control unit that causes the display means to display a first diameter distribution display image representing a change in diameter in the axial direction of the arterial region and a second diameter distribution display image representing a change in diameter in the axial direction of the vein region;
Including
The analysis unit
A nipple region specifying part for specifying a nipple region by analyzing the front image;
An analysis target region specifying unit that specifies an analysis target region based on the papillary region specified by the nipple region specifying unit;
A blood vessel region specifying unit for specifying a blood vessel region in the analysis target region specified by the analysis target region specifying unit;
A blood vessel diameter calculating unit for obtaining a diameter of the blood vessel region specified by the blood vessel region specifying unit;
A blood vessel region classification unit that classifies the diameter of the blood vessel region obtained by the blood vessel diameter calculation unit into the diameter of the arterial region and the diameter of the vein region;
Fundus analyzer including Each of the first diameter distribution display image and the second diameter distribution display image connects one end side of a plurality of orthogonal line segments each having a length corresponding to a diameter at a plurality of positions on a straight line representing the axis. The fundus analyzing apparatus according to claim 3 , further comprising a line connecting the line and the other end side. Including a user interface for manually correcting the nipple area;
The analysis target area identification unit according to any one of claims 1 to 4, characterized in that identifying the analysis target area based on the corrected said teats regions using the user interface Fundus analyzer. The measurement value includes at least one of corneal curvature, refractive index, and axial length of the eye to be examined,
The fundus analysis apparatus according to any one of claims 1 to 5 , wherein the size information generation unit generates the size information by performing magnification correction based on the measurement value. Including a storage unit that pre-stores standard values of ocular optical characteristics;
The fundus analyzer according to any one of claims 1 to 6 , wherein the size information generation unit generates the size information based on the measurement value and the standard value. The fundus analysis apparatus according to any one of claims 1 to 7 , wherein the image acquisition unit includes an imaging unit that acquires the front image by imaging the fundus. The fundus analysis according to any one of claims 1 to 8 , wherein the measurement value acquisition unit includes a measurement unit that acquires the measurement value by optically measuring the eye to be examined. apparatus.

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