Optical coherence tomography-based ophthalmic testing methods, devices and systems

• US 9,492,079 B2
• Filed: 08/28/2014
• Issued: 11/15/2016
• Est. Priority Date: 07/18/2008
• Status: Active Grant

• Current Assignee: Doheny Eye Institute
• Original Assignee: Doheny Eye Institute
• Inventors: Walsh, Alexander C., Updike, Paul G., Sadda, Srinivas R.
• Primary Examiner(s): HASAN, MOHAMMED A
• Application Number:
  US14/472,161
• Publication Number:
  US 20150085253A1
• Time in Patent Office: 810 Days
• Field of Search: 351200-246
• US Class Current: 1/1
• CPC Class Codes: A61B 3/0025 characterised by electronic signal processing, e.g. eye models
• CPC Class Codes: A61B 3/0033 characterised by user input arrangements
• CPC Class Codes: A61B 3/0041 characterised by display arrangements
• CPC Class Codes: A61B 3/0091 Fixation targets for viewing direction
• CPC Class Codes: A61B 3/028 for testing visual acuity; for determination of refraction, e.g. phoropters
• CPC Class Codes: A61B 3/085 for testing strabismus
• CPC Class Codes: A61B 3/102 for optical coherence tomography [OCT]
• CPC Class Codes: A61B 3/113 for determining or recording eye movement
• CPC Class Codes: A61B 3/117 for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
• CPC Class Codes: A61B 3/132 in binocular arrangement
• CPC Class Codes: A61B 3/18 Arrangement of plural eye-testing or -examining apparatus
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0073 by tomography, i.e. reconstruction of 3D images from 2D projections A61B5/0066 takes precedence
• CPC Class Codes: G02C 7/027 considering wearer's parameters

Abstract

In accordance with one aspect of the present invention, an optical coherence tomography-based ophthalmic testing center system includes an optical coherence tomography instrument comprising an eyepiece for receiving at least one eye of a user or subject; a light source that outputs light that is directed through the eyepiece into the user'"'"'s or subject'"'"'s eye, an interferometer configured to produce optical interference using light reflected from the user'"'"'s/subject'"'"'s eye, an optical detector disposed so as to detect said optical interference; and a processing unit coupled to the detector. The ophthalmic testing center system can be configured to perform a multitude of self-administered functional and/or structural ophthalmic tests and output the test data.

Claims

1. An optical coherence tomography-based system comprising:

an optical coherence tomography device comprising a first ocular that defines a first optical axis, the optical coherence tomography device configured to;

obtain an image of a first anterior region of at least one eye of a user, the at least one eye of the user defining a second optical axis;

based at least in part on the image of the first anterior region of the at least one eye of the user, automatically adjust a position of the first ocular such that the first optical axis and the second optical axis are substantially in alignment; and

after automatically adjusting the position of the first optical axis, obtain an optical coherence tomography scan of the at least one eye of the user; and

a computing system configured to analyze the optical coherence tomography scan or to generate an optical coherence tomography-based image based on the optical coherence tomography scan; and

an output device configured to provide an output based on the analysis of the optical coherence tomography scan or the optical coherence tomography-based image.

2. The optical coherence tomography-based system of claim 1, wherein the optical coherence tomography device further comprises a second ocular, and wherein the first and second oculars are configured to receive a pair of eyes of the user.

3. The optical coherence tomography-based system of claim 1, wherein the computing system is further configured to detect at least one ophthalmic characteristic in the at least one eye based on the optical coherence tomography scan, and wherein the computing system is further configured to perform at least one ophthalmic structural test based on the at least one ophthalmic characteristic.

4. The optical coherence tomography-based system of claim 1, wherein the computing system is further configured to detect based on the optical coherence tomography scan a first boundary position of a first structural element of the at least one eye and a second boundary position of a second structural element of the at least one eye, the computing system further configured to generate an ophthalmic measurement value based on the first and second boundary positions.

5. The optical coherence tomography-based system of claim 1, wherein the computing system is further configured to identify a fovea or a best fixating retina based on the optical coherence tomography scan.

6. The optical coherence tomography-based system of claim 1, wherein the optical coherence tomography device is configured to obtain a first optical coherence tomography scan of a region of the at least one eye of the user at a first time period and a second optical coherence tomography scan of the region of the at least one eye of the user at a second time period, and wherein the computing system is further configured to track at least one structural element of the at least one eye between the first and second optical coherence tomography scans.

7. The optical coherence tomography-based system of claim 6, wherein the computing system is further configured to perform a functional test based at least in part on the tracking of the at least one structural element of the at least one eye between the first and second optical coherence tomography scans.

8. The optical coherence tomography-based system of claim 6, wherein the optical coherence tomography device further comprises a display device configured to:

present, to the user, a first visual target at a first position during the first time period; and

present, to the user, a second visual target at a second position during the second time period;

wherein the at least one structural element of the at least one eye is tracked as the user looks at the first visual target during the first time period and looks at the second visual target during the second time period.

9. The optical coherence tomography-based system of claim 1, wherein the optical coherence tomography device includes at least one of an infrared-based imaging system or a scanning laser ophthalmoscope imaging system.

10. The optical coherence tomography-based system of claim 1, wherein the output is transmitted electronically to a remote location other than a location of the optical coherence tomography-based system.

11. The optical coherence tomography-based system of claim 1, wherein the computing system is further configured to classify a pixel as at least one of tissue, fluid, or pathologic tissue based on a measurement of at least one pixel intensity value of the pixel in the optical coherence tomography scan.

12. The optical coherence tomography-based system of claim 11, wherein the optical coherence tomography-based system is further configured to output via the output device a risk assessment based on the classification of the at least one pixel in the optical coherence tomography scan.

13. The optical coherence tomography-based system of claim 11, wherein the optical coherence tomography-based system is further configured to output via the output device a diagnosis or differential diagnosis based on classification of the at least one pixel in the optical coherence tomography scan.

14. The optical coherence tomography-based system of claim 1, wherein the optical coherence tomography device is further configured to enable the user to self-administer the optical coherence tomography scan.

15. The optical coherence tomography-based system of claim 1, wherein the first anterior eye region includes the cornea.

16. An optical coherence tomography-based system comprising:

an optical coherence tomography device configured to;

automatically adjust a Z offset of at least one ocular, thereby adjusting a depth at which scans are obtained;

automatically assess a lateral position of at least one eye of a subject; and

obtain a scan;

a computing system configured to;

perform tracking of at least one structural element of the at least one eye; and

perform at least one ophthalmic functional test based on the tracking,

wherein the at least one ophthalmic functional test is configured to measure movement of the at least one eye of the subject; and

an output device configured to generate an output based on the at least one ophthalmic functional test.

17. The optical coherence tomography-based system of claim 16, wherein the optical coherence tomography device includes at least one of an infrared-based imaging system or a scanning laser ophthalmoscope imaging system.

18. The optical coherence tomography-based system of claim 16, wherein the optical coherence tomography device is further configured to enable the subject to self-administer the scan by using the imaging device.

19. The optical coherence tomography-based system of claim 16, wherein performing tracking comprises determining a gaze preference of the at least one eye or tracking movement of the at least one eye based on using a first image and a second image as a functional input.

20. The optical coherence tomography-based system of claim 16, wherein the optical coherence tomography comprises a binocular device and wherein the ophthalmic functional test is at least one of a binocular pupillometry test, a binocular alignment test, an extraocular motility test, or a binocular foveal suppression test.

21. The optical coherence tomography-based system of claim 16, wherein the at least one ophthalmic functional test is at least one of a reading speed test or a color vision test.

22. The optical coherence tomography-based system of claim 16, wherein the output is transmitted electronically to a remote location other than a location of the ophthalmic testing system.

23. The optical coherence tomography-based system of claim 16, wherein the output device is further configured to output at least one of a risk assessment, a diagnosis, or a differential diagnosis based on at least a result of the at least one ophthalmic functional test.

24. The optical coherence tomography-based system of claim 16, wherein the computing system is further configured to compare a result of the at least one ophthalmic functional test with at least one of a reference value, a normative value, or a previously measured result of a functional test.

25. The optical coherence tomography-based system of claim 16, wherein the imaging device comprises a binocular device and wherein the ophthalmic functional test is a binocular stereoacuity test.

26. The optical coherence tomography-based system of claim 16, wherein the ophthalmic functional test is at least one of a visual acuity test or a visual field test.