Apparatus for diagnosis of optically identifiable ophthalmic conditions

• US 9,563,742 B2
• Filed: 02/28/2014
• Issued: 02/07/2017
• Est. Priority Date: 10/30/2003
• Status: Active Grant

• Current Assignee: Welch Allyn Incorporated
• Original Assignee: Welch Allyn Incorporated
• Inventors: Newman, Richard W., Fahrenkrug, Corinn C.
• Primary Examiner(s): Martinez, Joseph P
• Assistant Examiner(s): Thomas, Brandi
• Application Number:
  US14/193,920
• Publication Number:
  US 20140176134A1
• Time in Patent Office: 1,075 Days
• Field of Search: 359/200, 359/201, 359/202, 359/203, 359/204, 359/205, 359/206, 359/208, 359/209, 359/212, 359/222, 359/211, 359/216, 359/221, 359/233, 359/239, 359/245, 600/356, 600/558, 600/559, 606/5, 606/6, 606/204.25
• US Class Current: 1/1
• CPC Class Codes: A61B 3/0025 characterised by electronic signal processing, e.g. eye models
• CPC Class Codes: A61B 3/0058 for multiple images
• CPC Class Codes: A61B 3/0091 Fixation targets for viewing direction
• CPC Class Codes: A61B 3/10 Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
• CPC Class Codes: A61B 3/12 for looking at the eye fundus, e.g. ophthalmoscopes A61B3/13 takes precedence
• CPC Class Codes: A61B 3/14 Arrangements specially adapted for eye photography apparatus or arrangements for taking photographs per se G03B
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0068 Confocal scanning
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• CPC Class Codes: A61B 5/163 by tracking eye movement, gaze, or pupil change
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/4088 Diagnosing of monitoring cognitive diseases, e.g. Alzheimer, prion diseases or dementia
• CPC Class Codes: G01R 33/48 NMR imaging systems
• CPC Class Codes: G01T 1/2985 In depth localisation, e.g. using positron emitters; Tomographic imaging (longitudinal and transverse section imaging; apparatus for radiation diagnosis sequentially in different planes, steroscopic radiation diagnosis); using external radiation sources A61B6/02
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

An apparatus that can measure images of at least a portion of an eye and record data sets indicative of a neurological condition. A method interrelates an image and a data set to provide an interpretive result. The apparatus and method thereby provide guidance as to the presence of a medical condition in a patient. The apparatus and method can be used in an iterative measurement process, in which the apparatus attempts to discern normal health from a state of health that is not normal health. If the interpretive result is consistent with normal health, the process terminates, information is recorded, and an optional report is given. If the interpretive result is not consistent with normal health, the apparatus and method attempts to distinguish which condition is consistent with the data and images used, and can iterate with additional measurements and information to attempt to provide a useful interpretive result.

Claims

1. An apparatus for obtaining an interpretive result relating to a condition of a person, comprising:

at least one imager for imaging at least a portion of the eye of said person and configured to observe one or more images;

at least one data collection apparatus for collecting from said eye a data set indicative of a neurological disorder;

an analysis module comprising a programmable processor and computer software recorded on a computer-readable medium, said computer software when operating performing the steps of;

interrelating at least two disparate kinds of information selected from one or more images and one or more data sets to attempt to obtain an interpretive result relating to said condition of said person;

(a) in the event that said attempt to obtain an interpretive result relating to said condition of said person provides a result representing a state of normal health, recording said result and terminating said analysis; and

(b) in the event that said attempt to obtain an interpretive result relating to said condition of said person provides a result representing a state of health that is not normal health, attempting to distinguish a condition represented by said state of health that is not normal health;

(b)(1) in the event that said attempt to distinguish said condition represented by said state of health that is not normal health is successful, reporting an interpretive result of said condition and terminating said analysis;

(b)(2) in the event that said attempt to distinguish said condition represented by state of health that is not normal health is unsuccessful, reporting said failure to distinguish a condition;

(b)(3) optionally, prompting a user of said apparatus to provide additional information about said person.

2. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 1, wherein said computer software when operating further performing the step of:

(c) upon provision of said additional information about said person, iteratively repeating said interrelating step and, as appropriate, each of conditional steps (b), (b)(1), (b)(2), (b)(3) and this step (c) using said additional information provided in response to the prompting step (b)(3) in addition to said one or more data sets to attempt to obtain an interpretive result relating to said condition of said person until the first to occur of;

said analysis is terminated according to step (b)(1);

said iteratively repeating step is performed a predetermined number of times without distinguishing said condition represented by said state of health that is not normal health;

said iteratively repeating step is performed until a specified period of time elapses without distinguishing said condition represented by said state of health that is not normal health; and

a user of said apparatus determines that said analysis should be terminated, and intervenes to terminate said analysis.

3. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 2, wherein said additional information about said person comprises additional information from a magnetic resonance imaging (MRI) test.

4. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 2, wherein said additional information about said person comprises patient history data.

5. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 2, wherein said additional information about said person comprises vital signs data.

6. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 2, wherein said additional information about said person comprises additional information from a positron emission tomography (PET) test.

7. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 6, wherein said PET test comprises an FDG-PET glucose determination.

8. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 6, wherein said PET test comprises a C-PK11195-PET test.

9. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 2, wherein said additional information about said person comprises additional information from a brain biopsy.

10. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 2, wherein the order of performing the steps of obtaining a data set indicative of a condition of a person and obtaining said additional information about said person is not critical, and may be performed in any order that is convenient.

11. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 1, wherein when said computer software is operating, step (b)(1) is performed at least a second time to attempt to distinguish a second state of health that is not normal health different from said reported state of health that is not normal health.

12. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 1, wherein when said computer software is operating, optionally, in step (a) said apparatus provides information relating to state of normal health to a user of said apparatus.

13. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 1, wherein when said computer software is operating, optionally, in step (b)(1), said apparatus records said interpretive result of said condition.

14. The apparatus for obtaining an interpretive result relating to a condition of a person of claim 1, wherein said at least one imager for imaging at least a portion of the eye of said person is configured to provide image data comprising at least one image type selected from the group consisting of data from ophthalmic images using confocal microscopy data, retinal polarimetry data, optical coherence tomography data, thermal image data, spectroscopic image data, reflectometry data and visible image data.