Macular degeneration is the leading cause of vision loss in the United States of America. In macular degeneration, the central portion of the retina (a.k.a., the macula) deteriorates. When healthy, the macula collects and sends highly detailed images to the brain via the optic nerve. In early stages, macular degeneration typically does not significantly affect vision. If macular degeneration progresses beyond the early stages, vision becomes wavy and/or blurred. If macular degeneration continues to progress to advanced stages, central vision may be lost.
Although macular degeneration is currently considered to be incurable, treatments do exist that may slow the progression of the disease so as to prevent severe loss of vision. Treatment options include injection of an anti-angiogenic drug into the eye, laser therapy to destroy an actively growing abnormal blood vessel(s), and photodynamic laser therapy, which employs a light-sensitive drug to damage an abnormal blood vessel(s). Early detection of macular degeneration is of paramount importance in preventing advanced progression of macular degeneration prior to treatment to inhibit progression of the disease. Timely treatment of advanced AMD is important to maintain the patient's vision.
Early detection of macular degeneration and timely treatment decisions can be accomplished using a suitable retinal imaging system. For example, Optical Coherence Tomography (OCT) is a non-invasive imaging technique relying on low coherence interferometry that can be used to generate a cross-sectional image of the macula. The cross-sectional view of the macula shows if the layers of the macula are distorted and can be used to monitor whether distortion of the layers of the macula has increased or decreased relative to an earlier cross-sectional image to assess the impact of treatment of the macular degeneration.
Existing OCT imaging systems, however, are typically expensive and may have to be operated by a trained technician. For example, a trained technician may be required to properly align an optical axis of the OCT imaging system with the optical axis of the eye examined. As a result, the use of such OCT imaging systems is typically restricted to specialized eye care clinics, thereby limiting use of such OCT imaging systems for widespread screening for early stage macular degeneration. Alternatively, the alignment can be performed automatically by a closed loop control system utilizing imaging, processing, and motors to achieve the required positioning. Another example would be fundus camera that requires a technician or a motorized control loop to align the optical axis with the patient pupil to be able to take an image of the retina.
The following presents a simplified summary of some embodiments of the invention in order to provide a basic understanding of the invention. This summary is not an extensive overview of the invention. It is not intended to identify key/critical elements of the invention or to delineate the scope of the invention. Its sole purpose is to present some embodiments of the invention in a simplified form as a prelude to the more detailed description that is presented later.
Ophthalmic imaging devices and related methods orient an optical axis of the imaging device at an angle from 45 degrees to 85 degrees from a horizontal surface on which the ophthalmic imaging device is supported and employ a viewer assembly that stabilizes the user's head in a suitable position and orientation relative to the optical axis. In many embodiments, the imaging device conducts imaging over a relatively long period of time (e.g., 30 seconds) and the user engages the user's head with the viewer assembly to stabilize the position and orientation of the user's head relative to the optical axis over the imaging period. In many embodiments, the viewer assembly accommodates different positions and/or orientations of the user's head relative to the optical axis so as to enable alignment, by the user, of one of the user's eyes with the optical axis. The combination of the optical axis being angled relative to horizontal and the configuration of the viewer assembly enables the user to self-align an eye of the user with the optical axis and maintain the position of the eye relative to the optical axis over the imaging period while sitting in a natural, comfortable position. Moreover, the combination of the optical axis being angled relative to horizontal and the configuration of the viewer assembly effectively inhibits gravity induced downward drift movement by the user during the imaging period.
Thus, in many embodiments, an ophthalmic imaging device includes an imaging assembly having an optical axis, a housing assembly to which the imaging assembly is attached, and a viewer assembly coupled with the housing assembly. The housing assembly is configured to rest on a horizontal surface during operation of the imaging assembly. The optical axis is oriented at an angle from 45 degrees to 85 degrees from the horizontal surface when the housing assembly rests on the horizontal surface. The viewer assembly includes an interface surface shaped to engage a user's head to stabilize a position and an orientation of the user's head relative to the optical axis. The viewer assembly accommodates different positions and/or orientations of the user's head relative to the optical axis so as to enable alignment, by the user, of one of the user's eyes with the optical axis.
In many embodiments, the viewer assembly is adapted to block light when engaged by a user's head to create a dark environment to dilate the user's pupil to enhance imaging of the user's retina. For example, in some embodiments, the interface surface is configured to engage the user's head continuously along a perimeter segment that surrounds the user's eyes. In such embodiments, the perimeter segment can extend continuously from below the user's left eye, around the user's left eye between the user's left eye and the user's left ear, above the user's eyes, around the user's right eye between the user's right eye and the user's right ear, to below the user's right eye.
In many embodiments, the interface surface is configured to accommodate the different positions and/or orientations of the user's head relative to the optical axis. For example, the interface surface can be sized and/or shaped to accommodate the different positions and/or orientations of the user's head relative to the optical axis.
In many embodiments, the ophthalmic imaging device includes an aperture through which the imaging assembly images the one of the user's eyes aligned with the optical axis. In many embodiments, the viewer assembly comprises a light blocking side surface that extends between the interface surface and the aperture to block light continuously along the interface surface.
In many embodiments, the viewer assembly is deformable so that the shape of interface surface is conformable to the user's head to accommodate the different positions and/or orientations of the user's head relative to the optical axis. For example, in some embodiments, the viewer assembly includes a base component, a deformable component mounted to the base component, and a biocompatible layer that covers the deformable component. In such embodiments, the biocompatible layer can include the interface surface.
In many embodiments, the viewer assembly can be used any of many different users. For example, in many embodiments the viewer assembly accommodates different positions and/or orientations of each of a plurality of different user's heads relative to the optical axis so as to enable alignment, by the respective user, of one of the respective user's eye with the optical axis. In such embodiments, the plurality of different users includes a plurality of different distances by which the eyes of the respective user are separated.
In many embodiments, the viewer assembly is configured to engage with stable portions of the user's head. For example, in many embodiments, the interface surface is configured to engage the user's forehead and/or the user's cheeks.
In many embodiments, the imaging assembly has a focal point. In many embodiments, the focal point is disposed at a height between 180 mm to 350 mm above the horizontal surface when the housing assembly rests on the horizontal surface. In many embodiments, the housing assembly is adjustable to change the height at which the focal point is disposed above the horizontal surface. For example, the housing assembly can include a pair of legs that can be adjusted to change the height at which the focal point is disposed above the horizontal surface. In some embodiments, the housing assembly is adjustable to simultaneously change the height at which the focal point is disposed above the horizontal surface and the orientation of the optical axis relative to the horizontal surface. In such embodiments, each respective height can have a corresponding unique angle of the optical axis relative to the horizontal surface.
In many embodiments, the viewer assembly is adapted to enable a suitable range of positions and/or orientations of the user's head relative to the optical axis. For example, in many embodiments, the different positions and/or orientations of the user's head accommodated by the viewer assembly enable repositioning of the user's eye by 20 mm along any axis perpendicular to the optical axis.
In many embodiments, the ophthalmic imaging device is adapted to be restrained by the user to hold the viewer assembly in engagement with the user's head. For example, the housing assembly can include a pair of handles configured to be held by the user to hold the viewer assembly in engagement with the user's head.
In many embodiments, the ophthalmic imaging device is reconfigurable between a configuration for imaging the user's right eye retina and a configuration for imaging the user's left eye retina. For example, in many embodiments, the ophthalmic imaging device includes a repositioning mechanism by which the viewer assembly is coupled to the housing assembly. In such embodiments, the repositioning mechanism can be configured to enable repositioning of the viewer assembly relative to the housing assembly to enable separate alignment of each of the user's eyes with the optical axis. In some embodiments, the viewer assembly is slideably coupled with the housing assembly via the repositioning mechanism. In some embodiments, the viewer assembly is slideably relative to the housing assembly via the repositioning mechanism in two different directions transverse to the optical axis. In some embodiments, the repositioning mechanism is operable to reposition the viewer assembly relative to the focal point parallel to the optical axis.
In some embodiments, the housing assembly is adjustable to change the angle at which the optical axis is oriented relative to the horizontal surface. For example, in some embodiments, the housing assembly includes a pair of legs that can be adjusted to change the angle at which the optical axis is oriented relative to the horizontal surface.
For a fuller understanding of the nature and advantages of the present invention, reference should be made to the ensuing detailed description and accompanying drawings.
In the following description, various embodiments of the present invention will be described. For purposes of explanation, specific configurations and details are set forth in order to provide a thorough understanding of the embodiments. However, it will also be apparent to one skilled in the art that the present invention may be practiced without the specific details. Furthermore, well-known features may be omitted or simplified in order not to obscure the embodiment being described.
Introduction
Many patients with retinal diseases are treated with intra-ocular injection per general guidelines based on the average patient. Progression of a retinal disease in any specific patient, may progress differently than in the average patient. Moreover, the specific patient may respond differently to treatment than the average patient. Accordingly, there is a strong clinical need to monitor the progression of a retinal disease in some patients on a continual basis so that the patient can receive treatment based on their own disease progression. Ophthalmic imaging devices employing optical coherence tomography (OCT) imaging are often employed in eye clinics image a patient's retina to monitor the progression of a retinal disease. Having to travel to an eye clinic, however, may prevent sufficient continual monitoring in some patients. As a result, there is a need for affordable OCT based ophthalmic imaging devices that can be used by a patient at home to continually monitor the progression of the patient's retinal disease. Such retinal disease may be chorio-retinal eye diseases, such as AMD, ocular hystoplasmosis, myopia, central serous retinopathy, central serous choroidopathy, glaucoma, diabetic retinopathy, retintis pigmentosa, optic neuritis, epiretinal membrane, vascular abnormalities and/or occlusions, choroidal dystrophies, retinal dystrophies, macular hole, or choroidal or retinal degeneration.
In many embodiments, an affordable ophthalmic retinal imaging device (e.g., an affordable ophthalmic retinal imaging device that employs OCT imaging, an affordable ophthalmic retinal imaging device that employs a fundus camera and an additional retinal imaging device) presents a few challenges relative to alignment of a patient's eye with an optical axis of the imaging device. For example, the patient's pupil needs to be centered (e.g., in two directions transvers to the optical axis) and stable relative to the optical axis of the imaging device throughout the imaging time period. The patient needs to be fixated (e.g., gazing at a fixation target) throughout the imaging time period. The patient's retina needs to be at a suitable location along the optical axis throughout the imaging time period. Many patients, however, especially elderly patients, find it very hard to maintain suitable position and orientation of their eye relative to the imaging device through the applicable imaging time period.
As a result, ophthalmic retinal imaging devices that are employed at an eye clinic typically require significant technician assistance, include pricy hardware, and/or employ sophisticated algorithms to compensate for a patient's inability to maintain suitable position and orientation of their eye relative to the imaging device through the applicable imaging time period. For example, a clinic may often employ a technician who watches a monitor in real time to monitor positions of the patient's pupil and retina, operate an alignment device to align the imaging device with the patient's eye, and/or provide instruction to the patient on what to do to align and/or maintain alignment of the imaging device with the patient's eye. There are also ophthalmic imaging devices that include an auto-alignment system employing high scanning speed eye tracking to automatically maintain alignment of the imaging device with the patient's eye. Such auto-alignment systems, however, are typically expensive and unsuitable for mass production. There also ophthalmic imaging devices that employ anatomical land mark registration (blood vessels in the case or retinal imaging) to correct for movement and/or changes in orientation of the patient's eye relative to the imaging device during the imaging period. Such anatomical land mark registration, however, typically employs a fundus camera, which again increases the costs of the imaging device and renders the imaging device unsuitable for mass production. Moreover, certain regions of the eye, such as the central portion of the macula, do not have a blood vessel suitable for use as a visible landmark.
Moreover, simply asking a patient to fixate on a target and not move is typically insufficient. Even if the patient understands what the patient is being asked to do, using existing approaches, it can very difficult for the patient to maintain position and alignment of the patient's eye for any meaningful duration that is required to support the desired quality of images or enable use of lower cost components. For example, OCT is a scanning device that typically requires meaningful time of the patient in front of the device. (more than a few seconds)
Affordable Ophthalmic Imaging Devices
Affordable ophthalmic imaging devices and related methods are described herein that are suitable to be employed in a non-clinical environment (e.g., at a patient's home), thereby serving to reduce the cost associated with increased monitoring of progression of a patient's retinal disease. Referring now to the drawings, in which like reference numerals represent like parts throughout the several views,
In many embodiments, the optical axis of the ophthalmic imaging device is angled between 45 and 85 degrees relative to the horizontal surface. In some embodiments, the angle of the ophthalmic imaging device relative to the horizontal surface can be adjusted by the user so as to achieve a comfortable position while enabling alignment of the optical axis with the user's pupil while the user's head is positioned against the viewer. In many embodiments, the ophthalmic imaging device is configured to be stationary when not being adjusted or moved by the user and the user can make small lateral adjustments of the user's head relative to viewer and/or the housing of the ophthalmic imaging device (e.g., in axes X and Y perpendicular to the optical axis) to align the optical axis with the user's pupil. In many embodiments, the lateral movement of the user's head relative to the viewer and/or the housing is no more than 20 mm and typically in the order of 0.5 mm or less. In some embodiments, the viewer has a flexibility that accommodates lateral movement of the user's head relative to the housing. For example, the viewer can incorporate a flexible material (e.g., a soft foam) in the margins of the viewer such that the user can push the user's head against one part or the viewer relative to another part of the viewer to laterally reposition the user's head relative to the housing and thereby relative to the optical axis. Alternatively, the ophthalmic imaging device can include a mechanism allowing the viewer to slide laterally relative to the optical axis (e.g., on axes X and/or Y perpendicular to the optical axis) such that the user can tilt and/or reposition the user's head relative to the housing to cause the viewer to slide relative to the housing to bring the user's pupil into alignment with the optical axis.
In many embodiments, the imaging device 10 is configured to enable the user 12 to achieve alignment of an eye 30 of the user 12 with the optical axis 26 and maintain sufficient alignment of the eye with the optical axis 26 throughout an applicable imaging period of the imaging device 10. For example, when the user 12 is engaged with the viewer assembly 14 such that the user's eye 30 is aligned with the optical axis 26 as illustrated in
In many embodiments, the viewer assembly 14 is repositionable relative to the housing assembly 20 between a configuration for imaging of the user's right eye and a configuration for imaging of the user's left eye. For example,
In many embodiments, the viewer assembly 14 is configured to accommodate different positions and/or orientations of the user's head relative to the optical axis 26 so as to enable alignment, by the user 12, of the eye 30 with the optical axis 26. For example,
In many embodiments, the viewer assembly 14 has an interface surface 46 that is configured to engage the user's head continuously along a perimeter segment that surrounds the user's eyes. In many embodiments, the perimeter segment extends continuously from below the user's left eye, around the user's left eye between the user's left eye and the user's left ear, above the user's eyes, around the user's right eye between the user's right eye and the user's right ear, to below the user's right eye. In many embodiments, the interface surface 46 is configured to accommodate the different positions and/or orientations of the user's head relative to the optical axis 26. In many embodiments, the viewer assembly 14 is deformable so that the shape of interface surface 46 is conformable to the user's head to accommodate the different positions and/or orientations of the user's head relative to the optical axis. In many embodiments, the viewer assembly includes a base component, a deformable component mounted to the base component, and a biocompatible layer that covers the deformable component. In many embodiments, the biocompatible layer includes the interface surface 46. In some embodiments, the deformable component has different degrees of deformability in different regions of the interface surface.
In many embodiments, the viewer assembly 14 accommodates different positions and/or orientations of each of a plurality of different user's heads relative to the optical axis 26 so as to enable alignment, by the respective user, of one of the respective user's eye with the optical axis 26. For example, the plurality of different user's accommodated by the viewer assembly 14 can have a plurality of different distances by which the eyes of the respective user are separated.
Many embodiments of the imaging devices 10, 110 include a locking mechanism configured to inhibit (and in some embodiments prevent) inadvertent movement of the viewer assembly 14 relative to the housing assembly 20, 120 during an imaging session. Any suitable locking mechanism can be employed. For example,
Other variations are within the spirit of the present invention. Thus, while the invention is susceptible to various modifications and alternative constructions, certain illustrated embodiments thereof are shown in the drawings and have been described above in detail. It should be understood, however, that there is no intention to limit the invention to the specific form or forms disclosed, but on the contrary, the intention is to cover all modifications, alternative constructions, and equivalents falling within the spirit and scope of the invention, as defined in the appended claims.
The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. The term “connected” is to be construed as partly or wholly contained within, attached to, or joined together, even if there is something intervening. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate embodiments of the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
Preferred embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.
All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
Examples of the embodiments of the present disclosure can be described in view of the following clauses:
Clause 1. An ophthalmic imaging device, comprising: an imaging assembly having an optical axis; a housing assembly to which the imaging assembly is attached, wherein the housing assembly is configured to rest on a horizontal surface during operation of the imaging assembly, and wherein the optical axis is oriented at an angle from 45 degrees to 85 degrees from the horizontal surface when the housing assembly rests on the horizontal surface; and a viewer assembly coupled with the housing assembly, the viewer assembly comprising an interface surface shaped to engage a user's head to stabilize a position and an orientation of the user's head relative to the optical axis, the viewer assembly accommodating different positions and/or orientations of the user's head relative to the optical axis so as to enable alignment, by the user, of one of the user's eyes with the optical axis.
Clause 2. The ophthalmic imaging device of clause 1, wherein: the interface surface is configured to engage the user's head continuously along a perimeter segment that surrounds the user's eyes; and the perimeter segment extends continuously from below the user's left eye, around the user's left eye between the user's left eye and the user's left ear, above the user's eyes, around the user's right eye between the user's right eye and the user's right ear, to below the user's right eye.
Clause 3. The ophthalmic imaging device of any preceding clause, wherein the interface surface is configured to accommodate the different positions and/or orientations of the user's head relative to the optical axis.
Clause 4. The ophthalmic imaging device of any preceding clause, comprising an aperture through which the imaging assembly images the one of the user's eyes aligned with the optical axis, and wherein viewer assembly comprises a light blocking side surface that extends between the interface surface and the aperture to block light continuously along the interface surface.
Clause 5. The ophthalmic imaging device of any preceding clause, wherein the viewer assembly is deformable so that the shape of interface surface is conformable to the user's head to accommodate the different positions and/or orientations of the user's head relative to the optical axis.
Clause 6. The ophthalmic imaging device of clause 5, wherein: the viewer assembly comprises a base component, a deformable component mounted to the base component, and a biocompatible layer that covers the deformable component; and the biocompatible layer includes the interface surface.
Clause 7. The ophthalmic imaging device of any preceding clause, wherein: the viewer assembly accommodates different positions and/or orientations of each of a plurality of different user's heads relative to the optical axis so as to enable alignment, by the respective user, of one of the respective user's eye with the optical axis; and the plurality of different users comprise a plurality of different distances by which the eyes of the respective user are separated.
Clause 8. The ophthalmic imaging device of any preceding clause, wherein the interface surface is configured to engage the user's forehead.
Clause 9. The ophthalmic imaging device of any preceding clause, wherein the interface surface is configured to engage each of the user's cheeks.
Clause 10. The ophthalmic imaging device of any preceding clause, wherein: the imaging assembly has a focal point; and the focal point is disposed at a height between 180 mm to 350 mm above the horizontal surface when the housing assembly rests on the horizontal surface.
Clause 11. The ophthalmic imaging device of clause 10, wherein the housing assembly is adjustable to change the height at which the focal point is disposed above the horizontal surface.
Clause 12. The ophthalmic imaging device of clause 11, wherein the housing assembly comprises a pair of legs that can be adjusted to change the height at which the focal point is disposed above the horizontal surface.
Clause 13. The ophthalmic imaging device of any of clause 10 through clause 12, wherein: the housing assembly is adjustable to simultaneously change the height at which the focal point is disposed above the horizontal surface and the orientation of the optical axis relative to the horizontal surface; and each respective height has a corresponding unique angle of the optical axis relative to the horizontal surface.
Clause 14. The ophthalmic imaging device of any preceding clause, wherein the different positions and/or orientations of the user's head accommodated by the viewer assembly enable repositioning of the user's eye by 20 mm along any axis perpendicular to the optical axis.
Clause 15. The ophthalmic imaging device of any preceding clause, wherein the housing assembly includes a pair of handles configured to be held by the user to hold the viewer assembly in engagement with the user's head.
Clause 16. The ophthalmic imaging device of any preceding clause, further comprising a repositioning mechanism by which the viewer assembly is coupled to the housing assembly, the repositioning mechanism configured to enable repositioning of the viewer assembly relative to the housing assembly to enable separate alignment of each of the user's eyes with the optical axis.
Clause 17. The ophthalmic imaging device of clause 16, wherein the viewer assembly is slideably coupled with the housing assembly via the repositioning mechanism.
Clause 18. The ophthalmic imaging device of clause 17, wherein the viewer assembly is slideably relative to the housing assembly via the repositioning mechanism in two different directions transverse to the optical axis.
Clause 19. The ophthalmic imaging device of any of clause 16 through clause 18, wherein the repositioning mechanism is operable to reposition the viewer assembly relative to the focal point parallel to the optical axis.
Clause 20. The ophthalmic imaging device of any preceding clause, wherein the housing assembly is adjustable to change the angle at which the optical axis is oriented relative to the horizontal surface.
Clause 21. The ophthalmic imaging device of clause 20, wherein the housing assembly comprises a pair of legs that can be adjusted to change the angle at which the optical axis is oriented relative to the horizontal surface.
The present application is a Continuation of U.S. patent application Ser. No. 16/404,311, filed May 6, 2019, which is a Continuation-in-Part of International Application No. PCT/IL2018/051174, filed Nov. 4, 2018, which claims the benefit of U.S. Provisional Application Ser. No. 62/582,772, filed on Nov. 7, 2017, all of which are incorporated by reference herein in their entirety for all purposes.
Number | Date | Country | |
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62582772 | Nov 2017 | US |
Number | Date | Country | |
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Parent | 16404311 | May 2019 | US |
Child | 17345228 | US |
Number | Date | Country | |
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Parent | PCT/IL2018/051174 | Nov 2018 | US |
Child | 16404311 | US |