A classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma

Abstract

This invention proposes a classification system for lesions in the trabecular meshwork pathway of primary open-angle glaucoma. It acquires aqueous humor vein images at different times and under different drug effects, extracts different signals from different aqueous humor vein images, evaluates the location and extent of lesions in the trabecular meshwork based on changes in trabecular meshwork elastography after drug administration, and determines the extent of distal pathway lesions based on the degree of aqueous humor vein pulsation and the increase in aqueous humor vein drainage after pressure / drug administration. This provides objective evidence for medical personnel to determine the location and extent of lesions in the trabecular meshwork pathway.

Description

Technical Field

[0001] This invention relates to the field of medical image processing technology, and in particular to a classification system for lesions in the trabecular meshwork pathway of primary open-angle glaucoma. Background Technology

[0002] Glaucoma is the leading cause of irreversible blindness worldwide, with primary open-angle glaucoma being the most prevalent type. The trabecular meshwork pathway is crucial for the drainage of aqueous humor and constitutes a major obstacle to its outflow. Pathological changes in this pathway are the most important cause of elevated intraocular pressure, leading to the development and progression of primary open-angle glaucoma. Current treatments for primary open-angle glaucoma include medication, laser therapy, and surgery. Drug therapy can be categorized into three mechanisms: reducing aqueous humor production, increasing drainage through the trabecular meshwork pathway, and increasing drainage through the uveal-scleral pathway. Surgical treatment includes minimally invasive surgeries such as trabecular meshwork fenestration and circumferential trabecular meshwork incision, as well as colostomy surgeries such as trabeculectomy. Accurately determining the location and extent of lesions in the trabecular meshwork pathway is essential for developing a personalized treatment plan and is of great significance. Summary of the Invention

[0003] The purpose of this invention is to at least address one of the aforementioned technical deficiencies.

[0004] Therefore, one objective of this invention is to propose a classification system for lesions in the trabecular meshwork pathway in primary open-angle glaucoma. This system evaluates the location and extent of lesions in the trabecular meshwork based on changes in trabecular meshwork elastography after medication, and determines the extent of distal pathway lesions based on the degree of aqueous venous pulsation and the increase in aqueous venous drainage after pressure / medication. This provides objective evidence for medical personnel to determine the location and extent of lesions in the trabecular meshwork pathway.

[0005] To achieve the above objectives, an embodiment of the present invention provides a classification system for lesions in the trabecular meshwork pathway of primary open-angle glaucoma, including a first image acquisition module for acquiring original images of the first aqueous humor vein.

[0006] The second image acquisition module is used to acquire images of the second atrial vein under constant pressure compression.

[0007] The third image acquisition module is used to acquire images of the third atrial venule after the action of the first preparation.

[0008] The fourth image acquisition module is used to acquire images of the fourth atrial venule after the second preparation has been applied;

[0009] The fifth image acquisition module is used to acquire the first trabecular mesh elastic map of the eye at four points after the action of the first formulation and the second trabecular mesh elastic map of the eye at four points after the action of the second formulation.

[0010] The trabecular meshwork pathway lesion classification module is used to extract the pulsation intensity signal of the aqueous humor vein based on the first atrial venous image. When the extracted pulsation intensity signal of the aqueous humor vein exceeds the first intensity threshold, the trabecular meshwork fenestration location is determined based on the third atrial venous image and the obtained first or second trabecular meshwork elastogram; otherwise, the lesion site is screened based on the second and fourth atrial venous images.

[0011] More preferably, the trabecular meshwork pathway lesion site classification module includes:

[0012] The signal extraction module is used to extract the pulsation intensity signal of the aqueous humor vein from the first aqueous humor vein image; extract the drainage volume signal of the aqueous humor vein from the second and fourth aqueous humor vein images; and extract the intraocular pressure signal from the third aqueous humor vein image.

[0013] The comparison and classification module is used to compare the intensity signal of the first atrial venous pulsation with a first intensity threshold.

[0014] If the pulsation intensity signal of the first atrial vena cava is greater than the first intensity threshold, then it is further determined whether the reduction in intraocular pressure signal extracted from the third atrial vena cava image exceeds the second preset threshold; if so, the trabecular meshwork fenestration position is determined according to the first trabecular meshwork elasticity diagram; otherwise, the trabecular meshwork fenestration position is determined according to the second trabecular meshwork elasticity diagram after the second preparation has been applied.

[0015] If the pulsation intensity signal of the first atrial vein is less than or equal to the first intensity threshold, then it is determined whether the drainage signal of the atrial vein extracted from the second atrial vein image is enhanced. If so, it belongs to the circumferential lesion of the trabecular meshwork. Otherwise, it is determined whether the drainage signal of the atrial vein extracted from the fourth atrial vein image is enhanced. If so, it also belongs to the circumferential lesion of the trabecular meshwork. Otherwise, it belongs to the overall lesion of the trabecular meshwork.

[0016] More preferably, the first aqueous humor vein image is an aqueous humor vein image of at least 1 minute recorded using a slit lamp under diffuse cobalt blue light irradiation.

[0017] More preferably, the second aqueous humor vein image is an aqueous humor vein image recorded for at least 30 seconds by using an optimized Goldman probe to directionally compress the scleral vein.

[0018] More preferably, the third aqueous humor vein image is an aqueous humor vein image of at least 30 seconds recorded 10 minutes after the application of the first preparation, wherein the first preparation is a prostaglandin drug.

[0019] More preferably, the fourth aqueous humor vein image is an aqueous humor vein image of at least 30 seconds recorded 10 minutes after the second formulation is applied, wherein the second formulation is a receptor agonist.

[0020] More preferably, the trabecular mesh elasticity map obtained is a trabecular mesh elasticity map of four points (12, 3, 6, and 9) of the eye after phase light coherence imaging.

[0021] Furthermore, the second preset threshold is 5 mmHg.

[0022] More preferably, in the comparison and classification module, when classifying the trabecular mesh opening parts based on the trabecular mesh elastic map obtained by the fifth image acquisition module, the part with the largest amplitude of motion change in the trabecular mesh elastic map of the four points around the eye is selected as the trabecular mesh opening part.

[0023] The trabecular meshwork pathway lesion classification system provided by the present invention has at least the following advantages compared with the prior art: it evaluates the lesion location and degree of the trabecular meshwork based on changes in trabecular meshwork elastography before and after medication, and determines the degree of distal pathway lesion based on the degree of aqueous venous pulsation and the increase in aqueous venous drainage after pressure / medication, providing objective basis for medical personnel to determine the lesion location and degree of the trabecular meshwork pathway.

[0024] Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. Attached Figure Description

[0025] The above and / or additional aspects and advantages of the present invention will become apparent and readily understood from the description of the embodiments taken in conjunction with the following drawings, in which:

[0026] Figure 1 A structural diagram of a classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma;

[0027] Figure 2 A flowchart classifying lesions along the trabecular meshwork pathway in primary open-angle glaucoma. Detailed Implementation

[0028] Embodiments of the present invention are described in detail below, examples of which are illustrated in the accompanying drawings, wherein the same or similar reference numerals denote the same or similar elements or elements having the same or similar functions throughout. The embodiments described below with reference to the accompanying drawings are exemplary and intended to explain the present invention, and should not be construed as limiting the present invention.

[0029] like Figure 1-2 As shown, the classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma provided in this embodiment of the invention includes:

[0030] The first image acquisition module is used to acquire the original image of the first aqueductal vein.

[0031] The second image acquisition module is used to acquire images of the second atrial vein under constant pressure compression.

[0032] The third image acquisition module is used to acquire images of the third atrial venule after the action of the first preparation.

[0033] The fourth image acquisition module is used to acquire images of the fourth atrial venule after the second preparation has been applied;

[0034] The fifth image acquisition module is used to acquire the first trabecular mesh elastic map of the eye at four points after the action of the first formulation and the second trabecular mesh elastic map of the eye at four points after the action of the second formulation.

[0035] The first aqueous humor vein image is a minimum of 1 minute of aqueous humor vein image recorded using a slit lamp under diffuse cobalt blue light. The second aqueous humor vein image is a minimum of 30 seconds of aqueous humor vein image recorded using an optimized Goldman probe to apply constant pressure to the episcleral vein. The third aqueous humor vein image is a minimum of 30 seconds of aqueous humor vein image recorded 10 minutes after the application of the first formulation, which is a prostaglandin drug. The fourth aqueous humor vein image is a minimum of 30 seconds of aqueous humor vein image recorded 10 minutes after the application of the second formulation, which is an alpha-receptor agonist.

[0036] The elasticity map is obtained based on phase light coherent imaging technology. It is preferred to obtain the elasticity map of the trabecular meshwork at four points on the eye, which can be the 12 o'clock, 3 o'clock, 6 o'clock and 9 o'clock points on the eye.

[0037] The first trabecular meshwork elastogram is a trabecular meshwork elastogram of four points in the eye obtained 10 minutes after the use of prostaglandin drugs, based on phase light coherence imaging. The second trabecular meshwork elastogram is a trabecular meshwork elastogram of four points obtained 10 minutes after the use of α-receptor agonists.

[0038] The trabecular meshwork pathway lesion classification module is used to extract the pulsation intensity signal of the aqueous humor vein based on the first atrial venous image. When the extracted pulsation intensity signal of the aqueous humor vein exceeds the first intensity threshold, the trabecular meshwork fenestration location is determined based on the third atrial venous image and the acquired trabecular meshwork elastography. Otherwise, the lesion site is screened based on the second and fourth atrial venous images.

[0039] The trabecular meshwork pathway lesion site classification module includes:

[0040] The signal extraction module is used to extract the pulsation intensity signal of the aqueous humor vein from the first aqueous humor vein image; extract the drainage volume signal of the aqueous humor vein from the second and fourth aqueous humor vein images; and extract the intraocular pressure signal from the third aqueous humor vein image.

[0041] The comparison and classification module is used to compare the intensity signal of the first atrial venous pulsation with a first intensity threshold.

[0042] If the pulsation intensity signal of the first atrial vena cava is greater than the first intensity threshold, then it is further determined whether the reduction in intraocular pressure signal extracted from the third atrial vena cava image exceeds the second preset threshold; if so, the trabecular meshwork fenestration position is determined according to the first trabecular meshwork elasticity diagram; otherwise, the trabecular meshwork fenestration position is determined according to the second trabecular meshwork elasticity diagram.

[0043] If the pulsation intensity signal of the first atrial vein is less than or equal to the first intensity threshold, then the analysis continues to determine whether the drainage signal of the atrial vein extracted from the second atrial vein image is enhanced. If so, it belongs to a circumferential trabecular meshwork lesion; otherwise, the analysis continues to determine whether the drainage signal of the atrial vein extracted from the fourth atrial vein image is enhanced. If so, it also belongs to a circumferential trabecular meshwork lesion; otherwise, it belongs to a global trabecular meshwork lesion. 。

[0044] In a further preferred embodiment, in the comparison and classification module, when determining the window position of the beam mesh based on the elasticity map of the beam mesh obtained by the fifth image acquisition module,

[0045] In the elasticity graph of the trabecular mesh at four points around the eye, the part with the largest amplitude of motion change is the fenestrated part of the trabecular mesh.

[0046] The conditions that must be met for trabecular meshwork fenestration classification include: obvious aqueous humor venous pulsation (greater than the first intensity threshold); intraocular pressure decrease of not less than 5 mmHg 10 minutes after prostaglandin administration; evaluation of changes in trabecular meshwork elastography at four points, with the site of greatest motion change being the trabecular meshwork fenestration site, i.e., the stent or drainage device implantation site; or, intraocular pressure decrease of less than 5 mmHg 10 minutes after prostaglandin administration, followed by 10 minutes after administration of an alpha-receptor agonist, evaluation of changes in trabecular meshwork elastography at four points, with the site of greatest motion change being the trabecular meshwork fenestration site, i.e., the stent or drainage device implantation site.

[0047] The conditions required for circumferential trabecular meshwork lesions include: minimal pulsation of the aqueous humor veins (≤ first intensity threshold); enhanced pulsation of the aqueous humor veins when the episcleral veins are compressed with a goldman probe at constant pressure; circumferential trabecular meshwork incision is then performed. Alternatively, if the episcleral veins are compressed with a goldman probe at constant pressure but the pulsation of the aqueous humor veins does not increase, and the drainage of the aqueous humor veins increases after 10 minutes of continued use of an alpha-receptor agonist; circumferential trabecular meshwork incision is then performed.

[0048] The conditions that need to be met for trabecular meshwork lesions include: no obvious pulsation of the aqueous humor vein (≤ first intensity threshold); no increase in the pulsation of the aqueous humor vein when the episcleral vein is compressed with a fixed pressure using an optimized Goldman probe; no significant change in the drainage volume of the aqueous humor vein after 10 minutes of continued use of an alpha-receptor agonist; and a fistula surgery is performed at this time.

[0049] In the description of this specification, references to terms such as "one embodiment," "some embodiments," "example," "specific example," or "some examples," etc., indicate that a specific feature, structure, material, or characteristic described in connection with that embodiment or example is included in at least one embodiment or example of the invention. In this specification, the illustrative expressions of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials, or characteristics described may be combined in any suitable manner in one or more embodiments or examples.

[0050] Although embodiments of the present invention have been shown and described above, it is to be understood that the above embodiments are exemplary and should not be construed as limiting the present invention. Those skilled in the art can make changes, modifications, substitutions, and variations to the above embodiments within the scope of the present invention without departing from the principles and spirit of the invention. The scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma, characterized in that, include: The first image acquisition module is used to acquire the original image of the first aqueductal vein. The second image acquisition module is used to acquire images of the second atrial vein under constant pressure compression. The third image acquisition module is used to acquire images of the third atrial venule after the action of the first preparation. The fourth image acquisition module is used to acquire images of the fourth atrial venule after the second preparation has been applied; The fifth image acquisition module is used to acquire the first trabecular mesh elastic map of the eye at four points after the action of the first formulation and the second trabecular mesh elastic map of the eye at four points after the action of the second formulation. The trabecular meshwork pathway lesion classification module is used to extract the pulsation intensity signal of the aqueous humor vein based on the first aqueous humor vein image. When the extracted pulsation intensity signal of the aqueous humor vein exceeds the first intensity threshold, the trabecular meshwork fenestration location is determined based on the third aqueous humor vein image and the obtained first or second trabecular meshwork elastography. Otherwise, the lesion site is screened based on the second and fourth aqueous humor vein images. The trabecular meshwork pathway lesion site classification module includes: The signal extraction module is used to extract the pulsation intensity signal of the aqueous humor vein from the first aqueous humor vein image; Aqueous venous drainage signals were extracted from images of the second and fourth aqueous venous vessels; intraocular pressure signals were extracted from images of the third aqueous venous vessel. The comparison and classification module is used to compare the intensity signal of the first atrial venous pulsation with a first intensity threshold. If the pulsation intensity signal of the first aqueous humor vein is greater than the first intensity threshold, then it is further determined whether the reduction in intraocular pressure signal extracted from the third aqueous humor vein image exceeds the second preset threshold; if so, the trabecular meshwork fenestration position is determined according to the first trabecular meshwork elasticity diagram; otherwise, the trabecular meshwork fenestration position is determined according to the second trabecular meshwork elasticity diagram after the second preparation has been applied. If the pulsation intensity signal of the first atrial vein is less than or equal to the first intensity threshold, then it is determined whether the drainage signal of the atrial vein extracted from the second atrial vein image is enhanced. If so, it belongs to the circumferential lesion of the trabecular meshwork. Otherwise, it is determined whether the drainage signal of the atrial vein extracted from the fourth atrial vein image is enhanced. If so, it also belongs to the circumferential lesion of the trabecular meshwork. Otherwise, it belongs to the overall lesion of the trabecular meshwork.

2. The classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma according to claim 1, characterized in that, The first aqueous humor vein image is an aqueous humor vein image of at least 1 minute recorded using a slit lamp under diffuse cobalt blue light.

3. The classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma according to claim 1, characterized in that, The second aqueous humor vein image is a minimum 30-second image of the aqueous humor vein recorded using an optimized Goldman probe to directionally compress the scleral vein.

4. The classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma according to claim 1, characterized in that, The third aqueous humor vein image is an image of at least 30 seconds of aqueous humor vein recorded 10 minutes after the application of the first formulation, which is a prostaglandin drug.

5. The classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma according to claim 1, characterized in that, The fourth aqueous humor vein image is an aqueous humor vein image of at least 30 seconds recorded 10 minutes after the application of the second agent, which is an α-receptor agonist.

6. The classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma according to claim 1, characterized in that, The trabecular mesh elasticity map is the trabecular mesh elasticity map obtained based on phase light coherent imaging at four points: 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock in the eye.

7. The classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma according to claim 6, characterized in that, The second preset threshold is 5 mmHg.

8. The classification system for lesion sites in the trabecular meshwork pathway of primary open-angle glaucoma according to claim 2, characterized in that, In the comparison and classification module, when classifying the trabecular mesh opening parts based on the trabecular mesh elastic map obtained by the fifth image acquisition module, the part with the largest amplitude of motion change in the trabecular mesh elastic map of the four points around the eye is selected as the trabecular mesh opening part.

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