Real-time measurement of biomechanics at multiple ocular tissue locations

Abstract

Certain aspects of the present disclosure provide systems (10) and methods (800) for real-time measurement of biomechanics at a plurality of ocular tissue locations. In some embodiments, the method (800) may be performed by a computer (30) in communication with an optical coherence tomography (OCT) device (15, 315). The method includes receiving an indication that stimulation is applied to ocular tissue (346) of a patient (42). The method further includes instructing the OCT device (15, 315) to emit a plurality of light beams (344, 560, 660) to a plurality of measurement locations (772) on the ocular tissue (346) at substantially the same time in response to the received indication. The method (800) also includes receiving OCT data for each of the plurality of measurement locations (772) from the OCT device (15, 315). The method (800) also includes measuring a tissue response to the stimulation at the plurality of measurement locations based on the OCT data.

Description

Cross-reference to related applications

[0001] This application claims priority to U.S. Provisional Application No. 63 / 579,406, filed August 29, 2023, which is incorporated herein by reference in its entirety. Background Technology

[0002] Tissue biomechanics (such as corneal biomechanics) can play a crucial role in understanding, diagnosing, and treating eye diseases such as glaucoma, keratoconus, and ectasia. However, the ability to measure this biomechanics is often limited by hardware constraints. For example, optical coherence tomography (OCT) equipment is often not fast enough to capture useful measurements. Summary of the Invention

[0003] This disclosure relates to diagnostic systems and methods, and more specifically to systems and methods for measuring biomechanics in real time at multiple ocular tissue locations.

[0004] In some embodiments, a general aspect includes a system for real-time measurement of biomechanics at multiple ocular tissue locations. The system includes an optical coherence tomography (OCT) device and a computer communicatively coupled to the OCT device. The computer is operable to receive instructions that a stimulus be applied to a patient's ocular tissue, and in response to the received instructions, to instruct the OCT device to emit multiple beams of light to multiple measurement locations on the ocular tissue at approximately the same time. The computer is also operable to receive OCT data from the OCT device for each of the multiple measurement locations. The computer is further operable to measure the tissue response to stimulation at the multiple measurement locations based on the OCT data.

[0005] In some embodiments, another general aspect includes a method for measuring biomechanics in real time at multiple ocular tissue locations. The method may be performed by a computer communicating with an optical coherence tomography (OCT) device. The method includes receiving an instruction that a stimulus is applied to a patient's ocular tissue. The method also includes instructing the OCT device, in response to the received instruction, to fire multiple beams at multiple measurement locations on the ocular tissue at approximately the same time. The method further includes receiving OCT data from the OCT device for each of the multiple measurement locations. The method also includes measuring the tissue response to the stimulus at the multiple measurement locations based on the OCT data. Attached Figure Description

[0006] To gain a detailed understanding of how the features described above are implemented, the disclosure can be described in more detail with reference to embodiments (some of which are shown in the accompanying drawings). However, it should be noted that the drawings illustrate only exemplary embodiments and should not be construed as limiting the scope of the disclosure, and may allow for other equally effective embodiments.

[0007] Figure 1A Example configurations of ophthalmic diagnostic systems according to certain embodiments of this disclosure are shown.

[0008] Figure 1B Another example configuration of an ophthalmic diagnostic system according to certain embodiments of this disclosure is shown.

[0009] Figure 2 This is based on certain embodiments of the disclosure. Figures 1A to 1B A block diagram of the various components of an ophthalmic diagnostic system.

[0010] Figure 3 Example aspects of an ophthalmic diagnostic system according to certain embodiments of this disclosure are shown.

[0011] Figure 4 Examples of optical coherence tomography (OCT) engines operable for generating multiple imaging beams according to certain embodiments of this disclosure are shown.

[0012] Figure 5 Another example of an OCT engine operable for generating multiple imaging beams according to certain embodiments of this disclosure is shown.

[0013] Figure 6 Another example of an OCT engine operable for generating multiple imaging beams according to certain embodiments of this disclosure is shown.

[0014] Figures 7A to 7C Example measurement patterns of an eye are shown according to certain embodiments of this disclosure.

[0015] Figure 8 Examples of processes for real-time measurement of corneal biomechanics at multiple locations are shown, according to certain embodiments of this disclosure.

[0016] For ease of understanding, the same reference numerals have been used where possible to refer to the same elements common to the figures. It is contemplated that elements and features of one embodiment can be advantageously combined in other embodiments without further description. Detailed Implementation

[0017] For the purpose of facilitating an understanding of the principles of this disclosure, reference will now be made to the embodiments illustrated in the accompanying drawings, and these embodiments will be described using specific language. However, it should be understood that this is not intended to limit the scope of this disclosure. Any changes and further modifications to the described systems, devices, apparatuses, and methods, as well as any further applications of the principles of this disclosure, are fully contemplated and would normally occur to those skilled in the art to which this disclosure pertains. In particular, features, components, and / or steps described with respect to one embodiment may be combined with features, components, and / or steps described with respect to other embodiments of this disclosure. For simplicity, in some cases, the same reference numerals are used in all the drawings to refer to the same or similar parts.

[0018] Ocular biomechanics, including corneal biomechanics (e.g., corneal stiffness), plays a crucial role in understanding, diagnosing, and treating diseases such as glaucoma, keratoconus, and ectasia. Detailed clinical assessments of corneal biomechanics promise to revolutionize the ophthalmology industry by enabling personalized LASIK (laser-in-situ keratomileusis) and cataract surgery, for example. The assessment and understanding of corneal biomechanics can be applied in corneal surgery to determine patient fit and improve the safety and efficacy of procedures. For instance, corneal ectasia is a very rare but serious complication of refractive surgery, with an incidence of 0.04%–0.6%. Measuring corneal biomechanical properties can help screen refractive surgery candidates preoperatively to minimize the risk of postoperative corneal ectasia. For example, in cataract surgery, the range of surgically induced astigmatism (SIA) (0 to 1.5D) can be a significant source of refractive errors. Accurate measurement of corneal biomechanics allows for better prediction of patient-specific SIA in cataract surgery and improves surgical outcomes.

[0019] For example, one way to measure compressive stiffness is through Young's modulus. Calculating Young's modulus typically involves measuring the propagation speed of a shear wave across the corneal surface in response to a stimulus. Theoretically, data generated by an optical coherence tomography (OCT) device can be used to measure this propagation speed. However, in practice, shear waves can propagate at speeds, for example, tens of meters per second. Typically, a shear wave can travel across the entire cornea in just a few milliseconds. Because OCT devices typically operate at speeds less than 100 kHz, and because OCT-based methods involve scanning a laser beam, measuring the propagation speed of shear waves using OCT-based methods is challenging. While some of these technical difficulties can be mitigated by repeatedly applying a stimulus to the same location and then measuring the shear wave propagation speed at different locations at different times, this process is time-consuming and generally unsuitable for in vivo applications.

[0020] This disclosure describes examples of OCT-based methods for real-time measurement of biomechanics at multiple locations on a patient's eye. In various embodiments, for example, stimulation may be applied to the patient's cornea. Subsequently, a computer may instruct or cause an OCT device to simultaneously emit multiple beams of light at multiple locations on the cornea. In various embodiments, the multiple beams enable the reception of OCT data at each of the multiple locations in response to a single stimulus. Advantageously, in some embodiments, the OCT data can be used to measure the corneal response to a single stimulus at multiple locations, thereby significantly reducing measurement time. For example, shear wave propagation velocities can be calculated more efficiently and reliably based on OCT data obtained simultaneously from multiple locations. Furthermore, in various examples, shear wave propagation velocities can be more easily measured in multiple directions. Specific examples will be described in more detail with reference to the accompanying drawings.

[0021] For illustrative purposes, this disclosure describes various examples relating to the measurement of corneal biomechanics. However, it should be understood that similar principles apply to the measurement of the biomechanics of other parts and / or other tissues of the eye.

[0022] Figure 1A , Figure 1B and Figure 2 Examples of an ophthalmic diagnostic system 10 according to certain embodiments are shown. The ophthalmic diagnostic system 10 can be used for different types of diagnostic and treatment procedures. For example, the ophthalmic diagnostic system 10 can be used for the diagnosis or treatment of glaucoma, keratoconus, and / or ectasia. Additionally or alternatively, the ophthalmic diagnostic system 10 can be used to provide data support for personalized LASIK or cataract surgery.

[0023] Figure 1A The configuration 100A of the ophthalmic diagnostic system 10 is shown. Specifically, Figure 1A The head 6 of a patient 42 lying on bed 8 is shown. In the example shown, the ophthalmic diagnostic system 10 includes a camera 38 and components 39, wherein multiple imaging beams can exit the ophthalmic diagnostic system 10 and travel through area 41 toward the patient 42.

[0024] Figure 1B Configuration 100B of the ophthalmic diagnostic system 10 is shown. In configuration 100B, the ophthalmic diagnostic system 10 is configured as a desktop imaging system, wherein the patient 42 is seated in a chair 9.

[0025] refer to Figure 2The ophthalmic diagnostic system 10 includes an OCT device 15, a camera 38, and a control computer 30 coupled as shown. The OCT device 15 includes controllable components coupled as shown, such as an OCT engine 12, a beam scanner 16, one or more optical elements 17, and / or a focusing objective lens 18. The computer 30 includes logic 36 coupled as shown, a memory 32 (which stores computer programs 34), and a display 37. For ease of explanation, the following xyz coordinate system is used: the z-direction is defined by the propagation direction of the imaging beam, and the xy plane is orthogonal to the propagation direction. Other suitable xyz coordinate systems may be used.

[0026] Referring specifically to OCT device 15, OCT engine 12 generates and emits multiple imaging beams, which are guided to the tissues of patient 42's eye 22. For example, the imaging beams can be guided to different locations on the corneal surface of eye 22. (The remaining text appears to be unrelated and likely refers to a different topic.) Figures 3 to 6 , Figures 7A to 7C and Figure 8 As described in more detail, the OCT engine 12 can generate and emit imaging beams at approximately the same time (i.e., simultaneously).

[0027] The beam scanner 16 variably guides the imaging beam to one or more optical elements 17 based on its configuration and positioning. For example, the beam scanner 16 can variably guide the imaging beam by orienting it laterally and / or longitudinally. Lateral direction refers to a direction orthogonal to the beam propagation direction, i.e., the x-direction and y-direction. The beam scanner 16 can orient the imaging beam laterally in any suitable manner. For example, the beam scanner 16 may include a pair of galvanometer-actuated scanning mirrors that can tilt about mutually perpendicular axes. As another example, the beam scanner 16 may include an electro-optic crystal capable of electro-optically manipulating the imaging beam. In some embodiments, the beam scanner 16 can simultaneously adjust the imaging beam emitted by the OCT engine 12.

[0028] The longitudinal direction refers to the direction parallel to the propagation of the light beam, i.e., the z-direction. The beam scanner 16 can longitudinally orient the imaging beam in any suitable manner. For example, the beam scanner 16 may include a longitudinally adjustable lens, a lens with variable refractive power, or a deformable mirror that can control the z-position of the beam focus. The components of the beam scanner 16 can be arranged in any suitable manner along the applicable beam path, for example, in the same or different modular units.

[0029] One or more optical elements 17 direct the imaging beam toward the focusing objective 18. The optical elements 17 can act (e.g., transmit, reflect, refract, diffract, collimate, adjust, shape, focus, modulate, and / or otherwise act on) the imaging beam. Examples of optical elements include lenses, prisms, mirrors, diffractive optics (DOEs), holographic optics (HOEs), and spatial light modulators (SLMs). In some examples, the optical element 17 is a mirror or a dichroic mirror. The focusing objective 18 focuses the imaging beam toward a portion of the eye 22, such as the corneal surface of the eye. In examples, the focusing objective 18 is an objective lens, such as an f-θ objective lens.

[0030] OCT engine 12 receives the returned imaging beam backscattered from eye 22 in the opposite direction to the imaging beam. OCT engine 12 can be configured to generate one or more images to provide executable feedback for storage, as described in detail below. For example, in various embodiments, OCT engine 12 is configured to analyze the returned imaging beam using interferometry to provide OCT data representing the position-dependent structural characteristics of eye 22 (e.g., the structural characteristics of the cornea). For example, OCT engine 12 can be configured to provide OCT data representing corneal images at or near focal positions x, y, z, and to provide OCT data representing the position-dependent optical density n(x,y,z) and the position-dependent mass density p(x,y,z) of the cornea.

[0031] Although some examples of the OCT device 15 have been described above, it should be understood that in various embodiments, the OCT device 15 may be configured to perform different types of OCT scans. In some embodiments, the OCT device 15 may be configured to perform an M scan. In another example, the OCT device 15 may be configured to perform a B scan. In yet another example, the OCT device 15 may be configured to perform an MB scan. In still another example, the OCT device 15 may be configured to perform a BM scan. Other examples will be apparent to those skilled in the art upon careful reading of this disclosure.

[0032] Camera 38 can continuously capture one or more images of patient 42. For example, camera 38 can be focused on eye 22. Examples of cameras 38 include video cameras, interferometric cameras, thermal imaging cameras, ultrasound cameras, OCT cameras, and eye-tracking cameras. Camera 38 transmits image data representing recorded images of eye 22 to computer 30. In some embodiments, camera 38 may be a component of OCT device 15, rather than... Figure 2 That's a separate part.

[0033] Computer 30 controls components of ophthalmic diagnostic system 10 according to computer program 34. For example, computer 30 controls components (e.g., OCT engine 12, beam scanner 16, optics 17, and / or focusing lens 18) to focus the imaging beam of OCT engine 12 onto a desired measurement location on eye 22, such as a desired measurement location on the corneal surface of the eye. Memory 32 stores information used by computer 30. For example, memory 32 may store images of eye 22, OCT data, and / or other suitable information, and computer 30 can access the information from memory 32. In various embodiments, computer program 34 and its functions (such as focusing the imaging beam) may be managed by a user (e.g., a medical professional).

[0034] In some embodiments, computer 30 can measure corneal biomechanics of eye 22 in real time at multiple locations. In some embodiments, computer 30 monitors indications that a stimulus is applied to the patient's cornea. When computer 30 detects a stimulus or is notified of such a stimulus (e.g., by a user), computer 30 can instruct or cause OCT device 15 to fire multiple imaging beams at multiple different locations on the patient's cornea. Computer 30 can then receive OCT data generated by the imaging beams from OCT device 15. Computer 30 can use the OCT data to measure the corneal response to the stimulus at each of the multiple different locations in response to the detected stimulus. Computer 30 can record the OCT data and / or data related to the measured corneal response in memory 32 or other storage devices.

[0035] Figure 3 An example of an ophthalmic diagnostic system 310 is shown. Typically, the ophthalmic diagnostic system 310 may include information about... Figures 1A to 1B and Figure 2 The ophthalmic diagnostic system 10 may include any components and functions described with respect to the ophthalmic diagnostic system 310. Similarly, the ophthalmic diagnostic system 10 may include any components and functions described with respect to the ophthalmic diagnostic system 310. Therefore, for ease of description, similar components of the ophthalmic diagnostic system 10 and the ophthalmic diagnostic system 310 may occasionally be referred to interchangeably. For simplicity, Figure 3 The demonstration focuses on example OCT device 315, example camera 338, and stimulation device 352.

[0036] In the illustrated embodiment, the OCT device 315 includes an OCT engine 312, a beam scanner 316, one or more optical elements 317, a focusing lens 318, and lamps 348(1) and 348(2). Typically, the OCT engine 312, beam scanner 316, one or more optical elements 317, and focusing lens 318 can each be as follows: Figure 2It operates as described in relation to the OCT engine 12, the beam scanner 16, one or more optical elements 17 and / or the focusing objective 18, respectively.

[0037] With similar Figure 2 In the manner of OCT engine 12, OCT engine 312 generates and emits multiple imaging beams that are directed onto the surface of cornea 346 of eye 322, and the engine can then receive the backscattered imaging beams from eye 322 in the opposite direction to the imaging beams. For illustrative purposes, OCT engine 312 is shown generating and emitting three imaging beams, namely imaging beams 344(1), 344(2), and 344(3) (collectively referred to as imaging beam 344). However, it should be understood that the amount of imaging beam 344 can be configured to suit a given implementation.

[0038] exist Figure 3 In the example, the beam scanner 316 variably guides the imaging beam 344 to a specific location on one or more optical elements 317 based on its configuration and / or positioning. One or more optical elements 317 orient the imaging beam 344 toward these specific locations based on or according to the specific location on the focusing objective 318 to which the imaging beam 344 is guided by the beam scanner 316. For example, different beams can be directed to different locations on the focusing objective 318 due to the varying position and / or positioning characteristics of the one or more optical elements 317. The focusing objective 318 can focus the imaging beam 344 onto multiple desired measurement locations on the cornea 346. Figure 3 In the example, one or more optical elements 317 are shown as dichroic mirrors, and a focusing objective 318 is shown as an objective lens.

[0039] In some embodiments, camera 338 may be, for example, an iris camera focused or fixed to eye 322 and provides continuous images of eye 322 to computer 30. In various embodiments, lamps 348(1) and 348(2) may improve the quality of images captured by camera 338. For illustrative purposes, lamps 348(1) and 348(2) are shown as light-emitting diodes (LEDs) that direct light toward eye 322. Camera 338 may be as described above. Figures 1A to 1B and Figure 2 The camera 38 in the diagram operates as described. Those skilled in the art will understand that... Figure 3 The components shown can be present in any suitable quantity or configuration. For example, it should be understood that... Figure 3 The two lamps shown (i.e., lamps 348(1) and 348(2)) may be modified in number, type and / or configuration to suit a given implementation.

[0040] The stimulation device 352 can be any suitable device for applying external stimulation to the cornea 346. For example, the stimulation device 352 can apply an air pulse to induce corneal displacement. In another example, the stimulation device 352 can apply ultrasound to induce corneal displacement. Other examples of stimulation will be apparent to those skilled in the art upon careful reading of this disclosure.

[0041] In various embodiments, Figure 2 Computer 30 monitors indications of stimuli applied to cornea 346 by stimuli device 352. When computer 30 detects a stimulus applied by stimuli device 352 or is notified (e.g., by a user) of a stimulus, computer 30 may instruct or cause OCT device 315 to emit multiple imaging beams 344 at approximately the same time (i.e., simultaneously) to multiple different locations on cornea 346. Computer 30 can then receive OCT data generated by the imaging beams 344 from OCT device 315. Computer 30 can use the OCT data to measure the corneal response to the detected stimulus at each of the multiple different locations. Computer 30 may record the OCT data and / or data related to the measured corneal response in memory 32 or other storage devices.

[0042] Figure 4 An example of an OCT engine 412 operable for generating multiple imaging beams is shown. In various embodiments, the OCT engine 412 can be used as... Figure 2 OCT Engine 12 and / or used as Figure 3 The OCT engine 312. In the illustrated embodiment, the OCT engine 412 includes a beam source 454, a beam splitter 458, and optical elements 462(1) and 462(2).

[0043] In the illustrated embodiment, beam source 454 generates source beam 456 in any suitable manner. Beam splitter 458 splits source beam 456 into a first beam 460(1) to optical element 462(1) and a second beam 460(2) to optical element 462(2). Beam splitter 458 can be any suitable device for separating beams, such as a polarization beam splitter in some cases.

[0044] Optical elements 462(1) and 462(2) direct beams 460(1) and 460(2) toward beam scanner 316, respectively, such that beams 460(1) and 460(2) are multiple imaging beams generated by OCT engine 412. Optical elements 462(1) and 462(2) can act on (e.g., transmit, reflect, refract, diffract, collimate, adjust, shape, focus, modulate, and / or otherwise act on) beams 460(1) and 460(2). Examples of optical elements 462(1) and 462(2) include lenses, prisms, mirrors, diffractive optical elements (DOE), holographic optical elements (HOE), and spatial light modulators (SLM). Figure 4 In the example, optical elements 462(1) and 462(2) are mirrors. Beams 460(1) and 460(2) can be guided to the cornea via beam scanner 316, for example... Figure 3 The cornea 346, as about Figures 1A to 1B , Figure 2 and Figure 3 In summary.

[0045] Figure 5 An example of an OCT engine 512 operable for generating multiple imaging beams is shown. In various embodiments, the OCT engine 512 can be used as... Figure 2 OCT Engine 12 and / or used as Figure 3 The OCT engine 512. In the illustrated embodiment, the OCT engine 512 includes a beam source 554, a beam splitter 558, and optical elements 564(1), 564(2), 564(3) and 564(4) (collectively referred to as optical elements 564).

[0046] In the illustrated embodiment, beam source 554 generates source beam 556 in any suitable manner. Beam splitter 558 splits source beam 556 into a first beam 560(1) directed to optical element 564(1), a second beam 560(2) directed to optical element 564(2), a third beam 560(3) directed to optical element 564(3), and a fourth beam 560(4) directed to optical element 564(4) (collectively referred to as beam 560). Beam splitter 558 can be any suitable device for splitting beams. Figure 5 In the example shown, beam splitter 558 is a 1 × N fiber beam splitter, where N equals four in the illustrated embodiment. However, it should be understood that beam splitter 558 can split the source beam 556 into different numbers of beams depending on the requirements of a given implementation.

[0047] Optical element 564 directs beam 560 to beam scanner 316 such that beam 560 is one of multiple imaging beams generated by OCT engine 512. Optical element 564 can act on (e.g., transmit, reflect, refract, diffract, collimate, adjust, shape, focus, modulate, and / or otherwise act on) beam 560. Examples of optical elements 564 include lenses, prisms, mirrors, diffractive optics (DOE), holographic optics (HOE), and spatial light modulators (SLM). Figure 5 In this example, optical element 564 is a collimator. Beam 560 can be guided to the cornea via beam scanner 316, for example... Figure 3 The cornea 346, as about Figures 1A to 1B , Figure 2 and Figure 3 In summary.

[0048] Figure 6 An example of an OCT engine 612 operable for generating multiple imaging beams is shown. In various embodiments, the OCT engine 612 can be used as... Figure 2 OCT Engine 12 and / or used as Figure 3 The OCT engine 612. In the illustrated embodiment, the OCT engine 612 includes a beam source 654, beam splitters 658(1), 658(2), and 658(3), and optical elements 664(1), 664(2), 664(3), and 664(4) (collectively referred to as optical elements 664). It should be understood that the beam splitters 658(1), 658(2), and 658(3) can be configured to split the beam in any suitable manner.

[0049] In the illustrated embodiment, beam source 654 generates source beam 656 in any suitable manner. Beam splitter 658(1) splits source beam 656 into a first intermediate beam 659(1) directed to beam splitter 658(2) and a second intermediate beam 659(2) directed to beam splitter 658(3). For clarity, intermediate beams 659(1) and 659(2) are referred to as “intermediate” because they do not represent the beam output by OCT engine 612.

[0050] continue Figure 6For example, beam splitter 658(2) splits the intermediate beam 659(1) into a first output beam 660(1) directed to optical element 664(1) and a second output beam 660(2) directed to optical element 664(2). Similarly, beam splitter 658(3) splits the intermediate beam 659(2) into a third output beam 660(3) directed to optical element 664(3) and a fourth output beam 660(4) directed to optical element 664(4). Output beams 660(1), 660(2), 660(3) and 660(4) are collectively referred to as output beam 660.

[0051] Optical element 664 directs output beam 660 to beam scanner 316 such that output beam 660 is a plurality of imaging beams generated by OCT engine 612. Optical element 664 can act (e.g., transmit, reflect, refract, diffract, collimate, adjust, shape, focus, modulate, and / or otherwise act on) output beam 660. Examples of optical elements 664 include lenses, prisms, mirrors, diffractive optics (DOE), holographic optics (HOE), and spatial light modulators (SLM). Figure 6 In this example, optical element 664 is a collimator. The output beam 660 can be guided to the cornea via beam scanner 316, for example... Figure 3 The cornea 346, as about Figures 1A to 1B , Figure 2 and Figure 3 In summary.

[0052] Figures 7A to 7C A measurement pattern of the eye is shown. The eye is shown as having a cornea 746, a conjunctiva 766, and a limbus 768. Figure 7A Measurement pattern 700A is shown. In measurement pattern 700A, for example via... Figure 3 The stimulation device 352 applies stimulation at stimulation site 770A on the cornea 746. In response to the stimulation, an imaging beam is emitted toward measurement site 772A at approximately the same time (i.e., simultaneously), so that the corneal response can be measured.

[0053] Figure 7B An example measurement pattern 700B is shown. In measurement pattern 700B, for example via... Figure 3 The stimulation device 352 applies stimulation at stimulation site 770B on the cornea 746. In response to the stimulation, an imaging beam is emitted toward measurement site 772B at approximately the same time (i.e., simultaneously), so that the corneal response can be measured.

[0054] Figure 7C An example measurement pattern 700C is shown. In measurement pattern 700C, for example via... Figure 3The stimulation device 352 applies stimulation at stimulation site 770C on the cornea 746. In response to the stimulation, an imaging beam is emitted toward measurement site 772C at approximately the same time (i.e., simultaneously), so that the corneal response can be measured.

[0055] Figure 8 An example of a procedure 800 for real-time measurement of corneal biomechanics at multiple corneal locations is shown. In some embodiments, procedure 800 can be implemented by any system capable of processing OCT data. While any number of systems (in whole or in part) can implement procedure 800, for the sake of simplicity, it will be combined with information on... Figures 1A to 1B and Figure 2 Ophthalmic diagnostic system 10 and Figure 3 The process 800 is described using example components of the ophthalmic diagnostic system 310.

[0056] At box 802, computer 30 monitors that the stimulus has been applied to the patient's cornea (e.g., Figure 3 The indication of the cornea (346) can be, for example, automatically detected stimulation, user-provided input indicating stimulation has been applied, a computer-generated synchronization signal, the expiration of a synchronization timer for stimulation application, or a combination of the above. In various embodiments, the stimulation indication may include or be accompanied by an indication of the stimulation location. This can be, for example, via... Figure 3 The stimulation device 352 applies stimulation to each stimulation site separately, for example... Figure 7A , Figure 7B and Figure 7C The stimulation sites are 770A, 770B and 770C.

[0057] At decision box 804, computer 30 determines whether an instruction to apply a stimulus to the patient's eye has been received. If no instruction to apply a stimulus has been received, process 800 returns to box 802 and continues as previously described. Otherwise, if it is determined at decision box 804 that an instruction to apply a stimulus has been received, process 800 proceeds to box 806.

[0058] At box 806, computer 30 instructs OCT device 15 to emit multiple imaging beams toward multiple desired measurement sites on the patient's cornea at approximately the same time (i.e., simultaneously). In this example, the desired measurement sites may correspond to... Figure 7A , Figure 7B and Figure 7C The measurement positions are 772A, 772B, or 772C. Commands to the OCT device 15 can cause the OCT device 15 to perform the actions described above. Figures 1A to 1B and Figures 2 to 6Multiple imaging beams are generated and emitted in any manner as described herein, and OCT data is provided based thereon. At block 808, computer 30 receives from OCT device 15 OCT data generated by OCT device 15 for each of the multiple measurement locations.

[0059] At box 810, the computer measures the corneal response to stimulation at multiple measurement locations based on OCT data. For example, computer 30 may measure the propagation velocity of a shear wave along or within the patient's cornea based on the measurement location. In some embodiments, computer 30 may quantify tissue stiffness (e.g., Young's modulus) based, for example, on the propagation velocity of the shear wave. For example, if viscosity can be neglected, the Young's modulus (E) may be based on Equation 1 and the propagation velocity of the shear wave, or the shear wave velocity (E). Related to, among which, ρ is the material density, and mv is Poisson's ratio. Generally, the stiffness of a structure is proportional to Young's modulus, and a higher Young's modulus corresponds to greater (longitudinal) stiffness. Equation 1

[0060] At box 812, computer 30 stores and / or displays data generated from boxes 808 and 810, such as OCT data and generated corneal biomechanics. In various embodiments, the OCT data and / or generated corneal biomechanics may be stored in memory 32 or other storage devices in patient-related context. Alternatively or additionally, the OCT data and / or generated biomechanics may be displayed to the user or operator of ophthalmic diagnostic system 10.

[0061] At decision box 814, computer 30 determines whether to collect additional corneal biomechanics in response to further stimulation of the patient's eye. If it is determined at decision box 814 that additional corneal biomechanics should be collected, process 800 returns to box 802 and executes as previously described. Otherwise, process 800 terminates.

[0062] In various embodiments, diagnostic systems such as the example diagnostic systems described herein can offer a variety of advantages. For example, such diagnostic systems that measure the biomechanical properties of diseased or healthy corneas allow for the inclusion of new indicators in treatment planning algorithms to increase predictability and surgeon confidence. For instance, corneal biomechanics (such as those described herein) can help assess treatment interventions (compared to crosslinking) and can also help assess collagen degradation. Furthermore, in some embodiments, corneal biomechanics is highly correlated with myopia, thereby affecting the success of orthokeratology (Ortho-K) procedures (e.g., myopia reduction). High myopia may increase the risk of glaucoma. Therefore, in some embodiments, corneal biomechanics (such as those described herein) can help predict or identify the risk of myopia and / or glaucoma.

[0063] Alternatively or concurrently, in various embodiments, diagnostic systems (such as the example diagnostic systems described herein) can help identify patients at risk of post-LASIK complications. Typically, refractive surgery planning uses population-based average corneal biomechanics. Statistically, approximately one percent of LASIK patients experience ectasia. In various embodiments, individualized corneal biomechanics, as described herein, can improve the ability to predict the risks of surgical interventions, such as post-LASIK ectasia.

[0064] Alternatively or concurrently, the ability to generate corneal biomechanical measurements and apply them to treatment algorithms can support more accurate estimation, prediction, and / or establishment of cataract outcomes resulting from patient-specific surgical astigmatism (SIA), limbal laxity incision (LRI) outcomes calculated based on patient-specific data, treatment decisions regarding corneal refractive power, Ortho-K outcomes, treatment and / or diagnosis of dry eye, etc. For example, SIA can range from 0 to 1.5D, which can be a significant source of refractive errors. Corneal biomechanics (such as those described herein) can enable better prediction of patient-specific SIA during cataract surgery and improve the accuracy of LRI.

[0065] The subject matter disclosed above should be considered illustrative rather than restrictive, and the appended claims are intended to cover all such modifications, enhancements, and other embodiments falling within the true spirit and scope of this disclosure. Therefore, for the maximum permissible extent permitted by law, the scope of this disclosure shall be determined by the broadest possible interpretation of the appended claims and their equivalents, and should not be limited to or restricted by the foregoing detailed description.

Claims

1. A system for real-time measurement of biomechanics at multiple ocular tissue locations, the system comprising: Optical coherence tomography (OCT) equipment; as well as A computer communicatively coupled to the OCT device, wherein the computer is operable to: The system receives instructions to stimulate the patient's eye tissues. In response to a received instruction, the OCT device is instructed to emit multiple beams at multiple measurement locations on the eye tissue at approximately the same time; Receive OCT data from each of the plurality of measurement locations from the OCT device; and The tissue response to the stimulus is measured at the plurality of measurement locations based on the OCT data.

2. The system of claim 1, wherein the OCT device includes an OCT engine that generates the plurality of beams in approximately the same time in response to the instruction.

3. The system of claim 2, wherein the OCT device further comprises a beam scanner, optical elements, and a focusing objective, wherein: The beam scanner guides the generated multiple beams to a first plurality of positions on the optical element; The optical element orients the guided multiple beams toward a second plurality of positions on the focusing objective based on the first plurality of positions; and The focusing objective focuses multiple beams of light at multiple measurement locations on the eye tissue.

4. The system as described in claim 3, wherein, The optical element is a dichroic mirror.

5. The system of claim 2, wherein the OCT engine includes a beam splitter and a first optical element and a second optical element, wherein: The beam splitter splits the source beam into a first beam directed to the first optical element and a second beam directed to the second optical element; The first optical element and the second optical element direct the first beam and the second beam toward the beam scanner; and The plurality of beams generated by the OCT engine include a first oriented beam and a second oriented beam.

6. The system of claim 2, wherein the OCT engine comprises an optical fiber beam splitter and a first optical element and a second optical element, wherein: The fiber beam splitter splits the source beam into a first beam to the first optical element and a second beam to the second optical element; The first optical element and the second optical element direct the first beam and the second beam toward the beam scanner; and The plurality of beams generated by the OCT engine include a first oriented beam and a second oriented beam.

7. The system of claim 2, wherein the OCT engine comprises a plurality of beam splitters, the plurality of beam splitters including a first beam splitter, a second beam splitter, and a third beam splitter; and a plurality of optical elements, the plurality of optical elements including a first optical element, a second optical element, a third optical element, and a fourth optical element, wherein: The first beam splitter splits the source beam into a first intermediate beam to the second beam splitter and a second intermediate beam to the third beam splitter; The second beam splitter splits the first intermediate beam into a first output beam to the first optical element and a second output beam to the second optical element; The third beam splitter splits the second intermediate beam into a third output beam to the third optical element and a fourth output beam to the fourth optical element; The first optical element, the second optical element, the third optical element, and the fourth optical element direct the first output beam, the second output beam, the third output beam, and the fourth output beam to the beam scanner; and The plurality of beams generated by the OCT engine include a first oriented output beam, a second oriented output beam, a third oriented output beam, and a fourth oriented output beam.

8. The system of claim 1, wherein, The computer is operable to perform at least one of the following: record or display data generated by the measured tissue response.

9. The system as claimed in claim 1, wherein, The measurement includes measuring the propagation speed of shear waves within at least a portion of the eye tissue based on the OCT data.

10. The system of claim 9, wherein, The measurement includes quantifying tissue stiffness based on the propagation velocity of the shear wave.

11. The system of claim 1, wherein, The eye tissue includes the patient's cornea.

12. A method for measuring biomechanics in real time at multiple ocular tissue locations, the method comprising performing the following operations via a computer in communication with an optical coherence tomography (OCT) device: The system receives instructions to stimulate the patient's eye tissues. In response to a received instruction, the OCT device is instructed to emit multiple beams at multiple measurement locations on the eye tissue at approximately the same time; Receive OCT data from each of the plurality of measurement locations from the OCT device; as well as The tissue response to the stimulus is measured at the plurality of measurement locations based on the OCT data.

13. The method of claim 12, comprising at least one of the following: recording or displaying data generated from the measured tissue response.

14. The method of claim 12, wherein, The measurement of tissue response includes measuring the propagation speed of shear waves within at least a portion of the eye tissue based on the OCT data.

15. The method of claim 14, wherein, The measurement includes quantifying tissue stiffness based on the propagation speed of the shear wave.

16. The method of claim 12, further comprising the OCT device generating the plurality of beams in substantially the same time response to the instruction.

17. The method of claim 16, further comprising: Multiple beams generated are guided to first multiple locations on an optical element via a beam scanner; The optical elements direct multiple beams of light toward a second plurality of positions on the focusing objective lens based on the first plurality of positions; as well as Multiple beams of light, oriented in the direction of the beam, are focused onto the multiple measurement locations on the eye tissue via the focusing objective lens.

18. The method of claim 16, wherein generating the plurality of beams comprises: The source beam is split into a first beam directed to a first optical element and a second beam directed to a second optical element; as well as The first beam and the second beam are directed to the beam scanner via the first optical element and the second optical element, wherein the generated plurality of beams include the directed first beam and the directed second beam.

19. The method of claim 16, wherein generating the plurality of beams includes The source beam is split into a first intermediate beam and a second intermediate beam; The first intermediate beam is split into a first output beam to a first optical element and a second output beam to a second optical element; The second intermediate beam is split into a third output beam to a third optical element and a fourth output beam to a fourth optical element; as well as The first output beam, the second output beam, the third output beam, and the fourth output beam are directed to the beam scanner via the first optical element, the second optical element, the third optical element, and the fourth optical element, wherein the generated plurality of beams includes the directed first output beam, the directed second output beam, the directed third output beam, and the directed fourth output beam.

20. A computer program product comprising a non-transitory computer-usable medium containing computer-readable program code adapted to be executed to perform a method comprising: The system receives instructions to stimulate the patient's eye tissues. In response to a received instruction, the optical coherence tomography (OCT) device is instructed to emit multiple beams at multiple measurement locations on the eye tissue at approximately the same time; Receive OCT data from each of the plurality of measurement locations from the OCT device; as well as The tissue response to the stimulus is measured at the plurality of measurement locations based on the OCT data.

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