Multi-modality ophthalmic imaging system and method of imaging patient's eye

Abstract

To provide a multi-modality ophthalmic imaging system and a method of imaging a patient's eye by means of the multi-modality ophthalmic imaging system.SOLUTION: A multi-modal ophthalmic imaging system for acquiring ophthalmic images of a patient's eye comprises: a first imaging module, operable in a first imaging modality, for acquiring a first ophthalmic image of a first portion of the patient's eye; and one or more further imaging modules, each operable in a different imaging modality. The imaging system further comprises a control module arranged to: detect an anomaly in the first ophthalmic image that is indicative of an ocular disease; determine a region of interest in the patient's eye based on the detected anomaly, where the region of interest is a region within the patient's eye that is predicted to contain a second anomaly; and determine, based on the second anomaly, a second imaging modality for imaging the determined region of interest; and control the selected second imaging module to acquire a second ophthalmic image of the determined region of interest.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] Exemplary aspects of the present disclosure relate generally to a multi-modality ophthalmic imaging system and a method for imaging a patient's eye using a multi-modality ophthalmic imaging system. [Background technology]

[0002] A multi-modality ophthalmic imaging device allows a clinician to acquire ophthalmic images of a patient's eye using a variety of different imaging modalities. The imaging modality in which the ophthalmic imaging system operates is typically selected by the clinician based on the type of lesion the clinician wants to image in the patient's eye. In some cases, the clinician can acquire multiple ophthalmic images of the patient's eye using one or more imaging modalities of the ophthalmic imaging system.

[0003] When a clinician is imaging a patient's eye, the clinician may first obtain a front-facing scanning laser ophthalmoscope (SLO) image of the patient's retina. The clinician may then review the front-facing SLO image of the patient's retina to identify one or more regions that contain some sign of pathology that would not be present in a comparable image of a healthy eye. The presence of such regions may indicate a disease or other unhealthy condition in the subject. Once the clinician identifies one or more regions that contain signs of pathology, the clinician may capture further ophthalmic images, such as ophthalmic coherence tomography (OCT) images of the region of the eye, using one or more different imaging modalities.

[0004] This process of capturing an initial ophthalmic image, identifying areas indicative of disease, and then capturing additional ophthalmic images of the patient's eye using additional imaging modalities can be very time-consuming for both the clinician and the patient. Furthermore, if the ophthalmic imaging system is operated by a photographer who is unfamiliar with diagnosing ophthalmic diseases, the initial ophthalmic image may have to be sent to be reviewed by an ophthalmologist for analysis to determine whether additional ophthalmic images are needed. This can result in the patient having to be called back to the clinic multiple times to be imaged multiple times by the photographer based on feedback from the ophthalmologist.

[0005] The process of reviewing the initial ophthalmic images to identify pathology is a time-consuming process that requires a highly skilled ophthalmologist to review the images, which can significantly reduce patient throughput through the clinic and often requires the patient to return to the clinic to capture additional ophthalmic images in order to diagnose the ophthalmic disease. Summary of the Invention

[0006] According to a first exemplary aspect, a multimodal ophthalmic imaging system for acquiring ophthalmic images of a patient's eye is provided, the multimodal ophthalmic imaging system including: a first imaging module operable in a first imaging modality for acquiring a first ophthalmic image of the patient's eye; one or more further imaging modules, each operable in a respective imaging modality, where each imaging modality of the one or more further imaging modules is different from the first imaging modality; and a control module configured to detect an anomaly in the first ophthalmic image acquired by the first imaging module; and determine a related condition in the patient's eye based on the detected anomaly in the first ophthalmic image. The system further comprises a control module configured to: determine a cardiac region within the patient's eye, where the determined region of interest is a region within the patient's eye predicted to contain a second abnormality; determine a second imaging modality for imaging the determined region of interest based on the second abnormality, where the second imaging modality is different from the first imaging modality; select a second imaging module from the one or more further imaging modules that is operable in the determined second imaging modality; and control the selected second imaging module to acquire a second ophthalmic image of the determined region of interest.

[0007] In an exemplary embodiment, the abnormality detected in the first ophthalmic image may indicate a first stage of a multi-stage or progressive ocular disease, and the second abnormality may indicate a second stage of the multi-stage or progressive ocular disease.

[0008] In another exemplary embodiment, the first imaging module may comprise a scanning laser ophthalmoscope (SLO) and the first ophthalmic image may be a fundus image of the patient's eye.

[0009] In a further exemplary embodiment, the control module may be further configured to determine, based on the second anomaly, one or more image acquisition parameters of the second imaging module for controlling the second imaging module to acquire a second ophthalmic image of the determined area of ​​interest.

[0010] In an exemplary embodiment, the control module may be communicatively coupled to a database including medical records indicative of a patient's medical history, and the control module is configured to retrieve the patient's medical records from the database and determine an area of ​​interest based on both the detected anomaly and the patient's medical history.

[0011] In an exemplary embodiment, the control module may be configured to detect a discontinuity at a boundary of the second ophthalmic image, the discontinuity at the boundary indicative of a cropping of a second abnormality located in the second ophthalmic image, and in response to detecting the discontinuity at the boundary of the second ophthalmic image, the control module may be configured to control the second imaging module to increase a size of the determined region of interest to generate an enlarged region of interest and acquire an ophthalmic image of the enlarged region of interest.

[0012] In another exemplary embodiment, the control module may be configured to: determine a second region of interest based on the detected anomaly, where the second region of interest is a region including the detected anomaly; determine a third imaging modality for imaging the determined second region of interest based on the detected anomaly, where the third imaging modality is different from the first imaging modality; select a third imaging module from the one or more further imaging modules that is operable in the determined third imaging modality; and control the selected third imaging module to acquire a third ophthalmic image of the determined second region of interest.

[0013] According to a second exemplary aspect, a method of imaging a patient's eye is provided, the method including: acquiring a first ophthalmic image of the patient's eye using a first imaging module operating in a first imaging modality; detecting an anomaly in the first ophthalmic image acquired by the first imaging module; determining a region of interest in the patient's eye based on the detected anomaly in the first ophthalmic image, where the determined region of interest is a region in the patient's eye predicted to include a second anomaly; determining a second imaging modality for imaging the determined region of interest based on the second anomaly, where the second imaging modality is different from the first imaging modality; and acquiring a second ophthalmic image of the determined region of interest using the second imaging module operating in the determined second imaging modality.

[0014] In an exemplary embodiment, the abnormality detected in the first ophthalmic image may indicate a first stage of a multi-stage or progressive ocular disease, and the second abnormality may indicate a second stage of the multi-stage or progressive ocular disease.

[0015] In an exemplary embodiment, the method may include determining whether a second anomaly has been captured in the second ophthalmic image by detecting a discontinuity at a boundary of the second ophthalmic image, where detecting the presence of a discontinuity at the boundary may indicate cropping of the second anomaly in the second ophthalmic image.

[0016] In an exemplary embodiment, the method may include, in response to detecting the presence of a discontinuity at a boundary of the second ophthalmic image, increasing a size of the determined region of interest to generate an enlarged region of interest and acquiring a further ophthalmic image of the enlarged region of interest.

[0017] In a further exemplary embodiment, the method may include receiving a patient's medical record including the patient's medical history, and determining the region of interest may be based on a combination of the detected abnormality in the first ophthalmic image and the received patient's medical history.

[0018] In another exemplary embodiment, the method may further include determining one or more image acquisition parameters of a second imaging module based on the second anomaly and operating the second imaging module with the determined image acquisition parameters to acquire a second ophthalmic image.

[0019] In an exemplary embodiment, the method may include determining a second region of interest based on the detected anomaly, where the second region of interest is a region including the detected anomaly; determining a third imaging modality for imaging the determined second region of interest based on the detected anomaly, where the third imaging modality is different from the first imaging modality; selecting a third imaging module from the one or more further imaging modules that is operable in the determined third imaging modality; and controlling the selected third imaging module to acquire a third ophthalmic image of the determined second region of interest.

[0020] In a third exemplary aspect, a multi-modal ophthalmic imaging system is provided for acquiring ophthalmic images of an eye of a patient, the multi-modal ophthalmic imaging system including: a first imaging module operable in a first imaging modality for acquiring a first ophthalmic image of the eye of the patient, one or more further imaging modules, each operable in a respective imaging modality, wherein each imaging modality of the one or more further imaging modules is different from the first imaging modality; detecting an anomaly in the first ophthalmic image acquired by the first ophthalmic imaging module, the anomaly being indicative of a first stage of a multi-stage ophthalmic disease; predicting a second stage of the multi-stage ophthalmic disease based on the detected anomaly; and predicting a second stage of the multi-stage ophthalmic disease based on the detected anomaly. a control module configured to: determine a region of interest in the patient's eye based on the determined second stage, where the determined region of interest is a region in the patient's eye predicted to include a second abnormality indicative of a second stage of the multi-stage ocular disease; determine a second imaging modality for imaging the determined region of interest based on the second abnormality, where the second imaging modality is different from the first imaging modality; select a second imaging module from the one or more further imaging modules that is operable in the determined second imaging modality; and control the selected second imaging module to acquire a second ophthalmic image of the determined region of interest.

[0021] In a fourth exemplary aspect, a method of imaging a patient's eye is provided, the method including: acquiring a first ophthalmic image of the patient's eye using a first imaging module operating in a first imaging modality; detecting an abnormality in the first ophthalmic image acquired by the first ophthalmic imaging module; predicting a second stage of a multi-stage ophthalmic disease based on the detected abnormality; determining a region of interest in the patient's eye based on the predicted second stage of the multi-stage ophthalmic disease, where the determined region of interest is a region in the patient's eye predicted to include a second abnormality indicative of the second stage of the multi-stage ophthalmic disease; determining a second imaging modality for imaging the determined region of interest based on the second abnormality, where the second imaging modality is different from the first imaging modality; and acquiring a second ophthalmic image of the determined region of interest using a second imaging module operating in the determined second imaging modality.

[0022] Exemplary embodiments are now described in detail, by way of non-limiting example only, with reference to the accompanying drawings, in which: Like reference numbers appearing in the various drawings may denote identical or functionally similar elements, unless otherwise indicated, in which: [Brief description of the drawings]

[0023] [Figure 1] FIG. 1 is a schematic diagram of a multi-modal ophthalmic imaging system according to a first exemplary embodiment of the present disclosure. [Diagram 2] FIG. 2 is a schematic diagram of a fundus image captured by the multimodal ophthalmic imaging system of FIG. [Diagram 3] FIG. 3 is a flow chart illustrating a method for imaging a patient's eye, according to an exemplary embodiment of the present disclosure. [Figure 4] FIG. 4 is a schematic diagram of a multi-modal ophthalmic imaging system according to a second exemplary embodiment of the present disclosure. [Diagram 5]FIG. 5 is a schematic diagram of a first ophthalmic image captured by a first imaging module of the multimodal ophthalmic imaging system of FIG. 1 or FIG. [Figure 6] FIG. 6 is an exemplary hardware implementation of an apparatus capable of operating as a control module for a multi-modality ophthalmic imaging system, according to exemplary embodiments herein. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0024] In view of the background provided above, the inventors have devised a multi-modality ophthalmic imaging system having a control module or processor configured to detect an abnormality indicative of a first stage of a progressive or multi-stage ophthalmic disease in a first ophthalmic image acquired by a first ophthalmic imaging module operating in a first imaging modality. Upon detecting the abnormality in the first ophthalmic image, the control module is configured to determine one or more regions of interest in the patient's eye based on the detected abnormality. The one or more determined regions of interest may be regions of the patient's eye susceptible to progression or further stages of the multi-stage ophthalmic disease indicated by the detected abnormality. The control module may determine a second imaging modality for acquiring a second ophthalmic image of the determined regions of interest based on the detected abnormality. The control module is configured to select a second imaging module operable in the determined second imaging modality to acquire a second ophthalmic image of the one or more regions of interest using the second imaging module to acquire further ophthalmic images of regions in the patient's eye that are susceptible to progression of the multi-stage ophthalmic disease and predicted or expected to include a second abnormality indicative of progression of the multi-stage ophthalmic disease.

[0025] For example, the multi-modality ophthalmic imaging system may be an ophthalmic imaging system having a scanning laser ophthalmoscopy (SLO) imaging module and an optical coherence tomography (OCT) imaging module. The SLO imaging module may acquire a fundus image of the patient's eye. The control module may analyze or search the captured fundus image to check for the presence of an abnormality indicative of a multi-stage or progressive ocular disease. Upon detecting an abnormality in the fundus image, the control module may determine a region of interest in the fundus image predicted to include a second abnormality associated with the progression of the multi-stage ocular disease indicated by the detected abnormality. The determined region of interest may be a region for further imaging by a second imaging modality. For example, the region of interest may be a peripheral region of the patient's retina predicted to include a second abnormality associated with the progression of the multi-stage ocular disease based on the detection of the abnormality in the fundus image.

[0026] The control module is configured to select a second imaging modality for acquiring an ophthalmic image of the determined region of interest based on the detected abnormality and / or based on a type of lesion expected to be present as a second abnormality in the determined region of interest based on the expected advanced stage of the multi-stage eye disease indicated by the detected abnormality. For example, if the control module predicts that the second abnormality is a retinal hemorrhage, such as may be present in the determined region of interest, the control module may determine that the OCT imaging module should operate in an OCT angiography (OCTA) imaging modality to acquire a second ophthalmic image of the determined region of interest. The OCT imaging module then operates in the OCTA imaging modality to acquire the second ophthalmic image of the determined region of interest.

[0027] Advantageously, the multi-modality ophthalmic imaging system allows multiple images of the patient's eye to be acquired in a single imaging session. This can help capture the images necessary to accurately diagnose the progression level of the multi-stage ophthalmic disease in the patient's eye in a single visit by the patient to the clinician. Furthermore, the control module can select a second imaging modality for imaging the predicted second abnormality contained in the determined region of interest based on the detected abnormality and / or based on the predicted second abnormality contained in the determined region of interest. This advantageously allows the multi-modality ophthalmic imaging system to operate to capture high quality ophthalmic images of the abnormality in the patient's eye that assist the ophthalmologist in diagnosing the progression state of the patient's ophthalmic disease. Furthermore, the control module can modify acquisition parameters of the second imaging module based on the detected abnormality and / or based on the predicted second abnormality associated with the progression of the multi-stage ophthalmic disease predicted to be present in the determined region of interest to optimize the quality of the second ophthalmic image. Optimizing the quality of the second ophthalmic image enables the ophthalmic imaging system to obtain a high quality image of the patient's eye so that an ophthalmologist can accurately diagnose and assess the severity of ophthalmic disease present in the patient's eye without the patient having to return to the clinic for further imaging.

[0028] To place the exemplary embodiments in the proper context, reference is now made to Figure 1, which diagrammatically illustrates a multi-modality ophthalmic imaging system 10 for imaging a patient's eye 18. The multi-modality ophthalmic imaging system 10 includes a scanning laser ophthalmoscope (SLO) imaging module 14 and an optical coherence tomography (OCT) imaging module 16 for acquiring SLO and OCT images, respectively, of the patient's eye 18. The SLO imaging module 14 is an example of a first imaging module or system, and the OCT imaging module 16 is an example of a second imaging module or system. The SLO imaging module 14 and the OCT imaging module 16 may each be capable of operating in a number of different imaging modalities.

[0029] The ophthalmic imaging system 10 may further include an optical system 15 optically coupled to the SLO imaging module 14 and the OCT imaging module 16 and configured to transmit light from the SLO imaging module 14 and the OCT imaging module 16 to and from the patient's eye 18, as in this exemplary embodiment. The optical system 15 may include focusing optics and a scanning system (not shown) for scanning a light beam emitted by the SLO imaging module 14 and / or the OCT imaging module 16 over a target imaging region of the patient's eye 18. For example, the scanning system may include one or more scanning mirrors or galvanometers for scanning a light beam emitted by either of the imaging modules 14, 16 over a target imaging region of the eye 18, such as a region of interest in the patient's retina. The SLO imaging module 14 and the OCT imaging module 16 may include one or more photodetectors (not shown) for detecting light reflected by the patient's eye 18, and a signal processor (not shown) configured to generate an ophthalmic image based on the output of the photodetectors. The optical system 15 is configured to transmit light reflected by the patient's eye 18 to photodetectors located in the SLO imaging module 14 and the OCT imaging module 16 such that the signal processing device can generate an ophthalmic image of the patient's eye 18 based on the light reflected or scattered by the eye 18.

[0030] The ophthalmic imaging system 10 further comprises a processor or control module 12 coupled to the SLO imaging module 14, the OCT imaging module 16, and the optical system 15. The control module 12 is configured to control the SLO imaging module 14, the OCT imaging module 16, and the optical system 15. The processor or control module 12 is a component of the multi-modality ophthalmic imaging system 10 and is coupled to the SLO imaging module 14, the OCT imaging module 16, and the optical system 15 for controlling them and exchanging data and information therebetween.

[0031] The control module 12 is configured to select an operating modality of the multi-modality ophthalmic imaging system 10 and to operate one or more of the SLO imaging module 14 and the OCT imaging module 16 to acquire ophthalmic images of the patient's eye 18 according to the selected operating modality. Furthermore, the control module 12 can control the optical system 15 to select a target imaging region of the patient's eye 18 to be imaged such that a scanning system of the optical system 15 can scan a light beam emitted by either the SLO imaging module 14 or the OCT imaging module 16 across the target imaging region in the patient's eye 18 to acquire one or more ophthalmic images of the selected imaging region.

[0032] The multi-modality ophthalmic imaging system 10 may further be communicatively coupled to a database 11. The database 11 may include medical records of patients being imaged by the multi-modality ophthalmic imaging system 10. The patient's medical records include the patient's medical history. The control module 12 may access the patient's medical records and retrieve the patient's medical history. Advantageously, the control module 12 may review the retrieved medical history for symptoms that may be manifested in an ocular disease, as described in further detail below with reference to FIG. 3.

[0033] The multi-modality ophthalmic imaging system 10 is configured to acquire a first ophthalmic image of a patient's eye 18 using a first imaging module operable in a first imaging modality. With reference to FIG. 1 , the first ophthalmic imaging module may be an SLO imaging module 14 operating in a fundus imaging modality. The SLO imaging module 14 is capable of acquiring a fundus image of the patient's eye 18. The fundus image acquired by the SLO imaging module 14 is an example of a first ophthalmic image acquired by a first ophthalmic imaging system.

[0034] 2, a schematic fundus image 20 of a patient's eye 18 is shown. The fundus image 20 may be acquired by the SLO imaging module 14 of the multi-modality ophthalmic imaging system 10. The fundus image 20 includes a retinal vasculature 22 extending across the patient's retina 21 from the optic disc 24 toward the retinal periphery. The fundus image 20 includes an abnormality 26 located on the patient's retina 21 indicative of a first stage of a multi-stage or progressive ocular disease. The abnormality 26 is a feature of the fundus image 20 indicative of a multi-stage or progressive ocular disease in the eye 18, such as diabetic retinopathy or a tumor. The abnormality 26 may be one or more of a lesion, a retinal hole, a retinal detachment, a fluid accumulation, a tumor, a discoloration of the retina 21, a shadow on the retina 21, a hemorrhage in the retinal vasculature 22, a microaneurysm in the vasculature 22, or any other feature indicative of a multi-stage ocular disease that appears as an abnormality 26 on or below the surface of the patient's retina 21.

[0035] The fundus image 20 is an example of a first ophthalmic image captured by a first imaging module, which in this exemplary embodiment may be the SLO imaging module 14. Upon acquiring the fundus image 20, the SLO imaging module 14 may transmit the fundus image 20 to the control module 12. The control module 12 is configured to analyze the received fundus image 20 to detect the presence of one or more anomalies 26 indicative of a first stage of a multi-stage ocular disease in the fundus image 20. The control module 12 may detect the presence of anomalies in the fundus image 20 using image processing techniques or machine learning algorithms trained on ophthalmic image data, including images of healthy and diseased eyes, to detect the presence of anomalies in the fundus image 20. Such techniques for searching for anomalies in ophthalmic images are described in more detail in WO 2020 / 127233, the contents of which are incorporated herein by reference in their entirety.

[0036] If the control module 12 detects the presence of one or more anomalies 26 in the fundus image 20 indicative of a stage of a multi-stage or progressive ocular disease, the control module 12 is configured to determine a region of interest 28 based on the detection of the anomalies 26 in the fundus image 20, where the determined region of interest is predicted or expected to include a second anomaly 27 indicative of a further stage or progression of the multi-stage ocular disease. The second anomaly 27 may be an anomaly not visible in the first ophthalmic image. For example, the second anomaly 27 may be a sub-surface feature or an out-of-field feature of the first ophthalmic image 20.

[0037] If the anomaly 26 indicates bleeding into the retina, the anomaly 26 may indicate pre-proliferative retinopathy in the case of diabetic retinopathy. In this case, the next stage of diabetic retinopathy is proliferative retinopathy, which may result in retinal detachment. Thus, the region of interest 28 may be an area of ​​the eye 18 susceptible to retinal detachment, such as a peripheral region of the retina, and the second anomaly 27 may be predicted to be a retinal detachment.

[0038] The determined region of interest 28 is a region of the patient's eye 18 that is predicted to include the second anomaly 27 and is imaged by an imaging module operating in an imaging modality different from the imaging modality used to acquire the first ophthalmic image, in this example the fundus image 20. The determined region of interest 28 may be a region surrounding the detected anomaly 26, where the second anomaly 27 may be predicted to be an enlargement of the detected anomaly 26, or as shown in FIG. 2, the region of interest 28 may be a region distant from the detected anomaly 26 that is determined to be a region of interest in the patient's eye susceptible to a disease associated with the detected anomaly 26 and predicted to include the second anomaly 27. For example, if the anomaly 26 indicates a pathology that begins in a central region of the retina 21 and progresses to the periphery of the retina 21, the determined region of interest 28 may be located in the periphery of the retina 21. The size, location, and shape of the region of interest 28 may be determined by the control module 12 based on characteristics of the detected anomaly 26.

[0039] The detected abnormality 26 may be a region of swelling of blood vessels in the patient's retina 21, indicative of an early stage of diabetic retinopathy. For example, the swelling may be a microaneurysm, indicative of mild non-proliferative diabetic retinopathy. In an example where the abnormality 26 is indicative of an early stage of diabetic retinopathy, a region of interest 28 may be determined to be the region surrounding the detected microaneurysm, and an OCTA (OCT-angiography) imaging modality may be used to obtain further ophthalmic images of the determined region of interest 28 to establish whether a second abnormality 27 is present that is associated with hemorrhage into the retina, indicative of pre-proliferative retinopathy.

[0040] The control module 12 is configured to determine a second imaging modality for acquiring a second ophthalmic image of the determined region of interest 28 based on the detected anomaly 26 of the first ophthalmic image and / or based on the predicted second anomaly 27. The second imaging modality for imaging the determined region of interest 28 may be determined based on a type of lesion expected to be present in the region of interest 28 determined as the predicted second anomaly 27. The type of lesion expected to be present in the region of interest 28 in which the second anomaly 27 is determined is a lesion associated with the progression of a multi-stage ophthalmic disease indicated by the detected anomaly 26.

[0041] The control module 12 may determine a multi-stage eye disease indicated by the anomaly 26 based on one or more characteristics of the anomaly 26 detected in the first ophthalmic image 20. The characteristics of the anomaly 26 may be any one or more of the anomaly's size, shape, location, color, number of occurrences, or any other characteristic indicative of a multi-stage eye disease. Based on the characterization of the anomaly 26, the control module 12 is configured to predict a location within the eye and also predict a type of lesion likely to be present as a second anomaly 27 at the predicted location, and then determine a second imaging modality for acquiring a second ophthalmic image of the determined region of interest 28 based on the predicted second anomaly 27.

[0042] The control module 12 may use machine learning algorithms or image processing techniques to determine characteristics of the detected anomaly 26 and predict the type of multi-stage eye disease indicated by the detected anomaly 26. The size, shape, and location of the region of interest 28 is determined based on the type of multi-stage eye disease indicated by the detected anomaly 26 and / or based on the second anomaly 27 predicted to be present in the region of interest 28.

[0043] Based on the predicted second abnormality 27, the control module 12 determines a second imaging modality to be used to image the determined region of interest 28 and then selects a second imaging module operable in a second imaging mode to acquire the second ophthalmic image. For example, the control module 12 may determine that an OCT image of the region of interest 28 should be acquired to acquire cross-sectional image data of the predicted second abnormality 27. In this case, the control module 12 may select the OCT imaging module 16 operating in an OCT imaging mode to acquire the second ophthalmic image. Alternatively, the control module 12 may determine that an autofluorescence modality is required to acquire the second ophthalmic image of the predicted second abnormality 27. In this case, the control module 12 may select the SLO imaging module 14 operating in an autofluorescence imaging modality to acquire the second ophthalmic image of the region of interest 28.

[0044] The control module 12 is configured to operate the selected second imaging module to acquire a second ophthalmic image of the determined region of interest 28. Imaging the determined region of interest 28 predicted to include a second anomaly 27 associated with multi-stage ophthalmic progression that is synonymous with the detected anomaly 26 using an imaging modality selected based on characteristics of the detected anomaly 26 and / or based on a predicted second anomaly 27 associated with multi-stage ophthalmic progression in the first ophthalmic image allows high quality images of the anomaly 26 and / or the second anomaly 27 associated with multi-stage ophthalmic progression to be acquired with minimal input from an operator of the ophthalmic imaging system 10. This advantageously allows a relatively unskilled operator to image a patient using the multi-modality ophthalmic imaging system 10 while still capturing high quality ophthalmic images of the patient's eye 18 that may be forwarded to an ophthalmologist for diagnosis and evaluation of the multi-stage ophthalmic disease.

[0045] The control module 12 is further configured to determine acquisition characteristics or parameters of the second imaging module based on characteristics of the detected anomaly 26 and / or based on a type of lesion predicted to be present in the determined region of interest 28 in the form of the second anomaly 27. For example, the control module 12 may determine the acquisition parameters of the second imaging module, which may include determining one or more of a scanning range, an imaging depth, an imaging wavelength, a scanning pattern, a scanning speed, and a scanning density for imaging the region of interest 28. The acquisition characteristics of the second imaging module may be selected based on a type of lesion associated with a predicted advanced stage of the multi-stage ocular disease. For example, if the control module 12 predicts that the second anomaly 27 associated with a predicted advanced stage of the multi-stage ocular disease is subretinal fluid, the acquisition characteristics of the OCT imaging module 16 (or the second imaging module) may be set to acquire a wide-field, large-depth OCT image of the region of interest 28 to capture the entire area predicted to contain subretinal fluid. Furthermore, the location and shape of the determined region of interest 28 may affect the acquisition characteristics of the second imaging module. For example, the scan pattern, scan range, imaging depth, and imaging wavelength may be determined based on the determined location and shape of the region of interest 28.

[0046] The ophthalmic imaging system 10 may include a display (not shown) configured to display images acquired by the ophthalmic imaging system 10 to a user of the ophthalmic imaging system 10. The control module 12 may be coupled to the display such that the display can show the first ophthalmic image, the fundus image 20, to a user of the ophthalmic imaging system 10. Additionally, the display can overlay the determined region of interest 28 on the fundus image 20 such that the user of the ophthalmic imaging system 10 can see the location of the determined region of interest 28 relative to the patient's retina 21 in the first ophthalmic image. In an exemplary embodiment, the clinician can reposition and / or resize the determined region of interest 28.

[0047] The ophthalmic imaging system 10 of Figure 1 is communicatively coupled to a database 11. As shown in Figure 1, the control module 12 may be coupled to the database 11. The database 11 may form part of the ophthalmic imaging system 10 or the database may be a remote database 11. For example, the database 11 may be stored in the cloud and accessed wirelessly by the control module 12.

[0048] The database 11 is a database that includes medical information regarding the patient being imaged by the ophthalmic imaging system 10. For example, the database 11 may include digital medical records regarding the patient's medical history. The control module 12 is configured to access the database 11 to retrieve the medical records of the patient being imaged by the ophthalmic imaging system 10. For example, the control module 12 may access the database 11 to retrieve the patient's medical records and review the records for medical conditions that may manifest in ocular diseases, particularly, but not exclusively, multi-stage ocular diseases. For example, the control module 12 may review the patient's medical history to check for previous instances of ocular diseases or conditions such as the patient's age that may put the patient at risk for diabetes or multi-stage ocular diseases such as diabetic retinopathy or age-related macular degeneration.

[0049] Upon receiving a first ophthalmic image, e.g., a fundus image 20, the control module 12 is configured to analyze the first ophthalmic image for image abnormalities 26. The control module 12 may modify the analysis of the first ophthalmic image based on the patient's medical records. For example, if the patient is diabetic, the control module 12 may search the first ophthalmic image for abnormalities 26 indicative of diabetic retinopathy, such as microaneurysms, hemorrhage into the retina, retinal detachment, and blocked or leaking blood vessels in the macular.

[0050] Additionally, if the control module 12 detects the presence of an anomaly 26 indicative of ocular disease, the control module 12 can determine a region of interest 28 predicted to contain a second anomaly 27 and / or select a second imaging modality for imaging the region of interest 28 based on a combination of the patient's medical history and characteristics of the anomaly 26. For example, if the patient's medical history indicates that the patient is diabetic and an anomaly 26 indicative of neovascularization is detected, the control module 12 can determine the region of interest 28 and select a second imaging modality to investigate the progression of diabetic retinopathy. In this example, the control module 12 can determine an OCT angiography (OCTA) imaging modality (second imaging modality) to assess the severity of retinal neovascularization, and the control module 12 can then select the OCT imaging module 16 operating in the OCTA modality as the second imaging module to obtain a second ophthalmic image. If the patient's medical records are available, the control module 12 can determine the second imaging modality based on one or more combinations of the characteristics of the detected abnormality 26, the type of lesion predicted to be present in the determined region of interest, and the patient's medical history.

[0051] 3 is a flow chart illustrating a method of imaging a patient's eye 18. The method may be performed using the multi-modality ophthalmic imaging system 10 of FIG.

[0052] In step 301, the multi-modality ophthalmic imaging system 10 operates in a first imaging modality to acquire a first ophthalmic image of the patient's eye 18. Acquiring the first ophthalmic image of the patient's eye 18 may include operating a first imaging module operable in the first imaging modality to acquire the first ophthalmic image of the patient's eye 18. For example, the SLO imaging module 14 of the ophthalmic imaging system 10 may operate in a fundus imaging modality to acquire a fundus image 20 of the patient's retina 21.

[0053] Next, in step 302, the first ophthalmic image of the patient's eye 18 acquired in step 301 is analyzed or searched for the presence of anomalies indicative of a multi-stage or progressive ocular disease. Step 302 includes detecting anomalies 26 in the first ophthalmic image captured by the first ophthalmic imaging module, the detected anomalies 26 being anomalies indicative of a multi-stage ocular disease. Detecting the presence of anomalies 26 indicative of an ocular disease in the first ophthalmic image may include detecting the presence of anomalies 26 in the first ophthalmic image using image processing techniques or machine learning algorithms. For example, an artificial intelligence ophthalmic image analysis model may be used to detect the presence of anomalies 26 in the first ophthalmic image. Detecting the anomalies 26 may include one or more of detecting retinal discoloration, lesions, high or low rates of vascular network, retinal holes, or any other anomalies indicative of an ocular disease.

[0054] Detecting the anomaly 26 in the first ophthalmic image may further include determining a stage of a multi-stage eye disease indicative of the anomaly 26. For example, if the anomaly 26 is a microaneurysm in the patient's retinal vascular network, the method may further include determining that the anomaly 26 is indicative of background retinopathy, which is a first stage of diabetic retinopathy.

[0055] Upon detecting the anomaly 26 in the first ophthalmic image in step 302, the method includes determining a region of interest 28 of the patient's eye 18 predicted to include a second anomaly 27 in step 303. Determining the region of interest 28 may include determining a region of interest 28 of the patient's eye 18 imaged using a second imaging modality based on the detection of the anomaly 26 in the first ophthalmic image. Determining the region of interest 28 may include predicting a location or region of the patient's eye 18 predicted to be susceptible to an advanced stage of the multi-stage ocular disease and in which the second anomaly 27 will appear. The determined region of interest 28 may be a region of the patient's eye 18 predicted or expected to be susceptible to a second or advanced stage of the multi-stage ocular disease indicated by the detected anomaly 26 and to include the second anomaly 27.

[0056] In the example described above where the anomaly 26 is indicative of background retinopathy in a patient suffering from diabetic retinopathy (stage 1 diabetic retinopathy), the region of interest 28 may be the area surrounding the detected anomaly 26. The region of interest 28 in this example may be an area of ​​the retina 21 susceptible to hemorrhage caused by pre-proliferative retinopathy (stage 2 diabetic retinopathy), and the predicted second anomaly 27 may be hemorrhage associated with the pre-proliferative retinopathy.

[0057] However, in another exemplary embodiment, the region of interest 28 may be located away from the abnormality 26 detected in the first ophthalmic image. For example, if the abnormality 26 detected in the first ophthalmic image indicates extensive retinal hemorrhage or the like that would be indicative of pre-proliferative retinopathy (stage 2 of diabetic retinopathy), the region of interest 28 may be a peripheral region of the patient's retina 21 and the predicted second abnormality 27 may be a retinal detachment. This allows an image of the peripheral region of the patient's retina 21 to be captured such that a clinician can obtain an image of an area of ​​the patient's retina that is at risk for retinal detachment. The retinal detachment is indicative of proliferative retinopathy (stage 3 of diabetic retinopathy).

[0058] The size and location of the region of interest 28 may be determined based on characteristics of the detected anomaly and / or based on the predicted second anomaly 27. For example, if the anomaly 26 indicates a microaneurysm, the region of interest 28 may be determined to be a region surrounding the anomaly 26, and the predicted second anomaly 27 may be a hypertrophied region of hemorrhage. The determined region of interest 28 may be positioned such that an OCT angiogram image of the hypertrophied region around the microaneurysm may be obtained to assess the severity of the retinal hemorrhage. However, if the anomaly 26 indicates extensive retinal hemorrhage, the region of interest 28 may be a peripheral region of the retina 21, and the predicted second anomaly 27 may be a retinal detachment.

[0059] In another example, if the abnormality 26 indicates subretinal fluid, the region of interest 28 may be a larger region encompassing, for example, 2-10 times the area of ​​the detected abnormality 26. Determining the region of interest 28 may include determining a size and shape of the region of interest 28 based on characteristics of the detected abnormality 26 and / or based on predicted second abnormalities associated with an advanced stage of a multi-stage ocular disease associated with the detected lesion.

[0060] In step 304, the second imaging modality to be used to image the determined region of interest 28 is determined based on the type of lesion or the second anomaly 27 predicted to be present at the predicted advanced stage or second stage of the multi-stage eye disease indicated by the detected anomaly 26. Determining the second imaging modality may include determining which of a plurality of imaging modalities results in the highest quality ophthalmic image of the predicted second anomaly 27 such that the second ophthalmic image may be used to diagnose the lesion predicted to be present in the determined region of interest 28. This may be performed, for example, using a machine learning algorithm trained to select the imaging modality from a look-up table that allows the second imaging modality to be selected based on characteristics of the anomaly detected in the first ophthalmic image or based on the predicted advanced stage of the multi-stage eye disease.

[0061] Returning to the above example, if the detected abnormality 26 indicates a microaneurysm, which is synonymous with background retinopathy, the predicted advanced stage of the multi-stage eye disease is pre-proliferative retinopathy and the predicted second abnormality 27 is retinal hemorrhage. Thus, the second imaging modality may be selected based on the imaging modality most suitable for assessing the severity of the pre-proliferative retinopathy. For example, in this case, an OCT angiography imaging modality may be selected to visualize the severity of the hemorrhage into the retina 21. However, if the abnormality indicates subretinal fluid, the second imaging modality may be selected based on the imaging modality most suitable for assessing the severity and size of the subretinal fluid to establish how advanced the spread of the subretinal fluid has been. For example, an OCT imaging modality may be selected to obtain a cross-sectional image of the patient's retina so that the progression or spread of the subretinal fluid can be seen in the OCT image.

[0062] Step 304 may further include selecting image acquisition characteristics or control parameters of the second imaging modality based on characteristics of the detected abnormality and / or based on a predicted pathology type associated with progression of the abnormality detected in the first ophthalmic image. For example, the scanning range, imaging depth, imaging wavelength, scanning pattern, and scanning speed may be varied based on characteristics of the detected abnormality and / or based on a predicted pathology type associated with progression of the abnormality detected in the first ophthalmic image to maximize the quality of the ophthalmic image captured by the second imaging modality.

[0063] Steps 303 and 304 may further include receiving medical records indicative of the patient's medical history. Determining the region of interest in step 303 may predict a second abnormality 27 associated with an advanced stage or a second stage of the multi-stage ocular disease based on a combination of the detected abnormality and the patient's medical history. Furthermore, selecting a second imaging modality in step 304 to image the determined region of interest 28 may be performed based on a combination of the detected abnormality 26 and the patient's medical history.

[0064] In step 305, a second ophthalmic image of the determined region of interest 28 is acquired using a second imaging module operating in the second imaging modality selected in step 304. The first and second imaging modules may be the same imaging module operating in different imaging modalities. The method may include displaying, storing, and / or transmitting the first and / or second ophthalmic images.

[0065] The method may further include determining 306 whether a predicted second anomaly 27 located in the determined region of interest 28 has been captured in the second ophthalmic image. This is particularly beneficial when imaging an anomaly indicative of subretinal disease. For example, if the anomaly is indicative of subretinal fluid, it may not be possible to assess how far the subretinal fluid has spread until a second ophthalmic image is captured and evaluated.

[0066] Determining whether the second anomaly 27 was captured in the region of interest 28 in step 306 may include determining whether there is a discontinuity at a boundary of the second ophthalmic image. If a discontinuity is detected at a boundary or edge of the second ophthalmic image frame, it may be inferred that the region of interest 28 determined in step 303 was not large enough to encompass the second anomaly 27. For example, if the detected anomaly indicates subretinal fluid, the second imaging modality selected to image the region of interest 28 may be an OCT imaging modality. Upon acquiring the second ophthalmic image, which in this example is an OCT image, the method may include determining whether there is a structural discontinuity at the frame boundary of the second ophthalmic image, which indicates that the region of interest 28, and therefore the OCT image field of view, must be larger in a given dimension to fully capture the second anomaly 27. In this case, step 303 may be repeated to resize the region of interest 28 based on the detection of a discontinuity at the boundary of the second ophthalmic image, and the second ophthalmic image may be recaptured. This process may be repeated until no discontinuities are detected at the boundary of the second ophthalmic image, thereby indicating that the second anomaly 28 has been completely captured in the second ophthalmic image.

[0067] 4 is a schematic diagram of a multi-modality ophthalmic imaging system 40 according to a second exemplary embodiment of the present specification. The multi-modality ophthalmic imaging system 40 includes a first imaging module 42, a second imaging module 44, a third imaging module 46, an optical system 15, and a control module 12. The illustrated components and elements labeled with the same reference numbers as the first exemplary embodiment of FIG. 1 are the same and will not be described again.

[0068] The multi-modality ophthalmic imaging system 40 includes three imaging modules 42, 44, 46, each operable in one or more different imaging modalities. Each imaging module 42, 44, 46 includes a light source optically coupled to the optical system 15 for emitting a light beam to the optical system for scanning over a target imaging area of ​​the patient's eye 18. Additionally, each imaging module may include one or more photodetectors for detecting light reflected back from the patient's eye 18 through the optical system 15. Each imaging module may further include a signal processor configured to generate an ophthalmic image based on the output of the photodetectors. Although the multi-modality ophthalmic imaging system 40 includes three imaging modules 42, 44, 46, this is merely an example, and one skilled in the art will appreciate that any number of imaging modules 42, 44, 46 may be implemented in the multi-modality ophthalmic imaging system 40.

[0069] 1-3, the first imaging module 42 is operable to acquire a first ophthalmic image. The first imaging module 42 may be an SLO imaging module (shown in FIG. 1) and may be operable in a fundus imaging modality to acquire a fundus image of a patient's eye.

[0070] FIG. 5 illustrates an exemplary first ophthalmic image 50 captured by the first imaging module 42. As illustrated in FIG. 5, the first ophthalmic image 50 includes an anomaly 52 located at a branch of the retinal vasculature 22. The anomaly 52 illustrated in FIG. 5 may be a microaneurysm or bulge leaking a small amount of blood. The anomaly 52 illustrated in FIG. 5 may be an example of an anomaly 52 indicative of a multi-stage ocular disease, such as diabetic retinopathy. As discussed above, the control module 12 is configured to detect the presence of the anomaly 52 in the first ophthalmic image 50 and determine the stage of the multi-stage ocular disease that the anomaly 52 indicates. In an example where the anomaly 52 is a microaneurysm, the control module 12 may determine that the anomaly 52 is indicative of background retinopathy associated with a first stage of diabetic retinopathy.

[0071] Upon detecting the anomaly 52 in the first ophthalmic image 50, the control module 12 is configured to determine a region of interest 28 that is predicted to include a second anomaly 57 based on the detection of the anomaly 52 in the first ophthalmic image 50. In this example of an anomaly 52 indicative of a first stage of diabetic retinopathy, the control module 12 may determine that regions of interest associated with pathologies indicative of pre-proliferative and proliferative retinopathy should be imaged to establish how advanced the diabetic retinopathy is in the patient. Pre-proliferative and proliferative retinopathy are typically the second and third stages of progression, respectively, in diabetic retinopathy patients. Additionally, the control module 12 may receive the patient's medical records from the database 11 indicating that the patient is diabetic, thereby confirming that the anomaly 52 detected in the first ophthalmic image is likely indicative of diabetic retinopathy.

[0072] As shown in FIG. 5, the control module 12 determines a first region of interest 53 surrounding an anomaly 52 to be imaged using a second imaging modality and a second region of interest 55 away from the anomaly 52 and predicted to include a second anomaly 57 to be imaged by a third imaging modality.

[0073] The first region of interest 53 is a region surrounding the abnormality 52. ​​The first region of interest 53 is a region of the patient's eye 18 that is susceptible to the progression of a multi-stage eye disease, in this example diabetic retinopathy. The abnormality 52 in this example is a bulge or microaneurysm that the control module 12 has determined to be indicative of background retinopathy. To assess whether the diabetic retinopathy has progressed to a second stage of diabetic retinopathy, i.e., pre-proliferative retinopathy, the control module 12 has determined a region surrounding the abnormality 52 in which to assess the degree of hemorrhage into the retina that is often present in diabetic retinopathy patients at the second stage. The control module 12 is configured to determine a second imaging modality to be selected to image the region of interest 53. In this example, the control module 12 may select an OCT angiography imaging modality to image the region of interest 53 and determine the degree of hemorrhage into the retina that is indicative of the second stage of diabetic retinopathy, i.e., pre-proliferative retinopathy.

[0074] The control module 12 may further identify a second region of interest 55 associated with a more advanced stage of the multi-stage ocular disease and predicted to include a second abnormality 57. The second region of interest 55 may be a region of the patient's eye 18 away from the abnormality 52 detected by the control module 12 in the first ophthalmic image. For example, if the control module 12 determines that the detected abnormality 52 indicates a first stage of diabetic retinopathy, the second region of interest 55 may be a region susceptible to retinal detachment and the predicted second abnormality 57 may be a retinal detachment. A retinal detachment may be present in a patient suffering from proliferative retinopathy, which is a third stage of diabetic retinopathy. The control module 12 may determine that a wide field or ultra-wide field infrared imaging modality should be selected to acquire a reflectance image of the second region of interest 55 located at the periphery of the patient's eye 18 to help the clinician accurately diagnose and assess the progression of the retinal detachment by highlighting subretinal features that may not be visible in the first ophthalmic image.

[0075] 6 is a schematic diagram of a programmable signal processor 600 configured to control the imaging modules of the multi-modality ophthalmic imaging system 10. The programmable signal processor 600 can perform at least some of the functions of the control module 12, and in an exemplary embodiment of the present specification, at least some of the device 600 is included in the control module 12. The programmable signal processor 600 comprises a communication interface (I / F) 610 for receiving ophthalmic images acquired by the imaging modules and / or for outputting a determined imaging modality to operate the selected imaging module in the determined imaging modality. The communication interface (I / F) 610 can also receive medical records from the database 11. In an exemplary embodiment of the present specification, the communication interface (I / F) 610 can input / output any information acquired as part of the method described herein.

[0076] The signal processing device 600 further comprises a processor (e.g., a central processing unit CPU and / or a graphics processing unit GPU) 620, a working memory 630 (e.g., a random access memory) and an instruction store 640 for storing a computer program 645 comprising computer readable instructions which, when executed by the processor 620, cause the processor 620 to perform various functions including the functions of the control module 12 of Figures 1 and 4 and / or the functions of the methods described herein. In one exemplary embodiment herein, only the processor 620 is included in the control module 12, although in other examples, one or more further components of the device 600 are also included in the control module 12.

[0077] The working memory 630 stores information used by the processor 620 during the execution of the computer program 645. The instruction store 640 may, for example, comprise a ROM (e.g., in the form of an Electrically Erasable Programmable Read Only Memory (EEPROM) or Flash memory) preloaded with computer-readable instructions. Alternatively, the instruction store 640 may comprise a RAM or similar type of memory, and the computer-readable instructions for the computer program 645 may be entered into the instruction store 640 from a computer program product, such as a non-transitory computer-readable storage medium 650 in the form of a CD-ROM, DVD-ROM, etc., or from a computer-readable signal 660 carrying the computer-readable instructions. In either case, the computer program 645, when executed by the processor 620, causes the processor 620 to perform the methods described herein, including, by way of example and not limitation, the method of imaging a patient's eye described herein above.

[0078] In one exemplary embodiment of the present specification, the control module 12 of the exemplary embodiment described above comprises a computer processor 620 and an instruction store 640 that stores computer-readable instructions that, when executed by the computer processor 620, cause the computer processor 620 to perform the methods described herein, including, by way of example and not limitation, the method of imaging a patient's eye using the multi-modality ophthalmic imaging system 10 described herein.

[0079] In the above description, exemplary aspects have been described with reference to several exemplary embodiments. Therefore, the present specification should be considered as illustrative rather than restrictive. Similarly, the diagrams shown in the drawings that highlight the functionality and advantages of the exemplary embodiments are presented for illustrative purposes only. The architecture of the exemplary embodiments is sufficiently flexible and configurable that it may be utilized in ways other than those shown in the accompanying figures.

[0080] The example software embodiments presented herein may be provided as computer programs or software, such as one or more programs having instructions or sequences of instructions contained or stored in an article of manufacture, such as a machine-accessible or machine-readable medium, instruction store, or computer-readable storage device, each of which may be non-transitory in an exemplary embodiment. The programs or instructions in the non-transitory machine-accessible or machine-readable medium, instruction store, or computer-readable storage device may be used to program a computer system or other electronic device. The machine-readable or computer-readable medium, instruction store, and storage device may include, but is not limited to, floppy diskettes, optical disks, and magneto-optical disks, or other types of media / machine-readable media / instruction stores / storage devices suitable for storing or transmitting electronic instructions. The techniques described herein are not limited to any particular software configuration. They may find applicability in any computing or processing environment. As used herein, the terms "computer-readable medium," "machine-accessible medium," "machine-readable medium," "instruction store," and "computer-readable storage device" are intended to include any medium capable of storing, encoding, or transmitting an instruction or set of instructions for execution by a machine, computer, or computer processor, causing the machine / computer / computer processor to perform any one of the methods described herein. Furthermore, it is common in the art to refer to software in any form (e.g., program, procedure, process, application, module, unit, logic, etc.) as taking an action or causing a result. Such expressions are merely a shorthand way of stating that execution of the software by a processing system causes the processor to perform an action and produce a result.

[0081] Some embodiments may be implemented by the preparation of application specific integrated circuits, field programmable gate arrays, or by interconnecting an appropriate network of conventional component circuits.

[0082] Some embodiments include a computer program product. The computer program product may be one or more storage media, instruction stores, or storage devices having stored thereon or therein instructions usable to control or cause a computer or computer processor to execute any of the procedures of the exemplary embodiments described herein. The storage media / instruction stores / storage devices may include, by way of example and not limitation, optical disks, ROM, RAM, EPROM, EEPROM, DRAM, VRAM, flash memory, flash cards, magnetic cards, optical cards, nanosystems, molecular memory integrated circuits, RAID, remote data storage / archive / warehousing, and / or any other type of device suitable for storing instructions and / or data.

[0083] Some implementations stored on any one of one or more computer readable media, instruction stores, or storage devices include both software for controlling the hardware of the system and software for enabling the system or microprocessor to interact with a human user or other mechanisms that utilize the results of the exemplary embodiments described herein. Such software may include, but is not limited to, device drivers, operating systems, and user applications. Finally, such computer readable media or storage devices further include software for performing the exemplary aspects of the present invention, as described above.

[0084] The programming and / or software of the system includes software modules for implementing the procedures described herein, in some exemplary embodiments herein the modules include software, while in other exemplary embodiments herein the modules include hardware or a combination of hardware and software.

[0085] While various exemplary embodiments of the present invention have been described above, it should be understood that they have been presented by way of example, and not limitation. Various changes in form and detail can be made therein, as will be apparent to those skilled in the art. Thus, the present invention should not be limited by any of the exemplary embodiments described above, but should be defined only by the following claims and their equivalents.

[0086] It should also be understood that any steps recited in the claims do not have to be performed in the order presented.

[0087] Although the present specification contains many specific embodiment details, these should not be construed as limitations on the scope of any invention or what may be claimed, but rather as descriptions of features specific to the particular embodiments described herein. Some features described herein in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable subcombination. Moreover, although features may be described above as functioning in some combinations and may initially be claimed as such, one or more features from a claimed combination may, in some cases, be deleted from the combination, and the claimed combination may be directed to a subcombination or a variation of the subcombination.

[0088] In some situations, multitasking and parallel processing may be advantageous. Moreover, the separation of various components in the embodiments described above should not be understood to require such separation in all embodiments, and the program components and systems described may generally be integrated together in a single software product or packaged into multiple software products.

Claims

1. A multimodal ophthalmic imaging system (10, 40) for acquiring ophthalmic images of an eye (18) of a patient, said multimodal ophthalmic imaging system (10, 40) comprising: a first imaging module (14, 42) operable in a first imaging modality for acquiring a first ophthalmic image (20, 50) of the patient's eye (18); one or more further imaging modules (16, 44, 46), each operable in a respective imaging modality, each imaging modality of the one or more further imaging modules (16, 44, 46) being different from the first imaging modality; A control module (12), detecting an anomaly (26, 52) in the first ophthalmic image (20, 50) acquired by the first imaging module (14, 42); determining a region of interest (28, 53, 55) in the patient's eye based on the detected anomaly of the first ophthalmic image, the determined region of interest (28, 53, 55) being a region in the patient's eye (18) predicted to contain a second anomaly (27, 57); determining a second imaging modality for imaging the determined region of interest (28, 53, 55) based on the second abnormality (27, 57), the second imaging modality being different from the first imaging modality; selecting a second imaging module (16, 44, 46) from the one or more further imaging modules (16, 44, 46) that is operable in the determined second imaging modality; controlling the selected second imaging module (16, 44, 46) to acquire a second ophthalmic image of the determined region of interest (28, 53, 55); A control module (12) configured to: A multimodal ophthalmic imaging system (10, 40).

2. 2. The ophthalmic imaging system of claim 1, wherein the anomaly (26, 52) detected in the first ophthalmic image is indicative of a first stage of a multi-stage ophthalmic disease and the second anomaly (27, 57) is indicative of a second stage of the multi-stage ophthalmic disease.

3. 3. The ophthalmic imaging system of claim 1 or 2, wherein the first imaging module (14, 42) comprises a scanning laser ophthalmoscope (SLO) and the first ophthalmic image is a fundus image of the patient's eye (18).

4. The ophthalmic imaging system of any one of claims 1 to 3, wherein the control module (12) is further configured to determine one or more image acquisition parameters of the second imaging module (16, 44) for controlling the second imaging module (16, 44) to acquire the second ophthalmic image of the determined region of interest (28, 53) based on the second abnormality (27, 57).

5. The ophthalmic imaging system of any one of claims 1 to 4, wherein the control module (12) is communicatively coupled to a database (11) including medical records indicating the patient's medical history, and the control module (12) is configured to retrieve the patient's medical records from the database (11) and determine the region of interest (28, 53) based on both the detected abnormality (26) and the patient's medical history.

6. The ophthalmic imaging system of any one of claims 1 to 5, wherein the control module (12) is configured to detect discontinuities at a boundary of the second ophthalmic image, the discontinuities at the boundary indicating cropping of the second abnormality (27, 57) located in the second ophthalmic image.

7. the control module (12) in response to detecting the discontinuity at the boundary of the second ophthalmic image: Increasing the size of the determined region of interest to generate an enlarged region of interest; controlling the second imaging module to capture an ophthalmic image of the enlarged area of ​​interest; The ophthalmic imaging system of claim 6 , configured to:

8. The control module: determining a second region of interest based on the detected anomaly, the second region of interest being a region that includes the detected anomaly; determining a third imaging modality for imaging the determined second region of interest based on the detected anomaly, the third imaging modality being different from the first imaging modality; selecting a third imaging module from the one or more further imaging modules, the third imaging module operable in the determined third imaging modality; controlling the selected third imaging module to acquire a third ophthalmic image of the determined second region of interest; An ophthalmic imaging system according to any one of claims 1 to 7, configured to:

9. 1. A method of imaging an eye (18) of a patient, the method comprising: acquiring a first ophthalmic image (20, 50) of the patient's eye (18) using a first imaging module (14, 42) operating in a first imaging modality; detecting an anomaly (26, 52) in the first ophthalmic image (20, 50) acquired by the first imaging module (14, 42); determining a region of interest (28) within the patient's eye (18) based on the detected anomaly (26) of the first ophthalmic image, the determined region of interest (28) being a region within the patient's eye (18) predicted to contain a second anomaly (27, 57); determining a second imaging modality for imaging the determined region of interest (28) based on the second abnormality (27, 57), the second imaging modality being different from the first imaging modality; acquiring a second ophthalmic image of the determined region of interest (27, 57) using a second imaging module (16, 44) operating in the determined second imaging modality; A method comprising:

10. 10. The method of claim 9, wherein the anomaly (26) detected in the first ophthalmic image is indicative of a first stage of a multi-stage ophthalmic disease and the second anomaly (27) is indicative of a second stage of the multi-stage ophthalmic disease.

11. 11. The method of claim 9 or claim 10, further comprising determining whether the second anomaly has been captured in the second ophthalmic image by detecting a discontinuity at a boundary of the second ophthalmic image, wherein detecting the presence of a discontinuity at the boundary indicates cropping of the second anomaly in the second ophthalmic image.

12. A method according to any one of claims 9 to 11, comprising, in response to detecting the presence of the discontinuity at the boundary of the second ophthalmic image, increasing a size of the determined region of interest to generate an enlarged region of interest and acquiring a further ophthalmic image of the enlarged region of interest.

13. 13. The method of claim 9, further comprising receiving a medical record of the patient including a medical history of the patient, and wherein determining the region of interest is based on a combination of the detected abnormality in the first ophthalmic image and the received medical history of the patient.

14. The method of any one of claims 9 to 13, further comprising determining one or more image acquisition parameters of the second imaging module based on the second anomaly, and operating the second imaging module with the determined image acquisition parameters to acquire the second ophthalmic image.

15. determining a second region of interest based on the detected anomaly, the second region of interest being a region that includes the detected anomaly; determining a third imaging modality for imaging the determined second region of interest based on the detected anomaly, the third imaging modality being different from the first imaging modality; selecting a third imaging module from the one or more further imaging modules, the third imaging module operable in the determined third imaging modality; controlling the selected third imaging module to acquire a third ophthalmic image of the determined second region of interest; The method according to any one of claims 9 to 14, further comprising:

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